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Chivu CD, Crăciun MD, Pițigoi D, Aramă V, Luminos ML, Jugulete G, Constantin C, Apostolescu CG, Streinu Cercel A. The Dynamic Risk of COVID-19-Related Events in Vaccinated Healthcare Workers (HCWs) from a Tertiary Hospital in Bucharest, Romania: A Study Based on Active Surveillance Data. Vaccines (Basel) 2024; 12:182. [PMID: 38400165 PMCID: PMC10891893 DOI: 10.3390/vaccines12020182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Revised: 02/03/2024] [Accepted: 02/10/2024] [Indexed: 02/25/2024] Open
Abstract
Our study describes the frequency and severity of COVID-19 in HCWs and estimates the dynamic risk of COVID-19-related events. We actively surveyed all HCWs from a tertiary infectious disease hospital from 26 February 2020 to 31 May 2023. Of 1220 HCWs, 62.9% (767) had at least one COVID-19 episode. The under 29 years (p = 0.0001) and 40-49 years (p = 0.01) age groups, nurses (p = 0.0001), and high-risk departments (p = 0.037) were characteristics significantly more frequent in HCWs with COVID-19 history. A higher percentage of boosters (53.2%; p < 0.0001) were registered in the uninfected group. The second episode of COVID-19 was significantly milder than the first. Data regarding clinical outcomes from 31 January 2021 to 31 May 2023 were analyzed in a follow-up study to determine the risk of COVID-19-related events. The Cox regression analysis revealed that HCWs with booster shots had a lower risk of COVID-19 across all events, symptomatic events, and moderate to severe events as adjusted hazard ratio (aHR) were: 0.71 (95%CI: 0.54-0.96), 0.23 (95%CI: 0.12-0.46), and 0.17 (95%CI: 0.07-0.43), respectively. Within the vaccinated subgroup, the HCWs with hybrid immunity and booster had aHR for all followed-up events of 0.42 (95%CI: 0.30-0.58), for symptomatic events of 0.52 (95%CI: 0.36-0.74), and 0.15 (95%CI: 0.03-0.66) for moderate to severe events. The risk of COVID-19 clinical events was lower for HCWs with at least one booster than those completely vaccinated.
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Affiliation(s)
- Carmen-Daniela Chivu
- Department of Epidemiology 1, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania; (C.-D.C.); (D.P.)
- Emergency Clinical Hospital for Children “Grigore Alexandrescu”, 011743 Bucharest, Romania
| | - Maria-Dorina Crăciun
- Department of Epidemiology 1, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania; (C.-D.C.); (D.P.)
- Emergency Clinical Hospital for Children “Grigore Alexandrescu”, 011743 Bucharest, Romania
| | - Daniela Pițigoi
- Department of Epidemiology 1, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania; (C.-D.C.); (D.P.)
- National Institute for Infectious Diseases “Prof. Dr. Matei Balș”, 021105 Bucharest, Romania; (V.A.); (M.L.L.); (G.J.); (C.G.A.); (A.S.C.)
| | - Victoria Aramă
- National Institute for Infectious Diseases “Prof. Dr. Matei Balș”, 021105 Bucharest, Romania; (V.A.); (M.L.L.); (G.J.); (C.G.A.); (A.S.C.)
- Department of Infectious Diseases 1, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania
| | - Monica Luminița Luminos
- National Institute for Infectious Diseases “Prof. Dr. Matei Balș”, 021105 Bucharest, Romania; (V.A.); (M.L.L.); (G.J.); (C.G.A.); (A.S.C.)
- Department of Infectious Diseases 3, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania
| | - Gheorghiță Jugulete
- National Institute for Infectious Diseases “Prof. Dr. Matei Balș”, 021105 Bucharest, Romania; (V.A.); (M.L.L.); (G.J.); (C.G.A.); (A.S.C.)
- Department of Infectious Diseases 3, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania
| | - Ciprian Constantin
- Department of Clinical Sciences, Faculty of Medicine, Titu Maiorescu University, 031593 Bucharest, Romania;
- Carol Davila Central Military Emergency University Hospital, 010825 Bucharest, Romania
| | - Cătălin Gabriel Apostolescu
- National Institute for Infectious Diseases “Prof. Dr. Matei Balș”, 021105 Bucharest, Romania; (V.A.); (M.L.L.); (G.J.); (C.G.A.); (A.S.C.)
- Department of Infectious Diseases 1, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania
| | - Adrian Streinu Cercel
- National Institute for Infectious Diseases “Prof. Dr. Matei Balș”, 021105 Bucharest, Romania; (V.A.); (M.L.L.); (G.J.); (C.G.A.); (A.S.C.)
- Department of Infectious Diseases 1, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania
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Farnsworth CW, O’Neil CA, Dalton C, McDonald D, Vogt L, Hock K, Arter O, Wallace MA, Muenks C, Amor M, Alvarado K, Peacock K, Jolani K, Fraser VJ, Burnham CAD, Babcock HM, Budge PJ, Kwon JH. Association between SARS-CoV-2 Symptoms, Ct Values, and Serological Response in Vaccinated and Unvaccinated Healthcare Personnel. J Appl Lab Med 2023; 8:871-886. [PMID: 37478837 PMCID: PMC10482509 DOI: 10.1093/jalm/jfad042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Accepted: 05/15/2023] [Indexed: 07/23/2023]
Abstract
BACKGROUND SARS-CoV-2 vaccines are effective at reducing symptomatic and asymptomatic COVID-19. Limited studies have compared symptoms, threshold cycle (Ct) values from reverse transcription (RT)-PCR testing, and serological testing results between previously vaccinated vs unvaccinated populations with SARS-CoV-2 infection. METHODS Healthcare personnel (HCP) with a positive SARS-CoV-2 RT-PCR test within the previous 14 to 28 days completed surveys including questions about demographics, medical conditions, social factors, and symptoms of COVID-19. Ct values were observed, and serological testing was performed for anti-nucleocapsid (anti-N) and anti-Spike (anti-S) antibodies at enrollment and 40 to 90 days later. Serological results were compared to HCP with no known SARS-CoV-2 infection and negative anti-N testing. RESULTS There were 104 unvaccinated/not fully vaccinated and 77 vaccinated HCP with 2 doses of an mRNA vaccine at time of infection. No differences in type or duration of symptoms were reported (P = 0.45). The median (interquartile range [IQR]) Ct was 21.4 (17.6-24.6) and 21.5 (18.1-24.6) for the unvaccinated and vaccinated HCP, respectively. Higher anti-N IgG was observed in unvaccinated HCP (5.08 S/CO, 3.08-6.92) than vaccinated (3.61 signal to cutoff ratio [S/CO], 2.16-5.05). Anti-S IgG was highest among vaccinated HCP with infection (34 285 aribitrary units [AU]/mL, 17 672-61 775), followed by vaccinated HCP with no prior infection (1452 AU/mL, 791-2943), then unvaccinated HCP with infection (829 AU/mL, 290-1555). Anti-S IgG decreased 1.56% (0.9%-1.79%) per day in unvaccinated and 0.38% (0.03%-0.94%) in vaccinated HCP. CONCLUSIONS Vaccinated HCP infected with SARS-CoV-2 reported comparable symptoms and had similar Ct values relative to unvaccinated. However, vaccinated HCP had increased and prolonged anti-S and decreased anti-N response relative to unvaccinated.
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Affiliation(s)
- Christopher W Farnsworth
- Department of Pathology and Immunology, Washington University School of Medicine, St. Louis, MO, United States
| | - Caroline A O’Neil
- Department of Medicine, Division of Infectious Diseases, Washington University School of Medicine, St. Louis, MO, United States
| | - Claire Dalton
- Department of Pathology and Immunology, Washington University School of Medicine, St. Louis, MO, United States
| | - David McDonald
- Department of Medicine, Division of Infectious Diseases, Washington University School of Medicine, St. Louis, MO, United States
| | - Lucy Vogt
- Department of Medicine, Division of Infectious Diseases, Washington University School of Medicine, St. Louis, MO, United States
| | - Karl Hock
- Department of Pathology and Immunology, Washington University School of Medicine, St. Louis, MO, United States
| | - Olivia Arter
- Department of Medicine, Division of Infectious Diseases, Washington University School of Medicine, St. Louis, MO, United States
| | - Meghan A Wallace
- Department of Pathology and Immunology, Washington University School of Medicine, St. Louis, MO, United States
| | - Carol Muenks
- Department of Pathology and Immunology, Washington University School of Medicine, St. Louis, MO, United States
| | - Mostafa Amor
- Department of Medicine, Division of Infectious Diseases, Washington University School of Medicine, St. Louis, MO, United States
| | - Kelly Alvarado
- Department of Pathology and Immunology, Washington University School of Medicine, St. Louis, MO, United States
| | - Kate Peacock
- Department of Medicine, Division of Infectious Diseases, Washington University School of Medicine, St. Louis, MO, United States
| | - Kevin Jolani
- Department of Medicine, Division of Infectious Diseases, Washington University School of Medicine, St. Louis, MO, United States
| | - Victoria J Fraser
- Department of Medicine, Division of Infectious Diseases, Washington University School of Medicine, St. Louis, MO, United States
| | - Carey-Ann D Burnham
- Department of Pathology and Immunology, Washington University School of Medicine, St. Louis, MO, United States
| | - Hilary M Babcock
- Department of Medicine, Division of Infectious Diseases, Washington University School of Medicine, St. Louis, MO, United States
| | - Phillip J Budge
- Department of Medicine, Division of Infectious Diseases, Washington University School of Medicine, St. Louis, MO, United States
| | - Jennie H Kwon
- Department of Medicine, Division of Infectious Diseases, Washington University School of Medicine, St. Louis, MO, United States
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Rubin-Smith JE, Castro MYR, Preza I, Hasibra I, Sulo J, Fico A, Daja R, Vasili A, Kota M, Schmid A, Sridhar S, Guseinova A, Boshevska G, Bejtja G, Mühlemann B, Drosten C, Jorgensen P, Pebody R, Kissling E, Lafond KE, Katz MA, Bino S. Primary series COVID-19 vaccine effectiveness among healthcare workers in Albania, February-December 2021. IJID Reg 2023; 8:19-27. [PMID: 37317681 PMCID: PMC10106115 DOI: 10.1016/j.ijregi.2023.04.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/15/2023] [Revised: 04/09/2023] [Accepted: 04/11/2023] [Indexed: 06/16/2023]
Abstract
Background Healthcare workers have experienced high rates of morbidity and mortality from coronavirus disease 2019 (COVID-19). Methods A prospective cohort study was conducted in three Albanian hospitals between 19 February and 14 December 2021. All participants underwent polymerase chain reaction (PCR) and serological testing at enrolment, regular serology throughout, and PCR testing when symptomatic.Vaccine effectiveness (VE) against COVID-19 and against all severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infections (symptomatic or asymptomatic) was estimated. VE was estimated using a Cox regression model, with vaccination status as a time-varying variable. Findings In total, 1504 HCWs were enrolled in this study; 70% had evidence of prior SARS-CoV-2 infection. VE was 65.1% [95% confidence interval (CI) 37.7-80.5] against COVID-19, 58.2% (95% CI 15.7-79.3) among participants without prior SARS-CoV-2 infection, and 73.6% (95% CI 24.3-90.8) among participants with prior SARS-CoV-2 infection. For BNT162b2 alone, VE was 69.5% (95% CI 44.5-83.2). During the period when the Delta variant was predominant, VE was 67.1% (95% CI 38.3-82.5). VE against SARS-CoV-2 infection for the full study period was 36.9% (95% CI 15.8-52.7). Interpretation This study found moderate primary series VE against COVID-19 among healthcare workers in Albania. These results support the continued promotion of COVID-19 vaccination in Albania, and highlight the benefits of vaccination in populations with high levels of prior infection.
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Affiliation(s)
- Julia E. Rubin-Smith
- Global Health Program, Boston Children's Hospital, Boston, MA, USA
- Division of Emergency Medicine, Boston Children's Hospital, Boston, MA, USA
| | | | - Iria Preza
- Institute of Public Health, Tirana, Albania
| | | | - Jonilda Sulo
- Southeast European Centre for Surveillance and Control of Infectious Disease, Tirana, Albania
| | | | | | | | | | - Alexis Schmid
- Global Health Program, Boston Children's Hospital, Boston, MA, USA
- Division of Emergency Medicine, Boston Children's Hospital, Boston, MA, USA
| | - Shela Sridhar
- Global Health Program, Boston Children's Hospital, Boston, MA, USA
- Department of Global Health Equity, Brigham and Women's Hospital, Boston, MA, USA
| | - Alina Guseinova
- World Health Organization Regional Office for Europe, Copenhagen, Denmark
| | | | - Gazmend Bejtja
- World Health Organization Regional Office for Europe, Copenhagen, Denmark
| | - Barbara Mühlemann
- Institute of Virology, Charité–Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt – Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
- German Centre for Infection Research, Partner Site Charité, Berlin, Germany
| | - Christian Drosten
- Institute of Virology, Charité–Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt – Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
- German Centre for Infection Research, Partner Site Charité, Berlin, Germany
| | - Pernille Jorgensen
- World Health Organization Regional Office for Europe, Copenhagen, Denmark
| | - Richard Pebody
- World Health Organization Regional Office for Europe, Copenhagen, Denmark
| | | | - Kathryn E. Lafond
- Influenza Division, US Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Mark A. Katz
- World Health Organization Regional Office for Europe, Copenhagen, Denmark
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Bannick MS, Gao F, Brown ER, Janes HE. Retrospective, Observational Studies for Estimating Vaccine Effects on the Secondary Attack Rate of SARS-CoV-2. Am J Epidemiol 2023; 192:1016-1028. [PMID: 36883907 PMCID: PMC10505422 DOI: 10.1093/aje/kwad046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Revised: 11/21/2022] [Accepted: 02/23/2023] [Indexed: 03/09/2023] Open
Abstract
Coronavirus disease 2019 (COVID-19) vaccines are highly efficacious at preventing symptomatic infection, severe disease, and death. Most of the evidence that COVID-19 vaccines also reduce transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is based on retrospective, observational studies. Specifically, an increasing number of studies are evaluating vaccine effectiveness against the secondary attack rate of SARS-CoV-2 using data available in existing health-care databases or contact-tracing databases. Since these types of databases were designed for clinical diagnosis or management of COVID-19, they are limited in their ability to provide accurate information on infection, infection timing, and transmission events. We highlight challenges with using existing databases to identify transmission units and confirm potential SARS-CoV-2 transmission events. We discuss the impact of common diagnostic testing strategies, including event-prompted and infrequent testing, and illustrate their potential biases in estimating vaccine effectiveness against the secondary attack rate of SARS-CoV-2. We articulate the need for prospective observational studies of vaccine effectiveness against the SARS-CoV-2 secondary attack rate, and we provide design and reporting considerations for studies using retrospective databases.
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Affiliation(s)
- Marlena S Bannick
- Correspondence to Marlena Bannick, Department of Biostatistics, Hans Rosling Center for Population Health, Box 357232, University of Washington, Seattle, WA 98195 (e-mail: )
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Syrimi N, Sourri F, Giannakopoulou MC, Karamanis D, Pantousas A, Georgota P, Rokka E, Vladeni Z, Tsiantoula E, Soukara E, Lavda N, Gkaragkanis D, Zisaki A, Vakalidis P, Goula V, Loupou E, Palaiodimos L, Hatzigeorgiou D. Humoral and Cellular Response and Associated Variables Nine Months following BNT162b2 Vaccination in Healthcare Workers. J Clin Med 2023; 12:jcm12093172. [PMID: 37176612 PMCID: PMC10179201 DOI: 10.3390/jcm12093172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Revised: 04/21/2023] [Accepted: 04/26/2023] [Indexed: 05/15/2023] Open
Abstract
In this study, we aimed to illustrate the trajectory of humoral and cellular immunity nine months after primary vaccination with the BNT162b2 mRNA vaccine among 189 healthcare workers (HCWs). Additionally, we endeavored to identify correlations between immunity parameters and a number of common variables and comorbidities. A total of 189 healthcare workers (HCWs), vaccinated against COVID-19, were finally included in the study. All of the subjects had received two doses of the BNT162b2 vaccine; had undergone antibody tests one, four and nine months post-vaccination; and had completed a medical questionnaire. Further samples taken at nine months were tested for cellular immunity. No participants had evidence of COVID-19 infection pre- or post-vaccination. An anti-S1 receptor binding domain (RBD) antibody assay was used to assess humoral response, and cellular immunity was estimated with an INF-γ release assay (IGRA). Statistical analysis was performed using STATA. We report a statistically significant antibody drop over time. Being above the age of 40 or a smoker reduces the rise of antibodies by 37% and 28%, respectively. More than half of the participants did not demonstrate T-cell activation at nine months. Female gender and antibody levels at four months predispose detection of cellular immunity at nine months post-immunization. This study furthers the qualitative, quantitative, and temporal understanding of the immune response to the BNT162b2 mRNA vaccine and the effect of correlated factors.
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Affiliation(s)
- Natalia Syrimi
- Paediatric Department, 251 Hellenic Air Force General Hospital, P. Kanellopoulou Avenue, 11525 Athens, Greece
- Infection Prevention and Control Department, 251 Hellenic Air Force General Hospital, P. Kanellopoulou Avenue, 11525 Athens, Greece
| | - Flora Sourri
- Infection Prevention and Control Department, 251 Hellenic Air Force General Hospital, P. Kanellopoulou Avenue, 11525 Athens, Greece
| | - Maria-Christina Giannakopoulou
- COVID-19 Ward, 251 Hellenic Air Force General Hospital, P. Kanellopoulou Avenue, 11525 Athens, Greece
- Medical Directorate, Hellenic National and Defence General Staff, Mesogeion 227-231, 15561 Athens, Greece
| | - Dimitrios Karamanis
- Department of Health Informatics, Rutgers School of Health Professions, 65 Bergen St., Newark, NJ 07107, USA
- Department of Economics, University of Piraeus, Karaoli and Dimitriou 80, 18534 Piraeus, Greece
| | - Asterios Pantousas
- Department of Electrical and Computer Engineering, Democritus University of Thrace, 69100 Komotini, Greece
| | - Persefoni Georgota
- Immunology Laboratory, 251 Hellenic Air Force General Hospital, P. Kanellopoulou Avenue, 11525 Athens, Greece
| | - Eleni Rokka
- Oncology Ward, 251 Hellenic Air Force General Hospital, P. Kanellopoulou Avenue, 11525 Athens, Greece
| | - Zoe Vladeni
- Infection Prevention and Control Department, 251 Hellenic Air Force General Hospital, P. Kanellopoulou Avenue, 11525 Athens, Greece
| | - Euaggelia Tsiantoula
- Biochemistry Laboratory, 251 Hellenic Air Force General Hospital, P. Kanellopoulou Avenue, 11525 Athens, Greece
| | - Evangelia Soukara
- COVID-19 Ward, 251 Hellenic Air Force General Hospital, P. Kanellopoulou Avenue, 11525 Athens, Greece
| | - Nikoletta Lavda
- COVID-19 Ward, 251 Hellenic Air Force General Hospital, P. Kanellopoulou Avenue, 11525 Athens, Greece
| | - Dimitrios Gkaragkanis
- COVID-19 Ward, 251 Hellenic Air Force General Hospital, P. Kanellopoulou Avenue, 11525 Athens, Greece
| | - Aikaterini Zisaki
- Infection Prevention and Control Department, 251 Hellenic Air Force General Hospital, P. Kanellopoulou Avenue, 11525 Athens, Greece
| | - Panagiotis Vakalidis
- Biochemistry Laboratory, 251 Hellenic Air Force General Hospital, P. Kanellopoulou Avenue, 11525 Athens, Greece
| | - Vasiliki Goula
- Biochemistry Laboratory, 251 Hellenic Air Force General Hospital, P. Kanellopoulou Avenue, 11525 Athens, Greece
| | - Evdokia Loupou
- Biochemistry Laboratory, 251 Hellenic Air Force General Hospital, P. Kanellopoulou Avenue, 11525 Athens, Greece
| | - Leonidas Palaiodimos
- Department of Medicine, Jacobi Medical Center, Albert Einstein College of Medicine, New York, NY 10461, USA
| | - Dimitrios Hatzigeorgiou
- Medical Directorate, Hellenic National and Defence General Staff, Mesogeion 227-231, 15561 Athens, Greece
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Gravenstein S, DeVone F, Oyebanji OA, Abul Y, Cao Y, Chan PA, Halladay CW, McConeghy KW, Nugent C, Bosch J, King CL, Wilson BM, Balazs AB, White EM, Canaday DH. Durability of immunity and clinical protection in nursing home residents following bivalent SARS-CoV-2 vaccination. medRxiv 2023:2023.04.25.23289050. [PMID: 37163130 PMCID: PMC10168517 DOI: 10.1101/2023.04.25.23289050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
Abstract
Background Vaccines have substantially mitigated the disproportional impact of SARS-CoV-2 on the high morbidity and mortality experienced by nursing home residents. However, variation in vaccine efficacy, immune senescence and waning immunity all undermine vaccine effectiveness over time. The introduction of the bivalent vaccine in September 2022 aimed to counter this increasing susceptibility and consequences of breakthrough infection, however data on the durability and protection of the vaccine are limited. We evaluated the durability of immunity and protection after the first bivalent vaccination to SARS-CoV-2 in nursing home residents. Methods For the immunologic evaluation, community nursing home volunteers agreed to serial blood sampling before, at two weeks, three and six months after each vaccination for antibodies to spike protein and pseudovirus neutralization activity over time. Concurrent clinical outcomes were evaluated by reviewing electronic health record data from residents living in Veterans Administration managed nursing home units. Residents without recent infection but prior vaccination to SARS-CoV-2 were followed over time beginning with administration of the newly available bivalent vaccine using a target trial emulation (TTE) approach; TTE compared time to breakthrough infection, hospitalization and death between those who did and did not receive the bivalent vaccine. Results We evaluated antibodies in 650 nursing home residents; 452 had data available following a first monovalent booster, 257 following a second monovalent booster and 321 following a bivalent vaccine. We found a rise in BA.5 neutralization activity from the first and second monovalent boosters through the bivalent vaccination regardless of prior SARS-CoV-2 history. Titers declined at three and six months after the bivalent vaccination but generally exceeded those at three months compared to either prior boost. BA.5 neutralization titers six months after the bivalent vaccination were diminished but had detectable levels in 80% of infection-naive and 100% of prior infected individuals. TTE evaluated 5903 unique subjects, of whom 2235 received the bivalent boost. TTE demonstrated 39% or greater reduction in risk of infection, hospitalization or death at four months following the bivalent boost. Conclusion Immunologic results mirrored those of the TTE and suggest bivalent vaccination added substantial protection for up to six months after bivalent vaccination with notable exceptions. However, the level of protection declined over this period, and by six months may open a window of added vulnerability to infection before the next updated vaccine becomes available. We strongly agree with the CDC recommendation that those who have not received a bivalent vaccination receive that now and these results support a second bivalent booster for those at greatest risk which includes many nursing home residents.
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Affiliation(s)
- Stefan Gravenstein
- Warren Alpert Medical School, Brown University, Providence, RI
- Department of Health Services, Policy & Practice, School of Public Health, Brown University, Providence, Rhode Island
- Center of Innovation in Long-Term Services and Supports, Veterans Administration (VA) Medical Center, Providence, Rhode Island
| | - Frank DeVone
- Center of Innovation in Long-Term Services and Supports, Veterans Administration (VA) Medical Center, Providence, Rhode Island
| | | | - Yasin Abul
- Warren Alpert Medical School, Brown University, Providence, RI
- Center of Innovation in Long-Term Services and Supports, Veterans Administration (VA) Medical Center, Providence, Rhode Island
| | - Yi Cao
- Ragon Institute of MGH, MIT and Harvard, Cambridge, MA
| | - Philip A Chan
- Warren Alpert Medical School, Brown University, Providence, RI
- Rhode Island Department of Health, Providence, RI
| | - Christopher W Halladay
- Center of Innovation in Long-Term Services and Supports, Veterans Administration (VA) Medical Center, Providence, Rhode Island
| | - Kevin W McConeghy
- Center of Innovation in Long-Term Services and Supports, Veterans Administration (VA) Medical Center, Providence, Rhode Island
| | - Clare Nugent
- Warren Alpert Medical School, Brown University, Providence, RI
| | - Jürgen Bosch
- Case Western Reserve University School of Medicine, Cleveland, OH
| | | | - Brigid M Wilson
- Geriatric Research Education and Clinical Center, Louis Stokes Cleveland Department of Veterans Affairs Medical Center, Cleveland, Ohio
| | | | - Elizabeth M White
- Warren Alpert Medical School, Brown University, Providence, RI
- Department of Health Services, Policy & Practice, School of Public Health, Brown University, Providence, Rhode Island
| | - David H Canaday
- Case Western Reserve University School of Medicine, Cleveland, OH
- Geriatric Research Education and Clinical Center, Louis Stokes Cleveland Department of Veterans Affairs Medical Center, Cleveland, Ohio
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7
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Abstract
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection remains asymptomatic in 33% to 90% of older adults depending on their immune status from prior infection, vaccination, and circulating strain. Older adults symptomatic with SARS-CoV-2 often both present atypically, such as with a blunted fever response, and develop more severe disease. Early and late reports showed that older adults have increased severity of coronavirus disease 2019 (COVID-19) with higher case fatality rates and higher intensive care needs compared with younger adults. Infection and vaccine-induced antibody response and long-term effects of COVID-19 also differ in older adults.
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8
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Al-Akioui-Sanz K, Pascual-Miguel B, Díaz-Almirón M, Mestre-Durán C, Navarro-Zapata A, Clares-Villa L, Martín-Cortázar C, Vicario JL, Moreno MÁ, Balas A, De Paz R, Minguillón J, Pérez-Martínez A, Ferreras C. Donor selection for adoptive cell therapy with CD45RA - memory T cells for patients with coronavirus disease 2019, and dexamethasone and interleukin-15 effects on the phenotype, proliferation and interferon gamma release. Cytotherapy 2023; 25:330-340. [PMID: 36585293 PMCID: PMC9742221 DOI: 10.1016/j.jcyt.2022.12.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Revised: 12/02/2022] [Accepted: 12/06/2022] [Indexed: 12/14/2022]
Abstract
BACKGROUND AIMS We have previously demonstrated the safety and feasibility of adoptive cell therapy with CD45RA- memory T cells containing severe acute respiratory syndrome coronavirus 2-specific T cells for patients with coronavirus disease 2019 from an unvaccinated donor who was chosen based on human leukocyte antigen compatibility and cellular response. In this study, we examined the durability of cellular and humoral immunity within CD45RA- memory T cells and the effect of dexamethasone, the current standard of care treatment, and interleukin-15, a cytokine critically involved in T-cell maintenance and survival. METHODS We performed a longitudinal analysis from previously severe acute respiratory syndrome coronavirus 2-infected and infection-naïve individuals covering 21 months from infection and 10 months after full vaccination with the BNT162b2 Pfizer/BioNTech vaccine. RESULTS We observed that cellular responses are maintained over time. Humoral responses increased after vaccination but were gradually lost. In addition, dexamethasone did not alter cell functionality or proliferation of CD45RA- T cells, and interleukin-15 increased the memory T-cell activation state, regulatory T cell expression, and interferon gamma release. CONCLUSIONS Our results suggest that the best donors for adoptive cell therapy would be recovered individuals and 2 months after vaccination, although further studies with larger cohorts would be needed to confirm this finding. Dexamethasone did not affect the characteristics of the memory T cells at a concentration used in the clinical practice and IL-15 showed a positive effect on SARS-CoV-2-specific CD45RA- T cells.
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Affiliation(s)
- Karima Al-Akioui-Sanz
- IdiPAZ, Hospital La Paz Institute for Health Research, La Paz University Hospital, Madrid, Spain
| | - Bárbara Pascual-Miguel
- IdiPAZ, Hospital La Paz Institute for Health Research, La Paz University Hospital, Madrid, Spain
| | | | - Carmen Mestre-Durán
- IdiPAZ, Hospital La Paz Institute for Health Research, La Paz University Hospital, Madrid, Spain
| | - Alfonso Navarro-Zapata
- IdiPAZ, Hospital La Paz Institute for Health Research, La Paz University Hospital, Madrid, Spain
| | - Laura Clares-Villa
- IdiPAZ, Hospital La Paz Institute for Health Research, La Paz University Hospital, Madrid, Spain
| | - Carla Martín-Cortázar
- IdiPAZ, Hospital La Paz Institute for Health Research, La Paz University Hospital, Madrid, Spain
| | - José Luis Vicario
- Histocompatibility Unit, Transfusion Center of Madrid, Madrid, Spain
| | | | - Antonio Balas
- Histocompatibility Unit, Transfusion Center of Madrid, Madrid, Spain
| | - Raquel De Paz
- Cell Therapy Unit, Hematology Department, La Paz University Hospital, Madrid, Spain
| | - Jordi Minguillón
- IdiPAZ, Hospital La Paz Institute for Health Research, La Paz University Hospital, Madrid, Spain
| | - Antonio Pérez-Martínez
- IdiPAZ, Hospital La Paz Institute for Health Research, La Paz University Hospital, Madrid, Spain; Pediatric Hemato-oncology Department, La Paz University Hospital, Madrid, Spain; Faculty of Medicine Autonomous, University of Madrid, Madrid, Spain
| | - Cristina Ferreras
- IdiPAZ, Hospital La Paz Institute for Health Research, La Paz University Hospital, Madrid, Spain.
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9
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Yamamoto S, Matsuda K, Maeda K, Horii K, Okudera K, Oshiro Y, Inamura N, Takeuchi JS, Konishi M, Ozeki M, Mizoue T, Sugiyama H, Aoyanagi N, Mitsuya H, Sugiura W, Ohmagari N. Neutralizing antibodies after three doses of the BNT162b2 vaccine, breakthrough infection, and symptoms during the Omicron-predominant wave. Int J Infect Dis 2023; 128:347-354. [PMID: 36693493 PMCID: PMC9867771 DOI: 10.1016/j.ijid.2023.01.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Revised: 01/06/2023] [Accepted: 01/18/2023] [Indexed: 01/23/2023] Open
Abstract
OBJECTIVES To investigate the role of immunogenicity after the third vaccine dose against Omicron infection and COVID-19-compatible symptoms of infection. METHODS First, we examined vaccine effectiveness (VE) of the third dose against the second dose during the Omicron wave among the staff at a tertiary hospital in Tokyo. In a case-control study of third vaccine recipients, we compared the preinfection live-virus neutralizing antibodies (NAb) against Omicron between breakthrough cases and their controls who had close contact with patients with COVID-19. Among these cases, we examined the association between NAb levels and the number of COVID-19-compatible symptoms. RESULTS Among the 1456 participants for VE analysis, 60 breakthrough infections occurred during the Omicron wave. The third dose VE for infection was 54.6%. Among the third dose recipients, NAb levels against Omicron did not differ between the cases (n = 22) and controls (n = 21). Among the cases, those who experienced COVID-19-compatible symptoms had lower NAb levels against Omicron than those who did not. CONCLUSION The third vaccine dose was effective in decreasing the risk of SARS-CoV-2 infection during Omicron wave compared with the second dose. Among third dose recipients, higher preinfection NAb levels may not be associated with a lower risk of Omicron infection. Contrarily, they may be associated with fewer symptoms of infection.
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Affiliation(s)
- Shohei Yamamoto
- Department of Epidemiology and Prevention, Center for Clinical Sciences, National Center for Global Health and Medicine, Tokyo, Japan.
| | - Kouki Matsuda
- Department of Refractory Viral Infection, Research Institute, National Center for Global Health and Medicine, Tokyo, Japan; AIDS Clinical Center, National Center for Global Health and Medicine, Tokyo, Japan
| | - Kenji Maeda
- Department of Refractory Viral Infection, Research Institute, National Center for Global Health and Medicine, Tokyo, Japan; Division of Antiviral Therapy, Joint Research Center for Human Retrovirus Infection, Kagoshima University, Kagoshima, Japan
| | - Kumi Horii
- Infection Control Office, Center Hospital of the National Center for the Global Health and Medicine, Tokyo, Japan
| | - Kaori Okudera
- Infection Control Office, Kohnodai Hospital of the National Center for the Global Health and Medicine, Chiba, Japan
| | - Yusuke Oshiro
- Department of Laboratory Testing, Center Hospital of the National Center for the Global Health and Medicine, Tokyo, Japan
| | - Natsumi Inamura
- Department of Laboratory Testing, Center Hospital of the National Center for the Global Health and Medicine, Tokyo, Japan
| | - Junko S Takeuchi
- Department of Academic-Industrial Partnerships Promotion, Center for Clinical Sciences, National Center for Global Health and Medicine, Tokyo, Japan
| | - Maki Konishi
- Department of Epidemiology and Prevention, Center for Clinical Sciences, National Center for Global Health and Medicine, Tokyo, Japan
| | - Mitsuru Ozeki
- Department of Laboratory Testing, Center Hospital of the National Center for the Global Health and Medicine, Tokyo, Japan
| | - Tetsuya Mizoue
- Department of Epidemiology and Prevention, Center for Clinical Sciences, National Center for Global Health and Medicine, Tokyo, Japan.
| | - Haruhito Sugiyama
- Center Hospital of the National Center for the Global Health and Medicine, Tokyo, Japan
| | - Nobuyoshi Aoyanagi
- Kohnodai Hospital of the National Center for the Global Health and Medicine, Chiba, Japan
| | - Hiroaki Mitsuya
- Department of Refractory Viral Infection, Research Institute, National Center for Global Health and Medicine, Tokyo, Japan
| | - Wataru Sugiura
- Center for Clinical Sciences, National Center for Global Health and Medicine, Tokyo, Japan
| | - Norio Ohmagari
- Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan
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10
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Albreiki M, Mousa M, Azman SK, Vurivi H, Alhalwachi Z, Alshehhi F, AlShamsi S, Marzouqi NA, Alawadi T, Alrand H, Oulhaj A, Fikri A, Alsafar H. Risk of hospitalization and vaccine effectiveness among COVID-19 patients in the UAE during the Delta and Omicron outbreaks. Front Immunol 2023; 14:1049393. [PMID: 36860855 PMCID: PMC9969353 DOI: 10.3389/fimmu.2023.1049393] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Accepted: 01/20/2023] [Indexed: 02/17/2023] Open
Abstract
Introduction A rapid increase in COVID-19 cases due to the spread of the Delta and Omicron variants in vaccinated populations has raised concerns about the hospitalization risk associated with, and the effectiveness of, COVID-19 vaccines. Method This case-control study aims to determine the hospitalization risk associated with the inactivated BBIBP-CorV (Sinopharm) and mRNA BNT162b2 (Pfizer-BionTech) vaccines, and their effectiveness reducing the rate of hospital admission between 28 May 2021 and 13 January 2022, during the Delta and Omicron outbreaks. The estimation of vaccine effectiveness of 4,618 samples was based on the number of patients hospitalized at different vaccination statuses, adjusted for confounding variables. Results Hospitalization risk increases in patients affected with the Omicron variant if patients are aged ≤ 18 years (OR 6.41, 95% CI 2.90 to 14.17; p < 0.001), and in patients affected with the Delta variant if they are aged > 45 years (OR 3.41, 95% CI 2.21 to 5.50; p < 0.001). Vaccine effectiveness reducing the rate of hospital admission for fully vaccinated participants infected with the Delta and Omicron variants was similar for both the BBIBP-CorV (94%, 95% CI 90% to 97%; 90%, 95% CI 74% to 96%) and BNT162b2 vaccines (95%, 95% CI 61% to 99.3%; 94%, 95% CI 53% to 99%), respectively. Discussion The BBIBP-CorV and BNT162b2 vaccines utilized in the UAE vaccination program were highly effective in reducing the rate of COVID-19-related hospitalization during the Delta and Omicron outbreaks, and further effort must be taken to achieve high vaccine coverage rates in children and adolescents in the global context to reduce the hospitalization risk associated with COVID-19 on an international scale.
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Affiliation(s)
- Mohammed Albreiki
- Center for Biotechnology, Khalifa University of Science and Technology, Abu Dhabi, United Arab Emirates
| | - Mira Mousa
- Center for Biotechnology, Khalifa University of Science and Technology, Abu Dhabi, United Arab Emirates
- Nuffield Department of Women’s and Reproduction Health, Oxford University, Oxford, United Kingdom
| | - Syafiq Kamarul Azman
- Department of Electrical Engineering and Computer Science, Khalifa University of Science and Technology, Abu Dhabi, United Arab Emirates
| | - Hema Vurivi
- Center for Biotechnology, Khalifa University of Science and Technology, Abu Dhabi, United Arab Emirates
| | - Zainab Alhalwachi
- Center for Biotechnology, Khalifa University of Science and Technology, Abu Dhabi, United Arab Emirates
| | - Fatima Alshehhi
- Public Health Sector, Ministry of Health and Prevention, Dubai, United Arab Emirates
| | - Safiya AlShamsi
- National Center for Health Research, Ministry of Health and Prevention, Dubai, United Arab Emirates
| | - Nada Al Marzouqi
- Public Health Sector, Ministry of Health and Prevention, Dubai, United Arab Emirates
| | - Tayba Alawadi
- Public Health Sector, Ministry of Health and Prevention, Dubai, United Arab Emirates
| | - Hussain Alrand
- Public Health Sector, Ministry of Health and Prevention, Dubai, United Arab Emirates
| | - Abderrahim Oulhaj
- College of Medicine and Health Sciences, Khalifa University, Abu Dhabi, United Arab Emirates
- Research and Data Intelligence Support Center, Khalifa University, Abu Dhabi, United Arab Emirates
| | - Asma Fikri
- National Center for Health Research, Ministry of Health and Prevention, Dubai, United Arab Emirates
- Faculty of Medicine, University of Sharjah, Sharjah, United Arab Emirates
- Emirates Health Services Establishment, Dubai, United Arab Emirates
| | - Habiba Alsafar
- Center for Biotechnology, Khalifa University of Science and Technology, Abu Dhabi, United Arab Emirates
- Department of Biomedical Engineering, College of Engineering, Khalifa University of Science and Technology, Abu Dhabi, United Arab Emirates
- Department of Genetics and Molecular Biology, College of Medicine and Health Sciences, Khalifa University of Science and Technology, Abu Dhabi, United Arab Emirates
- Emirates Bio-Research Center, Ministry of Interior, Abu Dhabi, United Arab Emirates
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11
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Lin FJ, Doss AMA, Davis-Adams HG, Adams LJ, Hanson CH, VanBlargan LA, Liang CY, Chen RE, Monroy JM, Wedner HJ, Kulczycki A, Mantia TL, O’Shaughnessy CC, Raju S, Zhao FR, Rizzi E, Rigell CJ, Dy TB, Kau AL, Ren Z, Turner JS, O’Halloran JA, Presti RM, Fremont DH, Kendall PL, Ellebedy AH, Mudd PA, Diamond MS, Zimmerman O, Laidlaw BJ. SARS-CoV-2 booster vaccination rescues attenuated IgG1 memory B cell response in primary antibody deficiency patients. Front Immunol 2022; 13:1033770. [PMID: 36618402 PMCID: PMC9817149 DOI: 10.3389/fimmu.2022.1033770] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Accepted: 12/05/2022] [Indexed: 12/24/2022] Open
Abstract
Background Although SARS-CoV-2 vaccines have proven effective in eliciting a protective immune response in healthy individuals, their ability to induce a durable immune response in immunocompromised individuals remains poorly understood. Primary antibody deficiency (PAD) syndromes are among the most common primary immunodeficiency disorders in adults and are characterized by hypogammaglobulinemia and impaired ability to mount robust antibody responses following infection or vaccination. Methods Here, we present an analysis of both the B and T cell response in a prospective cohort of 30 individuals with PAD up to 150 days following initial COVID-19 vaccination and 150 days post mRNA booster vaccination. Results After the primary vaccination series, many of the individuals with PAD syndromes mounted SARS-CoV-2 specific memory B and CD4+ T cell responses that overall were comparable to healthy individuals. Nonetheless, individuals with PAD syndromes had reduced IgG1+ and CD11c+ memory B cell responses following the primary vaccination series, with the defect in IgG1 class-switching rescued following mRNA booster doses. Boosting also elicited an increase in the SARS-CoV-2-specific B and T cell response and the development of Omicron-specific memory B cells in COVID-19-naïve PAD patients. Individuals that lacked detectable B cell responses following primary vaccination did not benefit from booster vaccination. Conclusion Together, these data indicate that SARS-CoV-2 vaccines elicit memory B and T cells in most PAD patients and highlights the importance of booster vaccination in immunodeficient individuals.
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Affiliation(s)
- Frank J. Lin
- Department of Medicine, Washington University School of Medicine, St. Louis, MO, United States
| | | | - Hannah G. Davis-Adams
- Department of Medicine, Washington University School of Medicine, St. Louis, MO, United States
| | - Lucas J. Adams
- Department of Pathology and Immunology, Washington University School of Medicine, St. Louis, MO, United States
| | - Christopher H. Hanson
- Department of Medicine, Washington University School of Medicine, St. Louis, MO, United States
| | - Laura A. VanBlargan
- Department of Medicine, Washington University School of Medicine, St. Louis, MO, United States
| | - Chieh-Yu Liang
- Department of Medicine, Washington University School of Medicine, St. Louis, MO, United States
- Department of Pathology and Immunology, Washington University School of Medicine, St. Louis, MO, United States
| | - Rita E. Chen
- Department of Medicine, Washington University School of Medicine, St. Louis, MO, United States
- Department of Pathology and Immunology, Washington University School of Medicine, St. Louis, MO, United States
| | - Jennifer Marie Monroy
- Department of Medicine, Washington University School of Medicine, St. Louis, MO, United States
| | - H. James Wedner
- Department of Medicine, Washington University School of Medicine, St. Louis, MO, United States
| | - Anthony Kulczycki
- Department of Medicine, Washington University School of Medicine, St. Louis, MO, United States
| | - Tarisa L. Mantia
- Department of Medicine, Washington University School of Medicine, St. Louis, MO, United States
| | | | - Saravanan Raju
- Department of Pathology and Immunology, Washington University School of Medicine, St. Louis, MO, United States
| | - Fang R. Zhao
- Department of Medicine, Washington University School of Medicine, St. Louis, MO, United States
| | - Elise Rizzi
- Department of Medicine, Washington University School of Medicine, St. Louis, MO, United States
| | - Christopher J. Rigell
- Department of Medicine, Washington University School of Medicine, St. Louis, MO, United States
| | - Tiffany Biason Dy
- Department of Medicine, Washington University School of Medicine, St. Louis, MO, United States
| | - Andrew L. Kau
- Department of Medicine, Washington University School of Medicine, St. Louis, MO, United States
- Center for Women’s Infectious Disease Research, Washington University School of Medicine, St. Louis, MO, United States
| | - Zhen Ren
- Department of Medicine, Washington University School of Medicine, St. Louis, MO, United States
| | - Jackson S. Turner
- Department of Pathology and Immunology, Washington University School of Medicine, St. Louis, MO, United States
| | - Jane A. O’Halloran
- Department of Medicine, Washington University School of Medicine, St. Louis, MO, United States
| | - Rachel M. Presti
- Department of Medicine, Washington University School of Medicine, St. Louis, MO, United States
- Center for Vaccines and Immunity to Microbial Pathogens, Washington University School of Medicine, Saint Louis, MO, United States
| | - Daved H. Fremont
- Department of Pathology and Immunology, Washington University School of Medicine, St. Louis, MO, United States
| | - Peggy L. Kendall
- Department of Medicine, Washington University School of Medicine, St. Louis, MO, United States
| | - Ali H. Ellebedy
- Department of Pathology and Immunology, Washington University School of Medicine, St. Louis, MO, United States
- Center for Vaccines and Immunity to Microbial Pathogens, Washington University School of Medicine, Saint Louis, MO, United States
- The Andrew M. and Jane M. Bursky Center for Human Immunology & Immunotherapy Programs, Washington University School of Medicine, Saint Louis, MO, United States
| | - Philip A. Mudd
- Center for Vaccines and Immunity to Microbial Pathogens, Washington University School of Medicine, Saint Louis, MO, United States
- Department of Emergency Medicine, Washington University School of Medicine, St. Louis, MO, United States
| | - Michael S. Diamond
- Department of Medicine, Washington University School of Medicine, St. Louis, MO, United States
- Department of Pathology and Immunology, Washington University School of Medicine, St. Louis, MO, United States
- Center for Vaccines and Immunity to Microbial Pathogens, Washington University School of Medicine, Saint Louis, MO, United States
- The Andrew M. and Jane M. Bursky Center for Human Immunology & Immunotherapy Programs, Washington University School of Medicine, Saint Louis, MO, United States
- Department of Molecular Microbiology, Washington University School of Medicine, St. Louis, MO, United States
| | - Ofer Zimmerman
- Department of Medicine, Washington University School of Medicine, St. Louis, MO, United States
| | - Brian J. Laidlaw
- Department of Medicine, Washington University School of Medicine, St. Louis, MO, United States
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12
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Jubishi D, Okamoto K, Hamada K, Ishii T, Hashimoto H, Shinohara T, Yamashita M, Wakimoto Y, Otani A, Hisasue N, Ikeda M, Harada S, Okugawa S, Moriya K, Yanagimoto S. The association between adverse reactions and immune response against SARS-CoV-2 spike protein after vaccination with BNT162b2 among healthcare workers in a single healthcare system: a prospective observational cohort study. Hum Vaccin Immunother 2022; 18:2048559. [PMID: 35333697 PMCID: PMC9115791 DOI: 10.1080/21645515.2022.2048559] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Adverse reactions after vaccination with COVID-19 mRNA vaccines are common; however, the association between adverse reactions and humoral responses is uncertain. To determine whether humoral immune responses after BNT162b2 vaccine administration were associated with local and systemic adverse reactions, we conducted a prospective observational cohort study in a single tertiary referral center. Healthcare workers who received the first dose of BNT162b2 vaccine were recruited. SARS-CoV-2 anti-spike IgG antibody titers were measured three weeks after the second dose and information about adverse reactions after vaccination was collected. Among the 887 participants, 641 (72.3%) were women. The median age was 38 (range, 22–74) years. All but one showed anti-spike IgG levels well above the cutoff, with a median level of 13,600 arbitrary units/mL. Overall, 800 (92.2%) participants reported some reactions after the first dose and 822 (96.3%) after the second dose. Significantly more participants reported systemic reactions after the second dose than after the first dose (P < .01), and 625 (73.6%) reported that reactions were stronger after the second dose. Factors positively associated with elevation of anti-spike IgG levels were history of asthma (24% higher if present, P = .01) and stronger reactions after the second dose (19% higher if experienced, P = .02). The majority of participants showed good humoral responses and reported some adverse reactions after vaccination. Anti-spike IgG levels were significantly higher if adverse reactions after the second dose were stronger than those after the first dose. These findings may help inform current and future vaccine recipients.
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Affiliation(s)
- Daisuke Jubishi
- Department of Infectious Diseases, The University of Tokyo Hospital, Tokyo, Japan
| | - Koh Okamoto
- Department of Infectious Diseases, The University of Tokyo Hospital, Tokyo, Japan
| | - Kensuke Hamada
- Division for Health Service Promotion, The University of Tokyo, Tokyo, Japan
| | - Takashi Ishii
- Division for Health Service Promotion, The University of Tokyo, Tokyo, Japan
| | - Hideki Hashimoto
- Department of Infectious Diseases, The University of Tokyo Hospital, Tokyo, Japan
| | - Takayuki Shinohara
- Department of Infectious Diseases, The University of Tokyo Hospital, Tokyo, Japan
| | - Marie Yamashita
- Department of Infectious Diseases, The University of Tokyo Hospital, Tokyo, Japan
| | - Yuji Wakimoto
- Department of Infectious Diseases, The University of Tokyo Hospital, Tokyo, Japan
| | - Amato Otani
- Department of Infectious Diseases, The University of Tokyo Hospital, Tokyo, Japan
| | - Naoko Hisasue
- Division for Health Service Promotion, The University of Tokyo, Tokyo, Japan
| | - Mahoko Ikeda
- Department of Infectious Diseases, The University of Tokyo Hospital, Tokyo, Japan.,Department of Infection Control and Prevention, The University of Tokyo Hospital, Tokyo, Japan
| | - Sohei Harada
- Department of Infection Control and Prevention, The University of Tokyo Hospital, Tokyo, Japan
| | - Shu Okugawa
- Department of Infectious Diseases, The University of Tokyo Hospital, Tokyo, Japan
| | - Kyoji Moriya
- Department of Infectious Diseases, The University of Tokyo Hospital, Tokyo, Japan.,Department of Infection Control and Prevention, The University of Tokyo Hospital, Tokyo, Japan
| | - Shintaro Yanagimoto
- Division for Health Service Promotion, The University of Tokyo, Tokyo, Japan
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13
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Strickler SS, Esper A, Wells L, Wood A, Frediani JK, Nehl E, Waggoner JJ, Rebolledo PA, Levy JM, Figueroa J, Ramachandra T, Lam W, Martin GS. Severe acute respiratory syndrome coronavirus 2 vaccine breakthrough infections: A single metro-based testing network experience. Front Med (Lausanne) 2022; 9:1031083. [PMID: 36507539 PMCID: PMC9732086 DOI: 10.3389/fmed.2022.1031083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Accepted: 11/10/2022] [Indexed: 11/26/2022] Open
Abstract
Objectives Understanding the incidence and characteristics that influence severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccine breakthrough infections (VBIs) is imperative for developing public health policies to mitigate the coronavirus disease of 2019 (COVID-19) pandemic. We examined these factors and post-vaccination mitigation practices in individuals partially and fully vaccinated against SARS-CoV-2. Materials and methods Adults >18 years old were voluntarily enrolled from a single metro-based SARS-CoV-2 testing network from January to July 2021. Participants were categorized as asymptomatic or symptomatic, and as unvaccinated, partially vaccinated, or fully vaccinated. All participants had confirmed SARS-CoV-2 infection based on standard of care (SOC) testing with nasopharyngeal swabs. Variant analysis by rRT-PCR was performed in a subset of time-matched vaccinated and unvaccinated individuals. A subgroup of partially and fully vaccinated individuals with a positive SARS-CoV-2 rRT-PCR was contacted to assess disease severity and post-vaccination mitigation practices. Results Participants (n = 1,317) voluntarily underwent testing for SARS-CoV-2 during the enrollment period. A total of 29.5% of the population received at least one SARS-CoV-2 vaccine (n = 389), 12.8% partially vaccinated (n = 169); 16.1% fully vaccinated (n = 213). A total of 21.3% of partially vaccinated individuals tested positive (n = 36) and 9.4% of fully vaccinated individuals tested positive (n = 20) for SARS-CoV-2. Pfizer/BioNTech mRNA-1273 was the predominant vaccine received (1st dose = 66.8%, 2nd dose = 67.9%). Chronic liver disease and immunosuppression were more prevalent in the vaccinated (partially/fully) group compared to the unvaccinated group (p = 0.003, p = 0.021, respectively). There were more asymptomatic individuals in the vaccinated group compared to the unvaccinated group [n = 6 (10.7%), n = 16 (4.1%), p = 0.045]. CT values were lower for the unvaccinated group (median 24.3, IQR 19.1-30.5) compared to the vaccinated group (29.4, 22.0-33.7, p = 0.004). In the vaccinated group (n = 56), 18 participants were successfully contacted, 7 were lost to follow-up, and 2 were deceased. A total of 50% (n = 9) required hospitalization due to COVID-19 illness. Adherence to nationally endorsed mitigation strategies varied post-vaccination. Conclusion The incidence of SARS-CoV-2 infection at this center was 21.3% in the partially vaccinated group and 9.4% in the fully vaccinated group. Chronic liver disease and immunosuppression were more prevalent in the vaccinated SARS-CoV-2 positive group, suggesting that these may be risk factors for VBIs. Partially and fully vaccinated individuals had a higher incidence of asymptomatic SARS-CoV-2 and higher CT values compared to unvaccinated SARS-CoV-2 positive individuals.
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Affiliation(s)
- Samantha S. Strickler
- School of Medicine, Emory University, Atlanta, GA, United States,*Correspondence: Samantha S. Strickler,
| | - Annette Esper
- School of Medicine, Emory University, Atlanta, GA, United States
| | - Leona Wells
- School of Medicine, Emory University, Atlanta, GA, United States
| | - Anna Wood
- School of Medicine, Emory University, Atlanta, GA, United States
| | - Jennifer K. Frediani
- Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, GA, United States
| | - Eric Nehl
- Rollins School of Public Health, Atlanta, GA, United States
| | | | - Paulina A. Rebolledo
- School of Medicine, Emory University, Atlanta, GA, United States,Hubert Department of Global Health, Rollins School of Public Health, Atlanta, GA, United States
| | - Joshua M. Levy
- School of Medicine, Emory University, Atlanta, GA, United States
| | - Janet Figueroa
- School of Medicine, Emory University, Atlanta, GA, United States
| | | | - Wilbur Lam
- School of Medicine, Emory University, Atlanta, GA, United States,Georgia Institute of Technology, Atlanta, GA, United States
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14
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Kim JY, Kwon JS, Cha HH, Lim SY, Bae S, Kim SH. Comparison of the rapidity of SARS-CoV-2 immune responses between primary and booster vaccination for COVID-19. Korean J Intern Med 2022; 37:1234-1240. [PMID: 36217813 PMCID: PMC9666257 DOI: 10.3904/kjim.2022.173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Accepted: 06/15/2022] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND/AIMS The rapidity of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-specific memory B or T cell response in vaccinated individuals is important for our understanding of immunopathogenesis of coronavirus disease 2019 (COVID-19). We therefore compared the timing of adequate immune responses between the first and booster doses of COVID-19 vaccines in infection-naïve healthcare workers. METHODS We enrolled healthcare workers who received two doses of either the BNT162b2 vaccine or the ChAdOx1 vaccine, all of whom received the BNT162b2 vaccine as the booster (the third) dose. Spike 1 (S1)-immunoglobulin G (IgG) antibodies and interferon gamma producing T cell responses were measured at 0, 7, 14, and 21 days after the first dose, and at 0 and between 2 to 7 days after the booster dose. RESULTS After the first-dose vaccination, the S1-IgG antibody responses were elicited within 14 days in the BNT162b2 group and within 21 days in the ChAdOx1 group. After the booster dose, the S1-IgG antibody responses were elicited within 5 days in both groups. The SARS-CoV-2-specific T cell responses appeared at 7 days after the first dose and at 4 days after the booster dose. CONCLUSION SARS-CoV-2-specific immune responses by memory B cells and T cells may be expected to appear around 4 to 5 days after the booster dose.
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Affiliation(s)
- Ji Yeun Kim
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Ji-Soo Kwon
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Hye Hee Cha
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - So Yun Lim
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Seongman Bae
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Sung-Han Kim
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
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15
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Kayano T, Sasanami M, Kobayashi T, Ko YK, Otani K, Suzuki M, Nishiura H. Number of averted COVID-19 cases and deaths attributable to reduced risk in vaccinated individuals in Japan. Lancet Reg Health West Pac 2022; 28:100571. [PMID: 35971514 PMCID: PMC9366235 DOI: 10.1016/j.lanwpc.2022.100571] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/20/2023]
Abstract
BACKGROUND In Japan, vaccination against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was initiated on 17 February 2021, mainly using messenger RNA vaccines and prioritizing health care professionals. Whereas nationwide vaccination alleviated the coronavirus disease 2019 (COVID-19)-related burden, the population impact has yet to be quantified in Japan. We aimed to estimate the numbers of COVID-19 cases and deaths prevented that were attributable to the reduced risk among vaccinated individuals via a statistical modeling framework. METHODS We analyzed confirmed cases registered in the Health Center Real-time Information-sharing System on COVID-19 (3 March-30 November 2021) and publicly reported COVID-19-related deaths (24 March-30 November 2021). The vaccination coverage over this time course, classified by age and sex, was extracted from vaccine registration systems. The total numbers of prevented cases and deaths were calculated by multiplying the daily risk differences between unvaccinated and vaccinated individuals by the population size of vaccinated individuals. FINDINGS For both cases and deaths, the averted numbers were estimated to be the highest among individuals aged 65 years and older. In total, we estimated that 564,596 (95% confidence interval: 477,020-657,525) COVID-19 cases and 18,622 (95% confidence interval: 6522-33,762) deaths associated with SARS-CoV-2 infection were prevented owing to vaccination during the analysis period (i.e., fifth epidemic wave, caused mainly by the Delta variant). Female individuals were more likely to be protected from infection following vaccination than male individuals whereas more deaths were prevented in male than in female individuals. INTERPRETATION The vaccination program in Japan led to substantial reductions in the numbers of COVID-19 cases and deaths (33% and 67%, respectively). The preventive effect will be further amplified during future pandemic waves caused by variants with shared antigenicity. FUNDING This project was supported by the Japan Science and Technology Agency; the Japan Agency for Medical Research and Development; the Japan Society for the Promotion of Science; and the Ministry of Health, Labour and Welfare.
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Affiliation(s)
- Taishi Kayano
- Kyoto University School of Public Health, Yoshida-Konoe-cho, Sakyo-ku, Kyoto 606-8501, Japan
| | - Misaki Sasanami
- Kyoto University School of Public Health, Yoshida-Konoe-cho, Sakyo-ku, Kyoto 606-8501, Japan
| | - Tetsuro Kobayashi
- Kyoto University School of Public Health, Yoshida-Konoe-cho, Sakyo-ku, Kyoto 606-8501, Japan
| | - Yura K. Ko
- Center for Surveillance, Immunization, and Epidemiologic Research, National Institute of Infectious Diseases, Tokyo 162-8640, Japan
| | - Kanako Otani
- Center for Surveillance, Immunization, and Epidemiologic Research, National Institute of Infectious Diseases, Tokyo 162-8640, Japan
| | - Motoi Suzuki
- Center for Surveillance, Immunization, and Epidemiologic Research, National Institute of Infectious Diseases, Tokyo 162-8640, Japan
| | - Hiroshi Nishiura
- Kyoto University School of Public Health, Yoshida-Konoe-cho, Sakyo-ku, Kyoto 606-8501, Japan
- Corresponding author at: School of Public Health, Kyoto University, Yoshida-Konoe-cho, Sakyo-ku, Kyoto, 606-8501, Japan.
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16
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Ichii M, Kurajoh M, Okute Y, Ihara Y, Imai T, Morioka T, Mori K, Shoji T, Tsujimoto Y, Ubai T, Emoto M. Reduced Risk of Progression from Non-Severe to Severe COVID-19 in Hospitalized Dialysis Patients by Full COVID-19 Vaccination. J Clin Med 2022; 11:6348. [PMID: 36362579 PMCID: PMC9657170 DOI: 10.3390/jcm11216348] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Revised: 10/23/2022] [Accepted: 10/25/2022] [Indexed: 08/05/2023] Open
Abstract
Coronavirus disease 2019 (COVID-19) vaccination reduces the risk of progression to severe COVID-19 in the general population. To examine that preventive effect in dialysis patients, the association of vaccination status with severe COVID-19 progression was investigated in this retrospective observational study conducted from December 2020 to May 2022 of 100 such patients hospitalized for non-severe COVID-19 at Inoue Hospital (Suita, Japan). Fifty-seven were fully vaccinated, defined as receiving a COVID-19 vaccine second dose at least 14 days prior to the onset of COVID-19, while 43 were not. Among all patients, 13 (13.0%) progressed to severe COVID-19 with a median (interquartile range) time of 6 (2.5-9.5) days, while 87 (87.0%) were discharged after 11 (8-16) days. Kaplan-Meier analysis showed that fully vaccinated patients had a significantly lower rate of progression to severe COVID-19 (p = 0.001, log-rank test). Cox proportional hazard analysis also indicated that full COVID-19 vaccination was significantly associated with reduced instances of progression to severe COVID-19 (hazard ratio 0.104, 95% confidence interval 0.022 to 0.483; p = 0.004) after balancing patient background characteristics using an inverse probability of treatment weight method. These results suggest that full vaccination status contributes to reducing the risk of progression from non-severe to severe COVID-19 in dialysis patients.
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Affiliation(s)
- Mitsuru Ichii
- Division of Internal Medicine, Dialysis Center, Inoue Hospital, Suita 564-0053, Japan
| | - Masafumi Kurajoh
- Department of Metabolism, Endocrinology and Molecular Medicine, Osaka Metropolitan University Graduate School of Medicine, Osaka 545-8585, Japan
| | - Yujiro Okute
- Division of Internal Medicine, Dialysis Center, Inoue Hospital, Suita 564-0053, Japan
| | - Yasutaka Ihara
- Department of Medical Statistics, Osaka Metropolitan University Graduate School of Medicine, Osaka 545-8585, Japan
| | - Takumi Imai
- Department of Medical Statistics, Osaka Metropolitan University Graduate School of Medicine, Osaka 545-8585, Japan
| | - Tomoaki Morioka
- Department of Metabolism, Endocrinology and Molecular Medicine, Osaka Metropolitan University Graduate School of Medicine, Osaka 545-8585, Japan
| | - Katsuhito Mori
- Department of Nephrology, Osaka Metropolitan University Graduate School of Medicine, Osaka 545-8585, Japan
| | - Tetsuo Shoji
- Department of Vascular Medicine, Osaka Metropolitan University Graduate School of Medicine, Osaka 545-8585, Japan
| | - Yoshihiro Tsujimoto
- Division of Internal Medicine, Dialysis Center, Inoue Hospital, Suita 564-0053, Japan
| | - Takanobu Ubai
- Department of Urology, Inoue Hospital, Suita 564-0053, Japan
| | - Masanori Emoto
- Department of Metabolism, Endocrinology and Molecular Medicine, Osaka Metropolitan University Graduate School of Medicine, Osaka 545-8585, Japan
- Department of Nephrology, Osaka Metropolitan University Graduate School of Medicine, Osaka 545-8585, Japan
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17
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Sararat C, Wangkanai J, Wilasang C, Chantanasaro T, Modchang C. Individual-based modeling reveals that the COVID-19 isolation period can be shortened by community vaccination. Sci Rep 2022; 12:17543. [PMID: 36266440 PMCID: PMC9583066 DOI: 10.1038/s41598-022-21645-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2022] [Accepted: 09/29/2022] [Indexed: 01/19/2023] Open
Abstract
The isolation of infected individuals and quarantine of their contacts are usually employed to mitigate the transmission of SARS-CoV-2. Although 14-day isolation of infected individuals could effectively reduce the risk of subsequent transmission, it also substantially impacts the patient's psychological and emotional well-being. It is, therefore, vital to investigate how the isolation duration could be shortened when effective vaccines are available. Here, an individual-based modeling approach was employed to estimate the likelihood of secondary infections and the likelihood of an outbreak following the isolation of a primary case for a range of isolation periods. Our individual-based model integrated the viral loads and infectiousness profiles of vaccinated and unvaccinated infected individuals. The effects of waning vaccine-induced immunity against infection were also considered. By simulating the transmission of the SARS-CoV-2 Delta (B.1.617.2) variant in a community, we found that in the baseline scenario in which all individuals were unvaccinated and nonpharmaceutical interventions were not used, there was an approximately 3% chance that an unvaccinated individual would lead to at least one secondary infection after being isolated for 14 days, and a sustained chain of transmission could occur with a less than 1% chance. With the outbreak risk equivalent to that of the 14-day isolation in the baseline scenario, we found that the isolation duration could be shortened to 7.33 days (95% CI 6.68-7.98) if 75% of people in the community were fully vaccinated with the BNT162b2 vaccine within the last three months. In the best-case scenario in which all individuals in the community are fully vaccinated, isolation of Delta variant-infected individuals may no longer be necessary. However, to keep the outbreak risk lower than 1%, a booster vaccination may be necessary three months after full vaccination.
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Affiliation(s)
- Chayanin Sararat
- grid.10223.320000 0004 1937 0490Biophysics Group, Department of Physics, Faculty of Science, Mahidol University, Bangkok, 10400 Thailand ,grid.10223.320000 0004 1937 0490Center for Disease Modeling, Faculty of Science, Mahidol University, Bangkok, 10400 Thailand
| | - Jidchanok Wangkanai
- grid.10223.320000 0004 1937 0490Biophysics Group, Department of Physics, Faculty of Science, Mahidol University, Bangkok, 10400 Thailand ,grid.10223.320000 0004 1937 0490Center for Disease Modeling, Faculty of Science, Mahidol University, Bangkok, 10400 Thailand
| | - Chaiwat Wilasang
- grid.10223.320000 0004 1937 0490Biophysics Group, Department of Physics, Faculty of Science, Mahidol University, Bangkok, 10400 Thailand ,grid.10223.320000 0004 1937 0490Center for Disease Modeling, Faculty of Science, Mahidol University, Bangkok, 10400 Thailand
| | - Tanakorn Chantanasaro
- grid.10223.320000 0004 1937 0490Biophysics Group, Department of Physics, Faculty of Science, Mahidol University, Bangkok, 10400 Thailand ,grid.10223.320000 0004 1937 0490Center for Disease Modeling, Faculty of Science, Mahidol University, Bangkok, 10400 Thailand
| | - Charin Modchang
- grid.10223.320000 0004 1937 0490Biophysics Group, Department of Physics, Faculty of Science, Mahidol University, Bangkok, 10400 Thailand ,grid.10223.320000 0004 1937 0490Center for Disease Modeling, Faculty of Science, Mahidol University, Bangkok, 10400 Thailand ,grid.512258.9Centre of Excellence in Mathematics, MHESI, Bangkok, 10400 Thailand ,grid.450348.eThailand Center of Excellence in Physics, Ministry of Higher Education, Science, Research and Innovation, 328 Si Ayutthaya Road, Bangkok, 10400 Thailand
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18
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Reynolds MW, Xie Y, Knuth KB, Mack CD, Brinkley E, Toovey S, Dreyer NA. COVID-19 Vaccination Breakthrough Infections in a Real-World Setting: Using Community Reporters to Evaluate Vaccine Effectiveness. Infect Drug Resist 2022; 15:5167-5182. [PMID: 36090603 PMCID: PMC9451035 DOI: 10.2147/idr.s373183] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Accepted: 08/04/2022] [Indexed: 01/19/2023] Open
Affiliation(s)
- Matthew W Reynolds
- Real World Solutions, IQVIA, Cambridge, MA, USA
- Correspondence: Matthew W Reynolds, Real-World Solutions, IQVIA, 201 Broadway, Cambridge, MA, 02139, USA, Email
| | - Yiqiong Xie
- Real World Solutions, IQVIA, Cambridge, MA, USA
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19
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Iseki M, Nakayama H, Watanabe M, Uchibori A, Chiba A, Mizutani S. [A case of polyneuropathy after COVID-19 vaccine]. Rinsho Shinkeigaku 2022; 62:558-562. [PMID: 35753790 DOI: 10.5692/clinicalneurol.cn-001750] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
A 43-year-old-woman developed paresthesia, weakness of limbs, dysphagia and deep sensory impairment 12 days after vaccination of Pfizer COVID-19 vaccine. Her deep tendon reflexes were absent and cerebrospinal fluid showed normal cell counts and protein level. Anti-ganglioside antibodies were negative, and F wave frequency was decreased in nerve conduction studies. We diagnosed her as immune mediated polyneuropathy caused by COVID-19 vaccine, and plasma exchange improved her symptoms. Compared with Guillain-Barré syndrome and polyneuropathy following COVID-19 infection and COVID-19 vaccination, deep sensory impairment was the most characteristic of this case. We supposed that non-antigen specific mechanism played an important role in the pathogenesis of this case.
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Affiliation(s)
- Mari Iseki
- Department of Neurology, Tokyo Metropolitan Bokutoh Hospital
| | - Hiroki Nakayama
- Department of Neurology, Tokyo Metropolitan Bokutoh Hospital
| | | | | | - Atsuro Chiba
- Department of Neurology, Kyorin University Hospital
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20
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Abstract
We construct an agent-based SEIR model to simulate COVID-19 spread at a 16000-student mostly non-residential urban university during the Fall 2021 Semester. We find that mRNA vaccine coverage at 100% combined with weekly screening testing of 25% of the campus population make it possible to safely reopen to in-person instruction. Our simulations exhibit a right-skew for total infections over the semester that becomes more pronounced with less vaccine coverage, less vaccine effectiveness and no additional preventative measures. This suggests that high levels of infection are not exceedingly rare with campus social connections the main transmission route. Finally, we find that if vaccine coverage is 100% and vaccine effectiveness is above 80%, then a safe reopening is possible even without facemask use. This models possible future scenarios with high coverage of additional "booster" doses of COVID-19 vaccines.
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Affiliation(s)
- Matthew Junge
- Department of Mathematics, Baruch College, New York, New York, United States of America
| | - Sheng Li
- School of Public Health, City University of New York, New York, New York, United States of America
| | - Samitha Samaranayake
- School of Civil and Environmental Engineering, Cornell University, Ithaca, New York, United States of America
| | - Matthew Zalesak
- School of Operations Research and Information Engineering, Cornell University, Ithaca, New York, United States of America
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21
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Acosta N, Bautista MA, Waddell BJ, McCalder J, Beaudet AB, Man L, Pradhan P, Sedaghat N, Papparis C, Bacanu A, Hollman J, Krusina A, Southern DA, Williamson T, Li C, Bhatnagar S, Murphy S, Chen J, Kuzma D, Clark R, Meddings J, Hu J, Cabaj JL, Conly JM, Dai X, Lu X, Chekouo T, Ruecker NJ, Achari G, Ryan MC, Frankowski K, Hubert CRJ, Parkins MD. Longitudinal SARS-CoV-2 RNA wastewater monitoring across a range of scales correlates with total and regional COVID-19 burden in a well-defined urban population. Water Res 2022; 220:118611. [PMID: 35661506 PMCID: PMC9107283 DOI: 10.1016/j.watres.2022.118611] [Citation(s) in RCA: 26] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Revised: 04/13/2022] [Accepted: 05/13/2022] [Indexed: 05/03/2023]
Abstract
Wastewater-based epidemiology (WBE) is an emerging surveillance tool that has been used to monitor the ongoing COVID-19 pandemic by tracking SARS-CoV-2 RNA shed into wastewater. WBE was performed to monitor the occurrence and spread of SARS-CoV-2 from three wastewater treatment plants (WWTP) and six neighborhoods in the city of Calgary, Canada (population 1.44 million). A total of 222 WWTP and 192 neighborhood samples were collected from June 2020 to May 2021, encompassing the end of the first-wave (June 2020), the second-wave (November end to December 2020) and the third-wave of the COVID-19 pandemic (mid-April to May 2021). Flow-weighted 24-hour composite samples were processed to extract RNA that was then analyzed for two SARS-CoV-2-specific regions of the nucleocapsid gene, N1 and N2, using reverse transcription-quantitative polymerase chain reaction (RT-qPCR). Using this approach SARS-CoV-2 RNA was detected in 98.06% (406/414) of wastewater samples. SARS-CoV-2 RNA abundance was compared to clinically diagnosed COVID-19 cases organized by the three-digit postal code of affected individuals' primary residences, enabling correlation analysis at neighborhood, WWTP and city-wide scales. Strong correlations were observed between N1 & N2 gene signals in wastewater and new daily cases for WWTPs and neighborhoods. Similarly, when flow rates at Calgary's three WWTPs were used to normalize observed concentrations of SARS-CoV-2 RNA and combine them into a city-wide signal, this was strongly correlated with regionally diagnosed COVID-19 cases and clinical test percent positivity rate. Linked census data demonstrated disproportionate SARS-CoV-2 in wastewater from areas of the city with lower socioeconomic status and more racialized communities. WBE across a range of urban scales was demonstrated to be an effective mechanism of COVID-19 surveillance.
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Affiliation(s)
- Nicole Acosta
- Department of Microbiology, Immunology and Infectious Diseases, University of Calgary, 3330 Hospital Drive NW, Calgary, AB, T2N 4N1, Canada
| | - María A Bautista
- Geomicrobiology Group, Department of Biological Sciences, University of Calgary, 2500 University Drive NW, Calgary, Alberta, T2N 1N4, Canada
| | - Barbara J Waddell
- Department of Microbiology, Immunology and Infectious Diseases, University of Calgary, 3330 Hospital Drive NW, Calgary, AB, T2N 4N1, Canada
| | - Janine McCalder
- Department of Microbiology, Immunology and Infectious Diseases, University of Calgary, 3330 Hospital Drive NW, Calgary, AB, T2N 4N1, Canada; Geomicrobiology Group, Department of Biological Sciences, University of Calgary, 2500 University Drive NW, Calgary, Alberta, T2N 1N4, Canada
| | - Alexander Buchner Beaudet
- Department of Microbiology, Immunology and Infectious Diseases, University of Calgary, 3330 Hospital Drive NW, Calgary, AB, T2N 4N1, Canada; Geomicrobiology Group, Department of Biological Sciences, University of Calgary, 2500 University Drive NW, Calgary, Alberta, T2N 1N4, Canada
| | - Lawrence Man
- Geomicrobiology Group, Department of Biological Sciences, University of Calgary, 2500 University Drive NW, Calgary, Alberta, T2N 1N4, Canada
| | - Puja Pradhan
- Department of Microbiology, Immunology and Infectious Diseases, University of Calgary, 3330 Hospital Drive NW, Calgary, AB, T2N 4N1, Canada; Geomicrobiology Group, Department of Biological Sciences, University of Calgary, 2500 University Drive NW, Calgary, Alberta, T2N 1N4, Canada
| | - Navid Sedaghat
- Department of Microbiology, Immunology and Infectious Diseases, University of Calgary, 3330 Hospital Drive NW, Calgary, AB, T2N 4N1, Canada; Geomicrobiology Group, Department of Biological Sciences, University of Calgary, 2500 University Drive NW, Calgary, Alberta, T2N 1N4, Canada
| | - Chloe Papparis
- Department of Microbiology, Immunology and Infectious Diseases, University of Calgary, 3330 Hospital Drive NW, Calgary, AB, T2N 4N1, Canada; Geomicrobiology Group, Department of Biological Sciences, University of Calgary, 2500 University Drive NW, Calgary, Alberta, T2N 1N4, Canada
| | - Andra Bacanu
- Department of Microbiology, Immunology and Infectious Diseases, University of Calgary, 3330 Hospital Drive NW, Calgary, AB, T2N 4N1, Canada; Geomicrobiology Group, Department of Biological Sciences, University of Calgary, 2500 University Drive NW, Calgary, Alberta, T2N 1N4, Canada
| | - Jordan Hollman
- Department of Civil Engineering, University of Calgary, 2500 University Drive NW, Calgary, Alberta, T2N 1N4, Canada; Department of Geosciences, University of Calgary, 2500 University Drive NW, Calgary, Alberta, T2N 1N4, Canada
| | - Alexander Krusina
- Department of Medicine, Cumming School of Medicine, University of Calgary, 3330 Hospital Drive NW, Calgary, Alberta, T2N 4N1, Canada
| | - Danielle A Southern
- Department of Medicine, Cumming School of Medicine, University of Calgary, 3330 Hospital Drive NW, Calgary, Alberta, T2N 4N1, Canada
| | - Tyler Williamson
- Department of Community Health Sciences, University of Calgary, 3280 Hospital Drive NW, Calgary, Alberta, T2N 4Z6, Canada; O'Brien Institute for Public Health, University of Calgary, Calgary, 3280 Hospital Dr NW, Calgary, Alberta, T2N 4Z6, Canada
| | - Carmen Li
- Geomicrobiology Group, Department of Biological Sciences, University of Calgary, 2500 University Drive NW, Calgary, Alberta, T2N 1N4, Canada
| | - Srijak Bhatnagar
- Geomicrobiology Group, Department of Biological Sciences, University of Calgary, 2500 University Drive NW, Calgary, Alberta, T2N 1N4, Canada
| | - Sean Murphy
- Geomicrobiology Group, Department of Biological Sciences, University of Calgary, 2500 University Drive NW, Calgary, Alberta, T2N 1N4, Canada
| | - Jianwei Chen
- Geomicrobiology Group, Department of Biological Sciences, University of Calgary, 2500 University Drive NW, Calgary, Alberta, T2N 1N4, Canada
| | - Darina Kuzma
- Advancing Canadian Water Assets, University of Calgary, 3131 210 Ave SE, Calgary, Alberta, T0L 0×0, Canada
| | - Rhonda Clark
- Geomicrobiology Group, Department of Biological Sciences, University of Calgary, 2500 University Drive NW, Calgary, Alberta, T2N 1N4, Canada; Advancing Canadian Water Assets, University of Calgary, 3131 210 Ave SE, Calgary, Alberta, T0L 0×0, Canada
| | - Jon Meddings
- Department of Medicine, Cumming School of Medicine, University of Calgary, 3330 Hospital Drive NW, Calgary, Alberta, T2N 4N1, Canada
| | - Jia Hu
- Department of Community Health Sciences, University of Calgary, 3280 Hospital Drive NW, Calgary, Alberta, T2N 4Z6, Canada; O'Brien Institute for Public Health, University of Calgary, Calgary, 3280 Hospital Dr NW, Calgary, Alberta, T2N 4Z6, Canada; Provincial Population & Public Health, Alberta Health Services, 3030 Hospital Drive NW, Calgary, Alberta, T2N 4W4, Canada
| | - Jason L Cabaj
- Department of Community Health Sciences, University of Calgary, 3280 Hospital Drive NW, Calgary, Alberta, T2N 4Z6, Canada; O'Brien Institute for Public Health, University of Calgary, Calgary, 3280 Hospital Dr NW, Calgary, Alberta, T2N 4Z6, Canada; Provincial Population & Public Health, Alberta Health Services, 3030 Hospital Drive NW, Calgary, Alberta, T2N 4W4, Canada
| | - John M Conly
- Department of Microbiology, Immunology and Infectious Diseases, University of Calgary, 3330 Hospital Drive NW, Calgary, AB, T2N 4N1, Canada; Department of Medicine, Cumming School of Medicine, University of Calgary, 3330 Hospital Drive NW, Calgary, Alberta, T2N 4N1, Canada; O'Brien Institute for Public Health, University of Calgary, Calgary, 3280 Hospital Dr NW, Calgary, Alberta, T2N 4Z6, Canada; Infection Prevention and Control, Alberta Health Services, 1403 29th Street NW, Calgary, Alberta, T2N 2T9, Canada; Department of Pathology and Laboratory Medicine, University of Calgary, 3330 Hospital Drive NW, Calgary, Alberta, T2N 4N1, Canada; Snyder Institute for Chronic Diseases, University of Calgary, 3330 Hospital Drive NW, Calgary, Alberta, T2N 4N1, Canada
| | - Xiaotian Dai
- Department of Mathematics and Statistics, University of Calgary, 2500 Hospital Drive NW, Calgary, Alberta, T2N 1N4, Canada
| | - Xuewen Lu
- Department of Mathematics and Statistics, University of Calgary, 2500 Hospital Drive NW, Calgary, Alberta, T2N 1N4, Canada
| | - Thierry Chekouo
- Department of Mathematics and Statistics, University of Calgary, 2500 Hospital Drive NW, Calgary, Alberta, T2N 1N4, Canada
| | - Norma J Ruecker
- Water Quality Services, City of Calgary, 625 25 Ave SE, Calgary, Alberta, T2G 4k8, Canada
| | - Gopal Achari
- Department of Civil Engineering, University of Calgary, 2500 University Drive NW, Calgary, Alberta, T2N 1N4, Canada
| | - M Cathryn Ryan
- Department of Geosciences, University of Calgary, 2500 University Drive NW, Calgary, Alberta, T2N 1N4, Canada
| | - Kevin Frankowski
- Advancing Canadian Water Assets, University of Calgary, 3131 210 Ave SE, Calgary, Alberta, T0L 0×0, Canada
| | - Casey R J Hubert
- Geomicrobiology Group, Department of Biological Sciences, University of Calgary, 2500 University Drive NW, Calgary, Alberta, T2N 1N4, Canada
| | - Michael D Parkins
- Department of Microbiology, Immunology and Infectious Diseases, University of Calgary, 3330 Hospital Drive NW, Calgary, AB, T2N 4N1, Canada; Department of Medicine, Cumming School of Medicine, University of Calgary, 3330 Hospital Drive NW, Calgary, Alberta, T2N 4N1, Canada; Snyder Institute for Chronic Diseases, University of Calgary, 3330 Hospital Drive NW, Calgary, Alberta, T2N 4N1, Canada.
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22
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Noda H. A Macro-Level Association of Vaccination Rate with the Number of Confirmed COVID-19 Cases in the United States and Japan. Int J Environ Res Public Health 2022; 19:ijerph19127435. [PMID: 35742690 PMCID: PMC9223554 DOI: 10.3390/ijerph19127435] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/08/2022] [Revised: 06/07/2022] [Accepted: 06/14/2022] [Indexed: 02/04/2023]
Abstract
Aiming to evaluate a macro-level association of vaccination rate as well as booster vaccination rate with the number of confirmed COVID-19 cases in the United States and Japan, a cross-sectional study was conducted using data in each jurisdiction. Data on the total number of people who were fully vaccinated as of the end of December 2021, data on the total number of people who have received a booster dose as of the end of March 2022 and data on the cumulative number of confirmed COVID-19 cases were obtained from the website of the national governments. A generalized regression model was used to examine the association. This study showed that a higher vaccination rate was associated with a lower number of confirmed COVID-19 cases per year in 2021 for both the United States and Japan. The number of confirmed COVID-19 cases per 1000 population per year (95% confidence intervals) as a 1% increment of the vaccination rate was −0.74 (−1.29, −0.20), p = 0.007 for the United States and −1.48 (−1.95, −1.00), p < 0.0001 for Japan. A similar association was observed for the booster vaccination rate in 2022, although the association was attenuated in a multivariable model, particularly for the United States. This study provided macro-level evidence that vaccination may reduce the number of confirmed COVID-19 cases.
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Affiliation(s)
- Hiroyuki Noda
- Public Health, Department of Social Medicine, Graduate School of Medicine, Osaka University, Osaka 565-0871, Japan;
- Cabinet Secretariat, Tokyo 100-8968, Japan
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23
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Cafiero C, Palmirotta R, Micera A, Ottaiano MP, Re A, Pedata F, Costagliola D, Ponticelli D, Pisconti S, Schiavone B, Benincasa G. SARS-CoV-2 infection after vaccination in Italian health care workers: a case report. Natl Acad Sci Lett 2022; 45:249-254. [PMID: 35283546 PMCID: PMC8898326 DOI: 10.1007/s40009-022-01106-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Revised: 11/27/2021] [Accepted: 01/25/2022] [Indexed: 01/19/2023]
Abstract
Following the approval of COVID-19 vaccination program by EMA and national authorities, an immunization campaign started in Italy with BNT162b2mRNA vaccine, initially focused on healthcare workers. The active immunization was monitored by systemic antibody titration and continuous surveillance was guaranteed by antigenic/molecular tests on swabs. Cases of infection have been recently observed in vaccinated healthcare workers. Herein we describe an outbreak of infection occurring in five physicians out of 656 healthcare workers belonging to a private hospital, referring mild symptoms of COVID-19. Healthcare workers underwent complete vaccination and screening for antibody titration. Five out of 656 healthcare workers were tested positive for SARS-CoV-2 in nasopharyngeal swabs and referred mild COVID-19 symptoms. Molecular analyses were carried out to identify possible variants of Spike protein. Their genotyping performed on RNA extracts highlighted the presence of del69/70, N501Y, A570D, and 1841A > G (D614G) sequence variants, all indicative of VOC 202012/01-lineage B.1.1.7, suggesting a common source of infection. These cases might represent a serious emergency because outbreaks can compromise frail patients with important concomitant diseases.
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24
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Coburn SB, Humes E, Lang R, Stewart C, Hogan BC, Gebo KA, Napravnik S, Edwards JK, Browne LE, Park LS, Justice AC, Gordon KS, Horberg MA, Certa JM, Watson E, Jefferson CR, Silverberg MJ, Skarbinski J, Leyden WA, Williams CF, Althoff KN. Analysis of Postvaccination Breakthrough COVID-19 Infections Among Adults With HIV in the United States. JAMA Netw Open 2022; 5:e2215934. [PMID: 35671054 PMCID: PMC9175076 DOI: 10.1001/jamanetworkopen.2022.15934] [Citation(s) in RCA: 34] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Accepted: 04/21/2022] [Indexed: 02/02/2023] Open
Abstract
Importance Recommendations for additional doses of COVID-19 vaccines for people with HIV (PWH) are restricted to those with advanced disease or unsuppressed HIV viral load. Understanding SARS-CoV-2 infection risk after vaccination among PWH is essential for informing vaccination guidelines. Objective To estimate the rate and risk of breakthrough infections among fully vaccinated PWH and people without HIV (PWoH) in the United States. Design, Setting, and Participants This cohort study used the Corona-Infectious-Virus Epidemiology Team (CIVET)-II (of the North American AIDS Cohort Collaboration on Research and Design [NA-ACCORD], which is part of the International Epidemiology Databases to Evaluate AIDS [IeDEA]), collaboration of 4 prospective, electronic health record-based cohorts from integrated health systems and academic health centers. Adult PWH who were fully vaccinated prior to June 30, 2021, were matched with PWoH on date of full vaccination, age, race and ethnicity, and sex and followed up through December 31, 2021. Exposures HIV infection. Main Outcomes and Measures COVID-19 breakthrough infections, defined as laboratory evidence of SARS-CoV-2 infection or COVID-19 diagnosis after a patient was fully vaccinated. Results Among 113 994 patients (33 029 PWH and 80 965 PWoH), most were 55 years or older (80 017 [70%]) and male (104 967 [92%]); 47 098 (41%) were non-Hispanic Black, and 43 218 (38%) were non-Hispanic White. The rate of breakthrough infections was higher in PWH vs PWoH (55 [95% CI, 52-58] cases per 1000 person-years vs 43 [95% CI, 42-45] cases per 1000 person-years). Cumulative incidence of breakthroughs 9 months after full vaccination was low (3.8% [95% CI, 3.7%-3.9%]), albeit higher in PWH vs PWoH (4.4% vs 3.5%; log-rank P < .001; risk difference, 0.9% [95% CI, 0.6%-1.2%]) and within each vaccine type. Breakthrough infection risk was 28% higher in PWH vs PWoH (adjusted hazard ratio, 1.28 [95% CI, 1.19-1.37]). Among PWH, younger age (<45 y vs 45-54 y), history of COVID-19, and not receiving an additional dose (aHR, 0.71 [95% CI, 0.58-0.88]) were associated with increased risk of breakthrough infections. There was no association of breakthrough with HIV viral load suppression, but high CD4 count (ie, ≥500 cells/mm3) was associated with fewer breakthroughs among PWH. Conclusions and Relevance In this study, COVID-19 vaccination, especially with an additional dose, was effective against infection with SARS-CoV-2 strains circulating through December 31, 2021. PWH had an increased risk of breakthrough infections compared with PWoH. Expansion of recommendations for additional vaccine doses to all PWH should be considered.
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Affiliation(s)
- Sally B. Coburn
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Elizabeth Humes
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Raynell Lang
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
- Department of Medicine, University of Calgary, Calgary, Canada
| | - Cameron Stewart
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Brenna C. Hogan
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Kelly A. Gebo
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
- Department of Medicine, Johns Hopkins School of Medicine, Baltimore, Maryland
| | - Sonia Napravnik
- Department of Medicine, School of Medicine, University of North Carolina at Chapel Hill
- Department of Epidemiology, University of North Carolina at Chapel Hill
| | - Jessie K. Edwards
- Department of Epidemiology, University of North Carolina at Chapel Hill
| | - Lindsay E. Browne
- Department of Medicine, School of Medicine, University of North Carolina at Chapel Hill
| | - Lesley S. Park
- Stanford Center for Population Health Sciences, Palo Alto, California
| | - Amy C. Justice
- Department of Health Policy and Management, Yale School of Public Health, New Haven, Connecticut
- Department of Medicine, Yale School of Medicine, New Haven, Connecticut
- VA Connecticut Healthcare System, West Haven
| | - Kirsha S. Gordon
- Department of Medicine, Yale School of Medicine, New Haven, Connecticut
- VA Connecticut Healthcare System, West Haven
| | - Michael A. Horberg
- Kaiser Permanente Mid-Atlantic States, Mid-Atlantic Permanente Research Institute, Rockville, Maryland
| | - Julia M. Certa
- Kaiser Permanente Mid-Atlantic States, Mid-Atlantic Permanente Research Institute, Rockville, Maryland
| | - Eric Watson
- Kaiser Permanente Mid-Atlantic States, Mid-Atlantic Permanente Research Institute, Rockville, Maryland
| | - Celeena R. Jefferson
- Kaiser Permanente Mid-Atlantic States, Mid-Atlantic Permanente Research Institute, Rockville, Maryland
| | | | - Jacek Skarbinski
- Division of Research, Kaiser Permanente Northern California, Oakland
- Department of Infectious Diseases, Oakland Medical Center, Oakland, California
| | - Wendy A. Leyden
- Division of Research, Kaiser Permanente Northern California, Oakland
| | - Carolyn F. Williams
- Epidemiology Branch, Division of AIDS at National Institute of Allergy and Infectious Diseases, National Institutes of Health, Rockville, Maryland
| | - Keri N. Althoff
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
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25
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Mostafa HH, Luo CH, Morris CP, Li M, Swanson NJ, Amadi A, Gallagher N, Pekosz A. SARS-CoV-2 infections in mRNA vaccinated individuals are biased for viruses encoding spike E484K and associated with reduced infectious virus loads that correlate with respiratory antiviral IgG levels. J Clin Virol 2022; 150-151:105151. [PMID: 35398602 PMCID: PMC8979609 DOI: 10.1016/j.jcv.2022.105151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Revised: 03/12/2022] [Accepted: 03/31/2022] [Indexed: 01/19/2023]
Abstract
INTRODUCTION COVID-19 large scale immunization in the US has been associated with breakthrough positive molecular testing. In this study, we investigated whether a positive test is associated with a high anti-viral IgG, specific viral variant, recovery of infectious virus, or symptomatic infection during an early phase after vaccination rollout. METHODS We identified 133 SARS-CoV-2 positive patients who had received two doses of either Pfizer-BioNTech (BNT162b2) or Moderna (mRNA-1273) vaccines, the 2nd of which was received between January and April of 2021. The positive samples were collected between January and May of 2021. Samples were sequenced to characterize the whole genome and Spike protein changes and cycle thresholds that reflect viral loads were determined using a single molecular assay. Respiratory SARS-CoV-2 IgG antibodies were examined using ELISA and specimens were grown on cell culture to assess the recovery of infectious virus as compared to a control unvaccinated cohort. RESULTS Of 133 specimens, 24 failed sequencing and yielded a negative or very low viral load on the repeat PCR. Of 109 specimens that were used for further genome analysis, 68 (62.4%) were from symptomatic infections, 11 (10.1%) were admitted for COVID-19, and 2 (1.8%) required ICU admission with no associated mortality. The predominant virus variant was the Alpha (B.1.1.7), however a significant association between lineage B.1.526 and amino acid change S: E484K with positives after vaccination was noted. A significant reduction of the recovery of infectious virus on cell culture was accompanied by an increase in localized IgG levels in respiratory samples of vaccinated individuals. CONCLUSIONS Vaccination reduces the recovery of infectious virus in breakthrough infections caused primarily by the Alpha variant accompanied by an increase in upper respiratory tract IgG levels.
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Affiliation(s)
- Heba H Mostafa
- Johns Hopkins School of Medicine, Department of Pathology, Division of Medical Microbiology, 600 N. Wolfe St, Meyer B-121F, Baltimore, MD, 21287 USA.
| | - Chun Huai Luo
- Johns Hopkins School of Medicine, Department of Pathology, Division of Medical Microbiology, 600 N. Wolfe St, Meyer B-121F, Baltimore, MD, 21287 USA
| | - C Paul Morris
- Johns Hopkins School of Medicine, Department of Pathology, Division of Medical Microbiology, 600 N. Wolfe St, Meyer B-121F, Baltimore, MD, 21287 USA; National Institute of Allergy and Infectious Disease, National Institutes of Health, Bethesda, MD, USA
| | - Maggie Li
- W. Harry Feinstone Department of Molecular Microbiology and Immunology, The Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Nicholas J Swanson
- W. Harry Feinstone Department of Molecular Microbiology and Immunology, The Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Adannaya Amadi
- Johns Hopkins School of Medicine, Department of Pathology, Division of Medical Microbiology, 600 N. Wolfe St, Meyer B-121F, Baltimore, MD, 21287 USA
| | - Nicholas Gallagher
- Johns Hopkins School of Medicine, Department of Pathology, Division of Medical Microbiology, 600 N. Wolfe St, Meyer B-121F, Baltimore, MD, 21287 USA
| | - Andrew Pekosz
- W. Harry Feinstone Department of Molecular Microbiology and Immunology, The Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA; Department of Emergency Medicine, Johns Hopkins School of Medicine, 615 North Wolfe Street, rm W2116, Baltimore, MD, 21205-2103 USA.
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26
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Jolobe OMP. The new context in which breakthrough infections might emerge. QJM 2022; 115:338-339. [PMID: 34213546 DOI: 10.1093/qjmed/hcab182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Affiliation(s)
- Oscar M P Jolobe
- From the Flat 6 Souchay Court, 1 Clothorn Road, Manchester M20 6BR, UK
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27
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Chandan S, Khan SR, Deliwala S, Mohan BP, Ramai D, Chandan OC, Facciorusso A. Postvaccination SARS-CoV-2 infection among healthcare workers: A systematic review and meta-analysis. J Med Virol 2022; 94:1428-1441. [PMID: 34783055 PMCID: PMC8661690 DOI: 10.1002/jmv.27457] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2021] [Revised: 11/08/2021] [Accepted: 11/14/2021] [Indexed: 01/19/2023]
Abstract
Healthcare workers (HCWs) remain on the front line of the battle against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and coronavirus disease 2019 (COVID-19) infection and are among the highest groups at risk of infection during this raging pandemic. We conducted a systematic review and meta-analysis to assess the incidence of postvaccination SARS-CoV-2 infection among vaccinated HCWs. We searched multiple databases from inception through August 2021 to identify studies that reported on the incidence of postvaccination SARS-CoV-2 infection among HCWs. Meta-analysis was performed to determine pooled proportions of COVID-19 infection in partially/fully vaccinated as well as unvaccinated individuals. Eighteen studies with 228 873 HCWs were included in the final analysis. The total number of partially vaccinated, fully vaccinated, and unvaccinated HCWs were 132 922, 155 673, and 17 505, respectively. Overall pooled proportion of COVID-19 infections among partially/fully vaccinated and unvaccinated HCWs was 2.1% (95% confidence interval [CI] 1.2-3.5). Among partially vaccinated, fully vaccinated and unvaccinated HCWs, pooled proportion of COVID-19 infections was 2.3% (CI 1.2-4.4), 1.3% (95% CI 0.6-2.9), and 10.1% (95% CI 4.5-19.5), respectively. Our analysis shows the risk of COVID-19 infection in both partially and fully vaccinated HCWs remains exceedingly low when compared to unvaccinated individuals. There remains an urgent need for all frontline HCWs to be vaccinated against SARS-CoV-2 infection.
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Affiliation(s)
- Saurabh Chandan
- Division of Gastroenterology and HepatologyCHI Creighton University Medical CenterOmahaNebraskaUSA
| | - Shahab R. Khan
- Department of MedicineBrigham and Women's Hospital, Harvard Medical SchoolBostonMassachusettsUSA
| | - Smit Deliwala
- Department of Internal MedicineInternal Medicine, Hurley Medical CenterFlintMichiganUSA
| | - Babu P. Mohan
- Division of Gastroenterology and HepatologyUniversity of Utah School of MedicineSalt Lake CityUtahUSA
| | - Daryl Ramai
- Division of Gastroenterology and HepatologyUniversity of Utah School of MedicineSalt Lake CityUtahUSA
| | - Ojasvini C. Chandan
- Division of Pediatric GastroenterologyHepatology and Nutrition, Children's Hospital of OmahaOmahaNebraskaUSA
| | - Antonio Facciorusso
- Department of Surgical and Medical SciencesGastroenterology UnitUniversity of FoggiaFoggiaItaly
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28
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Hatcher SM, Endres-dighe SM, Angulo FJ, Srivastava A, Nguyen JL, Khan F, Martin C, Swerdlow DL, Mclaughlin JM, Ubaka-blackmore N, Brown LM. COVID-19 Vaccine Effectiveness: A Review of the First 6 Months of COVID-19 Vaccine Availability (1 January–30 June 2021). Vaccines (Basel) 2022; 10:393. [PMID: 35335025 PMCID: PMC8951318 DOI: 10.3390/vaccines10030393] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Revised: 02/16/2022] [Accepted: 02/28/2022] [Indexed: 02/07/2023] Open
Abstract
Observational studies are needed to demonstrate real-world vaccine effectiveness (VE) against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) outcomes. Our objective was to conduct a review of published SARS-CoV-2 VE articles, supplemented by preprints, during the first 6 months of COVID-19 vaccine availability. This review compares the effectiveness of completing the primary COVID-19 vaccination series against multiple SARS-CoV-2 disease presentations and disease severity outcomes in three population groups (general population, frontline workers, and older adults). Four hundred and seventy-one published articles and 47 preprints were identified. After title and abstract screening and full article review, 50 studies (28 published articles, 22 preprints) were included. VE results were reported for five COVID-19 vaccines and four combinations of COVID-19 vaccines. VE results for BNT162b2 were reported in 70.6% of all studies. Seventeen studies reported variant specific VE estimates; Alpha was the most common. This comprehensive review demonstrates that COVID-19 vaccination is an important tool for preventing COVID-19 morbidity and mortality among fully vaccinated persons aged 16 years and older and serves as an important baseline from which to follow future trends in COVID-19 evolution and effectiveness of new and updated vaccines.
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29
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Tande AJ, Pollock BD, Shah ND, Binnicker M, Berbari EF. mRNA vaccine effectiveness against asymptomatic severe acute respiratory coronavirus virus 2 (SARS-CoV-2) infection over seven months. Infect Control Hosp Epidemiol 2022; 43:393-395. [PMID: 34486511 PMCID: PMC8723985 DOI: 10.1017/ice.2021.399] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Revised: 08/19/2021] [Accepted: 08/31/2021] [Indexed: 01/19/2023]
Affiliation(s)
- Aaron J. Tande
- Division of Infectious Diseases, Mayo Clinic, Rochester, Minnesota
| | - Benjamin D. Pollock
- Department of Quality, Experience, and Affordability, Mayo Clinic, Rochester, Minnesota
- Division of Health Care Delivery Research, Robert D. and Patricia E, Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, Minnesota
| | | | - Matthew Binnicker
- Division of Clinical Microbiology, Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota
| | - Elie F. Berbari
- Division of Infectious Diseases, Mayo Clinic, Rochester, Minnesota
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30
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Larese Filon F, Rui F, Ronchese F, De Michieli P, Negro C. Incidence of COVID-19 infection in hospital workers from March 1, 2020 to May 31, 2021 routinely tested, before and after vaccination with BNT162B2. Sci Rep 2022; 12:2533. [PMID: 35169127 DOI: 10.1038/s41598-021-04665-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Accepted: 12/22/2021] [Indexed: 01/19/2023] Open
Abstract
To evaluate the incidence of COVID-19 infection in health care workers from the start of the COVID-19 pandemic in NE Italy, vaccination with BNT162b2. This was a retrospective cohort study. Healthcare workers were routinely tested for SARS-CoV-2 infection using real-time polymerase chain reaction tests in nasopharyngeal swabs. Logistic regression was used to calculate the incidence rate ratios (IRRs) of the factors associated with COVID-19. A total of 4251 workers were followed up, and the prevalence of COVID-19 was 13.6%. In March 2021 the incidence of infection was 4.88 and 103.55 cases for 100,000 person-days in vaccinated and non-vaccinated workers, respectively, with an adjusted IRRs of 0.05 (95% CI 0.02–0.08). Our study evaluated the monthly incidence in health care workers in Trieste hospitals before and after vaccination, finding an estimated vaccine effectiveness of 95% in health care workers routinely tested.
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31
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Illingworth CJR, Hamilton WL, Jackson C, Warne B, Popay A, Meredith L, Hosmillo M, Jahun A, Fieldman T, Routledge M, Houldcroft CJ, Caller L, Caddy S, Yakovleva A, Hall G, Khokhar FA, Feltwell T, Pinckert ML, Georgana I, Chaudhry Y, Curran M, Parmar S, Sparkes D, Rivett L, Jones NK, Sridhar S, Forrest S, Dymond T, Grainger K, Workman C, Gkrania-Klotsas E, Brown NM, Weekes MP, Baker S, Peacock SJ, Gouliouris T, Goodfellow I, Angelis DD, Török ME. A2B-COVID: A Tool for Rapidly Evaluating Potential SARS-CoV-2 Transmission Events. Mol Biol Evol 2022; 39:6519868. [PMID: 35106603 PMCID: PMC8892943 DOI: 10.1093/molbev/msac025] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
Identifying linked cases of infection is a critical component of the public health response to viral infectious diseases. In a clinical context, there is a need to make rapid assessments of whether cases of infection have arrived independently onto a ward, or are potentially linked via direct transmission. Viral genome sequence data are of great value in making these assessments, but are often not the only form of data available. Here, we describe A2B-COVID, a method for the rapid identification of potentially linked cases of COVID-19 infection designed for clinical settings. Our method combines knowledge about infection dynamics, data describing the movements of individuals, and evolutionary analysis of genome sequences to assess whether data collected from cases of infection are consistent or inconsistent with linkage via direct transmission. A retrospective analysis of data from two wards at Cambridge University Hospitals NHS Foundation Trust during the first wave of the pandemic showed qualitatively different patterns of linkage between cases on designated COVID-19 and non-COVID-19 wards. The subsequent real-time application of our method to data from the second epidemic wave highlights its value for monitoring cases of infection in a clinical context.
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Affiliation(s)
- Christopher J R Illingworth
- MRC-University of Glasgow Centre for Virus Research, Glasgow, United Kingdom,MRC Biostatistics Unit, University of Cambridge, Cambridge, United Kingdom,Department of Applied Mathematics and Theoretical Physics, University of Cambridge, Cambridge, United Kingdom,Institut für Biologische Physik, Universität zu Köln, Köln, Germany,Corresponding author: E-mail:
| | - William L Hamilton
- Department of Medicine, University of Cambridge, Cambridge, United Kingdom,Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom
| | | | - Ben Warne
- Department of Medicine, University of Cambridge, Cambridge, United Kingdom,Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom
| | - Ashley Popay
- Public Health England Field Epidemiology Unit, Cambridge Institute of Public Health, Cambridge, United Kingdom
| | - Luke Meredith
- Department of Pathology, Division of Virology, University of Cambridge, Cambridge, United Kingdom
| | - Myra Hosmillo
- Department of Pathology, Division of Virology, University of Cambridge, Cambridge, United Kingdom
| | - Aminu Jahun
- Department of Pathology, Division of Virology, University of Cambridge, Cambridge, United Kingdom
| | - Tom Fieldman
- Department of Medicine, University of Cambridge, Cambridge, United Kingdom,Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom
| | - Matthew Routledge
- Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom,Clinical Microbiology and Public Health Laboratory, Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom
| | | | | | - Sarah Caddy
- Cambridge Institute for Therapeutic Immunology and Infectious Disease, Jeffrey Cheah Biomedical Centre, Cambridge, United Kingdom
| | - Anna Yakovleva
- Department of Pathology, Division of Virology, University of Cambridge, Cambridge, United Kingdom
| | - Grant Hall
- Department of Pathology, Division of Virology, University of Cambridge, Cambridge, United Kingdom
| | - Fahad A Khokhar
- Department of Pathology, Division of Virology, University of Cambridge, Cambridge, United Kingdom
| | - Theresa Feltwell
- Department of Medicine, University of Cambridge, Cambridge, United Kingdom
| | - Malte L Pinckert
- Department of Pathology, Division of Virology, University of Cambridge, Cambridge, United Kingdom
| | - Iliana Georgana
- Department of Pathology, Division of Virology, University of Cambridge, Cambridge, United Kingdom
| | - Yasmin Chaudhry
- Department of Pathology, Division of Virology, University of Cambridge, Cambridge, United Kingdom
| | - Martin Curran
- Clinical Microbiology and Public Health Laboratory, Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom
| | - Surendra Parmar
- Clinical Microbiology and Public Health Laboratory, Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom
| | - Dominic Sparkes
- Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom,Clinical Microbiology and Public Health Laboratory, Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom
| | - Lucy Rivett
- Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom,Clinical Microbiology and Public Health Laboratory, Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom
| | - Nick K Jones
- Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom,Clinical Microbiology and Public Health Laboratory, Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom
| | - Sushmita Sridhar
- Department of Medicine, University of Cambridge, Cambridge, United Kingdom,Cambridge Institute for Therapeutic Immunology and Infectious Disease, Jeffrey Cheah Biomedical Centre, Cambridge, United Kingdom,Wellcome Sanger Institute, Hinxton, United Kingdom
| | | | - Tom Dymond
- Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom
| | - Kayleigh Grainger
- Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom
| | - Chris Workman
- Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom
| | - Effrossyni Gkrania-Klotsas
- Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom,MRC Epidemiology Unit, University of Cambridge, Level 3 Institute of Metabolic Science, Cambridge, United Kingdom,School of Clinical Medicine, University of Cambridge, Cambridge, United Kingdom
| | - Nicholas M Brown
- Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom,Clinical Microbiology and Public Health Laboratory, Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom
| | - Michael P Weekes
- Department of Medicine, University of Cambridge, Cambridge, United Kingdom,Cambridge Institute for Therapeutic Immunology and Infectious Disease, Jeffrey Cheah Biomedical Centre, Cambridge, United Kingdom
| | - Stephen Baker
- Department of Medicine, University of Cambridge, Cambridge, United Kingdom,Cambridge Institute for Therapeutic Immunology and Infectious Disease, Jeffrey Cheah Biomedical Centre, Cambridge, United Kingdom
| | - Sharon J Peacock
- Department of Medicine, University of Cambridge, Cambridge, United Kingdom,Wellcome Sanger Institute, Hinxton, United Kingdom
| | - Theodore Gouliouris
- Department of Medicine, University of Cambridge, Cambridge, United Kingdom,Clinical Microbiology and Public Health Laboratory, Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom
| | - Ian Goodfellow
- Department of Pathology, Division of Virology, University of Cambridge, Cambridge, United Kingdom
| | - Daniela De Angelis
- MRC Biostatistics Unit, University of Cambridge, Cambridge, United Kingdom,Public Health England, National Infection Service, London, United Kingdom
| | - M Estée Török
- Department of Medicine, University of Cambridge, Cambridge, United Kingdom,Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom
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32
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Fiolet T, Kherabi Y, MacDonald CJ, Ghosn J, Peiffer-Smadja N. Comparing COVID-19 vaccines for their characteristics, efficacy and effectiveness against SARS-CoV-2 and variants of concern: a narrative review. Clin Microbiol Infect 2022; 28:202-221. [PMID: 34715347 PMCID: PMC8548286 DOI: 10.1016/j.cmi.2021.10.005] [Citation(s) in RCA: 464] [Impact Index Per Article: 232.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Revised: 10/07/2021] [Accepted: 10/16/2021] [Indexed: 02/08/2023]
Abstract
BACKGROUND Vaccines are critical cost-effective tools to control the coronavirus disease 2019 (COVID-19) pandemic. However, the emergence of variants of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) may threaten the global impact of mass vaccination campaigns. AIMS The objective of this study was to provide an up-to-date comparative analysis of the characteristics, adverse events, efficacy, effectiveness and impact of the variants of concern for 19 COVID-19 vaccines. SOURCES References for this review were identified through searches of PubMed, Google Scholar, BioRxiv, MedRxiv, regulatory drug agencies and pharmaceutical companies' websites up to 22nd September 2021. CONTENT Overall, all COVID-19 vaccines had a high efficacy against the original strain and the variants of concern, and were well tolerated. BNT162b2, mRNA-1273 and Sputnik V after two doses had the highest efficacy (>90%) in preventing symptomatic cases in phase III trials. mRNA vaccines, AZD1222, and CoronaVac were effective in preventing symptomatic COVID-19 and severe infections against Alpha, Beta, Gamma or Delta variants. Regarding observational real-life data, full immunization with mRNA vaccines and AZD1222 seems to effectively prevent SARS-CoV-2 infection against the original strain and Alpha and Beta variants but with reduced effectiveness against the Delta strain. A decline in infection protection was observed at 6 months for BNT162b2 and AZD1222. Serious adverse event rates were rare for mRNA vaccines-anaphylaxis 2.5-4.7 cases per million doses, myocarditis 3.5 cases per million doses-and were similarly rare for all other vaccines. Prices for the different vaccines varied from $2.15 to $29.75 per dose. IMPLICATIONS All vaccines appear to be safe and effective tools to prevent severe COVID-19, hospitalization, and death against all variants of concern, but the quality of evidence greatly varies depending on the vaccines considered. Questions remain regarding a booster dose and waning immunity, the duration of immunity, and heterologous vaccination. The benefits of COVID-19 vaccination outweigh the risks, despite rare serious adverse effects.
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Affiliation(s)
- Thibault Fiolet
- Paris-Saclay University, UVSQ, INSERM, Gustave Roussy, ‘Exposome and Heredity’ team, CESP UMR1018, Villejuif, France,Corresponding author. Thibault Fiolet
| | - Yousra Kherabi
- Université de Paris, IAME, INSERM, Paris, France,Infectious and Tropical Diseases Department, Bichat-Claude Bernard Hospital, AP-HP, Paris, France
| | - Conor-James MacDonald
- Paris-Saclay University, UVSQ, INSERM, Gustave Roussy, ‘Exposome and Heredity’ team, CESP UMR1018, Villejuif, France
| | - Jade Ghosn
- Université de Paris, IAME, INSERM, Paris, France,Infectious and Tropical Diseases Department, Bichat-Claude Bernard Hospital, AP-HP, Paris, France
| | - Nathan Peiffer-Smadja
- Université de Paris, IAME, INSERM, Paris, France,Infectious and Tropical Diseases Department, Bichat-Claude Bernard Hospital, AP-HP, Paris, France,National Institute for Health Research Health Protection Research Unit in Healthcare Associated Infections and Antimicrobial Resistance, Imperial College, London, UK
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Teerawattananon Y, Anothaisintawee T, Pheerapanyawaranun C, Botwright S, Akksilp K, Sirichumroonwit N, Budtarad N, Isaranuwatchai W. A systematic review of methodological approaches for evaluating real-world effectiveness of COVID-19 vaccines: Advising resource-constrained settings. PLoS One 2022; 17:e0261930. [PMID: 35015761 PMCID: PMC8752025 DOI: 10.1371/journal.pone.0261930] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Accepted: 12/13/2021] [Indexed: 01/19/2023] Open
Abstract
Real-world effectiveness studies are important for monitoring performance of COVID-19 vaccination programmes and informing COVID-19 prevention and control policies. We aimed to synthesise methodological approaches used in COVID-19 vaccine effectiveness studies, in order to evaluate which approaches are most appropriate to implement in low- and middle-income countries (LMICs). For this rapid systematic review, we searched PubMed and Scopus for articles published from inception to July 7, 2021, without language restrictions. We included any type of peer-reviewed observational study measuring COVID-19 vaccine effectiveness, for any population. We excluded randomised control trials and modelling studies. All data used in the analysis were extracted from included papers. We used a standardised data extraction form, modified from STrengthening the Reporting of OBservational studies in Epidemiology (STROBE). Study quality was assessed using the REal Life EVidence AssessmeNt Tool (RELEVANT) tool. This study is registered with PROSPERO, CRD42021264658. Our search identified 3,327 studies, of which 42 were eligible for analysis. Most studies (97.5%) were conducted in high-income countries and the majority assessed mRNA vaccines (78% mRNA only, 17% mRNA and viral vector, 2.5% viral vector, 2.5% inactivated vaccine). Thirty-five of the studies (83%) used a cohort study design. Across studies, short follow-up time and limited assessment and mitigation of potential confounders, including previous SARS-CoV-2 infection and healthcare seeking behaviour, were major limitations. This review summarises methodological approaches for evaluating real-world effectiveness of COVID-19 vaccines and highlights the lack of such studies in LMICs, as well as the importance of context-specific vaccine effectiveness data. Further research in LMICs will refine guidance for conducting real-world COVID-19 vaccine effectiveness studies in resource-constrained settings.
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Affiliation(s)
- Yot Teerawattananon
- Health Intervention and Technology Assessment Program, Ministry of Public Health, Nonthaburi, Thailand
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
| | - Thunyarat Anothaisintawee
- Department of Family Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | | | - Siobhan Botwright
- Health Intervention and Technology Assessment Program, Ministry of Public Health, Nonthaburi, Thailand
- * E-mail:
| | - Katika Akksilp
- Health Intervention and Technology Assessment Program, Ministry of Public Health, Nonthaburi, Thailand
| | | | - Nuttakarn Budtarad
- Health Intervention and Technology Assessment Program, Ministry of Public Health, Nonthaburi, Thailand
| | - Wanrudee Isaranuwatchai
- Health Intervention and Technology Assessment Program, Ministry of Public Health, Nonthaburi, Thailand
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Servellita V, Morris MK, Sotomayor-Gonzalez A, Gliwa AS, Torres E, Brazer N, Zhou A, Hernandez KT, Sankaran M, Wang B, Wong D, Wang C, Zhang Y, Reyes KR, Glasner D, Deng X, Streithorst J, Miller S, Frias E, Rodgers M, Cloherty G, Hackett J, Hanson C, Wadford D, Philip S, Topper S, Sachdev D, Chiu CY. Predominance of antibody-resistant SARS-CoV-2 variants in vaccine breakthrough cases from the San Francisco Bay Area, California. Nat Microbiol 2022; 7:277-288. [PMID: 35013591 DOI: 10.1038/s41564-021-01041-4] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Accepted: 12/02/2021] [Indexed: 01/19/2023]
Abstract
Associations between vaccine breakthrough cases and infection by different SARS coronavirus 2 (SARS-CoV-2) variants have remained largely unexplored. Here we analysed SARS-CoV-2 whole-genome sequences and viral loads from 1,373 persons with COVID-19 from the San Francisco Bay Area from 1 February to 30 June 2021, of which 125 (9.1%) were vaccine breakthrough infections. Vaccine breakthrough infections were more commonly associated with circulating antibody-resistant variants carrying ≥1 mutation associated with decreased antibody neutralization (L452R/Q, E484K/Q and/or F490S) than infections in unvaccinated individuals (78% versus 48%, P = 1.96 × 10-8). Differences in viral loads were non-significant between unvaccinated and fully vaccinated cases overall (P = 0.99) and according to lineage (P = 0.09-0.78). Symptomatic vaccine breakthrough infections had comparable viral loads (P = 0.64), whereas asymptomatic breakthrough infections had decreased viral loads (P = 0.023) compared with infections in unvaccinated individuals. In 5 cases with serial samples available for serologic analyses, vaccine breakthrough infections were found to be associated with low or undetectable neutralizing antibody levels attributable to an immunocompromised state or infection by an antibody-resistant lineage. Taken together, our results show that vaccine breakthrough infections are overrepresented by antibody-resistant SARS-CoV-2 variants, and that symptomatic breakthrough infections may be as efficient in spreading COVID-19 as unvaccinated infections, regardless of the infecting lineage.
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Affiliation(s)
- Venice Servellita
- Department of Laboratory Medicine, University of California San Francisco, San Francisco, CA, USA.,UCSF-Abbott Viral Diagnostics and Discovery Center, San Francisco, CA, USA
| | - Mary Kate Morris
- Viral and Rickettsial Disease Laboratory, California Department of Public Health, Richmond, CA, USA
| | - Alicia Sotomayor-Gonzalez
- Department of Laboratory Medicine, University of California San Francisco, San Francisco, CA, USA.,UCSF-Abbott Viral Diagnostics and Discovery Center, San Francisco, CA, USA
| | - Amelia S Gliwa
- Department of Laboratory Medicine, University of California San Francisco, San Francisco, CA, USA.,UCSF-Abbott Viral Diagnostics and Discovery Center, San Francisco, CA, USA
| | | | - Noah Brazer
- Department of Laboratory Medicine, University of California San Francisco, San Francisco, CA, USA.,UCSF-Abbott Viral Diagnostics and Discovery Center, San Francisco, CA, USA
| | | | | | | | - Baolin Wang
- Department of Laboratory Medicine, University of California San Francisco, San Francisco, CA, USA.,UCSF-Abbott Viral Diagnostics and Discovery Center, San Francisco, CA, USA
| | - Daniel Wong
- Department of Laboratory Medicine, University of California San Francisco, San Francisco, CA, USA.,UCSF-Abbott Viral Diagnostics and Discovery Center, San Francisco, CA, USA
| | - Candace Wang
- Department of Laboratory Medicine, University of California San Francisco, San Francisco, CA, USA.,UCSF-Abbott Viral Diagnostics and Discovery Center, San Francisco, CA, USA
| | - Yueyuan Zhang
- Department of Laboratory Medicine, University of California San Francisco, San Francisco, CA, USA.,UCSF-Abbott Viral Diagnostics and Discovery Center, San Francisco, CA, USA
| | - Kevin R Reyes
- Department of Laboratory Medicine, University of California San Francisco, San Francisco, CA, USA.,UCSF-Abbott Viral Diagnostics and Discovery Center, San Francisco, CA, USA
| | - Dustin Glasner
- Department of Laboratory Medicine, University of California San Francisco, San Francisco, CA, USA.,UCSF-Abbott Viral Diagnostics and Discovery Center, San Francisco, CA, USA
| | - Xianding Deng
- Department of Laboratory Medicine, University of California San Francisco, San Francisco, CA, USA.,UCSF-Abbott Viral Diagnostics and Discovery Center, San Francisco, CA, USA
| | - Jessica Streithorst
- Department of Laboratory Medicine, University of California San Francisco, San Francisco, CA, USA.,UCSF-Abbott Viral Diagnostics and Discovery Center, San Francisco, CA, USA
| | - Steve Miller
- Department of Laboratory Medicine, University of California San Francisco, San Francisco, CA, USA.,UCSF-Abbott Viral Diagnostics and Discovery Center, San Francisco, CA, USA
| | | | | | | | | | - Carl Hanson
- Viral and Rickettsial Disease Laboratory, California Department of Public Health, Richmond, CA, USA
| | - Debra Wadford
- Viral and Rickettsial Disease Laboratory, California Department of Public Health, Richmond, CA, USA
| | - Susan Philip
- San Francisco Department of Public Health, San Francisco, CA, USA
| | | | - Darpun Sachdev
- San Francisco Department of Public Health, San Francisco, CA, USA
| | - Charles Y Chiu
- Department of Laboratory Medicine, University of California San Francisco, San Francisco, CA, USA. .,UCSF-Abbott Viral Diagnostics and Discovery Center, San Francisco, CA, USA. .,Department of Medicine, University of California San Francisco, San Francisco, CA, USA. .,Innovative Genomics Institute, University of California Berkeley, Berkeley, CA, USA.
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Stein M, Ashkenazi-Hoffnung L, Greenberg D, Dalal I, Livni G, Chapnick G, Stein-Zamir C, Ashkenazi S, Hecht-Sagie L, Grossman Z. The Burden of COVID-19 in Children and Its Prevention by Vaccination: A Joint Statement of the Israeli Pediatric Association and the Israeli Society for Pediatric Infectious Diseases. Vaccines (Basel) 2022; 10:81. [PMID: 35062742 PMCID: PMC8781684 DOI: 10.3390/vaccines10010081] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Revised: 12/23/2021] [Accepted: 12/29/2021] [Indexed: 01/27/2023] Open
Abstract
As of October 2021, SARS-CoV-2 infections were reported among 512,613 children and adolescents in Israel (~33% of all COVID-19 cases). The 5-11-year age group accounted for about 43% (223,850) of affected children and adolescents. In light of the availability of the Pfizer-BioNTech BNT162b2 vaccine against COVID-19 for children aged 5-11 years, we aimed to write a position paper for pediatricians, policymakers and families regarding the clinical aspects of COVID-19 and the vaccination of children against COVID-19. The first objective of this review was to describe the diverse facets of the burden of COVID-19 in children, including the direct effects of hospitalization during the acute phase of the disease, multisystem inflammatory syndrome in children, long COVID and the indirect effects of social isolation and interruption in education. In addition, we aimed to provide an update regarding the efficacy and safety of childhood mRNA COVID-19 vaccination and to instill confidence in pediatricians regarding the benefits of vaccinating children against COVID-19. We reviewed up-to-date Israeli and international epidemiological data and literature regarding COVID-19 morbidity and its sequelae in children, vaccine efficacy in reducing COVID-19-related morbidity and SARS-CoV-2 transmission and vaccine safety data. We conducted a risk-benefit analysis regarding the vaccination of children and adolescents. We concluded that vaccines are safe and effective and are recommended for all children aged 5 to 11 years to protect them from COVID-19 and its complications and to reduce community transmissions. Based on these data, after weighing the benefits of vaccination versus the harm, the Israeli Ministry of Health decided to recommend vaccination for children aged 5-11 years.
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Affiliation(s)
- Michal Stein
- Infectious Diseases and Infection Control Unit, Hillel Yaffe Medical Center, Hadera 3810101, Israel
- Rappaport Faculty of Medicine, Technion—Israel Institute of Technology, Haifa 3109601, Israel
| | - Liat Ashkenazi-Hoffnung
- Department of Day Care Hospitalization, Schneider Children’s Medical Center, Petah Tikva 4920235, Israel;
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv-Yafo 6997801, Israel; (I.D.); (G.L.)
| | - David Greenberg
- The Pediatric Infectious Disease Unit, Soroka Medical Center, Be’er Sheva 8458900, Israel;
- The Faculty of Health Sciences, Joyce & Irving Goldman Medical School at Ben Gurion University of the Negev, Be’er Sheva 8410501, Israel
| | - Ilan Dalal
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv-Yafo 6997801, Israel; (I.D.); (G.L.)
- Pediatric Department, E. Wolfson Medical Center, Holon 5822012, Israel
| | - Gilat Livni
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv-Yafo 6997801, Israel; (I.D.); (G.L.)
- Department of Pediatrics A, Schneider Children’s Medical Center, Petah Tikva 4920245, Israel
| | - Gil Chapnick
- Maccabi Healthcare Services, Tel Aviv-Yafo 6812509, Israel; (G.C.); (L.H.-S.); (Z.G.)
| | - Chen Stein-Zamir
- Jerusalem District Health Office, Jerusalem 9137001, Israel;
- Braun School of Public Health and Community Medicine, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem 9112102, Israel
| | - Shai Ashkenazi
- Schneider Children’s Medical Center, Petah Tikva 4920235, Israel;
- Adelson School of Medicine, Ariel University, Ari’el 4070000, Israel
| | - Lior Hecht-Sagie
- Maccabi Healthcare Services, Tel Aviv-Yafo 6812509, Israel; (G.C.); (L.H.-S.); (Z.G.)
| | - Zachi Grossman
- Maccabi Healthcare Services, Tel Aviv-Yafo 6812509, Israel; (G.C.); (L.H.-S.); (Z.G.)
- Adelson School of Medicine, Ariel University, Ari’el 4070000, Israel
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Tiwari H, Ali S, Bhattacharyya S, Ahmad F, C. Tiwari R, Jain T, Baad S. COVID infections breakthrough post-vaccination: Systematic review. J Pharm Bioallied Sci 2022; 14:S196-S199. [PMID: 36110618 PMCID: PMC9469404 DOI: 10.4103/jpbs.jpbs_132_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Revised: 01/30/2022] [Accepted: 02/28/2022] [Indexed: 01/19/2023] Open
Abstract
Introduction: Materials and Methods: Results: Discussion:
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Abstract
The germinal centre (GC) response is critical for the generation of affinity-matured plasma cells and memory B cells capable of mediating long-term protective immunity. Understanding whether severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection or vaccination elicits a GC response has profound implications for the capacity of responding B cells to contribute to protection against infection. However, direct assessment of the GC response in humans remains a major challenge. Here we summarize emerging evidence for the importance of the GC response in the establishment of durable and broad immunity against SARS-CoV-2 and discuss new approaches to modulate the GC response to better protect against newly emerging SARS-CoV-2 variants. We also discuss new findings showing that the GC B cell response persists in the draining lymph nodes for at least 6 months in some individuals following vaccination with SARS-CoV-2 mRNA-based vaccines.
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Affiliation(s)
- Brian J Laidlaw
- Division of Allergy and Immunology, Department of Medicine, Washington University School of Medicine, St Louis, MO, USA.
| | - Ali H Ellebedy
- Department of Pathology and Immunology, Washington University School of Medicine, St Louis, MO, USA.
- The Andrew M. and Jane M. Bursky Center for Human Immunology & Immunotherapy Programs, Washington University School of Medicine, St Louis, MO, USA.
- Center for Vaccines and Immunity to Microbial Pathogens, Washington University School of Medicine, St Louis, MO, USA.
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Ella R, Reddy S, Blackwelder W, Potdar V, Yadav P, Sarangi V, Aileni VK, Kanungo S, Rai S, Reddy P, Verma S, Singh C, Redkar S, Mohapatra S, Pandey A, Ranganadin P, Gumashta R, Multani M, Mohammad S, Bhatt P, Kumari L, Sapkal G, Gupta N, Abraham P, Panda S, Prasad S, Bhargava B, Ella K, Vadrevu KM. Efficacy, safety, and lot-to-lot immunogenicity of an inactivated SARS-CoV-2 vaccine (BBV152): interim results of a randomised, double-blind, controlled, phase 3 trial. Lancet 2021; 398:2173-2184. [PMID: 34774196 PMCID: PMC8584828 DOI: 10.1016/s0140-6736(21)02000-6] [Citation(s) in RCA: 196] [Impact Index Per Article: 65.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Revised: 08/17/2021] [Accepted: 08/25/2021] [Indexed: 01/19/2023]
Abstract
BACKGROUND We report the clinical efficacy against COVID-19 infection of BBV152, a whole virion inactivated SARS-CoV-2 vaccine formulated with a toll-like receptor 7/8 agonist molecule adsorbed to alum (Algel-IMDG) in Indian adults. METHODS We did a randomised, double-blind, placebo-controlled, multicentre, phase 3 clinical trial in 25 Indian hospitals or medical clinics to evaluate the efficacy, safety, and immunological lot consistency of BBV152. Adults (age ≥18 years) who were healthy or had stable chronic medical conditions (not an immunocompromising condition or requiring treatment with immunosuppressive therapy) were randomised 1:1 with a computer-generated randomisation scheme (stratified for the presence or absence of chronic conditions) to receive two intramuscular doses of vaccine or placebo administered 4 weeks apart. Participants, investigators, study coordinators, study-related personnel, the sponsor, and nurses who administered the vaccines were masked to treatment group allocation; an unmasked contract research organisation and a masked expert adjudication panel assessed outcomes. The primary outcome was the efficacy of the BBV152 vaccine in preventing a first occurrence of laboratory-confirmed (RT-PCR-positive) symptomatic COVID-19 (any severity), occurring at least 14 days after the second dose in the per-protocol population. We also assessed safety and reactogenicity throughout the duration of the study in all participants who had received at least one dose of vaccine or placebo. This report contains interim results (data cutoff May 17, 2021) regarding immunogenicity and safety outcomes (captured on days 0 to 56) and efficacy results with a median of 99 days for the study population. The trial was registered on the Indian Clinical Trials Registry India, CTRI/2020/11/028976, and ClinicalTrials.gov, NCT04641481 (active, not recruiting). FINDINGS Between Nov 16, 2020, and Jan 7, 2021, we recruited 25 798 participants who were randomly assigned to receive BBV152 or placebo; 24 419 received two doses of BBV152 (n=12 221) or placebo (n=12 198). Efficacy analysis was dependent on having 130 cases of symptomatic COVID-19, which occurred when 16 973 initially seronegative participants had at least 14 days follow-up after the second dose. 24 (0·3%) cases occurred among 8471 vaccine recipients and 106 (1·2%) among 8502 placebo recipients, giving an overall estimated vaccine efficacy of 77·8% (95% CI 65·2-86·4). In the safety population (n=25 753), 5959 adverse events occurred in 3194 participants. BBV152 was well tolerated; the same proportion of participants reported adverse events in the vaccine group (1597 [12·4%] of 12 879) and placebo group (1597 [12·4%] of 12 874), with no clinically significant differences in the distributions of solicited, unsolicited, or serious adverse events between the groups, and no cases of anaphylaxis or vaccine-related deaths. INTERPRETATION BBV152 was highly efficacious against laboratory-confirmed symptomatic COVID-19 disease in adults. Vaccination was well tolerated with no safety concerns raised in this interim analysis. FUNDING Bharat Biotech International and Indian Council of Medical Research.
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Affiliation(s)
- Raches Ella
- Bharat Biotech International, Hyderabad, India
| | | | | | - Varsha Potdar
- National Institute of Virology, Indian Council of Medical Research, Pune, India
| | - Pragya Yadav
- National Institute of Virology, Indian Council of Medical Research, Pune, India
| | | | | | - Suman Kanungo
- National Institute of Cholera and Enteric Diseases, Indian Council of Medical Research, Kolkatta, India
| | - Sanjay Rai
- All India Institute of Medical Sciences, New Delhi, India
| | | | - Savita Verma
- Pandit Bhagwat Dayal Sharma Post Graduate Institute of Medical Sciences, Rohtak, India
| | | | | | | | - Anil Pandey
- ESIC Medical College and Hospital, Faridabad, India
| | | | - Raghavendra Gumashta
- Department of Community Medicine, People's College of Medical Sciences and Research Centre, People's University, Bhopal, India
| | | | | | - Parul Bhatt
- GMERS Medical College and Civil Hospital, Ahmedabad, India
| | | | - Gajanan Sapkal
- National Institute of Virology, Indian Council of Medical Research, Pune, India
| | | | - Priya Abraham
- National Institute of Virology, Indian Council of Medical Research, Pune, India
| | - Samiran Panda
- Indian Council of Medical Research, New Delhi, India
| | - Sai Prasad
- Bharat Biotech International, Hyderabad, India
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Mendoza-Saldaña JD, Viton-Rubio JE, Guzman-Carrasco SB, Pacheco-Barrios NV, Lainez-Casal CR. Characteristics and outcomes from COVID-19 among Peruvian physicians: a nationwide register-based study. Arch Environ Occup Health 2021; 77:697-701. [PMID: 34872467 DOI: 10.1080/19338244.2021.2011694] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
The healthcare workforce has played an integral role in fighting COVID-19 and continues to do so despite the continuous adverse outcomes. To address this issue, official public data concerning COVID-19 cases and deaths of Peruvian physicians was used to quantify the risk of death and infection by SARS-CoV-2. 20.9% Peruvian physicians were infected and 0.7% died, with the male general practitioners being the most affected group within the workforce. Notably, the Loreto region was disproportionately affected and had the highest cumulative incidence, mortality and case fatality rate. Ultimately, this identified risk group needs to be supported with sufficient resources/tools such as personal protective equipment, training, access to health care, vaccination, etc.
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Affiliation(s)
- Juan-Diego Mendoza-Saldaña
- School of Medicine Alberto Hurtado, Cayetano Heredia Peruvian University, Lima, Peru
- High Altitude Research Institute, Cayetano Heredia Peruvian University, Lima, Peru
- Mental Health Working Group, Cayetano Heredia Peruvian University, Lima, Peru
- TBout Volunteering and Working Group, Cayetano Heredia Peruvian University, Lima, Peru
| | - José Enrique Viton-Rubio
- School of Medicine Alberto Hurtado, Cayetano Heredia Peruvian University, Lima, Peru
- High Altitude Research Institute, Cayetano Heredia Peruvian University, Lima, Peru
- Mental Health Working Group, Cayetano Heredia Peruvian University, Lima, Peru
- TBout Volunteering and Working Group, Cayetano Heredia Peruvian University, Lima, Peru
| | - Susana Brissvany Guzman-Carrasco
- School of Medicine Alberto Hurtado, Cayetano Heredia Peruvian University, Lima, Peru
- TBout Volunteering and Working Group, Cayetano Heredia Peruvian University, Lima, Peru
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Coburn SB, Humes E, Lang R, Stewart C, Hogan BC, Gebo KA, Napravnik S, Edwards JK, Browne LE, Park LS, Justice AC, Gordon K, Horberg MA, Certa JM, Watson E, Jefferson CR, Silverberg M, Skarbinski J, Leyden WA, Williams CF, Althoff KN. COVID-19 infections post-vaccination by HIV status in the United States. medRxiv 2021:2021.12.02.21267182. [PMID: 34909791 PMCID: PMC8669858 DOI: 10.1101/2021.12.02.21267182] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
IMPORTANCE Recommendations for additional doses of COVID vaccine are restricted to people with HIV who have advanced disease or unsuppressed HIV viral load. Understanding SARS-CoV-2 infection risk post-vaccination among PWH is essential for informing vaccination guidelines. OBJECTIVE Estimate the risk of breakthrough infections among fully vaccinated people with (PWH) and without (PWoH) HIV in the US. DESIGN SETTING AND PARTICIPANTS The Corona-Infectious-Virus Epidemiology Team (CIVET)-II cohort collaboration consists of 4 longitudinal cohorts from integrated health systems and academic health centers. Each cohort identified individuals ≥18 years old, in-care, and fully vaccinated for COVID-19 through 30 June 2021. PWH were matched to PWoH on date fully vaccinated, age group, race/ethnicity, and sex at birth. Incidence rates per 1,000 person-years and cumulative incidence of breakthrough infections with 95% confidence intervals ([,]) were estimated by HIV status. Cox proportional hazards models estimated adjusted hazard ratios (aHR) of breakthrough infections by HIV status adjusting for demographic factors, prior COVID-19 illness, vaccine type (BNT162b2, [Pfizer], mRNA-1273 [Moderna], Jansen Ad26.COV2.S [J&J]), calendar time, and cohort. Risk factors for breakthroughs among PWH, were also investigated. EXPOSURE HIV infection. OUTCOME COVID-19 breakthrough infections, defined as laboratory evidence of SARS-CoV-2 infection or COVID-19 diagnosis after an individual was fully vaccinated. RESULTS Among 109,599 individuals (31,840 PWH and 77,759 PWoH), the rate of breakthrough infections was higher in PWH versus PWoH: 44 [41, 48] vs. 31 [29, 33] per 1,000 person-years. Cumulative incidence at 210 days after date fully vaccinated was low, albeit higher in PWH versus PWoH overall (2.8% versus 2.1%, log-rank p<0.001, risk difference=0.7% [0.4%, 1.0%]) and within each vaccine type. Breakthrough infection risk was 41% higher in PWH versus PWoH (aHR=1.41 [1.28, 1.56]). Among PWH, younger age (18-24 versus 45-54), history of COVID-19 prior to fully vaccinated date, and J&J vaccination (versus Pfizer) were associated with increased risk of breakthroughs. There was no association of breakthrough with HIV viral load suppression or CD4 count among PWH. CONCLUSIONS AND RELEVANCE COVID-19 vaccination is effective against infection with SARS-CoV-2 strains circulating through 30 Sept 2021. PWH have an increased risk of breakthrough infections compared to PWoH. Recommendations for additional vaccine doses should be expanded to all PWH.
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Affiliation(s)
- Sally B Coburn
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Elizabeth Humes
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Raynell Lang
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
- Department of Medicine, University of Calgary, Calgary, Canada
| | - Cameron Stewart
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Brenna C Hogan
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Kelly A Gebo
- Department of Medicine, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - Sonia Napravnik
- Department of Medicine, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Jessie K Edwards
- Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Lindsay E Browne
- Department of Medicine, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Lesley S Park
- Stanford Center for Population Health Sciences, Palo Alto, CA, USA
| | - Amy C Justice
- Department of Health Policy and Management, Yale School of Public Health, New Haven, CT, USA
- Department of Medicine, Yale School of Medicine, New Haven, CT, USA
- VA Connecticut Healthcare System, West Haven, CT, USA
| | - Kirsha Gordon
- Department of Medicine, Yale School of Medicine, New Haven, CT, USA
- VA Connecticut Healthcare System, West Haven, CT, USA
| | - Michael A Horberg
- Kaiser Permanente Mid-Atlantic Permanente Research Institute, Rockville, MD, USA
| | - Julia M Certa
- Kaiser Permanente Mid-Atlantic Permanente Research Institute, Rockville, MD, USA
| | - Eric Watson
- Kaiser Permanente Mid-Atlantic Permanente Research Institute, Rockville, MD, USA
| | - Celeena R Jefferson
- Kaiser Permanente Mid-Atlantic Permanente Research Institute, Rockville, MD, USA
| | - Michael Silverberg
- Kaiser Permanente Northern California, Division of Research, Oakland CA, USA
| | - Jacek Skarbinski
- Kaiser Permanente Northern California, Division of Research, Oakland CA, USA
- Department of Infectious Diseases, Oakland Medical Center, Oakland CA, USA
| | - Wendy A Leyden
- Kaiser Permanente Northern California, Division of Research, Oakland CA, USA
| | - Carolyn F Williams
- Epidemiology Branch, Division of AIDS at National Institute of Allergy and Infectious Diseases (NIAID), National Institute of Health (NIH), Rockville, MD, USA
| | - Keri N Althoff
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
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Abstract
Background COVID-19 continues to impose significant morbidity and mortality in Japan even after implementing the vaccination program. It would remain elusive if restrictions for its mitigation were to be lifted or relaxed in the future. Methods A simulation study that explored possible vaccination coverage scenarios and changes in the intensity of nonpharmaceutical intervention restrictions was performed to assess the impact of COVID-19 based on death count. Results Assuming the basic reproduction number of circulating viruses was 5.0, vaccines could prevent 90% of infections and 95% of deaths, and the vaccination coverage rate was high (75%, 80%, and 90% in people aged 12-39 years, 40-59 years, ≥60 years, respectively), approximately 50 000 deaths would occur over 150 days in Japan if all restrictions were lifted. Most deaths would occur among older adults, even if their vaccination coverage was assumed to be especially high. A low vaccination coverage scenario (45%, 60%, and 80% in people aged 12-39 years, 40-59 years, ≥60 years, respectively) would require periodic implementation of strict measures even if the modified lifestyle observed in 2020 was sustained and vaccines were very effective. Some restrictions could be relaxed under high vaccination coverage. However, in the worst-case scenario where vaccines had decreased efficacy, as we have observed for the Delta variant, and people lived a relaxed lifestyle, our simulation suggests that even high vaccination coverage would occasionally require strict measures. Conclusions We should carefully explore a manageable degree of restrictions and their relaxation. We will have to keep bracing for occasional surges of COVID-19 infection, which could lead to strict measures, such as those under a state of emergency. Such strategies are essential even after a wide rollout of vaccination.
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Affiliation(s)
- Yuki Furuse
- Institute for Frontier Life and Medical Sciences, Kyoto University, Kyoto, Japan.,Hakubi Center for Advanced Research, Kyoto University, Kyoto, Japan.,Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
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42
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Prato' S, Paladino ME, Riva MA, Belingheri M. COVID-19 Vaccination and Asymptomatic Infection: Effect of BNT162b2 mRNA Vaccine on the Incidence of COVID-19 and Duration of Sick Leave Among Healthcare Workers. J Occup Environ Med 2021; 63:e868-e870. [PMID: 34538839 PMCID: PMC8630929 DOI: 10.1097/jom.0000000000002389] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
OBJECTIVE To determine the incidence of COVID-19 and the duration of sick leave among asymptomatic healthcare workers (HCWs) after vaccination with BNT162b2. METHODS From October 2020 to March 2021, we determined the incidence of COVID-19 in a cohort of 671 asymptomatic HCWs before and after the vaccination. We also analyzed the days required to obtain a negative RT-PCR result after infection. RESULTS Prior to vaccination 105 (15.6%) HCWs were positive. Positive cases were reduced to 42 (7.5%) after the vaccination period (P < 0.0001). A negative RT-PCR was observed at the first control in 80% of vaccinated HCWs and only in 37% before vaccination. CONCLUSIONS Even in case of asymptomatic infection, vaccinated HCWs have a reduced incidence and a shorter period of sick leave than before vaccination, suggesting vaccination impacts on the sustainability of the health system and labor costs.
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Affiliation(s)
- Simone Prato'
- Unit of Occupational Health, San Gerardo Hospital, Monza, Italy (Dr Prato', Dr Paladino, Dr Riva, and Dr Belingheri); School of Specialization in Occupational Health, University of Milan, Milano, Italy (Dr Prato'); School of Medicine and Surgery, University of Milano-Bicocca, Milano, Italy (Dr Paladino, Dr Riva, and Dr Belingheri)
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43
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Trunfio M, Verga F, Ghisetti V, Burdino E, Emanuele T, Bonora S, Di Perri G, Calcagno A. Clinical Phenotype and Contagiousness of Early Breakthrough SARS-CoV-2 Infections after BNT162b2 COVID-19 mRNA Vaccine: A Parallel Cohort Study in Healthcare Workers. Vaccines (Basel) 2021; 9:vaccines9121377. [PMID: 34960123 PMCID: PMC8705309 DOI: 10.3390/vaccines9121377] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Revised: 11/19/2021] [Accepted: 11/20/2021] [Indexed: 01/19/2023] Open
Abstract
We evaluated the clinical protection of BNT162b2 mRNA vaccine in healthcare workers (HCWs) and how COVID-19 manifestations and contagiousness change as the time since first dose increases. A matched (1:2 ratio) parallel cohort study was performed. During the first three months of vaccination campaign, HCWs of the entire health district ASL Città di Torino (Turin, Italy) were classified according to SARS-CoV-2-positivity in respect of the vaccination schedule: post-first-dose (fHCWs, <12 days), partially (PHCWs, ≥12 from first dose to ≤7 days after the second), and totally vaccinated (THCWs, ≥8 days after the second dose). Age-/sex-matched unvaccinated controls were randomly selected from all the SARS-CoV-2-positivity detected in the same district and period. Previous infections were excluded. Clinical and virologic data (ORF1ab gene cycle threshold values, Ct) were recorded. In total, 6800 HCWs received at least one dose, and 55 tested positive subsequently: 20 fHCWs, 25 PHCWs, 10 THCWs. Furthermore, 21.8% of breakthrough infections were in male, with a median age of 49 years (32–56), and 51.4% occurred while SARS-CoV-2 B.1.1.7 variant was predominant. The incident relative risk was 0.13 (0.12–0.15) for PHCWs and 0.06 (0.05–0.07) for THCWs. Compared to controls (n = 110), no difference was observed in fHCWs, while PHCWs and THCWs showed higher prevalence of asymptomatic infections, fewer signs/symptoms with a milder systemic involvement, and significantly higher Ct values (PHCWs 30.3 (24.1–35.5) vs. 22.3 (19.6–30.6), p = 0.023; THCWs 35.0 (31.3–35.9) vs. 22.5 (18.2–30.6), p = 0.024). Duration of symptoms was also shorter in THCWs (5 days (3–6) vs. 9 (7–14), p = 0.028). A linear increase of 3.81 points in Ct values was observed across the groups by vaccination status (p = 0.001) after adjusting for age, sex, comorbidities, and time between COVID-19 onset and swab collection. BNT162b2 decreased the risk of PCR-confirmed infections and severe disease, and was associated with a virologic picture of lesser epidemiologic concern as soon as 12 days after the first vaccine dose.
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Affiliation(s)
- Mattia Trunfio
- Unit of Infectious Diseases, Department of Medical Sciences, Amedeo di Savoia Hospital, University of Torino, Corso Svizzera 164, 10159 Torino, Italy; (S.B.); (G.D.P.); (A.C.)
- Correspondence: ; Tel.: +39-011-439-3884
| | - Federica Verga
- Occupational Medicine Unit, Maria Vittoria Hospital, 10159 Torino, Italy; (F.V.); (T.E.)
| | - Valeria Ghisetti
- Microbiology and Molecular Biology Unit, Amedeo di Savoia Hospital, 10159 Torino, Italy; (V.G.); (E.B.)
| | - Elisa Burdino
- Microbiology and Molecular Biology Unit, Amedeo di Savoia Hospital, 10159 Torino, Italy; (V.G.); (E.B.)
| | - Teresa Emanuele
- Occupational Medicine Unit, Maria Vittoria Hospital, 10159 Torino, Italy; (F.V.); (T.E.)
| | - Stefano Bonora
- Unit of Infectious Diseases, Department of Medical Sciences, Amedeo di Savoia Hospital, University of Torino, Corso Svizzera 164, 10159 Torino, Italy; (S.B.); (G.D.P.); (A.C.)
| | - Giovanni Di Perri
- Unit of Infectious Diseases, Department of Medical Sciences, Amedeo di Savoia Hospital, University of Torino, Corso Svizzera 164, 10159 Torino, Italy; (S.B.); (G.D.P.); (A.C.)
| | - Andrea Calcagno
- Unit of Infectious Diseases, Department of Medical Sciences, Amedeo di Savoia Hospital, University of Torino, Corso Svizzera 164, 10159 Torino, Italy; (S.B.); (G.D.P.); (A.C.)
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44
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Guo C, Peng Y, Lin L, Pan X, Fang M, Zhao Y, Bao K, Li R, Han J, Chen J, Song TZ, Feng XL, Zhou Y, Zhao G, Zhang L, Zheng Y, Zhu P, Hang H, Zhang L, Hua Z, Deng H, Hou B. A pathogen-like antigen-based vaccine confers immune protection against SARS-CoV-2 in non-human primates. Cell Rep Med 2021; 2:100448. [PMID: 34723223 PMCID: PMC8536523 DOI: 10.1016/j.xcrm.2021.100448] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Revised: 07/21/2021] [Accepted: 10/18/2021] [Indexed: 01/19/2023]
Abstract
Activation of nucleic acid sensing Toll-like receptors (TLRs) in B cells is involved in antiviral responses by promoting B cell activation and germinal center responses. In order to take advantage of this natural pathway for vaccine development, synthetic pathogen-like antigens (PLAs) constructed of multivalent antigens with encapsulated TLR ligands can be used to activate B cell antigen receptors and TLRs in a synergistic manner. Here we report a PLA-based coronavirus disease 2019 (COVID-19) vaccine candidate designed by combining a phage-derived virus-like particle carrying bacterial RNA as TLR ligands with the receptor-binding domain of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) S protein as the target antigen. This PLA-based vaccine candidate induces robust neutralizing antibodies in both mice and non-human primates (NHPs). Using a NHP infection model, we demonstrate that the viral clearance is accelerated in vaccinated animals. In addition, the PLA-based vaccine induces a T helper 1 (Th1)-oriented response and a durable memory, supporting its potential for further clinical development. AP205-RBD elicits neutralizing antibodies against SARS-CoV-2 in mice and macaques AP205-RBD induces Th1-oriented immune response and durable memory Vaccination of AP205-RBD accelerates viral clearance in infected macaques
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Affiliation(s)
- Chang Guo
- CAS Key Laboratory of Infection and Immunity, Institute of Biophysics, Chinese Academy of Sciences, Beijing 100101, China.,CAS Center for Excellence in Biomacromolecules, Institute of Biophysics, Chinese Academy of Sciences, Beijing 100101, China.,University of Chinese Academy of Sciences, Beijing 100049, China
| | - Yanan Peng
- CAS Key Laboratory of Infection and Immunity, Institute of Biophysics, Chinese Academy of Sciences, Beijing 100101, China.,CAS Center for Excellence in Biomacromolecules, Institute of Biophysics, Chinese Academy of Sciences, Beijing 100101, China
| | - Lin Lin
- CAS Key Laboratory of Infection and Immunity, Institute of Biophysics, Chinese Academy of Sciences, Beijing 100101, China.,CAS Center for Excellence in Biomacromolecules, Institute of Biophysics, Chinese Academy of Sciences, Beijing 100101, China
| | - Xiaoyan Pan
- State Key Laboratory of Virology, Wuhan Institute of Virology, Center for Biosafety Mega-Science, Chinese Academy of Sciences, Wuhan, Hubei 430071, China
| | - Mengqi Fang
- Comprehensive AIDS Research Center, Beijing Advanced Innovation Center for Structural Biology, School of Medicine and Vanke School of Public Health, Tsinghua University, Beijing 100084, China
| | - Yun Zhao
- Key Laboratory for Protein and Peptide Pharmaceuticals, National Laboratory of Biomacromolecules, Institute of Biophysics, Chinese Academy of Sciences, Beijing 100101, China
| | - Keyan Bao
- CAS Center for Excellence in Biomacromolecules, Institute of Biophysics, Chinese Academy of Sciences, Beijing 100101, China
| | - Runhan Li
- CAS Key Laboratory of Infection and Immunity, Institute of Biophysics, Chinese Academy of Sciences, Beijing 100101, China.,CAS Center for Excellence in Biomacromolecules, Institute of Biophysics, Chinese Academy of Sciences, Beijing 100101, China.,University of Chinese Academy of Sciences, Beijing 100049, China
| | - Jianbao Han
- National High-level Bio-safety Research Center for Non-human Primates, Center for Biosafety Mega-Science, Kunming Institute of Zoology, Chinese Academy of Sciences, Kunming 650107, China
| | - Jiaorong Chen
- CAS Key Laboratory of Infection and Immunity, Institute of Biophysics, Chinese Academy of Sciences, Beijing 100101, China.,CAS Center for Excellence in Biomacromolecules, Institute of Biophysics, Chinese Academy of Sciences, Beijing 100101, China.,University of Chinese Academy of Sciences, Beijing 100049, China
| | - Tian-Zhang Song
- National High-level Bio-safety Research Center for Non-human Primates, Center for Biosafety Mega-Science, Kunming Institute of Zoology, Chinese Academy of Sciences, Kunming 650107, China
| | - Xiao-Li Feng
- National High-level Bio-safety Research Center for Non-human Primates, Center for Biosafety Mega-Science, Kunming Institute of Zoology, Chinese Academy of Sciences, Kunming 650107, China
| | - Yahong Zhou
- CAS Key Laboratory of Infection and Immunity, Institute of Biophysics, Chinese Academy of Sciences, Beijing 100101, China.,CAS Center for Excellence in Biomacromolecules, Institute of Biophysics, Chinese Academy of Sciences, Beijing 100101, China
| | - Gan Zhao
- Advaccine Biopharmaceuticals (Suzhou), Suzhou 215000, China
| | - Leike Zhang
- State Key Laboratory of Virology, Wuhan Institute of Virology, Center for Biosafety Mega-Science, Chinese Academy of Sciences, Wuhan, Hubei 430071, China
| | - Yongtang Zheng
- National High-level Bio-safety Research Center for Non-human Primates, Center for Biosafety Mega-Science, Kunming Institute of Zoology, Chinese Academy of Sciences, Kunming 650107, China
| | - Ping Zhu
- CAS Center for Excellence in Biomacromolecules, Institute of Biophysics, Chinese Academy of Sciences, Beijing 100101, China.,University of Chinese Academy of Sciences, Beijing 100049, China
| | - Haiying Hang
- University of Chinese Academy of Sciences, Beijing 100049, China.,Key Laboratory for Protein and Peptide Pharmaceuticals, National Laboratory of Biomacromolecules, Institute of Biophysics, Chinese Academy of Sciences, Beijing 100101, China
| | - Linqi Zhang
- Comprehensive AIDS Research Center, Beijing Advanced Innovation Center for Structural Biology, School of Medicine and Vanke School of Public Health, Tsinghua University, Beijing 100084, China
| | - Zhaolin Hua
- CAS Key Laboratory of Infection and Immunity, Institute of Biophysics, Chinese Academy of Sciences, Beijing 100101, China.,CAS Center for Excellence in Biomacromolecules, Institute of Biophysics, Chinese Academy of Sciences, Beijing 100101, China.,University of Chinese Academy of Sciences, Beijing 100049, China
| | - Hongyu Deng
- CAS Key Laboratory of Infection and Immunity, Institute of Biophysics, Chinese Academy of Sciences, Beijing 100101, China.,CAS Center for Excellence in Biomacromolecules, Institute of Biophysics, Chinese Academy of Sciences, Beijing 100101, China.,University of Chinese Academy of Sciences, Beijing 100049, China
| | - Baidong Hou
- CAS Key Laboratory of Infection and Immunity, Institute of Biophysics, Chinese Academy of Sciences, Beijing 100101, China.,CAS Center for Excellence in Biomacromolecules, Institute of Biophysics, Chinese Academy of Sciences, Beijing 100101, China.,University of Chinese Academy of Sciences, Beijing 100049, China
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Adamson PC, Pfeffer MA, Arboleda VA, Garner OB, de St Maurice A, von Bredow B, Flint J, Kruglyak L, Currier JS. Lower Severe Acute Respiratory Syndrome Coronavirus 2 Viral Shedding Following Coronavirus Disease 2019 Vaccination Among Healthcare Workers in Los Angeles, California. Open Forum Infect Dis 2021; 8:ofab526. [PMID: 35005055 PMCID: PMC8689969 DOI: 10.1093/ofid/ofab526] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Accepted: 10/13/2021] [Indexed: 11/13/2022] Open
Abstract
Among 880 healthcare workers with a positive severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) test, 264 (30.0%) infections were identified following receipt of at least 1 vaccine dose. Median SARS-CoV-2 cycle threshold values were highest among individuals receiving 2 vaccine doses, corresponding to lower viral shedding. Vaccination might lead to lower transmissibility of SARS-CoV-2.
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Affiliation(s)
- Paul C Adamson
- Division of Infectious Diseases, Department of Medicine, David Geffen School of Medicine at UCLA, Los Angeles, California, USA
| | - Michael A Pfeffer
- Department of Medicine/Department of Information Services and Solutions, David Geffen School of Medicine at UCLA, Los Angeles, California, USA
| | - Valerie A Arboleda
- Department of Pathology and Laboratory Medicine, David Geffen School of Medicine at UCLA, Los Angeles, California, USA
- Department of Human Genetics, David Geffen School of Medicine at UCLA, Los Angeles, California, USA
| | - Omai B Garner
- Department of Pathology and Laboratory Medicine, David Geffen School of Medicine at UCLA, Los Angeles, California, USA
| | - Annabelle de St Maurice
- Division of Pediatric Infectious Diseases, Department of Pediatrics, David Geffen School of Medicine at UCLA, Los Angeles, California, USA
| | - Benjamin von Bredow
- Department of Pathology and Laboratory Medicine, David Geffen School of Medicine at UCLA, Los Angeles, California, USA
| | - Jonathan Flint
- Department of Human Genetics, David Geffen School of Medicine at UCLA, Los Angeles, California, USA
- Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at UCLA, Los Angeles, California, USA
| | - Leonid Kruglyak
- Department of Human Genetics, David Geffen School of Medicine at UCLA, Los Angeles, California, USA
- Howard Hughes Medical Institute, David Geffen School of Medicine at UCLA, Los Angeles, California, USA
- Department of Biological Chemistry, David Geffen School of Medicine at UCLA, Los Angeles, California, USA
| | - Judith S Currier
- Division of Infectious Diseases, Department of Medicine, David Geffen School of Medicine at UCLA, Los Angeles, California, USA
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Linsenmeyer K, Charness ME, O’Brien WJ, Strymish J, Doshi SJ, Ljaamo SK, Gupta K. Vaccination Status and the Detection of SARS-CoV-2 Infection in Health Care Personnel Under Surveillance in Long-term Residential Facilities. JAMA Netw Open 2021; 4:e2134229. [PMID: 34757413 PMCID: PMC8581724 DOI: 10.1001/jamanetworkopen.2021.34229] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
This cohort study examines the association of vaccination status and detection of SARS-CoV-2 infection in health care personnel at long-term residential facilities.
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Muhsen K, Maimon N, Mizrahi A, Bodenneimer O, Cohen D, Maimon M, Grotto I, Dagan R. Effectiveness of BNT162b2 mRNA Coronavirus Disease 2019 (COVID-19) Vaccine Against Acquisition of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Among Healthcare Workers in Long-Term Care Facilities: A Prospective Cohort Study. Clin Infect Dis 2021; 75:e755-e763. [PMID: 34698808 PMCID: PMC8675294 DOI: 10.1093/cid/ciab918] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2021] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND We assessed vaccine effectiveness (VE) of BNT162b2 mRNA coronavirus disease 2019 (COVID-19) vaccine against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) acquisition among healthcare workers (HCWs) of long-term care facilities (LTCFs). METHODS This prospective study, in the framework of the "Senior Shield" program in Israel, included routine weekly nasopharyngeal SARS-CoV-2 RT-PCR testing from all LTCF HCWs since July 2020. All residents and 75% of HCWs were immunized between December 2020 and January 2021. The analysis was limited to HCWs adhering to routine testing. Fully vaccinated (14+ days after second dose; n = 6960) and unvaccinated (n = 2202) HCWs were simultaneously followed until SARS-CoV-2 acquisition or end of follow-up, 11 April 2021. Hazard ratios (HRs) for vaccination versus no vaccination were calculated (Cox proportional hazards regression models, adjusting for sociodemographics and residential-area COVID-19 incidence). VE was calculated as (1- HR) × 100. RT-PCR cycle threshold (Ct) values were compared between vaccinated and unvaccinated HCWs. RESULTS At >14 days post-second dose, 40 vaccinated HCWs acquired SARS-CoV-2 (median follow-up, 66 days; cumulative incidence, 0.6%) versus 84 unvaccinated HCWs (median follow-up, 43 days; cumulative incidence, 5.1%) (HR, .11; 95% CI, .07-.17; unadjusted VE, 89%; 95% CI, 83-93%). Adjusted VE >7 and >14 days post-second dose were similar. The median PCR Ct targeting the ORF1ab gene among 20 vaccinated and 40 unvaccinated HCWs was 32.0 versus 26.7, respectively (P value = .008). CONCLUSIONS VE following 2 doses of BNT162b2 against SARS-CoV-2 acquisition in LTCF HCWs was high. The lower viral loads among SARS-CoV-2-positive HCWs suggest further reduction in transmission.
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Affiliation(s)
- Khitam Muhsen
- Department of Epidemiology and Preventive Medicine, School
of Public Health, the Sackler Faculty, Tel Aviv University, Ramat
Aviv, Tel Aviv, 6139001, Israel,Corresponding author: Prof. Khitam Muhsen (PhD), Department of
Epidemiology and Preventive Medicine, School of Public Health, the Sackler
Faculty, Tel Aviv University, Tel Aviv, 6139001, Israel.
| | - Nimrod Maimon
- Israel Ministry of Health, "Senior Shield"
Project, Israel
| | - Ami Mizrahi
- Israel Ministry of Health, "Senior Shield"
Project, Israel
| | | | - Dani Cohen
- Department of Epidemiology and Preventive Medicine, School
of Public Health, the Sackler Faculty, Tel Aviv University, Ramat
Aviv, Tel Aviv, 6139001, Israel
| | - Michal Maimon
- Faculty of Health Sciences, Ben-Gurion University of the
Negev, Beer-Sheva, Israel,Soroka University Medical Center,
Beer-Sheva, Israel
| | - Itamar Grotto
- Faculty of Health Sciences, Ben-Gurion University of the
Negev, Beer-Sheva, Israel,Ministry of Health, Jerusalem, Israel
| | - Ron Dagan
- Faculty of Health Sciences, Ben-Gurion University of the
Negev, Beer-Sheva, Israel,Alternate Corresponding author: Prof. Ron Dagan (MD), Faculty of
Health Sciences, Ben-Gurion University, Beer-Sheva, Israel,
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Marra AR, Kobayashi T, Suzuki H, Alsuhaibani M, Tofaneto BM, Bariani LM, de Amorim Auler M, Salinas JL, Edmond MB, Pinho JRR, Rizzo LV, Schweizer ML. The short-term effectiveness of coronavirus disease 2019 (COVID-19) vaccines among healthcare workers: a systematic literature review and meta-analysis. ASHE 2021; 1. [PMID: 36168453 PMCID: PMC9495770 DOI: 10.1017/ash.2021.195] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Revised: 08/25/2021] [Accepted: 08/27/2021] [Indexed: 01/19/2023]
Abstract
Abstract
Objective:
Healthcare workers (HCWs) are at risk of COVID-19 due to high levels of SARS-CoV-2 exposure. Thus, effective vaccines are needed. We performed a systematic literature review and meta-analysis on COVID-19 short-term vaccine effectiveness among HCWs.
Methods:
We searched PubMed, CINAHL, EMBASE, Cochrane Central Register of Controlled Trials, Scopus, and Web of Science from December 2019 to June 11, 2021, for studies evaluating vaccine effectiveness against symptomatic COVID-19 among HCWs. To meta-analyze the extracted data, we calculated the pooled diagnostic odds ratio (DOR) for COVID-19 between vaccinated and unvaccinated HCWs. Vaccine effectiveness was estimated as 100% × (1 − DOR). We also performed a stratified analysis for vaccine effectiveness by vaccination status: 1 dose and 2 doses of the vaccine.
Results:
We included 13 studies, including 173,742 HCWs evaluated for vaccine effectiveness in the meta-analysis. The vast majority (99.9%) of HCWs were vaccinated with the Pfizer/BioNTech COVID-19 mRNA vaccine. The pooled DOR for symptomatic COVID-19 among vaccinated HCWs was 0.072 (95% confidence interval [CI], 0.028–0.184) with an estimated vaccine effectiveness of 92.8% (95% CI, 81.6%–97.2%). In stratified analyses, the estimated vaccine effectiveness against symptomatic COVID-19 among HCWs who had received 1 dose of vaccine was 82.1% (95% CI, 46.1%–94.1%) and the vaccine effectiveness among HCWs who had received 2 doses was 93.5% (95% CI, 82.5%–97.6%).
Conclusions:
The COVID-19 mRNA vaccines are highly effective against symptomatic COVID-19, even with 1 dose. More observational studies are needed to evaluate the vaccine effectiveness of other COVID-19 vaccines, COVID-19 breakthrough after vaccination, and vaccine efficacy against new variants.
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49
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Robilotti EV, Whiting K, Lucca A, Poon C, Guest R, McMillen T, Jani K, Solovyov A, Kelson S, Browne K, Freeswick S, Hohl TM, Korenstein D, Ruchnewitz D, Lässig M, Łuksza M, Greenbaum B, Seshan VE, Esther Babady N, Kamboj M. Clinical and Genomic Characterization of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS CoV-2) Infections in mRNA Vaccinated Health Care Personnel in New York City. Clin Infect Dis 2021; 75:e774-e782. [PMID: 34644393 PMCID: PMC9612794 DOI: 10.1093/cid/ciab886] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2021] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND Vaccine-induced clinical protection against severe acute respiratory syndrome coronavirus 2 (SARS CoV-2) variants is an evolving target. There are limited genomic level data on SARS CoV-2 breakthrough infections and vaccine effectiveness (VE) since the global spread of the B.1.617.2 (Delta) variant. METHODS In a retrospective study from 1 November 2020 to 31 August 2021, divided as pre-Delta and Delta-dominant periods, laboratory-confirmed SARS CoV-2 infections among healthcare personnel (HCP) at a large tertiary cancer center in New York City were examined to compare the weekly infection rate-ratio in vaccinated, partially vaccinated, and unvaccinated HCP. We describe the clinical and genomic epidemiologic features of post-vaccine infections to assess for selection of variants of concern (VOC)/variants of interest (VOI) in the early post-vaccine period and impact of B.1.617.2 (Delta) variant domination on VE. RESULTS Among 13658 HCP in our cohort, 12379 received at least 1 dose of a messenger RNA (mRNA) vaccine. In the pre-Delta period overall VE was 94.5%. Whole genome sequencing (WGS) of 369 isolates in the pre-Delta period did not reveal a clade bias for VOC/VOI specific to post-vaccine infections. VE in the Delta dominant phase was 75.6%. No hospitalizations occurred among vaccinated HCP in the entire study period, compared to 17 hospitalizations and 1 death among unvaccinated HCP. CONCLUSIONS Findings show high VE among HCP in New York City in the pre-Delta phase, with moderate decline in VE post-Delta emergence. SARS CoV-2 clades were similarly distributed among vaccinated and unvaccinated infected HCP without apparent clustering during the pre-Delta period of diverse clade circulation. Strong vaccine protection against hospitalization was maintained through the entire study period.
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Affiliation(s)
| | | | - Anabella Lucca
- Infectious Diseases, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York, USA,Employee Health Service, Memorial Sloan Kettering Cancer Center, New York, New York, USA,Department of Medicine, Joan and Sanford Weill Medical College of Cornell University, New York, New York, USA
| | - Chester Poon
- Division of Digital Informatics and Technology Solutions, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Rebecca Guest
- Employee Health Service, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Tracy McMillen
- Clinical Microbiology Service, Department of Laboratory Medicine, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Krupa Jani
- Clinical Microbiology Service, Department of Laboratory Medicine, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Alexander Solovyov
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Suzanne Kelson
- Division of Digital Products and Informatics, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Kevin Browne
- Department of Nursing, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Scott Freeswick
- Division of Pharmacy, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Tobias M Hohl
- Infectious Diseases, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York, USA,Department of Medicine, Joan and Sanford Weill Medical College of Cornell University, New York, New York, USA
| | - Deborah Korenstein
- Department of Medicine, Joan and Sanford Weill Medical College of Cornell University, New York, New York, USA,Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Denis Ruchnewitz
- Institute for Biological Physics, University of Cologne, Cologne, Germany
| | - Michael Lässig
- Institute for Biological Physics, University of Cologne, Cologne, Germany
| | - Marta Łuksza
- Department of Oncological Sciences, Icahn School of Medicine at Mount Sinai, New York, New York, USA,Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Benjamin Greenbaum
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, New York, USA,Department of Physiology, Biophysics and Systems Biology, Weill Cornell Medicine, New York, New York, USA
| | - Venkatraman E Seshan
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - N Esther Babady
- Infectious Diseases, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York, USA,Clinical Microbiology Service, Department of Laboratory Medicine, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Mini Kamboj
- Correspondence: M. Kamboj, 1275 York Ave, New York, NY 10065 ()
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Rosano G, Jankowska EA, Ray R, Metra M, Abdelhamid M, Adamopoulos S, Anker SD, Bayes‐Genis A, Belenkov Y, Gal TB, Böhm M, Chioncel O, Cohen‐Solal A, Farmakis D, Filippatos G, González A, Gustafsson F, Hill L, Jaarsma T, Jouhra F, Lainscak M, Lambrinou E, Lopatin Y, Lund LH, Milicic D, Moura B, Mullens W, Piepoli MF, Ponikowski P, Rakisheva A, Ristic A, Savarese G, Seferovic P, Senni M, Thum T, Tocchetti CG, Van Linthout S, Volterrani M, Coats AJ. COVID-19 vaccination in patients with heart failure: a position paper of the Heart Failure Association of the European Society of Cardiology. Eur J Heart Fail 2021; 23:1806-1818. [PMID: 34612556 PMCID: PMC8652673 DOI: 10.1002/ejhf.2356] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2021] [Revised: 09/08/2021] [Accepted: 09/28/2021] [Indexed: 01/19/2023] Open
Abstract
Patients with heart failure (HF) who contract SARS‐CoV‐2 infection are at a higher risk of cardiovascular and non‐cardiovascular morbidity and mortality. Regardless of therapeutic attempts in COVID‐19, vaccination remains the most promising global approach at present for controlling this disease. There are several concerns and misconceptions regarding the clinical indications, optimal mode of delivery, safety and efficacy of COVID‐19 vaccines for patients with HF. This document provides guidance to all healthcare professionals regarding the implementation of a COVID‐19 vaccination scheme in patients with HF. COVID‐19 vaccination is indicated in all patients with HF, including those who are immunocompromised (e.g. after heart transplantation receiving immunosuppressive therapy) and with frailty syndrome. It is preferable to vaccinate against COVID‐19 patients with HF in an optimal clinical state, which would include clinical stability, adequate hydration and nutrition, optimized treatment of HF and other comorbidities (including iron deficiency), but corrective measures should not be allowed to delay vaccination. Patients with HF who have been vaccinated against COVID‐19 need to continue precautionary measures, including the use of facemasks, hand hygiene and social distancing. Knowledge on strategies preventing SARS‐CoV‐2 infection (including the COVID‐19 vaccination) should be included in the comprehensive educational programmes delivered to patients with HF.
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Affiliation(s)
| | - Ewa A. Jankowska
- Institute of Heart DiseasesWrocław Medical UniversityWrocławPoland
| | - Robin Ray
- Cardiology Clinical Academic GroupMolecular and Clinical Sciences Research Institute, St George's, University of London, St George's HospitalLondonUK
| | - Marco Metra
- Institute of CardiologyASST Spedali Civili di Brescia and Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of BresciaBresciaItaly
| | - Magdy Abdelhamid
- Faculty of Medicine, Kasr Al Ainy, Department of CardiologyCairo UniversityGizaEgypt
| | - Stamatis Adamopoulos
- Heart Failure ‐ Transplant ‐ Mechanical Circulatory Support UnitOnassis Cardiac Surgery CenterAthensGreece
| | - Stefan D. Anker
- Department of Cardiology (CVK)and Berlin Institute of Health Center for Regenerative Therapies (BCRT), German Centre for Cardiovascular Research (DZHK) partner site Berlin, Charité UniversitätsmedizinBerlinGermany
| | - Antoni Bayes‐Genis
- Heart Institute, Hospital Universitari Germans Trias i Pujol, Badalona & CIBERCV, Instituto de Salud Carlos IIIMadridSpain
| | - Yury Belenkov
- I.M. Sechenov First Moscow State Medical University (Sechenov University)MoscowRussia
| | - Tuvia B. Gal
- Department of Cardiology, Rabin Medical CenterPetah Tikva, Israel, & Sackler Faculty of Medicine, Tel Aviv UniversityTel AvivIsrael
| | - Michael Böhm
- Universitätsklinikum des Saarlandes, Klinik für Innere Medizin III, Saarland University, Kardiologie, Angiologie und Internistische IntensivmedizinHomburg/SaarGermany
| | - Ovidiu Chioncel
- Emergency Institute for Cardiovascular Diseases ‘Prof. C.C. Iliescu’, University of Medicine Carol DavilaBucharestRomania
| | - Alain Cohen‐Solal
- UMR‐S 942 Research UnitParis University, Lariboisiere Hospital, Cardiology Department, AP‐HPParisFrance
| | | | - Gerasimos Filippatos
- National and Kapodistrian University of Athens, School of Medicine, University Hospital AttikonAthensGreece
| | - Arantxa González
- Program of Cardiovascular Diseases, CIMA Universidad de Navarra, IdiSNA and CIBERCVPamplonaSpain
| | - Finn Gustafsson
- Department of CardiologyUniversity of CopenhagenCopenhagenDenmark
| | - Loreena Hill
- School of Nursing & Midwifery, Queen's University, BelfastNorthern IrelandUK
| | - Tiny Jaarsma
- Department of Health, Medicine and Caring Sciences, Linköping UniversityLinköpingSweden
| | - Fadi Jouhra
- Cardiology Clinical Academic GroupMolecular and Clinical Sciences Research Institute, St George's, University of London, St George's HospitalLondonUK
| | - Mitja Lainscak
- Division of CardiologyGeneral Hospital Murska Sobota, Murska Sobota, Slovenia, & Faculty of Medicine, University of LjubljanaLjubljanaSlovenia
| | - Ekaterini Lambrinou
- Department of NursingSchool of Health Sciences, Cyprus University of TechnologyLimassolCyprus
| | - Yury Lopatin
- Volgograd State Medical University, Regional Cardiology CentreVolgogradRussian Federation
| | - Lars H. Lund
- Department of MedicineKarolinska Institutet, and Heart and Vascular Theme, Karolinska University HospitalStockholmSweden
| | - Davor Milicic
- University of Zagreb School of MedicineZagrebCroatia
| | - Brenda Moura
- Armed Forces Hospital, Porto, & Faculty of Medicine, University of PortoPortoPortugal
| | - Wilfried Mullens
- Cardiovascular Physiology, Hasselt University, Belgium, & Heart Failure and Cardiac Rehabilitation Specialist, Ziekenhuis Oost‐LimburgGenkBelgium
| | - Massimo F. Piepoli
- Cardiac UnitGuglielmo da Saliceto Hospital, University of ParmaPiacenzaItaly
| | - Piotr Ponikowski
- Institute of Heart DiseasesWrocław Medical UniversityWrocławPoland
| | - Amina Rakisheva
- Department of CardiologyScientific Institution of Cardiology and Internal DiseasesAlmatyKazakhstan
| | - Arsen Ristic
- Department of CardiologyUniversity Clinical Center of Serbia, Belgrade University School of MedicineBelgradeSerbia
| | - Gianluigi Savarese
- Department of MedicineKarolinska Institutet, and Heart and Vascular Theme, Karolinska University HospitalStockholmSweden
| | - Petar Seferovic
- Department Faculty of MedicineUniversity of Belgrade, Belgrade & Serbian Academy of Sciences and ArtsBelgradeSerbia
| | - Michele Senni
- Cardiovascular Department, Cardiology 1 UnitPapa Giovanni XXIII Hospital Bergamo, University of Milano ‐ BicoccaBergamoItaly
| | - Thomas Thum
- Institute of Molecular and Therapeutic Strategies, Hannover & Fraunhofer Institute of Toxicology and Experimental MedicineHannoverGermany
| | - Carlo G. Tocchetti
- Department of Translational Medical Sciences, Center for Basic and Clinical Immunology Research (CISI), Interdepartmental Center of Clinical and Translational Sciences (CIRCET)Interdepartmental Hypertension Research Center (CIRIAPA), Federico II UniversityNaplesItaly
| | - Sophie Van Linthout
- Berlin Institute of Health at Charité ‐ Universitätmedizin Berlin, BIH Center for Regenerative Therapies, Berlin, German Center for Cardiovascular Research (DZHK), Partner site BerlinBerlinGermany
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