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Beretzky Z, Brodszky V. Sociodemographic determinants of vaccination and willingness to pay for COVID-19 vaccines in Hungary, results of a cross-sectional online questionnaire. BMC Public Health 2024; 24:1320. [PMID: 38755599 PMCID: PMC11097570 DOI: 10.1186/s12889-024-18797-z] [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: 02/15/2024] [Accepted: 05/08/2024] [Indexed: 05/18/2024] Open
Abstract
BACKGROUND Several different coronavirus disease (COVID-19) vaccines were authorized and distributed all over the world, including Hungary, but vaccination rates and acceptance of the different vaccines varied through 2021 and subsequent years. In Hungary Western vaccines and the Chinese and Russian vaccines were available in early 2021. Understanding preference and willingness to pay (WTP) for the COVID-19 vaccine could provide information for policy decision making to control the COVID-19 pandemic. We aimed to assess the socio-demographic factors influencing the COVID-19 vaccination and to analyse individual preferences for the available COVID-19 vaccines in Hungary. METHODS A cross-sectional online questionnaire survey was conducted between 25-05-2021 and 08-06-2021 exploring the vaccine acceptance and WTP for vaccination in the Hungarian general population. To assess the preferences towards the different vaccines available in Hungary at the time of the study, we used a multi-step WTP task. RESULTS Altogether 2,000 respondents filled out our survey, with the average age of 49.1 (SD = 15.3), out of whom 370 respondents (18.5%) stated that they already had a COVID-19 infection. Age above 65 years, male gender, higher level of education, higher income and residence in the capital or county seats were associated with a higher probability of vaccination. The average WTP ranged from 14.2 to 30.3 EUR for the different vaccine types. CONCLUSIONS Males, respondents with higher education and income stated a higher WTP value for all vaccines. Better socioeconomic status increased both vaccination coverage and willingness to pay for vaccines.
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Affiliation(s)
- Zsuzsanna Beretzky
- Department of Health Policy, Corvinus University of Budapest, Fővám Tér 8, 1093, Budapest, Hungary.
| | - Valentin Brodszky
- Department of Health Policy, Corvinus University of Budapest, Fővám Tér 8, 1093, Budapest, Hungary
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Nachlis H, Thomson K. Emergency Regulatory Procedures, Pharmaceutical Regulatory Politics, and the Political Economy of Vaccine Regulation in the COVID-19 Pandemic. J Health Polit Policy Law 2024; 49:73-98. [PMID: 37522337 DOI: 10.1215/03616878-10910278] [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: 08/01/2023]
Abstract
CONTEXT Regulatory approaches to COVID-19 vaccine authorizations varied substantially across countries. Facing a common public health threat, what accounts for regulatory variation? This study focuses on emergency pharmaceutical and vaccine regulatory procedures and whether and how regulators' emergency pharmaceutical regulatory procedures going into the pandemic shaped regulatory processes and decisions during the pandemic. METHODS The authors conducted an analysis of seven high-impact national and international pharmaceutical regulators with case studies from Brazil, China, India, Russia, the United Kingdom, the United States, and the European Medicines Agency. The authors analyzed evidence from primary source executive and legislative branch regulations and statutes as well as national and international scientific and general press reporting; they also drew on the secondary analysis of scholars, practitioners, and international organizations. FINDINGS Inherited emergency pharmaceutical and vaccine regulatory procedures substantially shaped COVID-19 vaccine regulation during the pandemic. Variation in the presence and content of emergency regulatory procedures affected the quality of pandemic regulatory processes, outcomes, and procedural updates and differentially empowered policy-making experts and elected politicians. CONCLUSIONS Emergency regulatory procedures affect key features of regulatory political economy and public health practices during crises. To improve future public health crisis responses, the authors provide policy recommendations for (1) establishing clear emergency pharmaceutical regulatory procedures, and (2) international collaboration.
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Moukafih B, Belaroussi L, Achour S, Kartouti AE. Side Effects Reported by Moroccan Medical Students Who Received COVID-19 Vaccines. Curr Drug Saf 2024; 19:268-276. [PMID: 37138485 DOI: 10.2174/1574886318666230503113713] [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] [Received: 10/22/2022] [Revised: 02/25/2023] [Accepted: 02/28/2023] [Indexed: 05/05/2023]
Abstract
BACKGROUND Low confidence in the safety of COVID-19 vaccines was found to be a key promoter of vaccine reluctance especially among youth. Furthermore, young adults are an important demographic for building herd immunity through vaccination. As a result, their reactions to getting COVID-19 vaccines are crucial in our fight against SARS-CoV-2. OBJECTIVE The overall goal of this study was to look into the shortterm side effects experienced by Moroccan medical and pharmacy students after receiving COVID-19 vaccines. METHODS A cross-sectional survey-based study to assess the COVID-19 vaccines' short-term AEFIs among Moroccan medical and pharmacy students. The validated questionnaire was delivered in a digital form to explore the side effects (SE) they encountered after the first or the second dose of one of three vaccines namely: AstraZeneca Vaxzevria, PfizerBioNTeck, and SinoPharm vaccines. RESULTS There were 510 students in total who took part. After the first and second doses, approximately 72 percent and 78 percent of subjects, respectively, reported no SE. The remainder had localized injection site side effects (26%). Fatigue (21%), fever (19%), headache (17%), and myalgia (16%) were the most common systemic adverse effects after the first dose. There were no serious SEs reported. CONCLUSION The majority of the reported AEFIs in our data were mild to moderate in intensity and lasted only one or two days. COVID-19 vaccinations are highly likely safe for young adults, according to the findings of this study.
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Affiliation(s)
- Badreddine Moukafih
- Central Pharmacy Department, CHU Hassan II, Medical Center for Biomedical and Translational Research, Faculty of Medicine, Pharmacy and dentistry of Fez, Sidi Mohammed Ben Abdellah University, Fez, Morocco
| | - Leila Belaroussi
- Occupational Health Department, CHU Hassan II-Fez, Epidemiology and Health Sciences Research Laboratory, Faculty of Medicine and Pharmacy of Fez, Sidi Mohammed Ben Abdellah University, Fez, Morocco
| | - Sanae Achour
- Toxicology Department, CHU Hassan II, Fez, Medical Center for Biomedical and Translational Research, Faculty of Medicine, Pharmacy and Dentistry of Fez, Sidi Mohammed Ben Abdellah University, Morocco Hospital, Fez, Morocco
| | - Abdeslam El Kartouti
- Pharmacy Service, Moulay Ismaïl Military Hospital, Meknès, Medical Center for Biomedical and Translational Research, Faculty of Medicine, Pharmacy and Dentistry of Fez, Sidi Mohammed Ben Abdellah University, Fez, Morocco
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Ao D, He X, Liu J, Xu L. Strategies for the development and approval of COVID-19 vaccines and therapeutics in the post-pandemic period. Signal Transduct Target Ther 2023; 8:466. [PMID: 38129394 PMCID: PMC10739883 DOI: 10.1038/s41392-023-01724-w] [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] [Received: 08/28/2023] [Revised: 11/24/2023] [Accepted: 12/06/2023] [Indexed: 12/23/2023] Open
Abstract
The spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has resulted in significant casualties and put immense strain on public health systems worldwide, leading to economic recession and social unrest. In response, various prevention and control strategies have been implemented globally, including vaccine and drug development and the promotion of preventive measures. Implementing these strategies has effectively curbed the transmission of the virus, reduced infection rates, and gradually restored normal social and economic activities. However, the mutations of SARS-CoV-2 have led to inevitable infections and reinfections, and the number of deaths continues to rise. Therefore, there is still a need to improve existing prevention and control strategies, mainly focusing on developing novel vaccines and drugs, expediting medical authorization processes, and keeping epidemic surveillance. These measures are crucial to combat the Coronavirus disease (COVID-19) pandemic and achieve sustained, long-term prevention, management, and disease control. Here, we summarized the characteristics of existing COVID-19 vaccines and drugs and suggested potential future directions for their development. Furthermore, we discussed the COVID-19-related policies implemented over the past years and presented some strategies for the future.
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Affiliation(s)
- Danyi Ao
- State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, 610041, Sichuan, People's Republic of China
| | - Xuemei He
- State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, 610041, Sichuan, People's Republic of China
| | - Jian Liu
- State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, 610041, Sichuan, People's Republic of China
| | - Li Xu
- State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, 610041, Sichuan, People's Republic of China.
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Compagnoni R, Cucchi D, Klumpp R, Ronga M, Berruto M, Di Giacomo G, Randelli PS. Operational strategies to deal with the COVID-19 emergency: recommendations from the Italian national society SIAGASCOT following the introduction of vaccines against the SARS-CoV-2 infection. Musculoskelet Surg 2023; 107:471-479. [PMID: 37658981 PMCID: PMC10709259 DOI: 10.1007/s12306-023-00796-9] [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: 07/17/2022] [Accepted: 08/20/2023] [Indexed: 09/05/2023]
Abstract
BACKGROUND This article aims to present the operational recommendations adopted by the Italian national society for orthopaedic surgery, arthroscopy, and sports medicine (SIAGASCOT) in managing patients eligible to undergo elective orthopaedic surgery during the COVID-19 pandemic after the beginning of a national vaccination campaign. MATERIALS AND METHODS An extensive literature search, analysing medical databases and scientific societies protocols, was performed to support this document. A four-step approach was used: 1-definition of priorities; 2-definition of significant clusters of interventions; 3-extraction of recommendations from international literature; and 4-adaptation of the recommendations to the specific features of the Italian healthcare system. RESULTS Three operational priorities were defined ("continuity of care and containment of the virus spread", "examination of waiting lists", and "definition of the role of vaccines"), six significant clusters of intervention were identified, and recommendations regarding the risk management for healthcare staff and hospital facility as well as the preoperative, in-hospital, and postoperative management were produced. Patient selection, preoperative screening, and pre-hospitalization procedures, which are regarded as pivotal roles in the safe management of patients eligible to undergo elective orthopaedic surgery, were analysed extensively. CONCLUSIONS This document presents national-wide recommendations for managing patients eligible to undergo elective orthopaedic surgery with the beginning of the vaccination campaign. This paper could be the basis for similar documents adapted to the local healthcare systems in other countries. LEVEL OF EVIDENCE Level IV.
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Affiliation(s)
- Riccardo Compagnoni
- 1° Clinica Ortopedica, ASST Centro Specialistico Ortopedico Traumatologico Gaetano Pini-CTO, Piazza Cardinal Ferrari 1, 20122, Milan, Italy
- Department of Biomedical, Surgical and Dental Sciences, Università degli Studi di Milano, Via della Commenda 10, 20122, Milan, Italy
| | - Davide Cucchi
- Department of Orthopaedics and Trauma Surgery, Universitätsklinikum Bonn, Venusberg-Campus 1, 53127, Bonn, Germany.
| | - Raymond Klumpp
- Reparto di Ortopedia e Traumatologia dell`Ospedale di Treviglio-Caravaggio, ASST Bergamo Ovest, Piazzale Ospedale Luigi Meneguzzo, 24047, Treviglio, Italy
| | - Mario Ronga
- Orthopaedic and Trauma Operative Unit, Department of Health Sciences, University of Eastern Piedmont, Novara - Italy. "Maggiore della Carità" Hospital, Corso Mazzini n.18, 28100, Novara, Italy
| | - Massimo Berruto
- 1° Clinica Ortopedica, ASST Centro Specialistico Ortopedico Traumatologico Gaetano Pini-CTO, Piazza Cardinal Ferrari 1, 20122, Milan, Italy
| | - Giovanni Di Giacomo
- Department of Orthopaedic and Trauma Surgery, Concordia Hospital for Special Surgery, 00145, Rome, Italy
| | - Pietro S Randelli
- 1° Clinica Ortopedica, ASST Centro Specialistico Ortopedico Traumatologico Gaetano Pini-CTO, Piazza Cardinal Ferrari 1, 20122, Milan, Italy
- Laboratory of Applied Biomechanics, Department of Biomedical Sciences for Health, Università degli Studi di Milano, Via Mangiagalli 31, 20133, Milan, Italy
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Castro I, Van Tricht M, Bonaccorso N, Sciortino M, Garcia Burgos J, Costantino C, Gonzalez-Quevedo R. Stakeholders' Understanding of European Medicine Agency's COVID-19 Vaccine Information Materials in EU and Regional Contexts. Vaccines (Basel) 2023; 11:1616. [PMID: 37897018 PMCID: PMC10610863 DOI: 10.3390/vaccines11101616] [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: 08/10/2023] [Revised: 10/11/2023] [Accepted: 10/12/2023] [Indexed: 10/29/2023] Open
Abstract
The COVID-19 pandemic posed challenges to communicating accurate information about vaccines because of the spread of misinformation. The European Medicines Agency (EMA) tried to reassure the public by communicating early on about the development and approval of COVID-19 vaccines. The EMA surveyed patients/consumers, healthcare professional organizations, and individual stakeholders, both at the EU level and in an Italian regional context. The objectives of the study were to see if the EMA's core information materials were informative and well-understood and which communication channels were preferred by the public. The main findings showed that individual patients/consumers generally prefer to obtain information about COVID-19 vaccines from the internet or mass media, while organizations and individual healthcare professionals prefer to obtain information from national and international health authorities. Both at EU and local levels, participants had a good understanding of the key messages from regulators and found the materials useful and relevant. However, some improvements were recommended to the visual, text, and dissemination formats, including publishing more information on safety and using a more public-friendly language. Also, it was recommended to maintain the EMA's approach of using media, stakeholder engagement, and web-based formats to communicate about COVID-19 vaccines. In conclusion, user-testing of proactive communication materials aimed to prebunk misinformation during a public health crisis helps to ensure that users understand the development and safety of novel vaccine technologies. This information can then be used as a basis for further evidence-based communication activities by regulators and public health bodies in an emergency context.
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Affiliation(s)
- Indiana Castro
- Public and Stakeholder Engagement Department, European Medicines Agency, Domenico Scarlattilaan 6, 1083 HS Amsterdam, The Netherlands
| | - Marie Van Tricht
- Public and Stakeholder Engagement Department, European Medicines Agency, Domenico Scarlattilaan 6, 1083 HS Amsterdam, The Netherlands
| | - Nicole Bonaccorso
- Department of Health Promotion Sciences, Maternal and Infant Care, Internal Medicine and Medical Specialties (PROMISE) “G. D’Alessandro”, University of Palermo, 90127 Palermo, Italy; (M.S.); (C.C.)
| | - Martina Sciortino
- Department of Health Promotion Sciences, Maternal and Infant Care, Internal Medicine and Medical Specialties (PROMISE) “G. D’Alessandro”, University of Palermo, 90127 Palermo, Italy; (M.S.); (C.C.)
| | - Juan Garcia Burgos
- Public and Stakeholder Engagement Department, European Medicines Agency, Domenico Scarlattilaan 6, 1083 HS Amsterdam, The Netherlands
| | - Claudio Costantino
- Department of Health Promotion Sciences, Maternal and Infant Care, Internal Medicine and Medical Specialties (PROMISE) “G. D’Alessandro”, University of Palermo, 90127 Palermo, Italy; (M.S.); (C.C.)
| | - Rosa Gonzalez-Quevedo
- Public and Stakeholder Engagement Department, European Medicines Agency, Domenico Scarlattilaan 6, 1083 HS Amsterdam, The Netherlands
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Cho G, Kim YJ, Seo SH, Jang G, Lee H. Cost-effectiveness analysis of COVID-19 variants effects in an age-structured model. Sci Rep 2023; 13:15844. [PMID: 37739967 PMCID: PMC10516971 DOI: 10.1038/s41598-023-41876-x] [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: 04/29/2023] [Accepted: 09/01/2023] [Indexed: 09/24/2023] Open
Abstract
This study analyzes the impact of COVID-19 variants on cost-effectiveness across age groups, considering vaccination efforts and nonpharmaceutical interventions in Republic of Korea. We aim to assess the costs needed to reduce COVID-19 cases and deaths using age-structured model. The proposed age-structured model analyzes COVID-19 transmission dynamics, evaluates vaccination effectiveness, and assesses the impact of the Delta and Omicron variants. The model is fitted using data from the Republic of Korea between February 2021 and November 2022. The cost-effectiveness of interventions, medical costs, and the cost of death for different age groups are evaluated through analysis. The impact of different variants on cases and deaths is also analyzed, with the Omicron variant increasing transmission rates and decreasing case-fatality rates compared to the Delta variant. The cost of interventions and deaths is higher for older age groups during both outbreaks, with the Omicron outbreak resulting in a higher overall cost due to increased medical costs and interventions. This analysis shows that the daily cost per person for both the Delta and Omicron variants falls within a similar range of approximately $10-$35. This highlights the importance of conducting cost-effect analyses when evaluating the impact of COVID-19 variants.
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Affiliation(s)
- Giphil Cho
- Department of Artificial Intelligence and Software, Kangwon National University, Chuncheon, Gangwon, 25913, Republic of Korea
| | - Young Jin Kim
- Division of Data Analysis, Center for Global R&D Data Analysis, Korea Institute of Science and Technology Information (KISTI), Seoul, 02456, Republic of Korea
| | - Sang-Hyup Seo
- National Institute for Mathematical Sciences, Daejeon, 34047, Republic of Korea
| | - Geunsoo Jang
- Nonlinear Dynamics and Mathematical Application Center, Kyungpook National University, Daegu, 41566, Republic of Korea
| | - Hyojung Lee
- Department of Statistics, Kyungpook National University, Daegu, 41566, Republic of Korea.
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Ziegler L, Klemis V, Schmidt T, Schneitler S, Baum C, Neumann J, Becker SL, Gärtner BC, Sester U, Sester M. Differences in SARS-CoV-2 specific humoral and cellular immune responses after contralateral and ipsilateral COVID-19 vaccination. EBioMedicine 2023; 95:104743. [PMID: 37574375 PMCID: PMC10505826 DOI: 10.1016/j.ebiom.2023.104743] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [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] [Received: 03/06/2023] [Revised: 07/02/2023] [Accepted: 07/21/2023] [Indexed: 08/15/2023] Open
Abstract
BACKGROUND Individual doses of dual-dose vaccine-regimens are sequentially administered into the deltoid muscle, but little attention has so far been paid to the immunological effects of choosing the ipsilateral or the contralateral side for the second dose. METHODS In an observational study, 303 previously naive individuals were recruited, who received the second dose of the COVID-19 vaccine BNT162b2 on either the ipsilateral (n = 147) or the contralateral side (n = 156). Spike-specific IgG, IgG-avidity, and neutralizing antibodies were quantified using ELISA and a surrogate assay 2 weeks after dose 2. A subgroup of 143 individuals (64 ipsilateral, 79 contralateral) was analysed for spike-specific CD4 and CD8 T-cells using flow-cytometry. FINDINGS Median spike-specific IgG-levels did not differ after ipsilateral (4590 (IQR 3438) BAU/ml) or contralateral vaccination (4002 (IQR 3524) BAU/ml, p = 0.106). IgG-avidity was also similar (p = 0.056). However, neutralizing activity was significantly lower after contralateral vaccination (p = 0.024). Likewise, median spike-specific CD8 T-cell levels were significantly lower (p = 0.004). Consequently, the percentage of individuals with detectable CD8 T-cells was significantly lower after contralateral than after ipsilateral vaccination (43.0% versus 67.2%, p = 0.004). Spike specific CD4 T-cell levels were similar in both groups, but showed significantly higher CTLA-4 expression after contralateral vaccination (p = 0.011). These effects were vaccine-specific, as polyclonally stimulated T-cell levels did not differ. INTERPRETATION Both ipsilateral and contralateral vaccination induce a strong immune response, but secondary boosting is more pronounced when choosing vaccine administration-routes that allows for drainage by the same lymph nodes used for priming. Higher neutralizing antibody activity and higher levels of spike-specific CD8 T-cells may have implications for protection from infection and severe disease and support general preference for ipsilateral vaccination. FUNDING Financial support was provided in part by the State chancellery of the Saarland to M.S.
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Affiliation(s)
- Laura Ziegler
- Department of Transplant and Infection Immunology, Saarland University, Germany
| | - Verena Klemis
- Department of Transplant and Infection Immunology, Saarland University, Germany
| | - Tina Schmidt
- Department of Transplant and Infection Immunology, Saarland University, Germany
| | - Sophie Schneitler
- Department of Medical Microbiology and Hygiene, Saarland University, Germany
| | - Christina Baum
- Occupational Health Care Center, Saarland University, 66421 Homburg, Germany
| | - Jürgen Neumann
- Department of Occupational Health, Robert Bosch GmbH, 66424 Homburg, Germany
| | - Sören L Becker
- Department of Medical Microbiology and Hygiene, Saarland University, Germany
| | - Barbara C Gärtner
- Department of Medical Microbiology and Hygiene, Saarland University, Germany
| | - Urban Sester
- Department of Nephrology, SHG-Klinikum Völklingen, 66333 Völklingen, Germany
| | - Martina Sester
- Department of Transplant and Infection Immunology, Saarland University, Germany.
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Vlaescu AN, Ionita E, Anghelina F, Mogoanta CA, Ciolofan SM, Rusescu A, Ionita IG, Voiosu C, Hainarosie R. Etiological Profile of Epistaxis: Pre-Pandemic Versus Pandemic. Curr Health Sci J 2023; 49:362-370. [PMID: 38314226 PMCID: PMC10832887 DOI: 10.12865/chsj.49.03.08] [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] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Accepted: 08/20/2023] [Indexed: 02/06/2024]
Abstract
Nosebleed or epistaxis is one of the most common forms of presenting an emergency in the ENT field. Since March 11, 2020, the World Health Organisation has proclaimed COVID-19 a global pandemic, and the world has been closed down. The main objective of the study is to analyse and compare the dynamics of epistaxis aetiology among the cases that required hospitalisation in the pre-pandemic period and the period of the COVID 19 pandemic. The study is multicenter retrospective from October 2018 to May 2022, including 380 cases of hospitalised epistaxis, with the mention that March 2020 is considered the beginning of the pandemic period. 60.8% of the patients enrolled in the study in the pre-pandemic period (60.8%) and 39.2% in the pandemic period. Differences between groups were not statistically significant between study entries (pre-pandemic vs. pandemic) and age (p=0.331), gender (p=0.916) or existence of local causes for epistaxis (p=0.895). Patients with general causes for epistaxis were more frequently enrolled in the pandemic period, while patients without general causes for epistaxis were more frequently enrolled in the pre-pandemic period. Patients with a hospitalisation period of more than 5 days were more frequently enrolled in the pre-pandemic period while patients with a hospitalisation period of 3 to 5 days were more frequently enrolled in the pandemic period. Also, patients with idiopathic epistaxis were more frequently enrolled in the pre-pandemic period. Based on the results presented in our study, the period of the Covid 19 pandemic directly influenced both the number of patients and the period of hospitalisation.
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Affiliation(s)
- Andreea Nicoleta Vlaescu
- PhD Student, Department of Otorhinolaryngology, Doctoral School, University of Medicine and Pharmacy of Craiova, Romania
| | - Elena Ionita
- Department of Otorhinolaryngology, University of Medicine and Pharmacy of Craiova, Romania
| | - Florin Anghelina
- Department of Otorhinolaryngology, University of Medicine and Pharmacy of Craiova, Romania
| | | | - Sorin-Mircea Ciolofan
- Department of Otorhinolaryngology, University of Medicine and Pharmacy of Craiova, Romania
| | - Andreea Rusescu
- Department of Otorhinolaryngology and Ophthalmology of "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania
| | - Irina-Gabriela Ionita
- Department of Otorhinolaryngology and Ophthalmology of "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania
| | - Catalina Voiosu
- Department of Otorhinolaryngology and Ophthalmology of "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania
| | - Razvan Hainarosie
- Department of Otorhinolaryngology and Ophthalmology of "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania
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Ossato A, Tessari R, Trabucchi C, Zuppini T, Realdon N, Marchesini F. Comparison of medium-term adverse reactions induced by the first and second dose of mRNA BNT162b2 (Comirnaty, Pfizer-BioNTech) vaccine: a post-marketing Italian study conducted between 1 January and 28 February 2021. Eur J Hosp Pharm 2023; 30:e15. [PMID: 34315774 PMCID: PMC8318724 DOI: 10.1136/ejhpharm-2021-002933] [Citation(s) in RCA: 34] [Impact Index Per Article: 34.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Accepted: 07/12/2021] [Indexed: 12/28/2022] Open
Abstract
OBJECTIVES On 21 December 2020 the European Commission granted conditional marketing authorisation in the European Union for the anti-COVID-19 mRNA vaccine Bnt162b2 (Comirnaty, Pfizer/BioNTech). The main endpoint of this epidemiological, observational, prospective and monocentric study was to identify the number, types, and severity of adverse events following immunisation that occurred in subjects who had been previously infected with COVID-19, and in those who had not, after vaccination with Comirnaty, and to compare the two groups of subjects looking at events that occurred within a month after the first and the second dose. METHODS Data were gathered by a questionnaire. The results included the responses of all healthcare workers (2030) of the IRCCS Sacro Cuore Don Calabria Hospital (Italy) vaccinated between 1st January and 28th February 2021. Adverse effects of the vaccine were reported after the first and the second doses. RESULTS There was a statistically significant increase (p<0.001, χ2=35.60) in participants who experienced some side-effects after receiving the first dose of the vaccine and who had previously been infected with the coronavirus, compared with participants who had not previously been infected. 46.76% (136) of the participants who had previously been infected experienced some side-effects after the first dose of vaccine, and 63.23% (184) experienced some side-effects after the second dose, compared with 29.15% (507) after the first dose and 70.79% (1231) after the second dose in those who had not been previously infected. The number of participants who experienced side-effects after the second dose and had previously been infected was significantly lower compared with participants who had not previously been infected (p=0.0094, χ2=6.743). CONCLUSIONS Most of the side-effects identified in this trial were also reported by the manufacturer and the US Food and Drug Administration. Active surveillance should always continue to constantly check the vaccine's risk/benefit ratio over time.
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Affiliation(s)
- Andrea Ossato
- Pharmaceutical & Pharmacological Sciences Department, University of Padua, Padova, Italy
| | - Roberto Tessari
- Hospital Pharmacy, IRCCS Ospedale Sacro Cuore Don Calabria, Negrar di Valpolicella, Italy
| | - Carlotta Trabucchi
- Hospital Pharmacy, IRCCS Ospedale Sacro Cuore Don Calabria, Negrar di Valpolicella, Italy
| | - Teresa Zuppini
- Hospital Pharmacy, IRCCS Ospedale Sacro Cuore Don Calabria, Negrar di Valpolicella, Italy
| | - Nicola Realdon
- Pharmaceutical & Pharmacological Sciences Department, University of Padua, Padova, Italy
| | - Francesca Marchesini
- Hospital Pharmacy, IRCCS Ospedale Sacro Cuore Don Calabria, Negrar di Valpolicella, Italy
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Bloem LT, Schelhaas J, López-Anglada L, Herberts C, van Hennik PB, Tenhunen O. European Conditional Marketing Authorization in a Rapidly Evolving Treatment Landscape: A Comprehensive Study of Anticancer Medicinal Products in 2006-2020. Clin Pharmacol Ther 2023. [PMID: 37129347 DOI: 10.1002/cpt.2906] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2022] [Accepted: 03/20/2023] [Indexed: 05/03/2023]
Abstract
Since 2006, the European conditional marketing authorization (CMA) aims to facilitate timely patient access to medicinal products for which there is an unmet medical need by accepting less comprehensive data than normally required. The granting of CMA requires a positive benefit-risk balance, unmet medical needs to be fulfilled, likely submission of comprehensive data postauthorization, and the benefit of immediate availability to outweigh the risks of data noncomprehensiveness. Since its first use, more than half of all CMAs represent (hemato-)oncology indications. Therefore, we aimed to investigate the conditions in which CMA has been applied for anticancer medicinal products and whether they have changed over time. We retrospectively assessed the European public assessment reports of the 30 anticancer medicinal products granted CMA in 2006-2020 (51% of all 59 CMAs). Comparison of 2006-2013 to 2014-2020 highlighted increased proportions of proactively requested CMAs (+40%), medicinal products that addressed unmet medical needs by providing a major therapeutic advantage over authorized treatments (+38%), and orphan designated indications (+32%). In contrast, it showed decreased proportions of medicinal products for which a scientific advisory group was consulted (-55%) and phase III randomized controlled trial data were available (-38%). This suggests that applicants and the European Medicines Agency have learned how to use the CMA as a regulatory tool, among others, through better planning and proactive interaction. However, the increasing number of granted CMAs complicates the establishment of unmet medical need and the benefit-risk balance, especially in crowded indications and when only phase II uncontrolled trials are available.
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Affiliation(s)
- Lourens T Bloem
- Division of Pharmacoepidemiology and Clinical Pharmacology, Utrecht Institute for Pharmaceutical Sciences (UIPS), Utrecht University, Utrecht, The Netherlands
| | - Jasmin Schelhaas
- Division of Pharmacoepidemiology and Clinical Pharmacology, Utrecht Institute for Pharmaceutical Sciences (UIPS), Utrecht University, Utrecht, The Netherlands
- Dutch Medicines Evaluation Board (CBG-MEB), Utrecht, The Netherlands
| | - Lucía López-Anglada
- Pharmacology and Clinical Assessment Division, Spanish Medicines Agency (AEMPS), Madrid, Spain
| | - Carla Herberts
- Dutch Medicines Evaluation Board (CBG-MEB), Utrecht, The Netherlands
| | | | - Olli Tenhunen
- Medical Research Center Oulu, University of Oulu and Oulu University Hospital, Oulu, Finland
- Finnish Medicines Agency (Fimea), Helsinki, Finland
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12
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Bishnoi M, Sonker A. Emergency use authorization of medicines: History and ethical dilemma. Perspect Clin Res 2023; 14:49-55. [PMID: 37325578 PMCID: PMC10267997 DOI: 10.4103/picr.picr_149_22] [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: 07/17/2022] [Revised: 11/26/2022] [Accepted: 11/29/2022] [Indexed: 06/17/2023] Open
Abstract
The regulatory approval process of the United States Food and Drug Administration and European Union is the most demanding and challenging worldwide. They have the provision of the expedited approval pathways, i.e., "Emergency use authorizations" and "Conditional marketing authorizations," respectively, to give approval to novel therapeutics agents during emergency situations. India, firstly formalized the accelerated pathway named "Accelerated Approval Process" as per the New Drugs and Clinical Trials rule 2019 to address unmet medical needs that was implemented by the Central Drug Standard Control Organization to approve the novel therapeutics agents during COVID-19. Hence, our aim is to understand and compare the different emergency approval processes in the world, their underlined claims and conditions with the list of approved products under this concept. All the information collected and analyzed from different official websites of regulatory bodies. In this review, we have enlightened on all these processes with their few approved products.
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Affiliation(s)
- Mamta Bishnoi
- Department of Pharmaceutical Sciences, Faculty of Life Sciences, Gurugram University, Gurugram, Haryana, India
| | - Aniket Sonker
- Department of Pharmaceutics, Delhi Pharmaceutical Sciences and Research University, New Delhi, India
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13
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Milne C, Wagner R, Cano F, Bruysters M, Waeterloos G, Pullirsch D, Wierer M, Mallet L. Independent control of COVID-19 vaccines by EU Official Control Authority Batch Release: challenges, strengths and successes. NPJ Vaccines 2023; 8:22. [PMID: 36823287 PMCID: PMC9950138 DOI: 10.1038/s41541-023-00617-x] [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: 09/20/2022] [Accepted: 01/27/2023] [Indexed: 02/25/2023] Open
Abstract
Vaccines have been a key tool in stemming the tide of the COVID-19 pandemic. The rapid development of effective vaccines against COVID-19, together with their regulatory approval and wide scale distribution has been achieved in an impressively short period thanks to the intense efforts of many. In parallel to vaccine development, the EU considered it important to prepare for the independent control of the COVID-19 vaccines, including testing, to help ensure that only vaccines that comply with the approved quality requirements reach the public and to help improve/increase public confidence in the vaccines. The existing EU Official Control Authority Batch Release (OCABR) system, co-ordinated by the European Directorate for the Quality of Medicines and HealthCare (EDQM), was able to effectively respond to the need, through rapid co-ordination, work-sharing, advance planning and early interaction with manufacturers, the Coalition for Epidemic Preparedness Innovation (CEPI) and regulatory authorities. The Official Medicines Control Laboratories (OMCLs) involved in the OCABR activity, using the strength of the established system in the OCABR network and adaptations to the crisis conditions, were ready to release the first COVID-19 vaccine batches, after protocol review and testing, at the time of the conditional marketing authorisation for each of the COVID-19 vaccines, with no delay for batches reaching the public. Thanks to the dedication of resources by the EU and national authorities as well as by the EDQM, this was done without impacting the release of the other vaccines and human blood and plasma derived medicinal products, essential for public health. Transparency and communication of practices were important factors to support reliance on the OCABR outcome in non-EU countries, with the goal to improve access to vaccines in Europe and beyond. An overview of the process, legal background, challenges and successes of OCABR for COVID-19 vaccines as well as a look at the international perspective and lessons learned is provided.
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Affiliation(s)
- Catherine Milne
- European Directorate for the Quality of Medicines & HealthCare, Department of Biological Standardisation, OMCL Network and HealthCare, Council of Europe, Strasbourg, France.
| | - Ralf Wagner
- grid.425396.f0000 0001 1019 0926Paul-Ehrlich-Institut, Federal Institute for Vaccines and Biomedicines, Langen, Germany
| | - François Cano
- grid.483743.f0000 0000 9681 5730French National Agency for Medicines and Health Product Safety (ANSM), Laboratory Controls Division, Lyon, France
| | - Martijn Bruysters
- grid.31147.300000 0001 2208 0118Dutch National Institute for Public Health and Environment, Centre for Health Protection (GZB), Bilthoven, The Netherlands
| | - Geneviève Waeterloos
- grid.508031.fSciensano, Scientific Directorate Biological Health Risks, Service quality of vaccines and blood products, Brussels, Belgium
| | - Dieter Pullirsch
- grid.414107.70000 0001 2224 6253Austrian Federal Office for Safety in Health Care, Austrian Agency for Health and Food Safety, Vienna, Austria
| | - Michael Wierer
- European Directorate for the Quality of Medicines & HealthCare, Department of Biological Standardisation, OMCL Network and HealthCare, Council of Europe, Strasbourg, France
| | - Laurent Mallet
- European Directorate for the Quality of Medicines & HealthCare, Department of Biological Standardisation, OMCL Network and HealthCare, Council of Europe, Strasbourg, France
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14
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Carnevale S, Giovanetti M, Benvenuto D, Ciccozzi M, Broccolo F. Is Molecular Mimicry between hPF4 and SARS-CoV-2 Spike Protein a Potential Basis for Autoimmune Responses in Vaccinated and Naturally Infected Patients? Semin Thromb Hemost 2023; 49:103-104. [PMID: 35021248 DOI: 10.1055/s-0041-1742092] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Affiliation(s)
- Sergio Carnevale
- Cerba HealthCare Italia, Section of Anatomic Pathology, Milan, Italy
| | - Marta Giovanetti
- Laboratório de Flavivírus, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro, Rio de Janeiro, Brazil
| | - Domenico Benvenuto
- Medical Statistic and Molecular Epidemiology Unit, University of Biomedical Campus, Rome, Italy
| | - Massimo Ciccozzi
- Medical Statistic and Molecular Epidemiology Unit, University of Biomedical Campus, Rome, Italy
| | - Francesco Broccolo
- Department of Medicine and Surgery, School of Medicine, University of Milano-Bicocca, Monza, Italy.,Cerba HealthCare Italia, Milan, Italy
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15
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AL-Mhanna SB, Wan Ghazali WS, Maqsood A, Mohamed M, Ahmed N, Afolabi HA, Mutalub YB, Heboyan A, Zafar MS. Physical activities pre- and post-COVID-19 vaccination and its implementations: A narrative review. SAGE Open Med 2023; 11:20503121231158981. [PMID: 36909796 PMCID: PMC9996076 DOI: 10.1177/20503121231158981] [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: 10/21/2022] [Accepted: 02/03/2023] [Indexed: 03/08/2023] Open
Abstract
Coronavirus disease 2019 is a severe communicable pulmonary medical problem that has been a challenging disease for everyone in the globe, but vaccines development and administration against this severe acute respiratory syndrome-inducing disease (coronavirus disease 2019) are currently yielding fabulous results. The mean duration of the coronavirus disease 2019 pandemic for this study spanned from 2020 until 2022. These manifestations are accompanied by symptoms of respiratory tract illnesses such as non-productive cough, sore throat, and nasal discharge. Relevant reviews on coronavirus disease 2019 manifestations and outcomes, consisting mainly of the infections/outbreaks, experimental information, and pre- and post-serovaccination details that occurred, were described. After a typical vaccination course, the study aims to summarize and understand more about the effectiveness of exercise on the pre-and post-coronavirus disease 2019 vaccination and its implementations. Physical activity is an immunological function adjuvant to decrease communicable disease risk and enhance immunity post-viral infection vaccination. Moderate-intensity resistance exercisesession directly before getting the influenza vaccine decreases vaccine responses in older adults, such as redness, pain, or inflammation at the injection spot or other adverse consequences compared to the inactive circumstance. However, it was reported that exercise after a shot is generally safe as long as vaccinated people feel well enough. Though exercise before or after vaccination has no negative impact on the protection afforded by the vaccine, people can exercise immediately after receiving the vaccine, as any changes in blood flow will not affect the vaccine's response. One episode of light-to-moderate-intensifying exercise after vaccination may improve the antibody reactions to influenza or the coronavirus disease 2019 vaccine. Vaccination administered pre- and post-regular exercise is an effective approach for boosting antibody responses due to its immunostimulant effects. Future research should investigate how different vaccine antibodies respond to low, moderate, and high physical activity levels.
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Affiliation(s)
- Sameer Badri AL-Mhanna
- Department of Physiology, School of
Medical Sciences, Universiti Sains Malaysia, Kelantan, Malaysia
| | | | - Afsheen Maqsood
- Department of Oral Pathology, Bahria
University Dental College, Karachi, Pakistan
| | - Mahaneem Mohamed
- Department of Physiology, School of
Medical Sciences, Universiti Sains Malaysia, Kelantan, Malaysia
| | - Naseer Ahmed
- Department of Prosthodontics, Altamash
Institute of Dental Medicine, Karachi, Pakistan
- Prosthodontics Unit, School of Dental
Sciences, Health Campus, Universiti Sains Malaysia, Kelantan, Malaysia
| | - Hafeez Abiola Afolabi
- Department of General Surgery, School
of Medical Sciences, Universiti Sains Malaysia, Kelantan, Malaysia
| | - Yahkub Babatunde Mutalub
- Department of Clinical Pharmacology,
College of Medical Sciences, Abubakar Tafawa Balewa University, Bauchi,
Nigeria
| | - Artak Heboyan
- Department of Prosthodontics, Faculty
of Stomatology, Yerevan State Medical University After Mkhitar Heratsi, Yerevan,
Armenia
- Artak Heboyan, Department of
Prosthodontics, Faculty of Stomatology, Yerevan State Medical University After
Mkhitar Heratsi, Str. Koryun 2, Yerevan, 0025, Armenia. Emails:
;
| | - Muhammad Sohail Zafar
- Department of Restorative Dentistry,
College of Dentistry, Taibah University, Al Madinah Al Munawwarah, Saudi
Arabia
- Department of Dental Materials, Islamic
International Dental College, Riphah International University, Islamabad,
Pakistan
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16
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Zare Z, Assarroudi A, Armat MR, Laal Ahangar M, Estaji M, MoghaddamHosseini V, Dianatinasab M. Signs, Symptoms, and Side-Effects Presented by Different Types of COVID-19 Vaccines: A Prospective Cohort Study. Life (Basel) 2022; 12. [PMID: 36556411 DOI: 10.3390/life12122046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Revised: 11/27/2022] [Accepted: 12/05/2022] [Indexed: 12/12/2022] Open
Abstract
The concern about post-COVID-19 vaccine complications still remains. In addition, the evidence on Sinopharm, Sputnik V, Covaxin, and, in particular, COVIran Barekat, as well as comparisons between them by dosage after post-vaccination, is scarce. This study aimed to investigate and compare the prevalence of self-reported post-vaccination signs and symptoms following the first and second doses of different types of COVID-19 vaccines. Research design and methods: This prospective cohort study was conducted on more than 1500 health professionals who had received at least one dose of any type of Sputnik V, Sinopharm, Oxford AstraZeneca, Covaxin, and COVIran Barekat vaccines in Iran. The survey questionnaire was sent to participants online, 28 days after receiving each dose of the vaccine. Results: About 73% of health professionals reported at least one post-vaccination sign or symptom, developing mostly within the first 12 h (69.9%) and lasting up to 12 h (59.0%). Pain and tenderness at the injection site, fever, and muscle pain were the most common post-vaccination signs and symptoms in all vaccines, which were significantly higher in the Oxford AstraZeneca vaccine (p < 0.001) for both the first and second doses. The incidence rate of all post-vaccination signs and symptoms was significantly higher in the first dose than in the second dose (p < 0.05). Conclusion: The Oxford AstraZeneca vaccine showed the highest incidence rate, onset, and lasting time of signs and symptoms in both doses; however, they were not life-threatening. The onset time of signs and symptoms was significantly higher for the COVIran Barekat and Oxford AstraZeneca vaccines in both the first and second doses.
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17
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Mohseni Afshar Z, Barary M, Hosseinzadeh R, Karim B, Ebrahimpour S, Nazary K, Sio TT, Sullman MJM, Carson-Chahhoud K, Moudi E, Babazadeh A. COVID-19 vaccination challenges: A mini-review. Hum Vaccin Immunother 2022; 18:2066425. [PMID: 35512088 PMCID: PMC9302531 DOI: 10.1080/21645515.2022.2066425] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [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] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Revised: 02/11/2022] [Accepted: 02/28/2022] [Indexed: 02/07/2023] Open
Abstract
The emergence of SARS-CoV-2 has led to the infection of many people across the globe, over six million deaths, and has placed an unprecedented burden on public health worldwide. The pandemic has led to the high-speed development and production of vaccines against the COVID-19, as vaccines can end the pandemic. At the beginning of the program, vaccinations were initially targeted only at high-risk groups, such as the elderly, those with comorbidities, or healthcare workers. Although most of the mentioned populations have received the two recommended doses, limited resources have left many authorities with an effective vaccine undersupply. Therefore, policies have been implemented to manage the available doses of the vaccines more efficiently. As there is no universally agreed consensus on this topic, we discuss the different recommendations and guidelines regarding the time interval between the two vaccine doses and explain the different scenarios for applying the two doses.
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Affiliation(s)
- Zeinab Mohseni Afshar
- Clinical Research Development Center, Imam Reza Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Mohammad Barary
- Student Research Committee, Virtual School of Medical Education and Management, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- Students’ Scientific Research Center (SSRC), Tehran University of Medical Sciences, Tehran, Iran
| | - Rezvan Hosseinzadeh
- Student Research Committee, Babol University of Medical Sciences, Babol, Iran
| | - Bardia Karim
- Student Research Committee, Babol University of Medical Sciences, Babol, Iran
| | - Soheil Ebrahimpour
- Infectious Diseases and Tropical Medicine Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Kosar Nazary
- Student Research Committee, Babol University of Medical Sciences, Babol, Iran
| | - Terence T. Sio
- Department of Radiation Oncology, Mayo Clinic, Phoenix, Arizona, USA
| | - Mark J. M. Sullman
- Department of Social Sciences, University of Nicosia, Nicosia, Cyprus
- Department of Life and Health Sciences, University of Nicosia, Nicosia, Cyprus
| | | | - Emaduddin Moudi
- Clinical Research Development Center, Shahid Beheshti Hospital, Babol University of Medical Sciences, Babol, Iran
| | - Arefeh Babazadeh
- Infectious Diseases and Tropical Medicine Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
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18
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Krekeler C, Reitnauer L, Bacher U, Khandanpour C, Steger L, Boeckel GR, Klosner J, Tepasse PR, Kemper M, Hennies MT, Mesters R, Stelljes M, Schmitz N, Kerkhoff A, Schliemann C, Mikesch JH, Schmidt N, Lenz G, Bleckmann A, Shumilov E. Efficacy of COVID-19 Booster Vaccines in Patients with Hematologic Malignancies: Experiences in a Real-World Scenario. Cancers (Basel) 2022; 14:cancers14225512. [PMID: 36428605 PMCID: PMC9688056 DOI: 10.3390/cancers14225512] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2022] [Revised: 11/03/2022] [Accepted: 11/04/2022] [Indexed: 11/12/2022] Open
Abstract
Background: Two-dose COVID-19 vaccination often results in poor humoral response rates in patients with hematologic malignancies (HMs); yet responses to COVID-19 booster vaccines and the risk of COVID-19 infection post-booster are mostly uncertain. Methods: We included 200 outpatients with HMs and predominantly lymphoid neoplasms (96%, 191/200) in our academic center and reported on the humoral responses, which were assessed by measurement of anti-spike IgG antibodies in peripheral blood as early as 14 days after mRNA-based prime-boost vaccination, as well as factors hampering booster efficacy. Previous basic (double) immunization was applied according to the local recommendations with mRNA- and/or vector-based vaccines. We also report on post-booster COVID-19 breakthrough infections that emerged in the Omicron era and the prophylaxis strategies that were applied to poor and non-responders to booster vaccines. Results: A total of 55% (110/200) of the patients achieved seroconversion (i.e., anti-spike protein IgG antibody titer > 100 AU/mL assessed in median 48 days after prime-boost vaccination) after prime-boost vaccination. Multivariable analyses revealed age, lymphocytopenia, ongoing treatment and prior anti-CD20 B-cell depletion to be independent predictors for booster failure. With each month between anti-CD20-mediated B-cell depletion and booster vaccination, the probability of seroconversion increased by approximately 4% (p < 0.001) and serum−antibody titer (S-AbT) levels increased by 90 AU/mL (p = 0.011). Notably, obinutuzumab treatment was associated with an 85% lower probability for seroconversion after prime-boost vaccination compared to rituximab (p = 0.002). Of poor or non-responders to prime-boost vaccination, 41% (47/114) underwent a second booster and 73% (83/114) underwent passive immunization. COVID-19 breakthrough infections were observed in 15% (29/200) of patients after prime-boost vaccination with predominantly mild courses (93%). Next to seroconversion, passive immunization was associated with a significantly lower risk of COVID-19 breakthrough infections after booster, even in vaccine non-responders (all p < 0.05). In a small proportion of analyzed patients with myeloid neoplasms (9/200), the seroconversion rate was higher compared to those with lymphoid ones (78% vs. 54%, accordingly), while the incidence rate of COVID-19 breakthrough infections was similar (22% vs. 14%, respectively). Following the low frequency of myeloid neoplasms in this study, the results may not be automatically applied to a larger cohort. Conclusions: Patients with HMs are at a high risk of COVID-19 booster vaccine failure; yet COVID-19 breakthrough infections after prime-boost vaccination are predominantly mild. Booster failure can likely be overcome by passive immunization, thereby providing immune protection against COVID-19 and attenuating the severity of COVID-19 courses. Further sophistication of clinical algorithms for preventing post-vaccination COVID-19 breakthrough infections is urgently needed.
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Affiliation(s)
- Carolin Krekeler
- Department of Medicine A for Hematology, Oncology and Pneumology, University Hospital Münster, 48149 Muenster, Germany
- Correspondence:
| | - Lea Reitnauer
- Department of Medicine A for Hematology, Oncology and Pneumology, University Hospital Münster, 48149 Muenster, Germany
| | - Ulrike Bacher
- Central Hematology Laboratory, Department of Hematology, Inselspital, Bern University Hospital, University of Bern, 3010 Bern, Switzerland
| | - Cyrus Khandanpour
- Department of Medicine A for Hematology, Oncology and Pneumology, University Hospital Münster, 48149 Muenster, Germany
- Department for Hematology and Oncology, University Hospital Schleswig-Holstein, 23564 Luebeck, Germany
| | - Leander Steger
- Department of Medicine A for Hematology, Oncology and Pneumology, University Hospital Münster, 48149 Muenster, Germany
| | - Göran Ramin Boeckel
- Department of Medicine B for Gastroenterology, Hepatology, Endocrinology and Clinical Infectiology, University Hospital Münster, 48149 Muenster, Germany
- Department of Medicine D for Nephrology and Rheumatology, University Hospital Münster, 48149 Muenster, Germany
| | - Justine Klosner
- Department of Medicine A for Hematology, Oncology and Pneumology, University Hospital Münster, 48149 Muenster, Germany
| | - Phil-Robin Tepasse
- Department of Medicine B for Gastroenterology, Hepatology, Endocrinology and Clinical Infectiology, University Hospital Münster, 48149 Muenster, Germany
| | - Marcel Kemper
- Department of Medicine A for Hematology, Oncology and Pneumology, University Hospital Münster, 48149 Muenster, Germany
| | - Marc Tim Hennies
- Institute of Virology, University Hospital Münster, 48149 Muenster, Germany
| | - Rolf Mesters
- Department of Medicine A for Hematology, Oncology and Pneumology, University Hospital Münster, 48149 Muenster, Germany
| | - Matthias Stelljes
- Department of Medicine A for Hematology, Oncology and Pneumology, University Hospital Münster, 48149 Muenster, Germany
| | - Norbert Schmitz
- Department of Medicine A for Hematology, Oncology and Pneumology, University Hospital Münster, 48149 Muenster, Germany
| | - Andrea Kerkhoff
- Department of Medicine A for Hematology, Oncology and Pneumology, University Hospital Münster, 48149 Muenster, Germany
| | - Christoph Schliemann
- Department of Medicine A for Hematology, Oncology and Pneumology, University Hospital Münster, 48149 Muenster, Germany
| | - Jan-Henrik Mikesch
- Department of Medicine A for Hematology, Oncology and Pneumology, University Hospital Münster, 48149 Muenster, Germany
| | - Nicole Schmidt
- Department of Hematology and Medical Oncology, University Medicine Göttingen (UMG), 37077 Goettingen, Germany
| | - Georg Lenz
- Department of Medicine A for Hematology, Oncology and Pneumology, University Hospital Münster, 48149 Muenster, Germany
| | - Annalen Bleckmann
- Department of Medicine A for Hematology, Oncology and Pneumology, University Hospital Münster, 48149 Muenster, Germany
| | - Evgenii Shumilov
- Department of Medicine A for Hematology, Oncology and Pneumology, University Hospital Münster, 48149 Muenster, Germany
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19
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Igual-Rouilleault AC, Soriano I, Elizalde A, Quan PL, Fernandez-Montero A, Sobrido C, Pina L. Axillary lymph node imaging in mRNA, vector-based, and mix-and-match COVID-19 vaccine recipients: ultrasound features. Eur Radiol 2022; 32:6598-6607. [PMID: 35554651 PMCID: PMC9098792 DOI: 10.1007/s00330-022-08846-9] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Revised: 04/21/2022] [Accepted: 04/25/2022] [Indexed: 02/01/2023]
Abstract
OBJECTIVES To assess ultrasound characteristics of ipsilateral axillary lymph nodes after two doses of four different COVID-19 vaccination protocols, to determine whether these parameters differed with age, and to describe how they changed on follow-up imaging. METHODS A total of 247 volunteer employees from our center who had received two doses of COVID-19 vaccination were recruited and followed prospectively. Axillary ultrasound of the ipsilateral vaccinated arm was performed the week after receiving the second dose to analyze lymph node features (number, long-axis, cortical thickness, morphology, and vascular imaging). Axillary lymphadenopathy resulting from four vaccination protocols-mRNA (BNT162b2, mRNA-1273), ChAdOx1-S, and mix-and-match-was compared. Analysis was conducted using the Kruskal-Wallis test and post hoc analysis with Bonferroni corrections. Nodal reactogenicity was evaluated for two age groups: young (< 45 years old) and middle-aged ( ≥ 45 years old). All parameters were compared between both groups using an unpaired-sample Student t test. A p value < 0.05 was considered statistically significant. RESULTS Significantly higher values for total number of visible nodes, cortical thickness, Bedi's classification (p < 0.001), and vascularity (p < 0.05) were observed in mRNA vaccine recipients compared to full ChAdOx1-S protocol recipients. Moreover, mix-and-match protocol recipients showed greater nodal cortical thickness and higher Bedi's classification than full ChAdOx1-S recipients (p < 0.001). Analyses between age groups revealed greater cortical thickness, Bedi's classification, and color Doppler signal in younger patients (p < 0.05). CONCLUSIONS Nodal parameters of Bedi's classification and cortical thickness were more often increased in mRNA and mix-and-match vaccine recipients when compared to ChAdOx1-S vaccine alone, especially in younger patients. KEY POINTS • Hyperplastic lymphadenopathy was observed more frequently in mRNA and mix-and-match vaccine protocols compared to full vector-based vaccination. • Higher values for cortical thickness, Bedi's classification, and color Doppler signal parameters were identified in younger patients. • Observed lymph node findings normalized in greater than 80% of patients by the third month following vaccination.
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Affiliation(s)
| | - Ignacio Soriano
- Department of Radiology, Clínica Universidad de Navarra, Avenida Pío XII, 36, 31008, Pamplona, Spain
| | - Arlette Elizalde
- Breast Imaging Unit, Department of Radiology, Clínica Universidad de Navarra, Avenida Pío XII, 36, Pamplona, Spain
| | - Paola Leonor Quan
- Department of Allergy and Clinical Immunology, Clínica Universidad de Navarra, Avenida Pío XII, 36, Pamplona, Spain
| | | | - Carolina Sobrido
- Breast Imaging Unit, Department of Radiology, Clínica Universidad de Navarra, C. Marquesado de Sta. Marta, 1, Madrid, Spain
| | - Luis Pina
- Breast Imaging Unit, Department of Radiology, Clínica Universidad de Navarra, Avenida Pío XII, 36, Pamplona, Spain
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Orlandi LB, Febo V, Perdichizzi S. The role of religiosity in product and technology acceptance: Evidence from COVID-19 vaccines. Technol Forecast Soc Change 2022; 185:122032. [PMID: 36117496 PMCID: PMC9464621 DOI: 10.1016/j.techfore.2022.122032] [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] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Revised: 09/02/2022] [Accepted: 09/06/2022] [Indexed: 06/07/2023]
Abstract
Previous research on religion and economic phenomena has suggested that religious attitudes are related to risk aversion. Moreover, risk attitudes play a significant role in the adoption and diffusion of technological innovations. However, the role of religiosity in technology-related phenomena is still relatively unexplored. The present study fills this gap and investigates the impact of religiosity on the acceptance of innovative technologies and products in the context of the COVID-19 pandemic. Specifically, we frame COVID-19 vaccines as new products based on innovative production technologies and show that their acceptance by the general public is negatively associated with country-level religiosity. Furthermore, we investigate the role of religious leaders in endorsing COVID-19 vaccines to their followers. Our hypotheses are empirically tested on 1179 weekly observations of vaccination rates in 22 European countries characterised by different levels of religiosity. The results suggest that religiosity is negatively associated with vaccine rates after controlling for country-level social and economic factors. Conversely, the countries where Roman Catholics are the majority religious group display a positive association between religiosity and vaccine rates, highlighting the role of leaders in endorsing the COVID-19 vaccination campaign.
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Affiliation(s)
| | - Valentina Febo
- EM Normandie Business School, Metis Lab, France, 30-32 Rue Henri Barbusse, 92110 Clichy, France
- Department of Management, University of Bologna, via Capo di Lucca 34, 40126 Bologna, Italy
| | - Salvatore Perdichizzi
- Department of Management, University of Bologna, via Capo di Lucca 34, 40126 Bologna, Italy
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21
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Albanesi B, Godono A, Comoretto RI, Casabona E, Curoso G, Leone MV, Milanesio N, Mirra I, Montrucchio G, Pittaluga F, Cavallo R, Clari M, Ciocan C. Immune Response of a Heterologous mRNA-1273 Second-Dose Immunization after a First Dose of ChadOx1 against SARS-CoV-2: A Cross-Sectional Study. Vaccines (Basel) 2022; 10:vaccines10081241. [PMID: 36016129 PMCID: PMC9416710 DOI: 10.3390/vaccines10081241] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Revised: 07/29/2022] [Accepted: 07/30/2022] [Indexed: 02/05/2023] Open
Abstract
Heterologous vaccination regimens could contribute to broadening vaccination coverage. To date, there is little evidence on the effectiveness of a combination of adenoviral COVID-19 vaccines with a second dose of mRNA vaccines. This study aims to evaluate the antibody response to the SARS-CoV-2 spike protein 25 weeks after vaccination with mRNA-1273 after a first dose of ChAdOx1. A cross-sectional study was conducted collecting sociodemographic data, clinical characteristics, and serological data from among the general population. Antibody levels were expressed as binding antibody units (BAU) per mL (cutoff = 33.8 BAU/mL). Linear regression models were used to assess the relationship between the subjects’ characteristics and anti-SARS-CoV-2 antibody levels. A total of 229 participants were followed up after a median time of 173 days. The overall anti-SARS-CoV-2 IgG antibody titer was 729.0 BAU/mL. The multivariable analysis showed that the only factor associated with anti-SARS-CoV-2 IgG levels was the BMI (p = 0.007), with decreases within the healthy range weight and increases in under- or overweight people. Our results support the use of heterologous COVID-19 vaccination regimens, as they can guarantee a sustained immune antibody response. More studies are needed to understand the link between BMI and body composition and the immune response to COVID-19 vaccinations.
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Affiliation(s)
- Beatrice Albanesi
- Department of Public Health and Pediatrics, University of Torino, 10126 Turin, Italy; (B.A.); (A.G.); (R.I.C.); (E.C.); (G.C.); (M.V.L.); (N.M.); (I.M.); (G.M.); (R.C.); (C.C.)
| | - Alessandro Godono
- Department of Public Health and Pediatrics, University of Torino, 10126 Turin, Italy; (B.A.); (A.G.); (R.I.C.); (E.C.); (G.C.); (M.V.L.); (N.M.); (I.M.); (G.M.); (R.C.); (C.C.)
| | - Rosanna Irene Comoretto
- Department of Public Health and Pediatrics, University of Torino, 10126 Turin, Italy; (B.A.); (A.G.); (R.I.C.); (E.C.); (G.C.); (M.V.L.); (N.M.); (I.M.); (G.M.); (R.C.); (C.C.)
| | - Elena Casabona
- Department of Public Health and Pediatrics, University of Torino, 10126 Turin, Italy; (B.A.); (A.G.); (R.I.C.); (E.C.); (G.C.); (M.V.L.); (N.M.); (I.M.); (G.M.); (R.C.); (C.C.)
| | - Giuliano Curoso
- Department of Public Health and Pediatrics, University of Torino, 10126 Turin, Italy; (B.A.); (A.G.); (R.I.C.); (E.C.); (G.C.); (M.V.L.); (N.M.); (I.M.); (G.M.); (R.C.); (C.C.)
| | - Massimiliano Victor Leone
- Department of Public Health and Pediatrics, University of Torino, 10126 Turin, Italy; (B.A.); (A.G.); (R.I.C.); (E.C.); (G.C.); (M.V.L.); (N.M.); (I.M.); (G.M.); (R.C.); (C.C.)
| | - Nicolò Milanesio
- Department of Public Health and Pediatrics, University of Torino, 10126 Turin, Italy; (B.A.); (A.G.); (R.I.C.); (E.C.); (G.C.); (M.V.L.); (N.M.); (I.M.); (G.M.); (R.C.); (C.C.)
| | - Ilenia Mirra
- Department of Public Health and Pediatrics, University of Torino, 10126 Turin, Italy; (B.A.); (A.G.); (R.I.C.); (E.C.); (G.C.); (M.V.L.); (N.M.); (I.M.); (G.M.); (R.C.); (C.C.)
| | - Giulia Montrucchio
- Department of Public Health and Pediatrics, University of Torino, 10126 Turin, Italy; (B.A.); (A.G.); (R.I.C.); (E.C.); (G.C.); (M.V.L.); (N.M.); (I.M.); (G.M.); (R.C.); (C.C.)
| | - Fabrizia Pittaluga
- Microbiology and Virology Unit, Città della Salute e della Scienza di Torino University Hospital, 10126 Turin, Italy;
| | - Rossana Cavallo
- Department of Public Health and Pediatrics, University of Torino, 10126 Turin, Italy; (B.A.); (A.G.); (R.I.C.); (E.C.); (G.C.); (M.V.L.); (N.M.); (I.M.); (G.M.); (R.C.); (C.C.)
| | - Marco Clari
- Department of Public Health and Pediatrics, University of Torino, 10126 Turin, Italy; (B.A.); (A.G.); (R.I.C.); (E.C.); (G.C.); (M.V.L.); (N.M.); (I.M.); (G.M.); (R.C.); (C.C.)
- Correspondence: ; Tel.: +39-011-6705831
| | - Catalina Ciocan
- Department of Public Health and Pediatrics, University of Torino, 10126 Turin, Italy; (B.A.); (A.G.); (R.I.C.); (E.C.); (G.C.); (M.V.L.); (N.M.); (I.M.); (G.M.); (R.C.); (C.C.)
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22
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Shumilov E, Aperdannier L, Schmidt N, Szuszies C, Neesse A, Hoffknecht P, Khandanpour C, Mikesch JH, Stelljes M, Boeckel GR, Tepasse PR, Reitnauer L, Koch R, Hasenkamp J, Bacher U, Scheithauer S, Trümper L, Schmitz N, Wulf G, Kerkhoff A, Lenz G, Krekeler C, Bleckmann A. Clinical Post-SARS-CoV-2 Infection Scenarios in Vaccinated and Non-Vaccinated Cancer Patients in Three German Cancer Centers: A Retrospective Analysis. Cancers (Basel) 2022; 14:cancers14153746. [PMID: 35954410 PMCID: PMC9367483 DOI: 10.3390/cancers14153746] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Revised: 07/20/2022] [Accepted: 07/26/2022] [Indexed: 02/04/2023] Open
Abstract
Simple Summary This study investigated SARS-CoV-2 infections and their impact on cancer in COVID-19 vaccinated (n = 49) and non-vaccinated (n = 84) cancer patients. A mild course of COVID-19 was documented more frequently in vaccinated cancer patients (49% vs. 29%), while the incidence of severe and critical courses occurred in approximately one-half of the non-vaccinated patients (22% vs. 42%). In comparison to non-vaccinated patients, admissions to intermediate and intensive care units and the need for non-invasive and invasive respiratory support were reduced by 71% and 50% among vaccinated patients. The median length of hospital stay was 11 days for non-vaccinated and 5 days for vaccinated patients. COVID-19 mortality was reduced by 83% in vaccinated patients. Finally, the median time from SARS-CoV-2 infection to restarting cancer therapy was 12 and 26 days among vaccinated and non-vaccinated groups, respectively. Our results provide evidence for the significant benefits of COVID-19 vaccines for cancer patients. Abstract COVID-19 vaccines have become an integral element in the protection of cancer patients against SARS-CoV-2. To date, there are no direct comparisons of the course of COVID-19 infection in cancer patients between the pre- and post-vaccine era. We analyzed SARS-CoV-2 infections and their impact on cancer in COVID-19 vaccinated and non-vaccinated patients from three German cancer centers. Overall, 133 patients with SARS-CoV-2 were enrolled in pre- and post-vaccine eras: 84 non-vaccinated and 49 vaccinated, respectively. A mild course of COVID-19 was documented more frequently in vaccinated patients (49% vs. 29%), while the frequency of severe and critical courses occurred in approximately one-half of the non-vaccinated patients (22% vs. 42%, p = 0.023). Particularly, patients with hematologic neoplasms benefited from vaccination in this context (p = 0.031). Admissions to intermediate- and intensive-care units and the necessity of non-invasive and invasive respiratory support were reduced by 71% and 50% among vaccinated patients, respectively. The median length of admission was 11 days for non-vaccinated and 5 days for vaccinated patients (p = 0.002). COVID-19 mortality was reduced by 83% in vaccinated patients (p = 0.046). Finally, the median time from SARS-CoV-2 infection to restarting cancer therapy was 12 and 26 days among vaccinated and non-vaccinated groups, respectively (p = 0.002). Although this study does not have enough power to perform multivariate analyses to account for confounders, it provides data on COVID-19 in non-vaccinated and vaccinated cancer patients and illustrates the potential benefits of COVID-19 vaccines for these patients.
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Affiliation(s)
- Evgenii Shumilov
- Department of Medicine A, Hematology, Oncology and Pneumology, University Hospital Münster, 48149 Münster, Germany; (C.K.); (J.-H.M.); (M.S.); (L.R.); (N.S.); (A.K.); (G.L.); (C.K.)
- Correspondence: or (E.S.); (A.B.)
| | - Lena Aperdannier
- Department of Hematology and Medical Oncology, University Medicine Göttingen (UMG), 37077 Göttingen, Germany; (L.A.); (N.S.); (C.S.); (R.K.); (J.H.); (L.T.); (G.W.)
| | - Nicole Schmidt
- Department of Hematology and Medical Oncology, University Medicine Göttingen (UMG), 37077 Göttingen, Germany; (L.A.); (N.S.); (C.S.); (R.K.); (J.H.); (L.T.); (G.W.)
| | - Christoph Szuszies
- Department of Hematology and Medical Oncology, University Medicine Göttingen (UMG), 37077 Göttingen, Germany; (L.A.); (N.S.); (C.S.); (R.K.); (J.H.); (L.T.); (G.W.)
| | - Albrecht Neesse
- Department of Gastroenterology, Gastrointestinal Oncology and Endocrinology, University Medicine Göttingen (UMG), 37077 Göttingen, Germany;
| | - Petra Hoffknecht
- Department of Thorax Oncology, Franziskus-Hospital Harderberg, Niels-Stensen-Kliniken, 49124 Georgsmarienhütte, Germany;
| | - Cyrus Khandanpour
- Department of Medicine A, Hematology, Oncology and Pneumology, University Hospital Münster, 48149 Münster, Germany; (C.K.); (J.-H.M.); (M.S.); (L.R.); (N.S.); (A.K.); (G.L.); (C.K.)
- Department of Hematology and Medical Oncology, University of Lübeck and University of Schleswig-Holstein, 23564 Lübeck, Germany
| | - Jan-Henrik Mikesch
- Department of Medicine A, Hematology, Oncology and Pneumology, University Hospital Münster, 48149 Münster, Germany; (C.K.); (J.-H.M.); (M.S.); (L.R.); (N.S.); (A.K.); (G.L.); (C.K.)
| | - Matthias Stelljes
- Department of Medicine A, Hematology, Oncology and Pneumology, University Hospital Münster, 48149 Münster, Germany; (C.K.); (J.-H.M.); (M.S.); (L.R.); (N.S.); (A.K.); (G.L.); (C.K.)
| | - Göran Ramin Boeckel
- Department of Medicine B for Gastroenterology, Hepatology, Endocrinology and Clinical Infectiology, University Hospital Münster, 48149 Münster, Germany; (G.R.B.); (P.-R.T.)
- Department of Medicine D for Nephrology and Rheumatology, University Hospital Münster, 48149 Münster, Germany
| | - Phil-Robin Tepasse
- Department of Medicine B for Gastroenterology, Hepatology, Endocrinology and Clinical Infectiology, University Hospital Münster, 48149 Münster, Germany; (G.R.B.); (P.-R.T.)
| | - Lea Reitnauer
- Department of Medicine A, Hematology, Oncology and Pneumology, University Hospital Münster, 48149 Münster, Germany; (C.K.); (J.-H.M.); (M.S.); (L.R.); (N.S.); (A.K.); (G.L.); (C.K.)
| | - Raphael Koch
- Department of Hematology and Medical Oncology, University Medicine Göttingen (UMG), 37077 Göttingen, Germany; (L.A.); (N.S.); (C.S.); (R.K.); (J.H.); (L.T.); (G.W.)
| | - Justin Hasenkamp
- Department of Hematology and Medical Oncology, University Medicine Göttingen (UMG), 37077 Göttingen, Germany; (L.A.); (N.S.); (C.S.); (R.K.); (J.H.); (L.T.); (G.W.)
| | - Ulrike Bacher
- Central Hematology Laboratory, Department of Hematology, Inselspital, Bern University Hospital, University of Bern, 3010 Bern, Switzerland;
| | - Simone Scheithauer
- Department of Infection Control and Infectious Diseases, University Medicine Göttingen (UMG), 37077 Göttingen, Germany;
| | - Lorenz Trümper
- Department of Hematology and Medical Oncology, University Medicine Göttingen (UMG), 37077 Göttingen, Germany; (L.A.); (N.S.); (C.S.); (R.K.); (J.H.); (L.T.); (G.W.)
| | - Norbert Schmitz
- Department of Medicine A, Hematology, Oncology and Pneumology, University Hospital Münster, 48149 Münster, Germany; (C.K.); (J.-H.M.); (M.S.); (L.R.); (N.S.); (A.K.); (G.L.); (C.K.)
| | - Gerald Wulf
- Department of Hematology and Medical Oncology, University Medicine Göttingen (UMG), 37077 Göttingen, Germany; (L.A.); (N.S.); (C.S.); (R.K.); (J.H.); (L.T.); (G.W.)
| | - Andrea Kerkhoff
- Department of Medicine A, Hematology, Oncology and Pneumology, University Hospital Münster, 48149 Münster, Germany; (C.K.); (J.-H.M.); (M.S.); (L.R.); (N.S.); (A.K.); (G.L.); (C.K.)
| | - Georg Lenz
- Department of Medicine A, Hematology, Oncology and Pneumology, University Hospital Münster, 48149 Münster, Germany; (C.K.); (J.-H.M.); (M.S.); (L.R.); (N.S.); (A.K.); (G.L.); (C.K.)
| | - Carolin Krekeler
- Department of Medicine A, Hematology, Oncology and Pneumology, University Hospital Münster, 48149 Münster, Germany; (C.K.); (J.-H.M.); (M.S.); (L.R.); (N.S.); (A.K.); (G.L.); (C.K.)
| | - Annalen Bleckmann
- Department of Medicine A, Hematology, Oncology and Pneumology, University Hospital Münster, 48149 Münster, Germany; (C.K.); (J.-H.M.); (M.S.); (L.R.); (N.S.); (A.K.); (G.L.); (C.K.)
- Correspondence: or (E.S.); (A.B.)
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23
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Padín-González E, Lancaster P, Bottini M, Gasco P, Tran L, Fadeel B, Wilkins T, Monopoli MP. Understanding the Role and Impact of Poly (Ethylene Glycol) (PEG) on Nanoparticle Formulation: Implications for COVID-19 Vaccines. Front Bioeng Biotechnol 2022; 10:882363. [PMID: 35747492 PMCID: PMC9209764 DOI: 10.3389/fbioe.2022.882363] [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] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Accepted: 05/09/2022] [Indexed: 12/27/2022] Open
Abstract
Poly (ethylene glycol) (PEG) is a widely used polymer in a variety of consumer products and in medicine. PEGylation refers to the conjugation of PEG to drugs or nanoparticles to increase circulation time and reduce unwanted host responses. PEG is viewed as being well-tolerated, but previous studies have identified anti-PEG antibodies and so-called pseudoallergic reactions in certain individuals. The increased use of nanoparticles as contrast agents or in drug delivery, along with the introduction of mRNA vaccines encapsulated in PEGylated lipid nanoparticles has brought this issue to the fore. Thus, while these vaccines have proven to be remarkably effective, rare cases of anaphylaxis have been reported, and this has been tentatively ascribed to the PEGylated carriers, which may trigger complement activation in susceptible individuals. Here, we provide a general overview of the use of PEGylated nanoparticles for pharmaceutical applications, and we discuss the activation of the complement cascade that might be caused by PEGylated nanomedicines for a better understanding of these immunological adverse reactions.
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Affiliation(s)
| | - Pearl Lancaster
- Department of Chemistry, Royal College of Surgeons in Ireland (RCSI), Dublin, Ireland
| | - Massimo Bottini
- Department of Experimental Medicine, University of Rome Tor Vergata, Rome, Italy
| | | | - Lang Tran
- Institute of Occupational Medicine, Edinburgh, United Kingdom
| | - Bengt Fadeel
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Terence Wilkins
- School of Chemical and Process Engineering, University of Leeds, Leeds, United Kingdom
- Correspondence: Terence Wilkins, ; Marco P. Monopoli,
| | - Marco P. Monopoli
- Department of Chemistry, Royal College of Surgeons in Ireland (RCSI), Dublin, Ireland
- Correspondence: Terence Wilkins, ; Marco P. Monopoli,
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24
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Franic J. What Lies Behind Substantial Differences in COVID-19 Vaccination Rates Between EU Member States? Front Public Health 2022; 10:858265. [PMID: 35757613 PMCID: PMC9231480 DOI: 10.3389/fpubh.2022.858265] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Accepted: 04/22/2022] [Indexed: 12/01/2022] Open
Abstract
Background Despite the billions of doses at disposal, less than three-quarters of EU citizens received a COVID-19 vaccine by the end of 2021. The situation is particularly worrying in transition societies, which experience much stronger opposition to vaccination compared to their Western counterparts. To understand whether and to what extent this has to do with the socialist legacy, in this paper we explore wider economic, political, and cultural determinants of the COVID-19 vaccine uptake in the EU. Methods Data from Flash Eurobarometer 494 conducted in May 2021 were used to model the attitudes of EU citizens toward COVID-19 vaccination. Based on their views and intentions, each of 26,106 survey participants was allocated into one of the following categories: (1) already vaccinated/plan to get vaccinated; (2) indecisive; (3) refuse vaccination. Multilevel multinomial logit was employed to understand what underlies the reasoning of each group. Results The survey revealed that 13.4% of Europeans planned to delay vaccination against COVID-19, while 11.2% did not intend to get vaccinated. Although numerous demographic and socio-economic factors jointly shape their viewpoints, it is trust (in the authorities, science, peers, and online social networks above all) that strongly dominates citizens' reasoning. Given that most transition societies are witnessing the pandemic of distrust at various levels, this seemingly unrelated feature appears to be vital in explaining why newer member states record lower vaccination rates. Education was also found to play a pivotal role, which is reflected in an individual's ability to critically assess information from various sources. Conclusion The study results clearly illustrate how long-lasting structural problems (specific for, but not confined to, transition countries) can manifest themselves in unforeseen circumstances if left unaddressed. It is hence of vital importance to learn the lesson and prevent similar issues in the future. Above all, this would require wide-ranging reforms aiming to repair the imperceptible psychological contract between citizens and the state authorities.
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25
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Fang E, Liu X, Li M, Zhang Z, Song L, Zhu B, Wu X, Liu J, Zhao D, Li Y. Advances in COVID-19 mRNA vaccine development. Signal Transduct Target Ther 2022; 7:94. [PMID: 35322018 PMCID: PMC8940982 DOI: 10.1038/s41392-022-00950-y] [Citation(s) in RCA: 141] [Impact Index Per Article: 70.5] [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: 11/22/2021] [Revised: 02/10/2022] [Accepted: 03/03/2022] [Indexed: 12/15/2022] Open
Abstract
To date, the coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has determined 399,600,607 cases and 5,757,562 deaths worldwide. COVID-19 is a serious threat to human health globally. The World Health Organization (WHO) has declared COVID-19 pandemic a major public health emergency. Vaccination is the most effective and economical intervention for controlling the spread of epidemics, and consequently saving lives and protecting the health of the population. Various techniques have been employed in the development of COVID-19 vaccines. Among these, the COVID-19 messenger RNA (mRNA) vaccine has been drawing increasing attention owing to its great application prospects and advantages, which include short development cycle, easy industrialization, simple production process, flexibility to respond to new variants, and the capacity to induce better immune response. This review summarizes current knowledge on the structural characteristics, antigen design strategies, delivery systems, industrialization potential, quality control, latest clinical trials and real-world data of COVID-19 mRNA vaccines as well as mRNA technology. Current challenges and future directions in the development of preventive mRNA vaccines for major infectious diseases are also discussed.
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Affiliation(s)
- Enyue Fang
- National Institute for Food and Drug Control, Beijing, 102629, China
- Wuhan Institute of Biological Products, Co., Ltd., Wuhan, 430207, China
| | - Xiaohui Liu
- National Institute for Food and Drug Control, Beijing, 102629, China
| | - Miao Li
- National Institute for Food and Drug Control, Beijing, 102629, China
| | - Zelun Zhang
- National Institute for Food and Drug Control, Beijing, 102629, China
| | - Lifang Song
- National Institute for Food and Drug Control, Beijing, 102629, China
| | - Baiyu Zhu
- Texas A&M University, College Station, TX, 77843, USA
| | - Xiaohong Wu
- National Institute for Food and Drug Control, Beijing, 102629, China
| | - Jingjing Liu
- National Institute for Food and Drug Control, Beijing, 102629, China
| | - Danhua Zhao
- National Institute for Food and Drug Control, Beijing, 102629, China
| | - Yuhua Li
- National Institute for Food and Drug Control, Beijing, 102629, China.
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26
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de Vries ST, Starokozhko V, Schellens IMM, Wijnans L, Enzmann H, Cavaleri M, Mol PGM. Attention for sex in COVID-19 trials: a review of regulatory dossiers. BMJ Glob Health 2022; 7:bmjgh-2021-008173. [PMID: 35304352 PMCID: PMC8935005 DOI: 10.1136/bmjgh-2021-008173] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [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: 12/02/2021] [Accepted: 02/08/2022] [Indexed: 12/13/2022] Open
Abstract
An under-representation of women and a lack of sex-specific analyses in COVID-19 trials has been suggested. However, the higher number of men than women who are severely affected by COVID-19 and the restricted information in scientific publications may have biased these suggestions. Therefore, we evaluated sex proportionality and sex-specific efficacy and safety data in trials of COVID-19 treatments and vaccines using both publicly available regulatory documents and confidential documents used by regulators in their review of medicinal products. Included were two treatments (ie, remdesivir and dexamethasone) and four vaccines (ie, BNT162b2 mRNA (BioNTech/Pfizer), mRNA-1273 (Moderna), ChAdOx1-S (AstraZeneca) and Ad26.COV2-S (Janssen)) that received marketing authorisation by the European Commission at the time of the study conduct. An under-representation of women was shown in three of the nine data sets for one treatment (ie, remdesivir), but the proportion of women included was representative in each of the data sets for the other five products. This indicates that there is no structural under-representation of women in the COVID-19 trials. Currently, sex-specific efficacy data are available for five of the six assessed products and sex-specific safety data are available for half of the products only. It is important that this information will also be made available for the other products. There are only small differences in efficacy and safety between men and women which are likely to be of limited clinical relevance. Sex-specific efficacy information can generally be found in the publicly available regulatory documents other than the Summary of Product Characteristics, for which more awareness might be required.
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Affiliation(s)
- Sieta T de Vries
- Department of Clinical Pharmacy and Pharmacology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.,Dutch Medicines Evaluation Board, Utrecht, The Netherlands
| | - Viktoriia Starokozhko
- Department of Clinical Pharmacy and Pharmacology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.,Dutch Medicines Evaluation Board, Utrecht, The Netherlands
| | | | | | - Harald Enzmann
- Committee for Medicinal Products for Human Use, European Medicines Agency (EMA), Amsterdam, The Netherlands.,Bundesinstitut für Arzneimittel und Medizinprodukte, Bonn, Germany
| | - Marco Cavaleri
- European Medicines Agency (EMA), Amsterdam, The Netherlands
| | - Peter G M Mol
- Department of Clinical Pharmacy and Pharmacology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands .,Dutch Medicines Evaluation Board, Utrecht, The Netherlands.,Scientific Advice Working Party, European Medicines Agency (EMA), Amsterdam, The Netherlands
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Finch CL, Martinez C, Leffel E, Skiadopoulos MH, Hacker A, Mwesigwa B, Maïga D, Mugisa I, Munkwase G, Rustomjee R. Vaccine Licensure in the Absence of Human Efficacy Data. Vaccines (Basel) 2022; 10:vaccines10030368. [PMID: 35335000 PMCID: PMC8954083 DOI: 10.3390/vaccines10030368] [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] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Revised: 02/18/2022] [Accepted: 02/19/2022] [Indexed: 02/01/2023] Open
Abstract
Clinical vaccine development and regulatory approval generally occurs in a linear, sequential manner: Phase 1: safety, immunogenicity; Phase 2: immunogenicity, safety, dose ranging, and preliminary efficacy; Phase 3: definitive efficacy, safety, lot consistency; and following regulatory approval, Phase 4: post-marketing safety and effectiveness. For candidate filovirus vaccines, where correlates of protection have not been identified, and phase 2 and 3 efficacy of disease prevention trials untenable, large and/or protracted, each trial may span decades, with full licensure expected only after several decades of development. Given the urgent unmet need for new Marburg virus and Ebola Sudan virus vaccines, the Sabin Vaccine Institute hosted a key stakeholder virtual meeting in May 2021 to explore the possibility of licensure by use of an “animal rule-like” licensure process, based on a risk/benefit assessment specific to regional needs and informed by epidemiology. This may be appropriate for diseases where there are no or limited treatment options, and those prone to sporadic outbreaks with high rates of transmission, morbidity, and mortality. The discussion focused on two contexts: licensure within the Ugandan regulatory environment, a high burden country where Ebola vaccine trials are ongoing, and licensure by the United States FDA—a well-resourced regulatory agency.
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Affiliation(s)
- Courtney L. Finch
- Sabin Vaccine Institute, Washington, DC 20037, USA;
- Correspondence: (C.L.F.); (R.R.)
| | | | | | | | - Adam Hacker
- Coalition for Epidemic Preparedness Innovations, Bloomsbury, London NW1 2BE, UK;
| | - Betty Mwesigwa
- Makerere University Walter Reed Project, Kampala 16524, Uganda;
| | - Diadié Maïga
- Regional Office of Africa, World Health Organization, Brazzaville P.O. Box 06, Congo;
| | - Ian Mugisa
- National Drug Authority, Kampala 23096, Uganda; (I.M.); (G.M.)
| | - Grant Munkwase
- National Drug Authority, Kampala 23096, Uganda; (I.M.); (G.M.)
| | - Roxana Rustomjee
- Sabin Vaccine Institute, Washington, DC 20037, USA;
- Correspondence: (C.L.F.); (R.R.)
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Jan M, Alqahtani M, Amer KA, Althubait B, Aldosari AAS, Al mudawi AAM. COVID-19 and Vaccine Hesitancy: Individual Determinants Among Saudis in Asir Region. Cureus 2022; 14:e22331. [PMID: 35317043 PMCID: PMC8934120 DOI: 10.7759/cureus.22331] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/17/2022] [Indexed: 11/05/2022] Open
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Ju JH, Lee N, Kim SH, Chang S, Yang M, Shin J, Lee E, Sung S, Kim JH, Hong JT, Oh HJ. Points to consider for COVID-19 vaccine quality control and national lot release in Republic of Korea: focus on a viral vector platform. Osong Public Health Res Perspect 2022; 13:4-14. [PMID: 35255674 PMCID: PMC8907614 DOI: 10.24171/j.phrp.2021.0311] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Accepted: 12/30/2021] [Indexed: 11/24/2022] Open
Abstract
Due to the global public health crisis caused by the coronavirus disease 2019 (COVID-19) pandemic, the importance of vaccine development has increased. In particular, a rapid supply of vaccines and prompt deployment of vaccination programs are essential to prevent and overcome the spread of COVID-19. As a part of the vaccine regulations, national lot release is regulated by the responsible authorities, and this process involves the assessment of the lot before a vaccine is marketed. A lot can be released for use when both summary protocol (SP) review and quality control testing are complete. Accelerated lot release is required to distribute COVID-19 vaccines in a timely manner. In order to expedite the process by simultaneously undertaking the verification of quality assessment and application for approval, it is necessary to prepare the test methods before marketing authorization. With the prolonged pandemic and controversies regarding the effectiveness of the COVID-19 vaccine against new variants, public interest for the development of a new vaccine are increasing. Domestic developers have raised the need to establish standard guidance on the requirements for developing COVID-19 vaccine. This paper presents considerations for quality control in the manufacturing process, test items, and SP content of viral vector vaccines.
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Kochhar S, Barreira D, Beattie P, Cavaleri M, Cravioto A, Frick MW, Ginsberg AM, Hudson I, Kaslow DC, Kurtz S, Lienhardt C, Madhi SA, Morgan C, Momeni Y, Patel D, Rees H, Rogalski-salter T, Schmidt A, Semete-makokotlela B, Voss G, White RG, Zignol M, Giersing B. Building the concept for WHO Evidence Considerations for Vaccine Policy (ECVP): Tuberculosis vaccines intended for adults and adolescents as a test case. Vaccine 2022. [PMID: 35164990 PMCID: PMC8914344 DOI: 10.1016/j.vaccine.2021.10.062] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Accepted: 10/25/2021] [Indexed: 12/17/2022]
Abstract
Currently, no formal mechanisms or systematic approaches exist to inform developers of new vaccines of the evidence anticipated to facilitate global policy recommendations, before a vaccine candidate approaches regulatory approval at the end of pre-licensure efficacy studies. Consequently, significant delays may result in vaccine introduction and uptake, while post-licensure data are generated to support a definitive policy decision. To address the uncertainties of the evidence-to-recommendation data needs and to mitigate the risk of delays between vaccine recommendation and use, WHO is evaluating the need for and value of a new strategic alignment tool: Evidence Considerations for Vaccine Policy (ECVP). EVCPs aim to fill a critical current gap by providing early (pre-phase 3 study design) information on the anticipated clinical trial and observational data or evidence that could support WHO and/or policy decision making for new vaccines in priority disease areas. The intent of ECVPs is to inform vaccine developers, funders, and other key stakeholders, facilitating stakeholder alignment in their strategic planning for late stage vaccine development. While ECVPs are envisaged as a tool to support dialogue on evidence needs between regulators and policy makers at the national, regional and global level, development of an ECVP will not preclude or supersede the independent WHO’s Strategic Advisory Group of Experts on Immunization (SAGE) evidence to recommendation (EtR) process that is required for all vaccines seeking WHO policy recommendation. Tuberculosis (TB) vaccine candidates intended for use in the adolescent and adult target populations comprise a portfolio of priority vaccines in late-stage clinical development. As such, TB vaccines intended for use in this target population provide a ‘test case’ to further develop the ECVP concept, and develop the first WHO ECVP considerations guidance.
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Barreiro NL, Ventura CI, Govezensky T, Núñez M, Bolcatto PG, Barrio RA. Strategies for COVID-19 vaccination under a shortage scenario: a geo-stochastic modelling approach. Sci Rep 2022; 12. [PMID: 35102216 PMCID: PMC8803887 DOI: 10.1038/s41598-022-05481-8] [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: 04/27/2021] [Accepted: 01/12/2022] [Indexed: 12/15/2022] Open
Abstract
In a world being hit by waves of COVID-19, vaccination is a light on the horizon. However, the roll-out of vaccination strategies and their influence on the pandemic are still open questions. In order to compare the effect of various strategies proposed by the World Health Organization and other authorities, a previously developed SEIRS stochastic model of geographical spreading of the virus is extended by adding a compartment for vaccinated people. The parameters of the model were fitted to describe the pandemic evolution in Argentina, Mexico and Spain to analyze the effect of the proposed vaccination strategies. The mobility parameters allow to simulate different social behaviors (e.g. lock-down interventions). Schemes in which vaccines are applied homogeneously in all the country, or limited to the most densely-populated areas, are simulated and compared. The second strategy is found to be more effective. Moreover, under the current global shortage of vaccines, it should be remarked that immunization is enhanced when mobility is reduced. Additionally, repetition of vaccination campaigns should be timed considering the immunity lapse of the vaccinated (and recovered) people. Finally, the model is extended to include the effect of isolation of detected positive cases, shown to be important to reduce infections.
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Darraj MA, Al-mekhlafi HM. Prospective Evaluation of Side-Effects Following the First Dose of Oxford/AstraZeneca COVID-19 Vaccine among Healthcare Workers in Saudi Arabia. Vaccines (Basel) 2022; 10:223. [PMID: 35214681 PMCID: PMC8875598 DOI: 10.3390/vaccines10020223] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Revised: 01/20/2022] [Accepted: 01/27/2022] [Indexed: 11/16/2022] Open
Abstract
Background: Several different types of vaccines have been developed for the prevention of coronavirus disease (COVID-19). Despite several local and systemic side-effects to COVID-19 vaccination reported, the vaccines are still considered the best intervention to tackle the spread of the virus and reduce the severity of COVID-19 infection. However, the reported side-effects continue to have a crucial role in public confidence in the vaccine and its acceptance. This study aimed to investigate the short-term side-effects reported by the healthcare workers (HCWs) in Saudi Arabia after receiving the first dose of the Oxford/AstraZeneca (ChAdOx1 nCoV-19) COVID-19 vaccine. Methods: A prospective cohort study was conducted among HCWs in the Jazan region of southwestern Saudi Arabia. Healthcare workers who had received the first dose of the COVID-19 vaccine and agreed to participate in the study were followed up for 3 weeks post vaccination through a weekly online survey. Information was collected on local and/or systemic side-effects reported following vaccine administration. Participants’ general and demographic information was also collected. Results: A total of 57.2% (250/437) of the HCWs who participated in this study reported at least one side-effect. Injection site pain and redness (80.0%), fever (73.2%), whole-body pain/fatigue (56.4%), and headache (48.8%) were the most commonly reported side-effects. Moreover, 12.4% of the participants who reported side-effects needed to see a physician, and only one female participant was admitted to the hospital. Multivariate regression analyses revealed that nationality (Saudi, adjusted odds ratio (aOR) = 3.65; 95% CI = 2.40, 5.55) and residency (Jazan governorate, aOR = 0.38; 95% CI = 0.15, 0.95) were the significant factors associated with reporting COVID-19 post-vaccination side-effects, while the number of reported side-effects was found to be significantly influenced by occupation (medical, aOR = 0.42; 95% CI = 0.26, 0.66; p < 0.001) and gender (female, aOR = 0.61; 95% CI = 0.38, 0.97; p = 0.038). Conclusions: Findings of the present study support the safety of the Oxford/AstraZeneca COVID-19 vaccine among HCWs in Saudi Arabia. All the reported side-effects were mild-to-moderate side-effects. The findings may help convince vaccine-hesitant individuals and skeptics to accept the COVID-19 vaccine.
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Ecer F. An extended MAIRCA method using intuitionistic fuzzy sets for coronavirus vaccine selection in the age of COVID-19. Neural Comput Appl 2022; 34:5603-5623. [PMID: 35017795 PMCID: PMC8736313 DOI: 10.1007/s00521-021-06728-7] [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] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Accepted: 11/02/2021] [Indexed: 12/28/2022]
Abstract
All over the world, the COVID-19 outbreak seriously affects life, whereas numerous people have infected and passed away. To control the spread of it and to protect people, appreciable vaccine development efforts continue with increasing momentum. Given that this pandemic will be in our lives for a long time, it is obvious that a reliable and useful framework is needed to choose among coronavirus vaccines. To this end, this paper proposes a new intuitionistic fuzzy extension of MAIRCA framework, named intuitionistic fuzzy MAIRCA (IF-MAIRCA) to assess coronavirus vaccines according to some evaluation criteria. Based on the group decision-making, the IF-MAIRCA framework both extracts the criteria weights and discovers the prioritization of the alternatives under uncertainty. In this work, as a case study, five coronavirus vaccines approved by the world's leading authorities are evaluated according to various criteria. The findings demonstrate that the most significant criteria considered in coronavirus vaccine selection are “duration of protection,” “effectiveness of the vaccine,” “success against the mutations,” and “logistics,” respectively, whereas the best coronavirus vaccine is AZD1222. Apart from this, the proposed model's robustness is verified with a three-phase sensitivity analysis.
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Affiliation(s)
- Fatih Ecer
- Department of Business Administrative, Faculty of Economics and Administrative Sciences, Afyon Kocatepe University, 03030 Afyonkarahisar, Turkey
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Nishiwaki S, Ando Y. COVID-19 Pandemic and Trends in Clinical Trials: A Multi-Region and Global Perspective. Front Med (Lausanne) 2022; 8:812370. [PMID: 35004791 PMCID: PMC8739772 DOI: 10.3389/fmed.2021.812370] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Accepted: 12/08/2021] [Indexed: 12/29/2022] Open
Abstract
To evaluate the effect of the COVID-19 pandemic on clinical development, the number of newly started clinical trials in each geographical region between January 2018 and December 2020 were calculated based on data from the ClinicalTrials.gov database. Data regarding new drug applications were obtained from European Medicines Agency monthly reports, pharmaceutical company press releases, and the archives of the Drugs.com database. The mean percentage change in newly started clinical trials for diseases other than COVID-19 between each month in 2019 and the corresponding month in 2020 was −7.5%, with the maximum of −57.3% observed between April 2019 and April 2020. Similarly, the mean percentage change of reported results for each month in 2019 and 2020 was −5.1%, with the maximum of −27.4% observed in July 2020. The activity of clinical trials was decreased as the number of COVID-19 patients was increased, and a statistically negative correlation was observed between the prevalence of COVID-19 and the percentage decrease in the number of clinical trials stared or reported results. As for new drug submissions, decreases were observed in the latter half of 2020 compared with the same period during the previous year, for each indicator. A considerable decline in non-COVID-19 activity for all indicators regarding clinical developments was suggested during the first wave of the COVID-19 pandemic. It is important to recognize the situation and continue to make efforts to conduct clinical trials for both COVID-19 and no-COVID-19 for new medical developments in the future.
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Affiliation(s)
- Satoshi Nishiwaki
- Department of Advanced Medicine, Nagoya University Hospital, Nagoya, Japan
| | - Yuichi Ando
- Department of Advanced Medicine, Nagoya University Hospital, Nagoya, Japan
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Al Kaabi N, Oulhaj A, Al Hosani FI, Al Mazrouei S, Najim O, Hussein SE, Abdalla JS, Fasihuddin MS, Hassan AA, Elghazali G, Al Rumaithi A, Al Azazi J, Weber S, Beiram R, Parekh KA, Sheek-Hussein M, Yang Y, Xiaoming Y, Quliang J, Eltantawy I, Mahmoud S, Koshy A, Xiao P, Ganesan S, Elamin W, Zaher W. The incidence of COVID-19 infection following emergency use authorization of BBIBP-CORV inactivated vaccine in frontline workers in the United Arab Emirates. Sci Rep 2022; 12:490. [PMID: 35017530 DOI: 10.1038/s41598-021-04244-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Accepted: 11/30/2021] [Indexed: 11/21/2022] Open
Abstract
Based on the findings from the Phase III clinical trials of inactivated SARS COV-2 Vaccine, (BBIBP-CORV) emergency use authorization (EUA) was granted for the vaccine to frontline workers in the UAE. A prospective cohort study was conducted among frontline workers to estimate the incidence rate and risk of symptomatic COVID-19 infection 14 days after the second dose of inoculation with BBIBP-CORV inactivated vaccine. Those who received two doses of the BBIBP-CORV vaccine in the period from 14th of September 2020 (first dose) to 21st of December 2020 (second dose) were followed up for COVID-19 infections. 11,322 individuals who received the two-dose BBIBP-CORV vaccine were included and were followed up post the second dose plus fourteen days. The incidence rate of symptomatic infection was 0.08 per 1000-person days (95% CI 0.07, 0.10). The estimated absolute risk of developing symptomatic infection was 0.97% (95% CI 0.77%, 1.17%). The confirmed seroconversion rate was 92.8%. There were no serious adverse events reported and no individuals suffered from severe disease. Our findings show that vaccinated individuals are likely to remain protected against symptomatic infection or becoming PCR positive for SARS COV 2 following the second dose of the vaccination.
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Nashwan AJ, Yassin MA, Soliman AT, De Sanctis V, Ibrahim MI. mRNA-based COVID-19 Vaccines Booster Dose: Benefits, Risks and Coverage. Acta Biomed 2022; 93:e2022236. [PMID: 35775753 PMCID: PMC9335425 DOI: 10.23750/abm.v93i3.13103] [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] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Accepted: 04/27/2022] [Indexed: 11/13/2022]
Abstract
The number of COVID-19 vaccine-rich countries that have started COVID-19 third-dose booster programs is growing dramatically despite the lack of robust evidence on the effectiveness, safety, and frequency of the required booster doses that makes the individuals/populations immune to COVID -19 infection. Beyond the ethical dilemma, the scarcity of studies on the optimal timing for offering booster doses, eligibility criteria, and if there is any association between premature or delayed administration and the degree of protection against infection. The aim of this mini- review was to collect and analyze published data on this topic in a trial to answer some questions related to the benefits versus the risks of offering frequent boosters of mRNA vaccines for increasing the population immunity against COVID-19 infection considering the current policy of providing SARS-CoV-2 vaccine booster doses in rich countries versus those in relatively poor countries with limited access to vaccination. (www.actabiomedica.it).
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Affiliation(s)
- Abdulqadir J. Nashwan
- Director of Nursing for Education & Practice Development, Hamad Medical Corporation, PO Box 3050, Doha, Qatar, College of Health Sciences, QU Health, Qatar University, P. O. Box:2713, Doha, Qatar
| | - Mohamed A. Yassin
- Department of Hematology/Oncology, National Cancer Institute, HMC, Doha, Qatar
| | | | - Vincenzo De Sanctis
- Pediatric and Adolescent Outpatients Clinic, Quisisana Hospital, Ferrara, Italy
| | - Mohamed I. Ibrahim
- College of Pharmacy, QU Health, Qatar University, PO Box 2713, Doha, Qatar
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Sung JC, Liu Y, Wu KC, Choi MC, Ma CH, Lin J, He EIC, Leung DY, Sze ET, Hamied YK, Lam DM, Kwong KW. Expression of SARS-CoV-2 Spike Protein Receptor Binding Domain on Recombinant B. subtilis on Spore Surface: A Potential COVID-19 Oral Vaccine Candidate. Vaccines (Basel) 2021; 10:2. [PMID: 35062663 DOI: 10.3390/vaccines10010002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Revised: 12/13/2021] [Accepted: 12/19/2021] [Indexed: 12/11/2022] Open
Abstract
Various types of vaccines, such as mRNA, adenovirus, and inactivated virus by injection, have been developed to prevent SARS-CoV-2 infection. Although some of them have already been approved under the COVID-19 pandemic, various drawbacks, including severe side effects and the requirement for sub-zero temperature storage, may hinder their applications. Bacillus subtilis (B. subtilis) is generally recognized as a safe and endotoxin-free Gram-positive bacterium that has been extensively employed as a host for the expression of recombinant proteins. Its dormant spores are extraordinarily resistant to the harsh environment in the gastrointestinal tract. This feature makes it an ideal carrier for oral administration in resisting this acidic environment and for release in the intestine. In this study, an engineered B. subtilis spore expressing the SARS-CoV-2 spike protein receptor binding domain (sRBD) on the spore surface was developed. In a pilot test, no adverse health event was observed in either mice or healthy human volunteers after three oral courses of B. subtilis spores. Significant increases in neutralizing antibody against sRBD, in both mice and human volunteers, after oral administration were also found. These findings may enable the further clinical developments of B. subtilis spores as an oral vaccine candidate against COVID-19 in the future.
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Córdova-Martínez A, Caballero-García A, Roche E, Noriega DC. β-Glucans Could Be Adjuvants for SARS-CoV-2 Virus Vaccines (COVID-19). Int J Environ Res Public Health 2021; 18:ijerph182312636. [PMID: 34886361 PMCID: PMC8656611 DOI: 10.3390/ijerph182312636] [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] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Revised: 11/26/2021] [Accepted: 11/27/2021] [Indexed: 12/23/2022]
Abstract
Waiting for an effective treatment against the SARS-CoV-2 virus (the cause of COVID-19), the current alternatives include prevention and the use of vaccines. At the moment, vaccination is the most effective strategy in the fight against pandemic. Vaccines can be administered with different natural biological products (adjuvants) with immunomodulating properties. Adjuvants can be taken orally, complementing vaccine action. Adjuvant compounds could play a key role in alleviating the symptoms of the disease, as well as in enhancing vaccine action. Adjuvants also contribute to an effective immune response and can enhance the protective effect of vaccines in immunocompromised individuals such as the elderly. Adjuvants must not produce adverse effects, toxicity, or any other symptoms that could alter immune system function. Vaccine adjuvants are substances of wide varying chemical structure that are used to boost the immune response against a simultaneously administered antigen. Glucans could work as adjuvants due to their immunomodulatory biological activity. In this respect, β-(1,3)-(1,6) glucans are considered the most effective and safe according to the list issued by the European Commission. Only glucans with a β-(1,3) bond linked to a β-(1,6) are considered modulators of certain biological responses. The aim of this review is to present the possible effects of β-glucans as adjuvants in the efficacy of vaccines against SARS-CoV-2 virus.
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Affiliation(s)
- Alfredo Córdova-Martínez
- Department of Biochemistry, Molecular Biology and Physiology, Faculty of Health Sciences, GIR: “Physical Exercise and Ageing”, University Campus “Los Pajaritos”, Valladolid University, 42004 Soria, Spain
- Correspondence:
| | - Alberto Caballero-García
- Department of Anatomy and Radiology, Faculty of Health Sciences, GIR: “Physical Exercise and Ageing”, University Campus “Los Pajaritos”, Valladolid University, 42004 Soria, Spain;
| | - Enrique Roche
- Department of Applied Biology-Nutrition, Institute of Bioengineering, Miguel Hernández University, 03202 Elche, Spain;
- Instituto de Investigación Sanitaria y Biomédica de Alicante (ISABIAL), 03010 Alicante, Spain
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain
| | - David C. Noriega
- Spine Unit, Department of Surgery, Ophthalmology, Otorhinolaryngology and Physiotherapy, Faculty of Medicine, Hospital Clínico Universitario de Valladolid, 47003 Valladolid, Spain;
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Mustapha M, Lawal BK, Sha’aban A, Jatau AI, Wada AS, Bala AA, Mustapha S, Haruna A, Musa A, Ahmad MH, Iliyasu S, Muhammad S, Mohammed FZ, Ahmed AD, Zainal H. Factors associated with acceptance of COVID-19 vaccine among University health sciences students in Northwest Nigeria. PLoS One 2021; 16:e0260672. [PMID: 34843594 PMCID: PMC8629299 DOI: 10.1371/journal.pone.0260672] [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] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2021] [Accepted: 11/12/2021] [Indexed: 12/23/2022] Open
Abstract
Students of the health sciences are the future frontliners to fight pandemics. The students' participation in COVID-19 response varies across countries and are mostly for educational purposes. Understanding the determinants of COVID-19 vaccine acceptability is necessary for a successful vaccination program. This study aimed to investigate the factors associated with COVID-19 vaccine acceptance among health sciences students in Northwest Nigeria. The study was an online self-administered cross-sectional study involving a survey among students of health sciences in some selected universities in Northwest Nigeria. The survey collected pertinent data from the students, including socio-demographic characteristics, risk perception for COVID-19, and willingness to accept the COVID-19 vaccine. Multiple logistic regression was used to determine the predictors of COVID-19 vaccine acceptance. A total of 440 responses with a median (interquartile range) age of 23 (4.0) years were included in the study. The prevalence of COVID-19 vaccine acceptance was 40.0%. Factors that independently predict acceptance of the vaccine were age of 25 years and above (adjusted odds ratio, aOR, 2.72; 95% confidence interval, CI, 1.44-5.16; p = 0.002), instructions from heads of institutions (aOR, 11.71; 95% CI, 5.91-23.20; p<0.001), trust in the government (aOR, 20.52; 95% CI, 8.18-51.51; p<0.001) and willingness to pay for the vaccine (aOR, 7.92; 95% CI, 2.63-23.85; p<0.001). The prevalence of COVID-19 vaccine acceptance among students of health sciences was low. Older age, mandate by heads of the institution, trust in the government and readiness to pay for the vaccine were associated with acceptance of the vaccine. Therefore, stakeholders should prioritize strategies that would maximize the vaccination uptake.
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Affiliation(s)
- Mohammed Mustapha
- School of Pharmaceutical Sciences, Universiti Sains Malaysia, Minden, Pulau Pinang, Malaysia
- Faculty of Pharmaceutical Sciences, Department of Clinical Pharmacy and Pharmacy Practice, Ahmadu Bello University, Zaria, Kaduna, Nigeria
| | - Basira Kankia Lawal
- Faculty of Pharmaceutical Sciences, Department of Clinical Pharmacy and Pharmacy Management, Kaduna State University, Kaduna, Nigeria
| | - Abubakar Sha’aban
- School of Pharmaceutical Sciences, Universiti Sains Malaysia, Minden, Pulau Pinang, Malaysia
- Faculty of Pharmaceutical Sciences, Department of Clinical Pharmacy and Pharmacy Practice, Ahmadu Bello University, Zaria, Kaduna, Nigeria
| | | | - Abubakar Sadiq Wada
- Department of Pharmacology and Therapeutics, Bayero University Kano, Kano, Nigeria
| | - Auwal Adam Bala
- Department of Pharmacology, College of Medicine and Health Sciences, Federal University Dutse, Jigawa, Nigeria
| | - Sagir Mustapha
- Department of Pharmacology, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia
- Faculty of Pharmaceutical Sciences, Department of Pharmacology and Therapeutics, Ahmadu Bello University, Zaria, Kaduna, Nigeria
| | - Anas Haruna
- Faculty of Pharmaceutical Sciences, Department of Pharmaceutical and Medicinal Chemistry, Kaduna State University, Kaduna, Nigeria
| | - Abbas Musa
- Faculty of Pharmaceutical Sciences, Department of Clinical Pharmacy and Pharmacy Management, Kaduna State University, Kaduna, Nigeria
| | - Mubarak Hussaini Ahmad
- Faculty of Pharmaceutical Sciences, Department of Pharmacology and Therapeutics, Ahmadu Bello University, Zaria, Kaduna, Nigeria
| | - Salim Iliyasu
- Department of Pharmaceutics and PharmaceuticalTechnology, Bayero University Kano, Kano, Nigeria
| | | | - Fatima Zaji Mohammed
- School of Dental Health Sciences, Shehu Idris Institute of Health Sciences and Technology, Kaduna State University, Makarfi, Kaduna, Nigeria
| | - Ahmed Danbala Ahmed
- Faculty of Pharmaceutical Sciences, Department of Pharmacology and Toxicology, Kaduna State University, Kaduna, Nigeria
| | - Hadzliana Zainal
- School of Pharmaceutical Sciences, Universiti Sains Malaysia, Minden, Pulau Pinang, Malaysia
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40
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Juvet LK, Robertson AH, Laake I, Mjaaland S, Trogstad L. Safety of Influenza A H1N1pdm09 Vaccines: An Overview of Systematic Reviews. Front Immunol 2021; 12:740048. [PMID: 34777351 PMCID: PMC8581668 DOI: 10.3389/fimmu.2021.740048] [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] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Accepted: 10/12/2021] [Indexed: 01/08/2023] Open
Abstract
Background In 2009, a new influenza A H1N1 virus emerged causing a global pandemic. A range of monovalent influenza A H1N1pdm09 vaccines with or without adjuvants were developed. After the mass vaccination campaigns safety concerns related to H1N1pdm09 vaccines were reported. More than a decade later, reported AEFIs are still under scrutiny. We performed a systematic review aiming to synthesize the evidence on the safety of the H1N1pdm09 vaccines on reported outcomes from existing systematic reviews. Methods Four electronic databases, PubMed, EMBASE, Epistimonikos and the Cochrane Database of Systematic Reviews were searched for articles on H1N1pdm09 vaccination published from 2009 to January 2021. Systematic reviews assessing short- or long-term adverse events after H1N1pdm09 vaccination were considered for inclusion. Data was extracted from all selected reviews. Outcomes were grouped and results from each included review were presented narratively and in tables. Results 16 systematic reviews met the inclusion criteria. Reported outcomes were short-term events (3 reviews), fetal/pregnancy outcomes (8 reviews), Guillain-Barré syndrome (GBS) (4 reviews), narcolepsy (2 reviews) demyelinating diseases (1 review based on one study only) and inflammatory bowel disease (IBD) (1 review). Short-term serious adverse events were rare, 3 cases amongst 16725 subjects in 18 randomized controlled trials (0.018%). No deaths were reported. The risks of local events were generally higher for adjuvanted vaccines as compared to unadjuvanted vaccines. Maternal H1N1pdm09 vaccination in any trimester was not associated with an increase in preterm birth, small for gestational age, congenital malformations or fetal death. For GBS, results were conflicting. The main systematic review on narcolepsy found a 5-14-fold increased risk in children, and a 2-7- fold increased risk in adults after vaccination with Pandemrix. The attributable risk of narcolepsy one year after vaccination was 1 case per 18 400 vaccine doses in children/adolescents, and 1 case per 181 000 vaccine doses in adults. Conclusion Adjuvanted vaccines had more local but not serious adverse events compared to unadjuvanted vaccines. Vaccination with Pandemrix was strongly associated with narcolepsy, particularly in children. No increased risks of pregnancy outcomes were seen after pandemic vaccination. The findings on GBS were inconclusive.
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Affiliation(s)
- Lene Kristine Juvet
- Division of Infection Control and Environmental Health, Norwegian Institute of Public Health, Oslo, Norway
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Abstract
The EU Medicines Regulatory Network (EMRN), comprised of the European Medicines Agency (EMA), the medicines regulatory authorities of the Member States and the European Commission (EC), is operating amid a complex crisis that has positioned regulators centre stage due to their key role in the development, approval and safety monitoring of vaccines and treatments for COVID-19. Here we consider the EMA's and EMRN's response to the pandemic and some of the early learnings that will help reshape medicines regulation in the post COVID-19 era. We also reflect on how some of these learnings will be formally followed up under revised EU legislation to extend EMA's mandate, reinforcing its role in crisis preparedness and response.
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Affiliation(s)
- Marco Cavaleri
- European Medicines Agency, Chair COVID-19 Task Force, Domenico Scarlattilaan 6, 1083 HS Amsterdam, The Netherlands
| | - Fergus Sweeney
- European Medicines Agency, Head of Clinical Studies and Manufacturing Task Force, Domenico Scarlattilaan 6, 1083 HS Amsterdam, The Netherlands
| | - Rosa Gonzalez-Quevedo
- European Medicines Agency, Stakeholders and Communication Division, Domenico Scarlattilaan 6, 1083 HS Amsterdam, The Netherlands
| | - Melanie Carr
- European Medicines Agency, Head of Stakeholders and Communication Division, Domenico Scarlattilaan 6, 1083 HS Amsterdam, The Netherlands
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42
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Grieco T, Maddalena P, Sernicola A, Muharremi R, Basili S, Alvaro D, Cangemi R, Rossi A, Pellacani G. Cutaneous adverse reactions after COVID-19 vaccines in a cohort of 2740 Italian subjects: An observational study. Dermatol Ther 2021; 34:e15153. [PMID: 34622531 PMCID: PMC8646410 DOI: 10.1111/dth.15153] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [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: 08/23/2021] [Revised: 09/21/2021] [Accepted: 10/03/2021] [Indexed: 12/21/2022]
Abstract
An in‐depth characterization of the incidence, morphology, and onset of COVID‐19‐vaccines cutaneous adverse reactions is currently lacking. The existing literature on COVID‐19 vaccination‐related cutaneous adverse reactions largely focused on messenger RNA vaccines and mainly included type 1 hypersensitivity reactions, such as urticaria and angioedema. Other cutaneous manifestations are still poorly characterized and have been classified as delayed hypersensitivity rash. Our prospective observational study on a sample of 2740 subjects who underwent the COVID‐19 vaccination aimed at defining the prevalence of cutaneous adverse reactions and at identifying their timing of onset and their correlation with the administered dose. Vaccine‐related cutaneous adverse reactions occurred in 50 subjects. Patients were asked to complete a questionnaire on the type of COVID‐19 vaccine received, the time of onset of cutaneous reactions, and the dates of administration. Out of 2740 individuals who received the COVID‐19 vaccination, 50 were diagnosed with cutaneous adverse reactions to vaccine, after the first dose in 28 patients, after the second in 20, and after both in two. We reported localized injection site erythema in 12 patients and generalized cutaneous reactions in 38 patients. Our study shows that cutaneous adverse reactions to COVID‐19 vaccination are not common and most often occur after the first dose, recurring infrequently after the second dose. These reactions are usually easily manageable and, even in severe generalized cases, oral antihistamines and corticosteroids were sufficient for resolution. Therefore, except for immediate hypersensitivity reactions, cutaneous adverse reactions do not represent a contraindication to the completion of the vaccination cycle.
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Affiliation(s)
- Teresa Grieco
- Department of Clinical Internal, Anesthesiological and Cardiovascular Sciences, "Sapienza" University of Rome, Rome, Italy
| | - Patrizia Maddalena
- Department of Clinical Internal, Anesthesiological and Cardiovascular Sciences, "Sapienza" University of Rome, Rome, Italy
| | - Alvise Sernicola
- Department of Clinical Internal, Anesthesiological and Cardiovascular Sciences, "Sapienza" University of Rome, Rome, Italy
| | - Rovena Muharremi
- Department of Clinical Internal, Anesthesiological and Cardiovascular Sciences, "Sapienza" University of Rome, Rome, Italy
| | - Stefania Basili
- Department of Translational and Precision Medicine, "Sapienza" University of Rome, Rome, Italy
| | - Domenico Alvaro
- Department of Translational and Precision Medicine, "Sapienza" University of Rome, Rome, Italy
| | - Roberto Cangemi
- Department of Translational and Precision Medicine, "Sapienza" University of Rome, Rome, Italy
| | - Alfredo Rossi
- Department of Clinical Internal, Anesthesiological and Cardiovascular Sciences, "Sapienza" University of Rome, Rome, Italy
| | - Giovanni Pellacani
- Department of Clinical Internal, Anesthesiological and Cardiovascular Sciences, "Sapienza" University of Rome, Rome, Italy
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43
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Greinacher A, Selleng K, Mayerle J, Palankar R, Wesche J, Reiche S, Aebischer A, Warkentin TE, Muenchhoff M, Hellmuth JC, Keppler OT, Duerschmied D, Lother A, Rieg S, Gawaz MP, Mueller KAL, Scheer CS, Napp M, Hahnenkamp K, Lucchese G, Vogelgesang A, Flöel A, Lovreglio P, Stufano A, Marschalek R, Thiele T. Anti-platelet factor 4 antibodies causing VITT do not cross-react with SARS-CoV-2 spike protein. Blood 2021; 138:1269-1277. [PMID: 34280256 PMCID: PMC8294553 DOI: 10.1182/blood.2021012938] [Citation(s) in RCA: 83] [Impact Index Per Article: 27.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Accepted: 07/12/2021] [Indexed: 11/21/2022] Open
Abstract
Vaccine-induced immune thrombotic thrombocytopenia (VITT) is a severe adverse effect of ChAdOx1 nCoV-19 COVID-19 vaccine (Vaxzevria) and Janssen Ad26.COV2.S COVID-19 vaccine, and it is associated with unusual thrombosis. VITT is caused by anti-platelet factor 4 (PF4) antibodies activating platelets through their FcγRIIa receptors. Antibodies that activate platelets through FcγRIIa receptors have also been identified in patients with COVID-19. These findings raise concern that vaccination-induced antibodies against anti-SARS-CoV-2 spike protein cause thrombosis by cross-reacting with PF4. Immunogenic epitopes of PF4 and SARS-CoV-2 spike protein were compared using in silico prediction tools and 3D modeling. The SARS-CoV-2 spike protein and PF4 share at least 1 similar epitope. Reactivity of purified anti-PF4 antibodies from patients with VITT was tested against recombinant SARS-CoV-2 spike protein. However, none of the affinity-purified anti-PF4 antibodies from 14 patients with VITT cross-reacted with SARS-CoV-2 spike protein. Sera from 222 polymerase chain reaction-confirmed patients with COVID-19 from 5 European centers were tested by PF4-heparin enzyme-linked immunosorbent assays and PF4-dependent platelet activation assays. We found anti-PF4 antibodies in sera from 19 (8.6%) of 222 patients with COVID-19. However, only 4 showed weak to moderate platelet activation in the presence of PF4, and none of those patients developed thrombotic complications. Among 10 (4.5%) of 222 patients who had COVID-19 with thrombosis, none showed PF4-dependent platelet-activating antibodies. In conclusion, antibodies against PF4 induced by vaccination do not cross-react with the SARS-CoV-2 spike protein, indicating that the intended vaccine-induced immune response against SARS-CoV-2 spike protein is not the trigger of VITT. PF4-reactive antibodies found in patients with COVID-19 in this study were not associated with thrombotic complications.
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Affiliation(s)
- Andreas Greinacher
- Institute of Immunology and Transfusion Medicine, Department of Transfusion Medicine, Universitätsmedizin Greifswald, Greifswald, Germany
| | - Kathleen Selleng
- Institute of Immunology and Transfusion Medicine, Department of Transfusion Medicine, Universitätsmedizin Greifswald, Greifswald, Germany
| | - Julia Mayerle
- Department of Medicine II, University Hospital Munich, and German Centre for Infection Research (DZIF) (partner site Munich), Munich, Germany
| | - Raghavendra Palankar
- Institute of Immunology and Transfusion Medicine, Department of Transfusion Medicine, Universitätsmedizin Greifswald, Greifswald, Germany
| | - Jan Wesche
- Institute of Immunology and Transfusion Medicine, Department of Transfusion Medicine, Universitätsmedizin Greifswald, Greifswald, Germany
| | - Sven Reiche
- Department of Experimental Animal Facilities and Biorisk Management, Friedrich-Loeffler Institut, Greifswald, Germany
| | - Andrea Aebischer
- Department of Experimental Animal Facilities and Biorisk Management, Friedrich-Loeffler Institut, Greifswald, Germany
| | - Theodore E Warkentin
- Department of Pathology and Molecular Medicine, and Department of Medicine, McMaster University, Hamilton, ON, Canada
| | - Maximilian Muenchhoff
- Max von Pettenkofer Institute, Virology, Ludwig Maximilians University of Munich, and DZIF, Munich, Germany
| | | | - Oliver T Keppler
- Max von Pettenkofer Institute, Virology, Ludwig Maximilians University of Munich, and DZIF, Munich, Germany
| | - Daniel Duerschmied
- Heart Center Freiburg University, Cardiology and Angiology I and Medical Intensive Care, Medical Center
| | - Achim Lother
- Heart Center Freiburg University, Cardiology and Angiology I and Medical Intensive Care, Medical Center
- Institute of Experimental and Clinical Pharmacology and Toxicology, and
| | - Siegbert Rieg
- Division of Infectious Diseases, Department of Medicine II, Faculty of Medicine, Medical Center, University of Freiburg, Freiburg, Germany
| | - Meinrad Paul Gawaz
- Department of Cardiology and Angiology, University Hospital Tübingen, Eberhard Karls University Tübingen, Tübingen, Germany
| | - Karin Anne Lydia Mueller
- Department of Cardiology and Angiology, University Hospital Tübingen, Eberhard Karls University Tübingen, Tübingen, Germany
| | | | - Matthias Napp
- Department of Anesthesiology and Intensive Care Medicine, and
| | | | - Guglielmo Lucchese
- Department of Neurology, University Medicine Greifswald, Greifswald, Germany
| | - Antje Vogelgesang
- Department of Neurology, University Medicine Greifswald, Greifswald, Germany
| | - Agnes Flöel
- Department of Neurology, University Medicine Greifswald, Greifswald, Germany
| | - Piero Lovreglio
- Interdisciplinary Department of Medicine, University of Bari Aldo Moro, Bari, Italy; and
| | - Angela Stufano
- Interdisciplinary Department of Medicine, University of Bari Aldo Moro, Bari, Italy; and
| | - Rolf Marschalek
- Institute of Pharmacology Biology, Biocenter, Goethe University, Frankfurt am Main, Germany
| | - Thomas Thiele
- Institute of Immunology and Transfusion Medicine, Department of Transfusion Medicine, Universitätsmedizin Greifswald, Greifswald, Germany
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44
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Chaudhary FA, Ahmad B, Khalid MD, Fazal A, Javaid MM, Butt DQ. Factors influencing COVID-19 vaccine hesitancy and acceptance among the Pakistani population. Hum Vaccin Immunother 2021; 17:3365-3370. [PMID: 34236952 DOI: 10.1080/21645515.2021.1944743] [Citation(s) in RCA: 49] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
This study examined the factors associated with acceptance of the COVID-19 vaccine compared to hesitance in the Pakistani population and specifically focusing on the perceived beliefs, knowledge, concerns, risk, and safety perception relating to the COVID-19 vaccine. A total of 423 subjects were recruited from the Pakistan Institute of Medical Sciences, Islamabad, Pakistan. A 27-item valid and reliable questionnaire was used to assess socio-demographic characteristics, acceptance, and hesitance toward COVID-19 vaccine, perceived beliefs, knowledge, perceived concerns, risk, and safety of COVID-19 vaccines and its source of information. Chi-square tests and logistic regression were used for analysis. About 53% of the participants were planning to get vaccinated and a significantly greater proportion of better educated, higher income, and healthier participants in the vaccine acceptance group (p < .05). The odds of knowing the vaccine they should get, having the confidence in the vaccine to stop the pandemic, and understanding the way vaccines work, were greater in the vaccine acceptance group than the vaccine-hesitant group (OR: 5.4; 3.5, 2.1, 3.1, respectively). Most participants (52.3%) obtained the information regarding the COVID-19 vaccine from the print and live news media (52.3%) followed by social media (23.7%). The lack of knowledge, understanding, and perception of the risk, safety partly explains the low rate of vaccine acceptance in the Pakistani population. Strategies to raise awareness of the benefits of vaccination should target individuals in the lower socioeconomic group and those with chronic disease.
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Affiliation(s)
- Farooq Ahmad Chaudhary
- Department of Community Dentistry, School of Dentistry, Shaheed Zulfiqar Ali Bhutto Medical University, Islamabad, Pakistan
| | - Basaruddin Ahmad
- School of Dental Sciences, Universiti Sains Malaysia, Kubang Kerian, Malaysia
| | | | - Ayesha Fazal
- Department of Community Dentistry, School of Dentistry, Shaheed Zulfiqar Ali Bhutto Medical University, Islamabad, Pakistan
| | - Muhammad Mohsin Javaid
- Department of Community Dentistry, School of Dentistry, Shaheed Zulfiqar Ali Bhutto Medical University, Islamabad, Pakistan
| | - Danial Qasim Butt
- Dental College, HITEC Institute of Medical Sciences, Taxila, Pakistan
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45
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Ivanova V, Pavlov D, Assenova T, Terzieva E, Milushewa P, Djemadan A, Vladimirova G, Dimitrova M, Kamusheva M. COVID-19 pandemic impact on the pharmaceutical sector in Bulgaria. PHAR 2021. [DOI: 10.3897/pharmacia.68.e71638] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
In December, 2019 in Wuhan, Hubei Province, China, a new, unknown strain of coronavirus called SARS-CoV-2 was identified. The virus has spread rapidly to other countries around the world, among which the most affected were Italy, Spain and the United States. As a result, in March 2020 The WHO has declared the new coronavirus epidemic a global pandemic. Despite timely measures and efforts to reduce morbidity, up to date, confirmed cases are 119,452,269, while the number of deaths reached 2,647,662 people. The COVID-19 pandemic has affected all areas of human life – health, social, economic. In each of them, a number of restrictions and obligations were imposed, including wearing of masks, use of disinfectants, education in an online environment, limited work in restaurants and shops. The health sector was particularly affected, and all actors in the pharmaceutical system had to reorganize and adapt their activities in the name of a common goal – ending the COVID-19 pandemic.
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46
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Domnich A, Grassi R, Fallani E, Spurio A, Bruzzone B, Panatto D, Marozzi B, Cambiaggi M, Vasco A, Orsi A, Icardi G. Changes in Attitudes and Beliefs Concerning Vaccination and Influenza Vaccines between the First and Second COVID-19 Pandemic Waves: A Longitudinal Study. Vaccines (Basel) 2021; 9:1016. [PMID: 34579253 PMCID: PMC8470379 DOI: 10.3390/vaccines9091016] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [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: 08/04/2021] [Revised: 09/07/2021] [Accepted: 09/10/2021] [Indexed: 12/01/2022] Open
Abstract
Perceptions of the risks of vaccine-preventable diseases and preventive behaviors change over time. The ongoing COVID-19 pandemic may have modified laypeople's attitudes towards routine vaccinations. In this longitudinal study, we aimed to assess changes in attitudes and beliefs concerning (influenza) vaccines between the first and second COVID-19 pandemic waves. A total of 1979 participants completed both 2020 and 2021 surveys. After one year, more interviewees agreed that vaccines were fundamental and should be mandatory (77.3% vs. 75.0%). Analogously, willingness to undergo influenza vaccination increased (p < 0.001) from 44.1% to 48.6%. This increase was seen in subjects aged ≥35 years. Previous influenza vaccinations, receipt of a COVID-19 vaccine, positive attitudes towards (influenza) vaccination, male sex, and older age were the main correlates of willingness to receive the 2021/22 influenza vaccine. Totals of 12.6% and 11.8% had no intention to receive the next seasonal influenza and COVID-19 vaccines, respectively. Most respondents favored a hypothetical combined influenza/COVID-19 vaccine (73.7%) or influenza and COVID-19 vaccine co-administration (67.5%). In Italy, influenza and COVID-19 vaccination hesitancy and refusal are common. Effective public health strategies to pursue higher uptake of both vaccines are urgently needed.
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Affiliation(s)
- Alexander Domnich
- Hygiene Unit, San Martino Policlinico Hospital-IRCCS for Oncology and Neurosciences, 16132 Genoa, Italy; (B.B.); (A.O.); (G.I.)
| | | | - Elettra Fallani
- Seqirus S.R.L., 53035 Monteriggioni, Italy; (E.F.); (M.C.); (A.V.)
- Department of Life Sciences, University of Siena, 53100 Siena, Italy
| | - Alida Spurio
- SWG S.p.A., 34133 Trieste, Italy; (R.G.); (A.S.)
| | - Bianca Bruzzone
- Hygiene Unit, San Martino Policlinico Hospital-IRCCS for Oncology and Neurosciences, 16132 Genoa, Italy; (B.B.); (A.O.); (G.I.)
| | - Donatella Panatto
- Department of Health Sciences (DISSAL), University of Genoa, 16132 Genoa, Italy;
| | - Barbara Marozzi
- Faculty of Medicine and Surgery, University of Genoa, 16126 Genoa, Italy;
| | - Maura Cambiaggi
- Seqirus S.R.L., 53035 Monteriggioni, Italy; (E.F.); (M.C.); (A.V.)
| | - Alessandro Vasco
- Seqirus S.R.L., 53035 Monteriggioni, Italy; (E.F.); (M.C.); (A.V.)
| | - Andrea Orsi
- Hygiene Unit, San Martino Policlinico Hospital-IRCCS for Oncology and Neurosciences, 16132 Genoa, Italy; (B.B.); (A.O.); (G.I.)
- Department of Health Sciences (DISSAL), University of Genoa, 16132 Genoa, Italy;
| | - Giancarlo Icardi
- Hygiene Unit, San Martino Policlinico Hospital-IRCCS for Oncology and Neurosciences, 16132 Genoa, Italy; (B.B.); (A.O.); (G.I.)
- Department of Health Sciences (DISSAL), University of Genoa, 16132 Genoa, Italy;
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47
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Karimi N, Boostani R, Fatehi F, Panahi A, Asghar Okhovat A, Ziaadini B, Basiri K, Abdi S, Sinaei F, Rezaei M, Shamsaei G, Ansari B, Nafissi S. Guillain-Barre Syndrome and COVID-19 Vaccine: A Report of Nine Patients. Basic Clin Neurosci 2021; 12:703-710. [PMID: 35173924 PMCID: PMC8818119 DOI: 10.32598/bcn.2021.3565.1] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [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: 07/11/2021] [Revised: 07/02/2021] [Accepted: 08/04/2021] [Indexed: 01/14/2023] Open
Abstract
Introduction: Guillain-Barre Syndrome (GBS) is an autoimmune acute inflammatory demyelinating polyneuropathy usually elicited by an upper respiratory tract infection. Several studies reported GBS associated with Coronavirus Disease 2019 (COVID-19) infection. In this study, we described nine GBS patients following the COVID-19 vaccine. Methods: In this study, nine patients were introduced from six referral centers for neuromuscular disorders in Iran between April 8 and June 20, 2021. Four patients received the Sputnik V, three patients received the Sinopharm, and two cases received the AstraZeneca vaccine. All patients were diagnosed with GBS evidenced by nerve conduction studies and/or cerebrospinal fluid analysis. Results: The median age of the patients was 54.22 years (ranged 26–87 years), and seven patients were male. The patients were treated with Intravenous Immunoglobulin (IVIg) or Plasma Exchange (PLEX). All patients were discharged with some improvements. Conclusion: The link between the COVID-19 vaccine and GBS is not well understood. Given the prevalence of GBS over the population, this association may be coincidental; therefore, more studies are needed to investigate a causal relationship.
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Affiliation(s)
- Narges Karimi
- Immunogenetics Research Center, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran.,Department of Neurology, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran.,Neuromuscular Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Reza Boostani
- Department of Neurology, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Farzad Fatehi
- Department of Neurology, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran.,Neuromuscular Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Akram Panahi
- Department of Neurology, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran.,Neuromuscular Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Ali Asghar Okhovat
- Department of Neurology, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran.,Neuromuscular Research Center, Tehran University of Medical Sciences, Tehran, Iran.,Department of Neurology, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Bentolhoda Ziaadini
- Department of Neurology, Kerman Neuroscience Research Center, Kerman University of Medical Science, Kerman, Iran
| | - Keivan Basiri
- Department of Neurology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.,Neuroscience Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Siamak Abdi
- Department of Neurology, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Farnaz Sinaei
- Department of Neurology, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Mojtaba Rezaei
- Department of Neurology, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Gholamreza Shamsaei
- Neurology Department, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Behnaz Ansari
- Department of Neurology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.,Isfahan Neuroscience Research Center, AL-Zahra Research Institute, Isfahan University of Medical Science, Isfahan, Iran
| | - Shahriar Nafissi
- Department of Neurology, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran.,Neuromuscular Research Center, Tehran University of Medical Sciences, Tehran, Iran
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48
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Schiaffino S, Pinker K, Magni V, Cozzi A, Athanasiou A, Baltzer PAT, Camps Herrero J, Clauser P, Fallenberg EM, Forrai G, Fuchsjäger MH, Helbich TH, Kilburn-Toppin F, Kuhl CK, Lesaru M, Mann RM, Panizza P, Pediconi F, Pijnappel RM, Sella T, Thomassin-Naggara I, Zackrisson S, Gilbert FJ, Sardanelli F. Axillary lymphadenopathy at the time of COVID-19 vaccination: ten recommendations from the European Society of Breast Imaging (EUSOBI). Insights Imaging 2021; 12:119. [PMID: 34417642 PMCID: PMC8378785 DOI: 10.1186/s13244-021-01062-x] [Citation(s) in RCA: 41] [Impact Index Per Article: 13.7] [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: 05/17/2021] [Accepted: 07/17/2021] [Indexed: 01/12/2023] Open
Abstract
Unilateral axillary lymphadenopathy is a frequent mild side effect of COVID-19 vaccination. European Society of Breast Imaging (EUSOBI) proposes ten recommendations to standardise its management and reduce unnecessary additional imaging and invasive procedures: (1) in patients with previous history of breast cancer, vaccination should be performed in the contralateral arm or in the thigh; (2) collect vaccination data for all patients referred to breast imaging services, including patients undergoing breast cancer staging and follow-up imaging examinations; (3) perform breast imaging examinations preferentially before vaccination or at least 12 weeks after the last vaccine dose; (4) in patients with newly diagnosed breast cancer, apply standard imaging protocols regardless of vaccination status; (5) in any case of symptomatic or imaging-detected axillary lymphadenopathy before vaccination or at least 12 weeks after, examine with appropriate imaging the contralateral axilla and both breasts to exclude malignancy; (6) in case of axillary lymphadenopathy contralateral to the vaccination side, perform standard work-up; (7) in patients without breast cancer history and no suspicious breast imaging findings, lymphadenopathy only ipsilateral to the vaccination side within 12 weeks after vaccination can be considered benign or probably-benign, depending on clinical context; (8) in patients without breast cancer history, post-vaccination lymphadenopathy coupled with suspicious breast finding requires standard work-up, including biopsy when appropriate; (9) in patients with breast cancer history, interpret and manage post-vaccination lymphadenopathy considering the timeframe from vaccination and overall nodal metastatic risk; (10) complex or unclear cases should be managed by the multidisciplinary team.
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Affiliation(s)
- Simone Schiaffino
- Unit of Radiology, IRCCS Policlinico San Donato, San Donato Milanese, Italy
| | - Katja Pinker
- Department of Biomedical Imaging and Image-guided Therapy, Division of General and Pediatric Radiology, Research Group: Molecular and Gender Imaging, Medical University of Vienna, Wien, Austria.,Department of Radiology, Breast Imaging Service, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Veronica Magni
- Department of Biomedical Sciences for Health, Università degli Studi di Milano, Milan, Italy
| | - Andrea Cozzi
- Department of Biomedical Sciences for Health, Università degli Studi di Milano, Milan, Italy
| | | | - Pascal A T Baltzer
- Department of Biomedical Imaging and Image-guided Therapy, Division of General and Pediatric Radiology, Research Group: Molecular and Gender Imaging, Medical University of Vienna, Wien, Austria
| | | | - Paola Clauser
- Department of Biomedical Imaging and Image-guided Therapy, Division of General and Pediatric Radiology, Research Group: Molecular and Gender Imaging, Medical University of Vienna, Wien, Austria
| | - Eva M Fallenberg
- Department of Diagnostic and Interventional Radiology, School of Medicine & Klinikum Rechts der Isar, Technical University of Munich (TUM) , München , Germany
| | - Gábor Forrai
- Department of Radiology, Duna Medical Center, Budapest, Hungary
| | - Michael H Fuchsjäger
- Division of General Radiology, Department of Radiology, Medical University Graz, Graz, Austria
| | - Thomas H Helbich
- Department of Biomedical Imaging and Image-guided Therapy, Division of General and Pediatric Radiology, Research Group: Molecular and Gender Imaging, Medical University of Vienna, Wien, Austria
| | | | - Christiane K Kuhl
- University Hospital of Aachen, Rheinisch-Westfälische Technische Hochschule Aachen, Aachen, Germany
| | - Mihai Lesaru
- Radiology and Imaging Laboratory, Fundeni Institute, Bucharest, Romania
| | - Ritse M Mann
- Department of Medical Imaging, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands.,Department of Radiology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Pietro Panizza
- Breast Imaging Unit, IRCCS Ospedale San Raffaele, Milan, Italy
| | - Federica Pediconi
- Department of Radiological, Oncological, and Pathological Sciences , Università degli Studi di Roma "La Sapienza" , Rome, Italy
| | - Ruud M Pijnappel
- Department of Imaging, University Medical Centre Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Tamar Sella
- Department of Diagnostic Imaging, Hadassah Hebrew University Medical Center, Jerusalem, Israel
| | | | - Sophia Zackrisson
- Diagnostic Radiology, Department of Translational Medicine, Skåne University Hospital, Lund University, Malmö, Sweden
| | - Fiona J Gilbert
- Department of Radiology, University of Cambridge, Cambridge, UK
| | - Francesco Sardanelli
- Unit of Radiology, IRCCS Policlinico San Donato, San Donato Milanese, Italy. .,Department of Biomedical Sciences for Health, Università degli Studi di Milano, Milan, Italy.
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Jung K, Shin S, Nam M, Hong YJ, Roh EY, Park KU, Song EY. Performance evaluation of three automated quantitative immunoassays and their correlation with a surrogate virus neutralization test in coronavirus disease 19 patients and pre-pandemic controls. J Clin Lab Anal 2021; 35:e23921. [PMID: 34369009 PMCID: PMC8418513 DOI: 10.1002/jcla.23921] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [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: 05/16/2021] [Revised: 07/04/2021] [Accepted: 07/15/2021] [Indexed: 12/11/2022] Open
Abstract
Background SARS‐CoV‐2 pandemic is currently ongoing, meanwhile vaccinations are rapidly underway in some countries. The quantitative immunoassays detecting antibodies against spike antigen of SARS‐CoV‐2 have been developed based on the findings that they have a better correlation with the neutralizing antibody. Methods The performances of the Abbott Architect SARS‐CoV‐2 IgG II Quant, DiaSorin LIAISON SARS‐CoV‐2 TrimericS IgG, and Roche Elecsys anti‐SARS‐CoV‐2 S were evaluated on 173 sera from 126 SARS‐CoV‐2 patients and 151 pre‐pandemic sera. Their correlations with GenScript cPass SARS‐CoV‐2 Neutralization Antibody Detection Kit were also analyzed on 173 sera from 126 SARS‐CoV‐2 patients. Results Architect SARS‐CoV‐2 IgG II Quant and Elecsys anti‐SARS‐CoV‐2 S showed the highest overall sensitivity (96.0%), followed by LIAISON SARS‐CoV‐2 TrimericS IgG (93.6%). The specificities of Elecsys anti‐SARS‐CoV‐2 S and LIAISON SARS‐CoV‐2 TrimericS IgG were 100.0%, followed by Architect SARS‐CoV‐2 IgG II Quant (99.3%). Regarding the correlation with cPass neutralization antibody assay, LIAISON SARS‐CoV‐2 TrimericS IgG showed the best correlation (Spearman rho = 0.88), followed by Architect SARS‐CoV‐2 IgG II Quant and Elecsys anti‐SARS‐CoV‐2 S (all rho = 0.87). Conclusions The three automated quantitative immunoassays showed good diagnostic performance and strong correlations with neutralization antibodies. These assays will be useful in diagnostic assistance, evaluating the response to vaccination, and the assessment of herd immunity in the future.
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Affiliation(s)
- Kiwook Jung
- Department of Laboratory Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Sue Shin
- Department of Laboratory Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Minjeong Nam
- Department of Laboratory Medicine, Konkuk University Medical Center, Seoul, Korea
| | - Yun Ji Hong
- Department of Laboratory Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Eun Youn Roh
- Department of Laboratory Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Kyoung Un Park
- Department of Laboratory Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Eun Young Song
- Department of Laboratory Medicine, Seoul National University College of Medicine, Seoul, Korea
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Glenton C, Carlsen B, Lewin S, Wennekes MD, Winje BA, Eilers R. Healthcare workers' perceptions and experiences of communicating with people over 50 years of age about vaccination: a qualitative evidence synthesis. Cochrane Database Syst Rev 2021; 7:CD013706. [PMID: 34282603 PMCID: PMC8407331 DOI: 10.1002/14651858.cd013706.pub2] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [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] [Indexed: 12/14/2022]
Abstract
BACKGROUND Infectious diseases are a major cause of illness and death among older adults. Vaccines can prevent infectious diseases, including against seasonal influenza, pneumococcal diseases, herpes zoster and COVID-19. However, the uptake of vaccination among older adults varies across settings and groups. Communication with healthcare workers can play an important role in older people's decisions to vaccinate. To support an informed decision about vaccination, healthcare workers should be able to identify the older person's knowledge gaps, needs and concerns. They should also be able to share and discuss information about the person's disease risk and disease severity; the vaccine's effectiveness and safety; and practical information about how the person can access vaccines. Therefore, healthcare workers need good communication skills and to actively keep up-to-date with the latest evidence. An understanding of their perceptions and experiences of this communication can help us train and support healthcare workers and design good communication strategies. OBJECTIVES To explore healthcare workers' perceptions and experiences of communicating with older adults about vaccination. SEARCH METHODS We searched MEDLINE, CINAHL and Scopus on 21 March 2020. We also searched Epistemonikos for related reviews, searched grey literature sources, and carried out reference checking and citation searching to identify additional studies. We searched for studies in any language. SELECTION CRITERIA We included qualitative studies and mixed-methods studies with an identifiable qualitative component. We included studies that explored the perceptions and experiences of healthcare workers and other health system staff towards communication with adults over the age of 50 years or their informal caregivers about vaccination. DATA COLLECTION AND ANALYSIS We extracted data using a data extraction form designed for this review. We assessed methodological limitations using a list of predefined criteria. We extracted and assessed data regarding study authors' motivations for carrying out their study. We used a thematic synthesis approach to analyse and synthesise the evidence. We used the GRADE-CERQual (Confidence in the Evidence from Reviews of Qualitative research) approach to assess our confidence in each finding. We examined each review finding to identify factors that may influence intervention implementation and we developed implications for practice. MAIN RESULTS We included 11 studies in our review. Most studies explored healthcare workers' views and experiences about vaccination of older adults more broadly but also mentioned communication issues specifically. All studies were from high-income countries. The studies focused on doctors, nurses, pharmacists and others working in hospitals, clinics, pharmacies and nursing homes. These healthcare workers discussed different types of vaccines, including influenza, pneumococcal and herpes zoster vaccines. The review was carried out before COVID-19 vaccines were available. We downgraded our confidence in several of the findings from high confidence to moderate, low or very low confidence. One reason for this was that some findings were based on only small amounts of data. Another reason was that the findings were based on studies from only a few countries, making us unsure about the relevance of these findings to other settings. Healthcare workers reported that older adults asked about vaccination to different extents, ranging from not asking about vaccines at all, to great demand for information (high confidence finding). When the topic of vaccination was discussed, healthcare workers described a lack of information, and presence of misinformation, fears and concerns about vaccines among older adults (moderate confidence). The ways in which healthcare workers discussed vaccines with older adults appeared to be linked to what they saw as the aim of vaccination communication. Healthcare workers differed among themselves in their perceptions of this aim and about their own roles and the roles of older adults in vaccine decisions. Some healthcare workers thought it was important to provide information but emphasised the right and responsibility of older adults to decide for themselves. Others used information to persuade and convince older adults to vaccinate in order to increase 'compliance' and 'improve' vaccination rates, and in some cases to gain financial benefits. Other healthcare workers tailored their approach to what they believed the older adult needed or wanted (moderate confidence). Healthcare workers believed that older adults' decisions could be influenced by several factors, including the nature of the healthcare worker-patient relationship, the healthcare worker's status, and the extent to which healthcare workers led by example (low confidence). Our review also identified factors that are likely to influence how communication between healthcare workers and older adults take place. These included issues tied to healthcare workers' views and experiences regarding the diseases in question and the vaccines; as well as their views and experiences of the organisational and practical implementation of vaccine services. AUTHORS' CONCLUSIONS There is little research focusing specifically on healthcare workers' perceptions and experiences of communication with older adults about vaccination. The studies we identified suggest that healthcare workers differed among themselves in their perceptions about the aim of this communication and about the role of older adults in vaccine decisions. Based on these findings and the other findings in our review, we have developed a set of questions or prompts that may help health system planners or programme managers when planning or implementing strategies for vaccination communication between healthcare workers and older adults.
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Affiliation(s)
- Claire Glenton
- Norwegian Institute of Public Health, Oslo, Norway
- TRS National Resource Centre for Rare Disorders, Sunnaas Rehabilitation Hospital, Nesoddtangen, Norway
| | - Benedicte Carlsen
- Department of Health Promotion and Development, University of Bergen, Bergen, Norway
| | - Simon Lewin
- Norwegian Institute of Public Health, Oslo, Norway
- Health Systems Research Unit, South African Medical Research Council, Cape Town, South Africa
| | - Manuela Dominique Wennekes
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, Netherlands
- Athena Institute, Free University, Amsterdam, Netherlands
| | - Brita Askeland Winje
- Norwegian Institute of Public Health, Oslo, Norway
- Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
| | - Renske Eilers
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, Netherlands
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