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Toledo-Romaní ME, Valenzuela-Silva C, Montero-Díaz M, Iñiguez-Rojas L, Rodríguez-González M, Martínez-Cabrera M, Puga-Gómez R, German-Almeida A, Fernández-Castillo S, Climent-Ruiz Y, Santana-Mederos D, López-González L, Morales-Suárez I, Doroud D, Valdés-Balbín Y, García-Rivera D, Van der Stuyft P, Vérez-Bencomo V. Real-world effectiveness of the heterologous SOBERANA-02 and SOBERANA-Plus vaccine scheme in 2-11 years-old children during the SARS-CoV-2 Omicron wave in Cuba: a longitudinal case-population study. Lancet Reg Health Am 2024; 34:100750. [PMID: 38699214 PMCID: PMC11063520 DOI: 10.1016/j.lana.2024.100750] [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] [Subscribe] [Scholar Register] [Received: 09/02/2023] [Revised: 03/29/2024] [Accepted: 04/09/2024] [Indexed: 05/05/2024]
Abstract
Background Increased pediatric COVID-19 occurrence due to the SARS-CoV-2 Omicron variant has raised concerns about the effectiveness of existing vaccines. The protection provided by the SOBERANA-02-Plus vaccination scheme against this variant has not yet been studied. We aimed to evaluate the scheme's effectiveness against symptomatic Omicron infection and severe disease in children. Methods In September 2021, Cuba implemented a mass pediatric immunization with the heterologous SOBERANA-02-Plus scheme: 2 doses of conjugated SOBERANA-02 followed by a heterologous SOBERANA-Plus dose. By December, before the Omicron outbreak, 95.4% of 2-18 years-old had been fully immunized. During the entire Omicron wave, we conducted a nationwide longitudinal post-vaccination case-population study to evaluate the real-world effectiveness of the SOBERANA-02-Plus scheme against symptomatic infection and severe disease in children without previous SARS-CoV-2 infection. The identification of COVID-19 cases relied on surveillance through first line services, which refer clinical suspects to pediatric hospitals where they are diagnosed based on a positive RT-PCR test. We defined the Incidence Rate ratio (IRR) as IRvaccinated age group/IRunvaccinated 1-year-old and calculated vaccine effectiveness as VE = (1-IRR)∗100%. 24 months of age being the 'eligible for vaccination' cut-off, we used a regression discontinuity approach to estimate effectiveness by contrasting incidence in all unvaccinated 1-year-old versus vaccinated 2-years-old. Estimates in the vaccinated 3-11 years-old are reported from a descriptive perspective. Findings We included 1,098,817 fully vaccinated 2-11 years-old and 98,342 not vaccinated 1-year-old children. During the 24-week Omicron wave, there were 7003/26,241,176 person-weeks symptomatic COVID-19 infections in the vaccinated group (38.2 per 105 person-weeks in 2-years-old and 25.5 per 105 person-weeks in 3-11 years-old) against 3577/2,312,273 (154.7 per 105 person-weeks) in the unvaccinated group. The observed overall vaccine effectiveness against symptomatic infection was 75.3% (95% CI, 73.5-77.0%) in 2-years-old children, and 83.5% (95% CI, 82.8-84.2%) in 3-11 years-old. It was somewhat lower during Omicron BA.1 then during Omicron BA.2 variant circulation, which took place 1-3 and 4-6 months after the end of the vaccination campaign. The effectiveness against severe symptomatic disease was 100.0% (95% CI not estimated) and 94.6% (95% CI, 82.0-98.6%) in the respective age groups. No child death from COVID-19 was observed. Interpretation Immunization of 2-11 years-old with the SOBERANA-02-Plus scheme provided strong protection against symptomatic and severe disease caused by the Omicron variant, which was sustained during the six months post-vaccination follow-up. Our results contrast with the observations in previous real-world vaccine effectiveness studies in children, which might be explained by the type of immunity a conjugated protein-based vaccine induces and the vaccination strategy used. Funding National Fund for Science and Technology (FONCI-CITMA-Cuba).
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Affiliation(s)
| | | | | | - Luisa Iñiguez-Rojas
- Latin-American Faculty of Social Sciences, Havana University, La Havana, Cuba
| | | | | | | | | | | | | | | | - Lissette López-González
- “Juan Manuel Marquez” Pediatric Hospital and National Group of Pediatric, Ministry of Public Health, Cuba
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Albrecht S, Grässli F, Cusini A, Brucher A, Goppel S, Betschon E, Möller JC, Ortner M, Ruetti M, Stocker R, Vuichard-Gysin D, Besold U, Risch L, Von Kietzell M, Schlegel M, Vernazza P, Kuster SP, Kahlert CR, Kohler P. SARS-CoV-2 immunity and reasons for non-vaccination among healthcare workers from eastern and northern Switzerland: results from a nested multicentre cross-sectional study. Swiss Med Wkly 2024; 154:3734. [PMID: 38689545 DOI: 10.57187/s.3734] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/02/2024] Open
Abstract
AIMS OF THE STUDY We aimed to assess the extent of SARS-CoV-2 humoral immunity elicited by previous infections and/or vaccination among healthcare workers, and to identify reasons why healthcare workers decided against vaccination. METHODS This nested cross-sectional study included volunteer healthcare workers from 14 healthcare institutions in German-speaking Switzerland. In January 2021, SARS-CoV-2 vaccines were available for healthcare workers. In May and June 2022, participants answered electronic questionnaires regarding baseline characteristics including SARS-CoV-2 vaccination status (with one or more vaccine doses defined as vaccinated) and previous SARS-CoV-2 infections. Unvaccinated participants indicated their reasons for non-vaccination. Participants underwent testing for SARS-CoV-2 anti-spike (anti-S) and anti-nucleocapsid (anti-N) antibodies. Antibody prevalence was described across age groups. In addition, we performed multivariable logistic regression to identify baseline characteristics independently associated with non-vaccination and described reasons for non-vaccination. RESULTS Among 22,438 eligible employees, 3,436 (15%) participated; the median age was 43.7 years (range 16-73), 2,794 (81.3%) were female, and 1,407 (47.7%) identified as nurses; 3,414 (99.4%) underwent serology testing, among whom 3,383 (99.0%) had detectable anti-S (3,357, 98.3%) antibodies, anti-N (2,396, 70.1%) antibodies, or both (2,370, 69.4%). A total of 296 (8.6%) healthcare workers were unvaccinated, whereas 3,140 (91.4%) were vaccinated. In multivariable analysis, age (adjusted OR [aOR] 1.02 per year, 95% CI 1.01-1.03), being a physician (aOR 3.22, 95% CI 1.75-5.92) or administrator (aOR 1.88, 95% CI 1.27-2.80), and having higher education (aOR 2.23, 95% CI 1.09-4.57) were positively associated with vaccine uptake, whereas working in non-acute care (aOR 0.58, 95% CI 0.34-0.97), active smoking (aOR 0.68, 95% CI 0.51-0.91), and taking prophylactic home remedies against SARS-CoV-2 (aOR 0.42, 95% CI 0.31-0.56) were negatively associated. Important reasons for non-vaccination were a belief that the vaccine might not have long-lasting immunity (267/291, 92.1%) and a preference for gaining naturally acquired instead of vaccine-induced immunity (241/289, 83.4%). CONCLUSIONS Almost all healthcare workers in our cohort had specific antibodies against SARS-CoV-2 from natural infection and/or from vaccination. Young healthcare workers and those working in non-acute settings were less likely to be vaccinated, whereas physicians and administrative staff showed higher vaccination uptake. Presumed ineffectiveness of the vaccine is an important reason for non-vaccination.
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Affiliation(s)
- Selina Albrecht
- Cantonal Hospital St Gallen, Division of Infectious Diseases and Hospital Epidemiology, St Gallen, Switzerland
| | - Fabian Grässli
- Cantonal Hospital St Gallen, Division of Infectious Diseases and Hospital Epidemiology, St Gallen, Switzerland
| | - Alexia Cusini
- Cantonal Hospital of Grisons, Division of Infectious Diseases, Chur, Switzerland
| | - Angela Brucher
- Psychiatry Services of the Canton of St. Gallen (South), Trübbach, Switzerland
| | - Stephan Goppel
- Psychiatry Services of the Canton of St. Gallen (North), Wil, Switzerland
| | | | - J Carsten Möller
- Center for Neurological Rehabilitation, Zihlschlacht, Switzerland
| | - Manuela Ortner
- Rheintal Werdenberg Sarganserland Hospital Group, Grabs, Switzerland
| | - Markus Ruetti
- Fuerstenland Toggenburg Hospital Group, Wil, Switzerland
| | | | - Danielle Vuichard-Gysin
- Thurgau Hospital Group, Division of Infectious Diseases and Hospital Epidemiology, Muensterlingen, Switzerland
- Swiss National Centre for Infection Prevention (Swissnoso), Berne, Switzerland
| | - Ulrike Besold
- Geriatric Clinic St. Gallen, St. Gallen, Switzerland
| | - Lorenz Risch
- Labormedizinisches Zentrum Dr Risch Ostschweiz AG, Buchs, Switzerland
- Private Universität im Fürstentum Liechtenstein, Institut für Labormedizin, Triesen, Liechtenstein
- Center of Laboratory Medicine, University Institute of Clinical Chemistry, University of Berne, Inselspital, Berne, Switzerland
| | | | - Matthias Schlegel
- Cantonal Hospital St Gallen, Division of Infectious Diseases and Hospital Epidemiology, St Gallen, Switzerland
| | - Pietro Vernazza
- Cantonal Hospital St Gallen, Division of Infectious Diseases and Hospital Epidemiology, St Gallen, Switzerland
| | - Stefan P Kuster
- Cantonal Hospital St Gallen, Division of Infectious Diseases and Hospital Epidemiology, St Gallen, Switzerland
| | - Christian R Kahlert
- Cantonal Hospital St Gallen, Division of Infectious Diseases and Hospital Epidemiology, St Gallen, Switzerland
- Children's Hospital of Eastern Switzerland, Department of Infectious Diseases and Hospital Epidemiology, St. Gallen, Switzerland
| | - Philipp Kohler
- Cantonal Hospital St Gallen, Division of Infectious Diseases and Hospital Epidemiology, St Gallen, Switzerland
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Jacobson MA, Blanc PD, Tulsky J, Tilly M, Meister R, Huen W, McNicholas JE. Risk of subsequent SARS-CoV-2 infection among vaccinated employees with or without hybrid immunity acquired early in the Omicron-predominant era of the COVID-19 pandemic. Am J Ind Med 2024; 67:334-340. [PMID: 38316635 DOI: 10.1002/ajim.23570] [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: 06/08/2023] [Revised: 01/24/2024] [Accepted: 01/24/2024] [Indexed: 02/07/2024]
Abstract
BACKGROUND Hybrid immunity, from COVID-19 vaccination followed by SARS-CoV-2 infection acquired after its Omicron variant began predominating, has provided greater protection than vaccination alone against subsequent infection over 1-3 months of observation. Its longer-term protection is unknown. METHODS We conducted a retrospective cohort study of COVID-19 case incidence among healthcare personnel (HCP) mandated to be vaccinated and report on COVID-19-associated symptoms, high-risk exposures, or known-positive test results to an employee health hotline. We compared cases with hybrid immunity, defined as incident COVID-19 during the first 6 weeks of Omicron-variant predominance (run-in period), to those with immunity from vaccination alone during the run-in period. Time until COVID-19 infection over 13 subsequent months (observation period) was analyzed by standard survival analysis. RESULTS Of 5867 employees, 641 (10.9%, 95% confidence interval [CI]: 10.1%-11.8%) acquired hybrid immunity during the run-in period. Of these, 104 (16.2%, 95% CI: 13.5%-19.3%) experienced new SARS-CoV-2 infection during the 13-month observation period, compared to 2177 (41.7%, 95% CI: 40.3%-43.0%) of the 5226 HCP without hybrid immunity. Time until incident infection was shorter among the latter (hazard ratio: 3.09, 95% CI: 2.54-3.78). CONCLUSIONS In a cohort of vaccinated employees, Omicron-era acquired SARS-CoV-2 hybrid immunity was associated with significantly lower risk of subsequent infection over more than a year of observation-a time period far longer than previously reported and during which three, progressively more resistant, Omicron subvariants became predominant. These findings can inform institutional policy and planning for future COVID-19 additional vaccine dosing requirements for employees, for surveillance programs, and for risk modification efforts.
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Affiliation(s)
- Mark A Jacobson
- Department of Medicine, Division of Occupational, Environmental, and Climate Medicine, University of California San Francisco School of Medicine, San Francisco, California, USA
- Department of Medicine, Division of HIV, Infectious Diseases, and Global Medicine, University of California San Francisco School of Medicine, San Francisco, California, USA
- Department of Medicine, University of California San Francisco School of Medicine, San Francisco, California, USA
| | - Paul D Blanc
- Department of Medicine, Division of Occupational, Environmental, and Climate Medicine, University of California San Francisco School of Medicine, San Francisco, California, USA
- Department of Medicine, University of California San Francisco School of Medicine, San Francisco, California, USA
| | - Jacqueline Tulsky
- Department of Medicine, Division of Occupational, Environmental, and Climate Medicine, University of California San Francisco School of Medicine, San Francisco, California, USA
- Department of Medicine, Division of HIV, Infectious Diseases, and Global Medicine, University of California San Francisco School of Medicine, San Francisco, California, USA
- Department of Medicine, University of California San Francisco School of Medicine, San Francisco, California, USA
| | - Monica Tilly
- Department of Medicine, Division of Occupational, Environmental, and Climate Medicine, University of California San Francisco School of Medicine, San Francisco, California, USA
- Department of Medicine, University of California San Francisco School of Medicine, San Francisco, California, USA
| | - Raymond Meister
- Department of Medicine, Division of Occupational, Environmental, and Climate Medicine, University of California San Francisco School of Medicine, San Francisco, California, USA
- Department of Medicine, University of California San Francisco School of Medicine, San Francisco, California, USA
| | - Will Huen
- Department of Medicine, University of California San Francisco School of Medicine, San Francisco, California, USA
| | - James E McNicholas
- Department of Medicine, Division of Occupational, Environmental, and Climate Medicine, University of California San Francisco School of Medicine, San Francisco, California, USA
- Department of Medicine, University of California San Francisco School of Medicine, San Francisco, California, USA
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Di Chiara C, Boracchini R, Cantarutti A, Kakkar F, Oletto A, Padoan A, Donà D, Giaquinto C. Risk of SARS-CoV-2 Reinfection in Children Within the 12 Months Following Mild COVID-19: Insights From a Survey Study. Pediatr Infect Dis J 2024; 43:e128-e130. [PMID: 38241645 PMCID: PMC10919262 DOI: 10.1097/inf.0000000000004233] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/07/2023] [Indexed: 01/21/2024]
Abstract
Understanding the correlation between immune response and protection from COVID-19 will play a pivotal role in predicting the effectiveness of vaccines in children. We studied SARS-CoV-2 reinfection risk in children 12 months post-mild COVID-19. Children under 5 years old exhibited lower reinfection risk than older infected or vaccinated siblings during 12 months postimmunization.
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Affiliation(s)
- Costanza Di Chiara
- From the Department for Women's and Children's Health, University of Padua, Padua, Italy
- Penta - Child Health Research, Padua, Italy
| | - Riccardo Boracchini
- Division of Biostatistics, Epidemiology and Public Health, Laboratory of Healthcare Research and Pharmacoepidemiology, Department of Statistics and Quantitative Methods, University of Milano-Bicocca, Milan, Italy
| | - Anna Cantarutti
- Division of Biostatistics, Epidemiology and Public Health, Laboratory of Healthcare Research and Pharmacoepidemiology, Department of Statistics and Quantitative Methods, University of Milano-Bicocca, Milan, Italy
| | - Fatima Kakkar
- Division of Infectious Diseases, Department of Pediatrics, CHU Sainte-Justine, Montréal, Québec, Canada
| | | | - Andrea Padoan
- Department of Medicine-DIMED, University of Padua, Padua, Italy
| | - Daniele Donà
- From the Department for Women's and Children's Health, University of Padua, Padua, Italy
- Penta - Child Health Research, Padua, Italy
| | - Carlo Giaquinto
- From the Department for Women's and Children's Health, University of Padua, Padua, Italy
- Penta - Child Health Research, Padua, Italy
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Shen H, Chen D, Li C, Huang T, Ma W. A mini review of reinfection with the SARS-CoV-2 Omicron variant. Health Sci Rep 2024; 7:e2016. [PMID: 38605725 PMCID: PMC11007061 DOI: 10.1002/hsr2.2016] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2023] [Revised: 02/28/2024] [Accepted: 03/12/2024] [Indexed: 04/13/2024] Open
Abstract
Background COVID-19 has caused severe morbidity and mortality worldwide. After the end of the dynamic zero-COVID policy in China in December, 2022, concerns regarding reinfection were raised while little was known due to the lack of surveillance data in this country. Aims This study reviews the probability, risk factors, and severity of severe acute respiratory syndrome coronavirus 2 Omicron variant reinfection, as well as the interval between infections, risk of onward transmission by reinfected cases, and the role of booster vaccination against reinfection. Sources References for this review were identified through searches of PubMed and Web of Science up to September 24, 2023. Results The rate of reinfection ranges from 3.1% to 13.0%. Factors associated with a higher risk of reinfection include being female, having comorbidities, and being unvaccinated. Reinfection with the BA.4 or BA.5 variant occurs approximately 180 days after the initial infection. Reinfections are less clinically severe than primary infections, and there is evidence of lower transmissibility. The debate surrounding the effectiveness and feasibility of booster vaccinations in preventing reinfection continues. Conclusions The reinfection rate during the Omicron epidemic is significantly higher than in previous epidemic periods. However, the symptoms and infectivity of reinfection were weaker than those of the prior infection. Medical staff and individuals at high risk of reinfection should be vigilant. The efficacy of booster vaccinations in reducing reinfection is currently under debate.
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Affiliation(s)
- Hongwei Shen
- Shenzhen Hospital of Southern Medical UniversityShenzhenGuangdongChina
| | - Dingqiang Chen
- Zhujiang Hospital of Southern Medical UniversityGuangzhouGuangdongChina
| | - Chenglin Li
- Shenzhen Hospital of Southern Medical UniversityShenzhenGuangdongChina
| | - Tingting Huang
- Shenzhen Hospital of Southern Medical UniversityShenzhenGuangdongChina
| | - Wen Ma
- Shenzhen Hospital of Southern Medical UniversityShenzhenGuangdongChina
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Ma Z, Rennert L. An epidemiological modeling framework to inform institutional-level response to infectious disease outbreaks: a Covid-19 case study. Sci Rep 2024; 14:7221. [PMID: 38538693 PMCID: PMC10973339 DOI: 10.1038/s41598-024-57488-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Accepted: 03/19/2024] [Indexed: 04/04/2024] Open
Abstract
Institutions have an enhanced ability to implement tailored mitigation measures during infectious disease outbreaks. However, macro-level predictive models are inefficient for guiding institutional decision-making due to uncertainty in local-level model input parameters. We present an institutional-level modeling toolkit used to inform prediction, resource procurement and allocation, and policy implementation at Clemson University throughout the Covid-19 pandemic. Through incorporating real-time estimation of disease surveillance and epidemiological measures based on institutional data, we argue this approach helps minimize uncertainties in input parameters presented in the broader literature and increases prediction accuracy. We demonstrate this through case studies at Clemson and other university settings during the Omicron BA.1 and BA.4/BA.5 variant surges. The input parameters of our toolkit are easily adaptable to other institutional settings during future health emergencies. This methodological approach has potential to improve public health response through increasing the capability of institutions to make data-informed decisions that better prioritize the health and safety of their communities while minimizing operational disruptions.
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Affiliation(s)
- Zichen Ma
- Department of Mathematics, Colgate University, Hamilton, NY, USA
- Center for Public Health Modeling and Response, Department of Public Health Sciences, Clemson University, 517 Edwards Hall, Clemson, SC, 29634, USA
| | - Lior Rennert
- Center for Public Health Modeling and Response, Department of Public Health Sciences, Clemson University, 517 Edwards Hall, Clemson, SC, 29634, USA.
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Chen Y, Zhu W, Han X, Chen M, Li X, Huang H, Zhang M, Wei R, Zhang H, Yang C, Zhang T. How does the SARS-CoV-2 reinfection rate change over time? The global evidence from systematic review and meta-analysis. BMC Infect Dis 2024; 24:339. [PMID: 38515023 PMCID: PMC10956270 DOI: 10.1186/s12879-024-09225-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: 10/04/2023] [Accepted: 03/14/2024] [Indexed: 03/23/2024] Open
Abstract
BACKGROUND There is a significant increase in the number of SARS-CoV-2 reinfection reports in various countries. However, the trend of reinfection rate over time is not clear. METHODS We searched PubMed, Web of Science, Medline, Embase, Cochrane Central Register of Controlled Trials, China National Knowledge Infrastructure, and Wanfang for cohort studies, case-control studies, and cross-sectional studies up to March 16, 2023, to conduct a meta-analysis of global SARS-CoV-2 reinfection rate. Subgroup analyses were performed for age, country, study type, and study population, and time-varying reinfection rates of SARS-CoV-2 were estimated using meta-regression. The risk of bias was assessed using the Newcastle-Ottawa Scale and the Joanna Briggs Institute critical appraisal tool. RESULT A total of 55 studies involving 111,846 cases of SARS-CoV-2 reinfection were included. The pooled SARS-CoV-2 reinfection rate was 0.94% (95% CI: 0.65 -1.35%). In the subgroup analyses, there were statistically significant differences in the pooled reinfection rates by reinfection variant, and study type (P < 0.05). Based on meta-regression, the reinfection rate fluctuated with time. CONCLUSION Meta-regression analysis found that the overall reinfection rate increased and then decreased over time, followed by a period of plateauing and then a trend of increasing and then decreasing, but the peak of the second wave of reinfection rate was lower than the first wave. SARS-CoV-2 is at risk of reinfection and the Omicron variant has a higher reinfection rate than other currently known variants. The results of this study could help guide public health measures and vaccination strategies in response to the Coronavirus Disease 2019 (COVID-19) pandemic.
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Affiliation(s)
- Ying Chen
- Department of Epidemiology and Health Statistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan Province, China
| | - Wenhui Zhu
- Department of Epidemiology and Health Statistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan Province, China
| | - Xinyue Han
- Department of Epidemiology and Health Statistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan Province, China
| | - Miaoshuang Chen
- Department of Epidemiology and Health Statistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan Province, China
| | - Xin Li
- Department of Epidemiology and Health Statistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan Province, China
| | - Haiping Huang
- Department of Epidemiology and Health Statistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan Province, China
| | - Mengyuan Zhang
- Sichuan Center for Disease Control and Prevention, Chengdu, Sichuan Province, China
| | - Rongjie Wei
- Sichuan Center for Disease Control and Prevention, Chengdu, Sichuan Province, China
| | - Huadong Zhang
- Chongqing Center for Disease Control and Prevention, Chongqing, China
| | - Changhong Yang
- Sichuan Center for Disease Control and Prevention, Chengdu, Sichuan Province, China.
| | - Tao Zhang
- Department of Epidemiology and Health Statistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan Province, China.
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Wei J, Stoesser N, Matthews PC, Khera T, Gethings O, Diamond I, Studley R, Taylor N, Peto TEA, Walker AS, Pouwels KB, Eyre DW. Risk of SARS-CoV-2 reinfection during multiple Omicron variant waves in the UK general population. Nat Commun 2024; 15:1008. [PMID: 38307854 PMCID: PMC10837445 DOI: 10.1038/s41467-024-44973-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2023] [Accepted: 01/10/2024] [Indexed: 02/04/2024] Open
Abstract
SARS-CoV-2 reinfections increased substantially after Omicron variants emerged. Large-scale community-based comparisons across multiple Omicron waves of reinfection characteristics, risk factors, and protection afforded by previous infection and vaccination, are limited. Here we studied ~45,000 reinfections from the UK's national COVID-19 Infection Survey and quantified the risk of reinfection in multiple waves, including those driven by BA.1, BA.2, BA.4/5, and BQ.1/CH.1.1/XBB.1.5 variants. Reinfections were associated with lower viral load and lower percentages of self-reporting symptoms compared with first infections. Across multiple Omicron waves, estimated protection against reinfection was significantly higher in those previously infected with more recent than earlier variants, even at the same time from previous infection. Estimated protection against Omicron reinfections decreased over time from the most recent infection if this was the previous or penultimate variant (generally within the preceding year). Those 14-180 days after receiving their most recent vaccination had a lower risk of reinfection than those >180 days from their most recent vaccination. Reinfection risk was independently higher in those aged 30-45 years, and with either low or high viral load in their most recent previous infection. Overall, the risk of Omicron reinfection is high, but with lower severity than first infections; both viral evolution and waning immunity are independently associated with reinfection.
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Affiliation(s)
- Jia Wei
- Nuffield Department of Medicine, University of Oxford, Oxford, UK.
- Big Data Institute, Nuffield Department of Population Health, University of Oxford, Oxford, UK.
| | - Nicole Stoesser
- Nuffield Department of Medicine, University of Oxford, Oxford, UK
- Department of Infectious Diseases and Microbiology, Oxford University Hospitals NHS Foundation Trust, John Radcliffe Hospital, Oxford, UK
- The National Institute for Health Research Health Protection Research Unit in Healthcare Associated Infections and Antimicrobial Resistance at the University of Oxford, Oxford, UK
- The National Institute for Health Research Oxford Biomedical Research Centre, University of Oxford, Oxford, UK
| | - Philippa C Matthews
- Nuffield Department of Medicine, University of Oxford, Oxford, UK
- The Francis Crick Institute, 1 Midland Road, London, UK
- Division of infection and immunity, University College London, London, UK
| | | | | | | | | | | | - Tim E A Peto
- Nuffield Department of Medicine, University of Oxford, Oxford, UK
- Department of Infectious Diseases and Microbiology, Oxford University Hospitals NHS Foundation Trust, John Radcliffe Hospital, Oxford, UK
- The National Institute for Health Research Health Protection Research Unit in Healthcare Associated Infections and Antimicrobial Resistance at the University of Oxford, Oxford, UK
- The National Institute for Health Research Oxford Biomedical Research Centre, University of Oxford, Oxford, UK
| | - A Sarah Walker
- Nuffield Department of Medicine, University of Oxford, Oxford, UK
- Big Data Institute, Nuffield Department of Population Health, University of Oxford, Oxford, UK
- The National Institute for Health Research Health Protection Research Unit in Healthcare Associated Infections and Antimicrobial Resistance at the University of Oxford, Oxford, UK
- MRC Clinical Trials Unit at UCL, UCL, London, UK
| | - Koen B Pouwels
- The National Institute for Health Research Health Protection Research Unit in Healthcare Associated Infections and Antimicrobial Resistance at the University of Oxford, Oxford, UK
- Health Economics Research Centre, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - David W Eyre
- Big Data Institute, Nuffield Department of Population Health, University of Oxford, Oxford, UK
- Department of Infectious Diseases and Microbiology, Oxford University Hospitals NHS Foundation Trust, John Radcliffe Hospital, Oxford, UK
- The National Institute for Health Research Health Protection Research Unit in Healthcare Associated Infections and Antimicrobial Resistance at the University of Oxford, Oxford, UK
- The National Institute for Health Research Oxford Biomedical Research Centre, University of Oxford, Oxford, UK
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Kassanjee R, Davies MA, Heekes A, Mahomed H, Hawkridge AJ, Wolmarans M, Morden E, Jacobs T, Cohen C, Moultrie H, Lessells RJ, Van Der Walt N, Arendse JO, Goeiman H, Mudaly V, Wolter N, Walaza S, Jassat W, von Gottberg A, Hannan PL, Rousseau P, Feikin D, Cloete K, Boulle A. COVID-19 vaccine uptake and effectiveness by time since vaccination in the Western Cape province, South Africa: An observational cohort study during 2020-2022. medRxiv 2024:2024.01.24.24301721. [PMID: 38343866 PMCID: PMC10854330 DOI: 10.1101/2024.01.24.24301721] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 02/18/2024]
Abstract
Background There are few data on the real-world effectiveness of COVID-19 vaccines and boosting in Africa, which experienced high levels of SARS-CoV-2 infection in a mostly vaccine-naïve population, and has limited vaccine coverage and competing health service priorities. We assessed the association between vaccination and severe COVID-19 in the Western Cape, South Africa. Methods We performed an observational cohort study of >2 million adults during 2020-2022. We described SARS-CoV-2 testing, COVID-19 outcomes, and vaccine uptake over time. We used multivariable cox models to estimate the association of BNT162b2 and Ad26.COV2.S vaccination with COVID-19-related hospitalisation and death, adjusting for demographic characteristics, underlying health conditions, socioeconomic status proxies and healthcare utilisation. Results By end 2022, only 41% of surviving adults had completed vaccination and 8% a booster dose, despite several waves of severe COVID-19. Recent vaccination was associated with notable reductions in severe COVID-19 during distinct analysis periods dominated by Delta, Omicron BA.1/2 and BA.4/5 (sub)lineages: within 6 months of completing vaccination or boosting, vaccine effectiveness was 46-92% for death (range across periods), 45-92% for admission with severe disease or death, and 25-90% for any admission or death. During the Omicron BA.4/5 wave, within 3 months of vaccination or boosting, BNT162b2 and Ad26.COV2.S were each 84% effective against death (95% CIs: 57-94 and 49-95, respectively). However, there were distinct reductions of VE at larger times post completing or boosting vaccination. Conclusions Continued emphasis on regular COVID-19 vaccination including boosting is important for those at high risk of severe COVID-19 even in settings with widespread infection-induced immunity.
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Affiliation(s)
- Reshma Kassanjee
- Centre for Infectious Disease Epidemiology and Research, School of Public Health, University of Cape Town, South Africa
| | - Mary-Ann Davies
- Centre for Infectious Disease Epidemiology and Research, School of Public Health, University of Cape Town, South Africa
- Division of Public Health Medicine, School of Public Health, University of Cape Town, South Africa
- Centre for Infectious Diseases Research in Africa, University of Cape Town, South Africa
- Health Intelligence, Western Cape Government Department of Health and Wellness, South Africa
| | - Alexa Heekes
- Centre for Infectious Disease Epidemiology and Research, School of Public Health, University of Cape Town, South Africa
- Health Intelligence, Western Cape Government Department of Health and Wellness, South Africa
| | - Hassan Mahomed
- Division of Health Systems and Public Health, Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University, South Africa
- Metro Health Services, Western Cape Government Department of Health and Wellness, South Africa
| | - Anthony J Hawkridge
- Rural Health Services, Western Cape Government Department of Health and Wellness, South Africa
| | | | - Erna Morden
- Health Intelligence, Western Cape Government Department of Health and Wellness, South Africa
- School of Public Health, University of Cape Town, South Africa
| | - Theuns Jacobs
- Health Intelligence, Western Cape Government Department of Health and Wellness, South Africa
| | - Cheryl Cohen
- Centre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases of the National Health Laboratory Service, South Africa
- School of Public Health, University of the Witwatersrand, South Africa
| | - Harry Moultrie
- Centre for Tuberculosis, National Institute for Communicable Diseases of the National Health Laboratory Service, South Africa
| | - Richard J Lessells
- KwaZulu-Natal Research Innovation & Sequencing Platform, University of KwaZulu-Natal, South Africa
| | - Nicolette Van Der Walt
- Emergency & Clinical Services Support, Western Cape Government Department of Health and Wellness, South Africa
| | - Juanita O Arendse
- Division of Health Systems and Public Health, Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University, South Africa
- Emergency & Clinical Services Support, Western Cape Government Department of Health and Wellness, South Africa
| | - Hilary Goeiman
- Western Cape Government Department of Health and Wellness, South Africa
| | - Vanessa Mudaly
- Division of Public Health Medicine, School of Public Health, University of Cape Town, South Africa
- Western Cape Government Department of Health and Wellness, South Africa
| | - Nicole Wolter
- Centre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases of the National Health Laboratory Service, South Africa
- School of Pathology, University of the Witwatersrand, South Africa
| | - Sibongile Walaza
- Centre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases of the National Health Laboratory Service, South Africa
- School of Public Health, University of the Witwatersrand, South Africa
| | - Waasila Jassat
- Health Practice, Genesis Analytics, South Africa
- Division of Public Health Surveillance and Response, National Institute for Communicable Diseases of the National Health Laboratory Service, South Africa
| | - Anne von Gottberg
- Centre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases of the National Health Laboratory Service, South Africa
- School of Pathology, University of the Witwatersrand, South Africa
| | - Patrick L Hannan
- Division of Epidemiology and Biostatistics, School of Public Health, University of Cape Town, South Africa
| | - Petro Rousseau
- South African National Department of Health, South Africa
| | - Daniel Feikin
- Department of Immunizations, Vaccines, and Biologicals, World Health Organization, Switzerland
| | - Keith Cloete
- Western Cape Government Department of Health and Wellness, South Africa
| | - Andrew Boulle
- Centre for Infectious Disease Epidemiology and Research, School of Public Health, University of Cape Town, South Africa
- Division of Public Health Medicine, School of Public Health, University of Cape Town, South Africa
- Centre for Infectious Diseases Research in Africa, University of Cape Town, South Africa
- Health Intelligence, Western Cape Government Department of Health and Wellness, South Africa
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10
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Du H, Saiyed S, Gardner LM. Association between vaccination rates and COVID-19 health outcomes in the United States: a population-level statistical analysis. BMC Public Health 2024; 24:220. [PMID: 38238709 PMCID: PMC10797940 DOI: 10.1186/s12889-024-17790-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] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Accepted: 01/16/2024] [Indexed: 01/22/2024] Open
Abstract
BACKGROUND Population-level vaccine efficacy is a critical component of understanding COVID-19 risk, informing public health policy, and mitigating disease impacts. Unlike individual-level clinical trials, population-level analysis characterizes how well vaccines worked in the face of real-world challenges like emerging variants, differing mobility patterns, and policy changes. METHODS In this study, we analyze the association between time-dependent vaccination rates and COVID-19 health outcomes for 48 U.S. states. We primarily focus on case-hospitalization risk (CHR) as the outcome of interest, using it as a population-level proxy for disease burden on healthcare systems. Performing the analysis using Generalized Additive Models (GAMs) allowed us to incorporate real-world nonlinearities and control for critical dynamic (time-changing) and static (temporally constant) factors. Dynamic factors include testing rates, activity-related engagement levels in the population, underlying population immunity, and policy. Static factors incorporate comorbidities, social vulnerability, race, and state healthcare expenditures. We used SARS-CoV-2 genomic surveillance data to model the different COVID-19 variant-driven waves separately, and evaluate if there is a changing role of the potential drivers of health outcomes across waves. RESULTS Our study revealed a strong and statistically significant negative association between vaccine uptake and COVID-19 CHR across each variant wave, with boosters providing additional protection during the Omicron wave. Higher underlying population immunity is shown to be associated with reduced COVID-19 CHR. Additionally, more stringent government policies are generally associated with decreased CHR. However, the impact of activity-related engagement levels on COVID-19 health outcomes varied across different waves. Regarding static variables, the social vulnerability index consistently exhibits positive associations with CHR, while Medicaid spending per person consistently shows a negative association. However, the impacts of other static factors vary in magnitude and significance across different waves. CONCLUSIONS This study concludes that despite the emergence of new variants, vaccines remain highly correlated with reduced COVID-19 harm. Therefore, given the ongoing threat posed by COVID-19, vaccines remain a critical line of defense for protecting the public and reducing the burden on healthcare systems.
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Affiliation(s)
- Hongru Du
- Center for Systems Science and Engineering, Johns Hopkins University, 3400 N. Charles Street, Shaffer 4, Baltimore, MD, 21218, USA.
- Department of Civil and Systems Engineering, Johns Hopkins University, Baltimore, MD, 21218, USA.
| | - Samee Saiyed
- Center for Systems Science and Engineering, Johns Hopkins University, 3400 N. Charles Street, Shaffer 4, Baltimore, MD, 21218, USA
- Department of Civil and Systems Engineering, Johns Hopkins University, Baltimore, MD, 21218, USA
| | - Lauren M Gardner
- Center for Systems Science and Engineering, Johns Hopkins University, 3400 N. Charles Street, Shaffer 4, Baltimore, MD, 21218, USA
- Department of Civil and Systems Engineering, Johns Hopkins University, Baltimore, MD, 21218, USA
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, 21205, USA
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11
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Kandeel A, Fahim M, Deghedy O, BahaaEldin H, Roshdy WH, Khalifa MK, Kandeil A, El Shesheny R, Naguib A, AbdelFatah M, Afifi S, Abdel Ghaffar K. Comparative analysis of COVID-19 and influenza prevalence among Egyptian pilgrims returning from Hajj and Umrah in 2022: epidemiology, clinical characteristics, and genomic sequencing. Arch Public Health 2024; 82:6. [PMID: 38216978 PMCID: PMC10785524 DOI: 10.1186/s13690-023-01229-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Accepted: 12/14/2023] [Indexed: 01/14/2024] Open
Abstract
PURPOSE To describe the changes that occurred in the SARS-CoV-2 and influenza Prevalence, epidemiology, clinical picture, and prevalent genotypes among the Egyptian pilgrims returning from Hajj and Umrah 2022 seasons. METHODS Pilgrims were contacted at the airport and invited to participate in the survey. Pilgrims who consented were interviewed using a standardized line list that included participant demographics, respiratory symptoms if any, previous COVID-19 infection, influenza vaccination whereas COVID-19 vaccination information were collected from vaccination cards. Participants were asked to provide throat and nasopharyngeal swabs for SARS-CoV-2 and influenza testing using RT-PCR and a subset of isolates were sequenced. Descriptive data analysis was performed to describe the epidemiology and clinical symptoms of SARS-CoV-2 and influenza. Prevalence rates of SARS-CoV-2 and influenza during Hajj were calculated and compared to Umrah surveys using chi2 and t-test with a significance level < 0.05. RESULTS Overall, 3,862 Egyptian pilgrims enrolled, their mean age was 50.5 ± 47 years, half of them were > 50 years of age and 58.2% were males. Of them, 384 (9.9%) tested positive for SARS-CoV-2 and 51 (1.3%) for influenza viruses. Prevalence of SARS-CoV-2 infections (vaccine breakthrough) increased significantly between the Umrah and Hajj surveys (6.7% vs. 9.9%, p < 0.001), and variants of the virus varied considerably. Whereas no significant difference was found in influenza prevalence, vaccine coverage and vaccine breakthrough infection rates (11.7 vs. 9.2%, 26.9 vs. 26.8%, and 1.4 vs. 1.1% respectively). CONCLUSIONS SARS-CoV-2 prevalence among Egyptian pilgrims returning from Hajj in July increased with reduced vaccine effectiveness compared to Umrah in March 2022 suggesting a possible wave of SARS-CoV-2 in the upcoming winter.
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Affiliation(s)
- Amr Kandeel
- Preventive Sector, Ministry of Health and Population, Governmental District, New Administrative Capital, Cairo, Egypt
| | - Manal Fahim
- Department of Epidemiology and Surveillance, Preventive Sector, Ministry of Health and Population, Governmental District, New Administrative Capital, Cairo, Egypt
| | - Ola Deghedy
- Department of Epidemiology and Surveillance, Preventive Sector, Ministry of Health and Population, Governmental District, New Administrative Capital, Cairo, Egypt
| | - Hala BahaaEldin
- Department of Epidemiology and Surveillance, Preventive Sector, Ministry of Health and Population, Governmental District, New Administrative Capital, Cairo, Egypt.
| | - Wael H Roshdy
- Central Public Health Laboratory, Ministry of Health and Population, Governmental District, New Administrative Capital, Cairo, Egypt
| | - Mohamed Kamal Khalifa
- Central Public Health Laboratory, Ministry of Health and Population, Governmental District, New Administrative Capital, Cairo, Egypt
| | - Ahmed Kandeil
- Centre of Scientific Excellence for Influenza Viruses, National Research Centre, 12622 Dokki, Giza, Egypt
| | - Rabeh El Shesheny
- Centre of Scientific Excellence for Influenza Viruses, National Research Centre, 12622 Dokki, Giza, Egypt
| | - Amel Naguib
- Central Public Health Laboratory, Ministry of Health and Population, Governmental District, New Administrative Capital, Cairo, Egypt
| | - Mohamad AbdelFatah
- Preventive Sector, Ministry of Health and Population, Governmental District, New Administrative Capital, Cairo, Egypt
| | - Salma Afifi
- Ministry of Health and Population Consultant, Governmental District, New Administrative Capital, Cairo, Egypt
| | - Khaled Abdel Ghaffar
- Ministry of Health and Population, Governmental District, New Administrative Capital, Cairo, Egypt
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12
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Lo E, Fortin É, Gilca R, Trépanier PL, Geagea H, Zhou Z. Evolution of illness severity in hospital admissions due to COVID-19, Québec, Canada, January to April 2022. Can Commun Dis Rep 2024; 50:63-76. [PMID: 38655241 PMCID: PMC11037885 DOI: 10.14745/ccdr.v50i12a08] [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] [Subscribe] [Scholar Register] [Indexed: 04/26/2024]
Abstract
Background The coronavirus disease 2019 (COVID-19) severity is influenced by multiple factors, such as age, underlying medical conditions, individual immunity, infecting variant, and clinical practice. The highly transmissible Omicron variants resulted in decreased COVID-19 screening capacity, which limited disease severity surveillance. Objective To report on the temporal evolution of disease severity among patients admitted to Québec hospitals due to COVID-19 between January 2, 2022, and April 23, 2022, which corresponded to the peak period of hospitalizations due to Omicron. Methods Retrospective population-based cohort study of all hospital admissions due to COVID-19 in Québec, between January 2, 2022, and April 23, 2022. Study period was divided into four-week periods, corresponding roughly to January, February, March and April. Regression using Cox and Poisson generalized estimating equations (GEEs) was used to quantify temporal variations in length of stay and risk of complications (intensive care admission or in-hospital death) through time, using the Omicron peak (January 2022) as reference. Measures were adjusted for age, sex, vaccination status, presence of chronic diseases, and clustering by hospital. Results During the study period, 9,178 of all 18,272 (50.2%) patients hospitalized with a COVID-19 diagnosis were admitted due to COVID-19. Of these, 1,026 (11.2%) were admitted to intensive care and 1,523 (16.6%) died. Compared to January, the risk of intensive care admission was 25% and 31% lower in March and April respectively, while in-hospital fatality continuously decreased by 45% lower in April. The average length of stay was temporarily lower in March (9%). Conclusion Severity of admissions due to COVID-19 decreased in the first months of 2022, when predominant circulating variants were considered to be of similar severity. Monitoring hospital admissions due to COVID-19 can contribute to disease severity surveillance.
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Affiliation(s)
- Ernest Lo
- Institut national de santé publique du Québec, Québec, QC
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montréal, QC
| | - Élise Fortin
- Institut national de santé publique du Québec, Québec, QC
- Département de microbiologie, Infectiologie et immunologie, Faculté de médecine, Université de Montréal, Québec, QC
- Département de médecine sociale et préventive, Faculté de médecine, Université Laval, Québec, QC
| | - Rodica Gilca
- Institut national de santé publique du Québec, Québec, QC
- Département de médecine sociale et préventive, Faculté de médecine, Université Laval, Québec, QC
- Centre de recherche du CHU de Québec, Université Laval, Québec, QC
| | | | - Hany Geagea
- Institut national de santé publique du Québec, Québec, QC
| | - Zhou Zhou
- Institut national de santé publique du Québec, Québec, QC
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13
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Jang YA, Wu HY, Hsu YT, Chen YK, Chiou HY, Sytwu HK, Chen WJ, Tsou HH. Beyond the waves: Unraveling pandemic outcomes with genomic insights and immunity analysis - Evidence from 14 countries. Prev Med 2024; 178:107820. [PMID: 38092329 DOI: 10.1016/j.ypmed.2023.107820] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Revised: 12/08/2023] [Accepted: 12/09/2023] [Indexed: 12/24/2023]
Abstract
OBJECTIVE Although the World Health Organization and many governments have recategorized COVID-19 as a generally mild to moderately severe disease, consecutive pandemic waves driven by immune escape variants have underscored the need for timely and accurate prediction of the next outbreak. Nevertheless, little attention has been paid to translating genomic data and infection- and vaccine-induced immunity into direct estimates. METHODS We retrieved epidemiologic and genomic data shortly before pandemic waves across 14 developed countries from late 2021 to mid-2022 and examined associations between early-stage variant competition, infection- and vaccine-induced immunity, and the time intervals between wave peaks. We applied regression analysis and the generalized estimating equation method to construct an inferential model. RESULTS Each per cent increase in the proportion of a new variant was associated with a 1.0% reduction in interpeak intervals on average. Curvilinear associations between vaccine-induced immunity and outcome variables were observed, suggesting that reaching a critical vaccine distribution rate may decrease the caseload of the upcoming wave. CONCLUSIONS By leveraging readily accessible pre-outbreak genomic and epidemiologic data, our results not only substantiate the predictive potential of early variant fractions but also propose that immunity acquired through infection alone may not sufficiently mitigate transmission. Conversely, a rapid and widespread vaccination initiative appears to be correlated with a decrease in disease incidence.
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Affiliation(s)
- Yung-An Jang
- Institute of Population Health Sciences, National Health Research Institutes, Zhunan, Miaoli County, Taiwan
| | - Hsiao-Yu Wu
- Institute of Population Health Sciences, National Health Research Institutes, Zhunan, Miaoli County, Taiwan
| | - Ya-Ting Hsu
- Institute of Population Health Sciences, National Health Research Institutes, Zhunan, Miaoli County, Taiwan
| | - Yi-Kai Chen
- Institute of Population Health Sciences, National Health Research Institutes, Zhunan, Miaoli County, Taiwan
| | - Hung-Yi Chiou
- Institute of Population Health Sciences, National Health Research Institutes, Zhunan, Miaoli County, Taiwan; School of Public Health, College of Public Health, Taipei Medical University, Taiwan; Master Program in Applied Epidemiology, College of Public Health, Taipei Medical University, Taiwan
| | - Huey-Kang Sytwu
- National Institute of Infectious Diseases and Vaccinology, National Health Research Institutes, Taiwan
| | - Wei J Chen
- Center for Neuropsychiatric Research, National Health Research Institutes, Taiwan; Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taiwan.
| | - Hsiao-Hui Tsou
- Institute of Population Health Sciences, National Health Research Institutes, Zhunan, Miaoli County, Taiwan; Graduate Institute of Biostatistics, College of Public Health, China Medical University, Taiwan.
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14
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Perrig L, Abela IA, Banholzer N, Audigé A, Epp S, Mugglin C, Zürcher K, Egger M, Trkola A, Fenner L. Long-term course of neutralising antibodies against SARS-CoV-2 in vaccinated and unvaccinated staff and residents in a Swiss nursing home: a cohort study 2021-2022. Swiss Med Wkly 2023; 153:3502. [PMID: 38579325 DOI: 10.57187/s.3502] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/07/2024] Open
Abstract
BACKGROUND Given their high-risk resident population, nursing homes were critical institutions in the COVID-19 pandemic, calling for continued monitoring and vaccine administration to healthcare workers and residents. Here, we studied long-term severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) immunity in vaccinated and unvaccinated healthcare workers and residents of a nursing home in Switzerland between February 2021 and June 2022. METHODS Our study comprised 45 participants, of which 39 were healthcare workers and six were residents. All participants were offered a maximum of three mRNA vaccine doses (Pfizer/BioNTech, BNT162b2) in December 2020, January 2021, and November/December 2021. Thirty-five participants received three vaccinations, seven either one or two, and three remained unvaccinated. We collected four blood samples: one in March 2021 and three during follow-ups in November 2021, February 2022, and June 2022. We performed a multifactorial serological SARS-CoV-2 assay (ABCORA) for immunoglobulin G, A, and M responses to spike (receptor-binding domain, S1, and S2) and nucleocapsid (N) proteins. Furthermore, we assessed predicted neutralisation activity based on signal over cutoff in ABCORA. We collected epidemiological data from participants via a standardised questionnaire. RESULTS Thirty-two (71%) of the 45 participants showed hybrid immunity from combined vaccination and previous infection; 10 (22%) had only vaccine-induced immunity; and three (7%) had only post-infection immunity. Participants with hybrid immunity showed the highest predicted neutralisation activity at the end of the study period (median Sum S1 = 273), and unvaccinated participants showed the lowest (median Sum S1 = 41). Amongst participants who reported a SARS-CoV-2 infection, median Sum S1 levels increased with the number of vaccinations (p = 0.077). The healthcare worker group showed a significant time-dependent decrease in median Sum S1 after base immunisation (93% decrease, p = 0.0005) and the booster dose (26% decrease, p = 0.010). Predicted neutralisation activity was lower amongst residents (adjusted ratio of means [AM] = 0.7, 95% confidence interval [CI] = 0.3-1.0) and amongst smokers (AM = 0.5, 95% CI 0.3-0.8). Activity increased with the number of vaccinations (booster: AM = 3.6, 95% CI 1.5-8.8; no booster: AM = 2.3, 95% CI 0.9-2.5). Positive SARS-CoV-2 infection status tended to confer higher predicted neutralisation levels (AM = 1.5, 95% CI 0.9-2.5). CONCLUSIONS Our study of the long-term serological course of SARS-CoV-2 in a nursing home showed that the first SARS-CoV-2 booster vaccine was essential for maintaining antiviral antibody levels. Hybrid immunity sustained SARS-CoV-2 immunity at the highest level. In critical settings such as nursing homes, monitoring the SARS-CoV-2 immune status may guide booster vaccinations.
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Affiliation(s)
- Lisa Perrig
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
| | - Irene A Abela
- Institute of Medical Virology, University of Zurich, Zurich, Switzerland
- Department of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich, Zurich, Switzerland
| | - Nicolas Banholzer
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
| | - Annette Audigé
- Institute of Medical Virology, University of Zurich, Zurich, Switzerland
| | - Selina Epp
- Institute of Medical Virology, University of Zurich, Zurich, Switzerland
| | - Catrina Mugglin
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
- Department of Infectious Diseases, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Kathrin Zürcher
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
| | - Matthias Egger
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
- Centre for Infectious Disease Epidemiology and Research, University of Cape Town, Cape Town, South Africa
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - Alexandra Trkola
- Institute of Medical Virology, University of Zurich, Zurich, Switzerland
| | - Lukas Fenner
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
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15
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Intawong K, Chariyalertsak S, Chalom K, Wonghirundecha T, Kowatcharakul W, Thongprachum A, Chotirosniramit N, Noppakun K, Khwanngern K, Teacharak W, Piamanant P, Chantaklang P, Khammawan P. Role of booster vaccines and hybrid immunity against severe COVID-19 outcomes during BA.5 omicron predominance in Thailand. Hum Vaccin Immunother 2023; 19:2291882. [PMID: 38083848 PMCID: PMC10732593 DOI: 10.1080/21645515.2023.2291882] [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: 07/25/2023] [Accepted: 12/04/2023] [Indexed: 12/18/2023] Open
Abstract
Owing to both vaccine- and infection-induced immunity, the COVID-19 seroprevalence is ~90% in most countries. It is important to examine the protective role of booster vaccines and hybrid immunity in the COVID-endemic state. Utilizing a hospital information system for COVID-19, we conducted a cohort study by linking laboratory-confirmed COVID-19 case data to the national immunization records during the BA.5 omicron predominant period (1 August-31 December 2022) in Chiang Mai, Thailand. Out of 63,009 adults with COVID-19 included in the study, there were 125 (0.2%) severe COVID outcomes and 6.4% had a previous omicron infection. Protection against severe COVID-19 was highest among those with at least one booster vaccine (63%; aHR 0.37 [95%CI 0.19-0.73]) as compared to those without prior vaccination or natural infection. Hybrid immunity offered better protection (35%; aHR 0.65 [95%CI 0.09-4.73) than primary vaccine series alone or previous infection alone. Evaluating risk by age group, those aged 70 years or more had nearly 40 times (aHR 39.58 [95%CI 18.92-82.79]) the risk of severe-COVID-19 as compared to the 18-39-year age group. While booster vaccines remain the most effective way of protecting against severe COVID-19, particularly in the elderly, hybrid immunity may offer additional benefit.
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Affiliation(s)
- Kannikar Intawong
- Faculty of Public Health, Chiang Mai University, Chiang Mai, Thailand
| | | | | | | | | | | | | | | | - Krit Khwanngern
- Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | | | - Prapon Piamanant
- Nakornping Hospital, Ministry of Public Health, Chiang Mai, Thailand
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16
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Kitamura N, Otani K, Kinoshita R, Yan F, Takizawa Y, Fukushima K, Yoneoka D, Suzuki M, Kamigaki T. Protective effect of previous infection and vaccination against reinfection with BA.5 Omicron subvariant: a nationwide population-based study in Japan. Lancet Reg Health West Pac 2023; 41:100911. [PMID: 38223396 PMCID: PMC10786644 DOI: 10.1016/j.lanwpc.2023.100911] [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] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Revised: 08/29/2023] [Accepted: 09/06/2023] [Indexed: 01/16/2024]
Abstract
Background The Omicron variant of SARS-CoV-2 was reported to evade immunity derived from vaccination and previous infection. A better understanding of hybrid immunity informs effective infection control strategies. Since the reinfection risk was not well-assessed in East Asia, this study aims to evaluate the risk of infection with Omicron subvariant BA.5 among previously infected individuals in Japan. Methods All notified cases were extracted from the Japanese national COVID-19 surveillance database including 20,297,335 records up to 25 September 2022. Reinfection with BA.5 was defined as the infection notified during the BA.5 dominated period with any prior SARS-CoV-2 infection. The protective effect of prior infections against reinfections with BA.5 was estimated by applying a case-population design and the protective effect of vaccination was estimated by a multivariable Cox regression adjusting for age, sex, variants of prior infection, and the time since the last vaccination. Findings Among 19,830,548 SARS-CoV-2 first infections, 233,424 (1.2%) were reinfected with BA.5. The protective effect against BA.5 reinfection of prior infection with Wuhan strain was 46%, Alpha variant was 35%, Delta variant was 41%, and BA.1/BA.2 subvariant was 74%. The reduced risk of BA.5 reinfection by 7%, 33%, and 66% was associated with two, three, and four doses of vaccination, respectively, compared with one-dose vaccination. Interpretation The prior infections with Omicron subvariant BA.1/BA.2 protected BA.5 reinfection more than pre-Omicron variants. Increased frequency of vaccination led to more protection from reinfection with BA.5. Up-to-date vaccination may be encouraged to prevent future reinfection among the previously infected population. Funding None.
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Affiliation(s)
- Noriko Kitamura
- Center for Surveillance, Immunization, and Epidemiologic Research, National Institute of Infectious Diseases, Tokyo, Japan
| | - Kanako Otani
- Center for Surveillance, Immunization, and Epidemiologic Research, National Institute of Infectious Diseases, Tokyo, Japan
| | - Ryo Kinoshita
- Center for Surveillance, Immunization, and Epidemiologic Research, National Institute of Infectious Diseases, Tokyo, Japan
| | - Fangyu Yan
- Center for Surveillance, Immunization, and Epidemiologic Research, National Institute of Infectious Diseases, Tokyo, Japan
| | - Yu Takizawa
- Center for Surveillance, Immunization, and Epidemiologic Research, National Institute of Infectious Diseases, Tokyo, Japan
| | - Kohei Fukushima
- Center for Surveillance, Immunization, and Epidemiologic Research, National Institute of Infectious Diseases, Tokyo, Japan
| | - Daisuke Yoneoka
- Center for Surveillance, Immunization, and Epidemiologic Research, National Institute of Infectious Diseases, Tokyo, Japan
| | - Motoi Suzuki
- Center for Surveillance, Immunization, and Epidemiologic Research, National Institute of Infectious Diseases, Tokyo, Japan
| | - Taro Kamigaki
- Center for Surveillance, Immunization, and Epidemiologic Research, National Institute of Infectious Diseases, Tokyo, Japan
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17
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Dietler D, Kahn F, Inghammar M, Björk J. Waning protection after vaccination and prior infection against COVID-19-related mortality over 18 months. Clin Microbiol Infect 2023; 29:1573-1580. [PMID: 37580016 DOI: 10.1016/j.cmi.2023.08.007] [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: 03/29/2023] [Revised: 08/04/2023] [Accepted: 08/07/2023] [Indexed: 08/16/2023]
Abstract
OBJECTIVES Evidence on waning patterns in protection from vaccine-induced, infection-induced, and hybrid immunity against death is scarce. The aim of this study is to assess the temporal trends in protection against mortality. METHODS Population-based case-control study nested in the total population of Scania Region, Sweden using individual-level registry data of COVID-19-related deaths (<30 days after positive SARS-CoV-2 test) between 27 December 2020 and 3 June 2022. Controls were matched for age, sex, and index date. Conditional logistic regression was used to estimate the preventable fraction (PF) from vaccination (PFvac corresponding to vaccine effectiveness; ≥2 vaccine doses vs. 0 doses), prior infection (PFinf), and hybrid immunity (PFhybrid). PF was calculated as one minus odds ratio. Models were adjusted for comorbidities, long-term care facility residence, prior infection (for PFvac), country of birth, socio-economic conditions, and time since last vaccination (for PFinf). RESULTS In total, 14 936 individuals (1440 COVID-19-related deaths and 13 496 controls) were included in the case-control analyses (45% females, median age: 84 years). PFvac was above 90% during the first month after vaccination, regardless of the number of vaccine doses. After 6 months, PFvac of two doses waned to 34% (95% CI: -30% to 66%). PFinf for people surviving a SARS-CoV-2 infection waned from 88% (-16% to 99%) 3 months after infection to 62% (34-79%) after 9 months. No differences in waning patterns in PFvac were seen between virus variants, gender, and age. DISCUSSION Given the waning of protection against death, continuous surveillance of population immunity status, particularly among the most vulnerable population groups, could help to further fine-tune vaccination recommendations.
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Affiliation(s)
- Dominik Dietler
- Division of Occupational and Environmental Medicine, Lund University, Lund, Sweden.
| | - Fredrik Kahn
- Department of Clinical Sciences Lund, Section for Infection Medicine, Skåne University Hospital, Lund University, Lund, Sweden
| | - Malin Inghammar
- Department of Clinical Sciences Lund, Section for Infection Medicine, Skåne University Hospital, Lund University, Lund, Sweden
| | - Jonas Björk
- Division of Occupational and Environmental Medicine, Lund University, Lund, Sweden; Clinical Studies Sweden, Forum South, Skåne University Hospital, Lund, Sweden
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18
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Hogan AB, Wu SL, Toor J, Olivera Mesa D, Doohan P, Watson OJ, Winskill P, Charles G, Barnsley G, Riley EM, Khoury DS, Ferguson NM, Ghani AC. Long-term vaccination strategies to mitigate the impact of SARS-CoV-2 transmission: A modelling study. PLoS Med 2023; 20:e1004195. [PMID: 38016000 PMCID: PMC10715640 DOI: 10.1371/journal.pmed.1004195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Revised: 12/12/2023] [Accepted: 10/25/2023] [Indexed: 11/30/2023] Open
Abstract
BACKGROUND Vaccines have reduced severe disease and death from Coronavirus Disease 2019 (COVID-19). However, with evidence of waning efficacy coupled with continued evolution of the virus, health programmes need to evaluate the requirement for regular booster doses, considering their impact and cost-effectiveness in the face of ongoing transmission and substantial infection-induced immunity. METHODS AND FINDINGS We developed a combined immunological-transmission model parameterised with data on transmissibility, severity, and vaccine effectiveness. We simulated Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) transmission and vaccine rollout in characteristic global settings with different population age-structures, contact patterns, health system capacities, prior transmission, and vaccine uptake. We quantified the impact of future vaccine booster dose strategies with both ancestral and variant-adapted vaccine products, while considering the potential future emergence of new variants with modified transmission, immune escape, and severity properties. We found that regular boosting of the oldest age group (75+) is an efficient strategy, although large numbers of hospitalisations and deaths could be averted by extending vaccination to younger age groups. In countries with low vaccine coverage and high infection-derived immunity, boosting older at-risk groups was more effective than continuing primary vaccination into younger ages in our model. Our study is limited by uncertainty in key parameters, including the long-term durability of vaccine and infection-induced immunity as well as uncertainty in the future evolution of the virus. CONCLUSIONS Our modelling suggests that regular boosting of the high-risk population remains an important tool to reduce morbidity and mortality from current and future SARS-CoV-2 variants. Our results suggest that focusing vaccination in the highest-risk cohorts will be the most efficient (and hence cost-effective) strategy to reduce morbidity and mortality.
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Affiliation(s)
- Alexandra B. Hogan
- School of Population Health, Faculty of Medicine and Health, University of New South Wales, Sydney, Australia
- MRC Centre for Global Infectious Disease Analysis, Jameel Institute, School of Public Health, Imperial College London, London, United Kingdom
| | - Sean L. Wu
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, United States of America
| | - Jaspreet Toor
- MRC Centre for Global Infectious Disease Analysis, Jameel Institute, School of Public Health, Imperial College London, London, United Kingdom
| | - Daniela Olivera Mesa
- MRC Centre for Global Infectious Disease Analysis, Jameel Institute, School of Public Health, Imperial College London, London, United Kingdom
| | - Patrick Doohan
- MRC Centre for Global Infectious Disease Analysis, Jameel Institute, School of Public Health, Imperial College London, London, United Kingdom
| | - Oliver J. Watson
- MRC Centre for Global Infectious Disease Analysis, Jameel Institute, School of Public Health, Imperial College London, London, United Kingdom
- London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Peter Winskill
- MRC Centre for Global Infectious Disease Analysis, Jameel Institute, School of Public Health, Imperial College London, London, United Kingdom
| | - Giovanni Charles
- MRC Centre for Global Infectious Disease Analysis, Jameel Institute, School of Public Health, Imperial College London, London, United Kingdom
| | - Gregory Barnsley
- MRC Centre for Global Infectious Disease Analysis, Jameel Institute, School of Public Health, Imperial College London, London, United Kingdom
| | - Eleanor M. Riley
- Institute of Immunology and Infection Research, School of Biological Sciences, University of Edinburgh, Edinburgh, United Kingdom
| | - David S. Khoury
- Kirby Institute, University of New South Wales, Sydney, Australia
| | - Neil M. Ferguson
- MRC Centre for Global Infectious Disease Analysis, Jameel Institute, School of Public Health, Imperial College London, London, United Kingdom
| | - Azra C. Ghani
- MRC Centre for Global Infectious Disease Analysis, Jameel Institute, School of Public Health, Imperial College London, London, United Kingdom
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19
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Baerends EA, Hvidt AK, Reekie J, Søgaard OS, Stærke NB, Raben D, Nielsen H, Petersen KT, Juhl MR, Johansen IS, Lindvig SO, Madsen LW, Wiese L, Knudsen LS, Iversen MB, Benfield T, Iversen KK, Andersen SD, Juhl AK, Dietz LL, Andreasen SR, Fischer TK, Erikstrup C, Valentiner-Branth P, Lundgren J, Østergaard L, Tolstrup M. SARS-CoV-2 vaccine-induced antibodies protect against Omicron breakthrough infection. iScience 2023; 26:107621. [PMID: 37682631 PMCID: PMC10481355 DOI: 10.1016/j.isci.2023.107621] [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: 06/09/2023] [Revised: 07/17/2023] [Accepted: 08/10/2023] [Indexed: 09/10/2023] Open
Abstract
SARS-CoV-2 Omicron quickly spread globally, also in regions with high vaccination coverage, emphasizing the importance of exploring the immunological requirements for protection against Omicron breakthrough infection. The test-negative matched case-control study (N = 964) characterized Omicron breakthrough infections in triple-vaccinated individuals from the ENFORCE cohort. Within 60 days before a PCR test spike-specific IgG levels were significantly lower in cases compared to controls (GMR [95% CI] for BA.2: 0.83 [0.73-0.95], p = 0.006). Multivariable logistic regression showed significant associations between high antibody levels and lower odds of infection (aOR [95% CI] for BA.2 spike-specific IgG: 0.65 [0.48-0.88], p = 0.006 and BA.2 ACE2-blocking antibodies: 0.46 [0.30-0.69], p = 0.0002). A sex-stratified analysis showed more pronounced associations for females than males. High levels of vaccine-induced antibodies provide partial protection against Omicron breakthrough infections. This is important knowledge to further characterize a threshold for protection against new variants and to estimate the necessity and timing of booster vaccination.
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Affiliation(s)
- Eva A.M. Baerends
- Department of Infectious Diseases, Aarhus University Hospital, Aarhus, Denmark
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Astrid K. Hvidt
- Department of Infectious Diseases, Aarhus University Hospital, Aarhus, Denmark
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Joanne Reekie
- Center of Excellence for Health, Immunity and Infections, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Ole S. Søgaard
- Department of Infectious Diseases, Aarhus University Hospital, Aarhus, Denmark
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Nina B. Stærke
- Department of Infectious Diseases, Aarhus University Hospital, Aarhus, Denmark
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Dorthe Raben
- Center of Excellence for Health, Immunity and Infections, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Henrik Nielsen
- Department of Infectious Diseases, Aalborg University Hospital, Aalborg, Denmark
- Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - Kristine T. Petersen
- Department of Infectious Diseases, Aalborg University Hospital, Aalborg, Denmark
| | - Maria R. Juhl
- Department of Infectious Diseases, Aalborg University Hospital, Aalborg, Denmark
| | - Isik S. Johansen
- Department of Infectious Diseases, Odense University Hospital, Odense, Denmark
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Susan O. Lindvig
- Department of Infectious Diseases, Odense University Hospital, Odense, Denmark
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Lone W. Madsen
- Department of Infectious Diseases, Odense University Hospital, Odense, Denmark
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Lothar Wiese
- Department of Medicine, Zealand University Hospital, Roskilde, Denmark
| | - Lene S. Knudsen
- Department of Medicine, Zealand University Hospital, Roskilde, Denmark
| | - Mette B. Iversen
- Department of Medicine, Zealand University Hospital, Roskilde, Denmark
| | - Thomas Benfield
- Department of Infectious Diseases, Copenhagen University Hospital – Amager and Hvidovre, Hvidovre, Denmark
- Departments of Clinical Medicine and Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Kasper K. Iversen
- Department of Infectious Diseases, Copenhagen University Hospital – Amager and Hvidovre, Hvidovre, Denmark
- Department of Cardiology and Emergency Medicine, Herlev Hospital, Herlev, Denmark
| | - Sidsel D. Andersen
- Department of Infectious Diseases, Aarhus University Hospital, Aarhus, Denmark
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Anna K. Juhl
- Department of Infectious Diseases, Aarhus University Hospital, Aarhus, Denmark
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Lisa L. Dietz
- Department of Infectious Diseases, Aarhus University Hospital, Aarhus, Denmark
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Signe R. Andreasen
- Department of Infectious Diseases, Aarhus University Hospital, Aarhus, Denmark
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Thea K. Fischer
- Departments of Clinical Medicine and Public Health, University of Copenhagen, Copenhagen, Denmark
- Department of Clinical Research, Nordsjællands University Hospital, Hillerød, Denmark
| | - Christian Erikstrup
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
- Department of Clinical Immunology, Aarhus University Hospital, Aarhus, Denmark
| | - Palle Valentiner-Branth
- Department of Infectious Disease Epidemiology and Prevention, Statens Serum Institut, Copenhagen, Denmark
| | - Jens Lundgren
- Center of Excellence for Health, Immunity and Infections, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
- Departments of Clinical Medicine and Public Health, University of Copenhagen, Copenhagen, Denmark
- Department of Infectious Diseases, Copenhagen University Hospital – Rigshospitalet, Copenhagen, Denmark
| | - Lars Østergaard
- Department of Infectious Diseases, Aarhus University Hospital, Aarhus, Denmark
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Martin Tolstrup
- Department of Infectious Diseases, Aarhus University Hospital, Aarhus, Denmark
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
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20
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Breznik JA, Rahim A, Zhang A, Ang J, Stacey HD, Bhakta H, Clare R, Liu LM, Kennedy A, Hagerman M, Kajaks T, Miller MS, Nazy I, Bramson JL, Costa AP, Bowdish DM. Early Omicron infection is associated with increased reinfection risk in older adults in long-term care and retirement facilities. EClinicalMedicine 2023; 63:102148. [PMID: 37753447 PMCID: PMC10518514 DOI: 10.1016/j.eclinm.2023.102148] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Revised: 07/24/2023] [Accepted: 07/25/2023] [Indexed: 09/28/2023] Open
Abstract
Background Older adults are at increased risk of SARS-CoV-2 Omicron infection and severe disease, especially those in congregate living settings, despite high SARS-CoV-2 vaccine coverage. It is unclear whether hybrid immunity (combined vaccination and infection) after one Omicron infection provides increased protection against subsequent Omicron reinfection in older adults. Methods Incidence of SARS-CoV-2 Omicron infection was examined in 750 vaccinated residents of long-term care and retirement homes in the observational cohort COVID in Long-Term Care Study in Ontario, Canada, within a 75-day period (July to September 2022). Risk of infection was assessed by Cox proportional hazards regression. Serum anti-spike and anti-RBD SARS-CoV-2 IgG and IgA antibodies, microneutralization titres, and spike-specific T cell memory responses, were examined in a subset of 318 residents within the preceding three months. Findings 133 of 750 participants (17.7%) had a PCR-confirmed Omicron infection during the observation period. Increased infection risk was associated with prior Omicron infection (at 9-29 days: 47.67 [23.73-95.76]), and this was not attributed to days since fourth vaccination (1.00 [1.00-1.01]) or residence outbreaks (>6 compared to ≤6: 0.95 [0.37-2.41]). Instead, reinfected participants had lower serum neutralizing antibodies to ancestral and Omicron BA.1 SARS-CoV-2, and lower anti-RBD IgG and IgA antibodies, after their initial Omicron infection. Interpretation Counterintuitively, SARS-CoV-2 Omicron infection was associated with increased risk of Omicron reinfection in residents of long-term care and retirement homes. Less robust humoral hybrid immune responses in older adults may contribute to risk of Omicron reinfection. Funding COVID-19 Immunity Task Force of the Public Health Agency of Canada.
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Affiliation(s)
- Jessica A. Breznik
- McMaster Immunology Research Centre, McMaster University, Hamilton, Ontario, Canada
- Michael G. DeGroote Institute for Infectious Disease Research, McMaster University, Hamilton, Ontario, Canada
- Department of Medicine, Michael G. DeGroote School of Medicine, McMaster University, Hamilton, Ontario, Canada
- McMaster Institute for Research on Aging, McMaster University, Hamilton, Ontario, Canada
| | - Ahmad Rahim
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Canada
| | - Ali Zhang
- McMaster Immunology Research Centre, McMaster University, Hamilton, Ontario, Canada
- Michael G. DeGroote Institute for Infectious Disease Research, McMaster University, Hamilton, Ontario, Canada
- Department of Biochemistry & Biomedical Sciences, McMaster University, Hamilton, Ontario, Canada
| | - Jann Ang
- McMaster Immunology Research Centre, McMaster University, Hamilton, Ontario, Canada
- Michael G. DeGroote Institute for Infectious Disease Research, McMaster University, Hamilton, Ontario, Canada
- Department of Biochemistry & Biomedical Sciences, McMaster University, Hamilton, Ontario, Canada
| | - Hannah D. Stacey
- McMaster Immunology Research Centre, McMaster University, Hamilton, Ontario, Canada
- Michael G. DeGroote Institute for Infectious Disease Research, McMaster University, Hamilton, Ontario, Canada
- Department of Biochemistry & Biomedical Sciences, McMaster University, Hamilton, Ontario, Canada
| | - Hina Bhakta
- Department of Biochemistry & Biomedical Sciences, McMaster University, Hamilton, Ontario, Canada
| | - Rumi Clare
- Department of Biochemistry & Biomedical Sciences, McMaster University, Hamilton, Ontario, Canada
| | - Li-Min Liu
- McMaster Immunology Research Centre, McMaster University, Hamilton, Ontario, Canada
- Michael G. DeGroote Institute for Infectious Disease Research, McMaster University, Hamilton, Ontario, Canada
- Department of Medicine, Michael G. DeGroote School of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Allison Kennedy
- McMaster Immunology Research Centre, McMaster University, Hamilton, Ontario, Canada
- Michael G. DeGroote Institute for Infectious Disease Research, McMaster University, Hamilton, Ontario, Canada
- Department of Medicine, Michael G. DeGroote School of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Megan Hagerman
- McMaster Immunology Research Centre, McMaster University, Hamilton, Ontario, Canada
- Michael G. DeGroote Institute for Infectious Disease Research, McMaster University, Hamilton, Ontario, Canada
- Department of Medicine, Michael G. DeGroote School of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Tara Kajaks
- McMaster Institute for Research on Aging, McMaster University, Hamilton, Ontario, Canada
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Canada
| | - Matthew S. Miller
- McMaster Immunology Research Centre, McMaster University, Hamilton, Ontario, Canada
- Michael G. DeGroote Institute for Infectious Disease Research, McMaster University, Hamilton, Ontario, Canada
- Department of Biochemistry & Biomedical Sciences, McMaster University, Hamilton, Ontario, Canada
| | - Ishac Nazy
- Department of Biochemistry & Biomedical Sciences, McMaster University, Hamilton, Ontario, Canada
| | - Jonathan L. Bramson
- McMaster Immunology Research Centre, McMaster University, Hamilton, Ontario, Canada
- Michael G. DeGroote Institute for Infectious Disease Research, McMaster University, Hamilton, Ontario, Canada
- Department of Medicine, Michael G. DeGroote School of Medicine, McMaster University, Hamilton, Ontario, Canada
- Department of Biochemistry & Biomedical Sciences, McMaster University, Hamilton, Ontario, Canada
| | - Andrew P. Costa
- Department of Medicine, Michael G. DeGroote School of Medicine, McMaster University, Hamilton, Ontario, Canada
- McMaster Institute for Research on Aging, McMaster University, Hamilton, Ontario, Canada
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Canada
- Centre for Integrated Care, St. Joseph's Health System, Hamilton, Ontario, Canada
| | - Dawn M.E. Bowdish
- McMaster Immunology Research Centre, McMaster University, Hamilton, Ontario, Canada
- Michael G. DeGroote Institute for Infectious Disease Research, McMaster University, Hamilton, Ontario, Canada
- Department of Medicine, Michael G. DeGroote School of Medicine, McMaster University, Hamilton, Ontario, Canada
- McMaster Institute for Research on Aging, McMaster University, Hamilton, Ontario, Canada
- Firestone Institute of Respiratory Health, St Joseph's Healthcare, Hamilton, Ontario, Canada
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21
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Zhu K, Ma S, Chen H, Xie J, Huang D, Ma G, Huang Y. Factors associated with COVID-19 vaccination coverage in hypertensive patients with Omicron infection in Shanghai, China. Hum Vaccin Immunother 2023; 19:2253599. [PMID: 37905728 PMCID: PMC10760500 DOI: 10.1080/21645515.2023.2253599] [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: 04/07/2023] [Accepted: 08/27/2023] [Indexed: 11/02/2023] Open
Abstract
The potential future burden of COVID-19 is determined by the level of susceptibility of the population to infection. The protective effect provided by those previously infected diminishes over several months, while individuals with mixed immunity have the highest degree and persistence of protection. This study aimed to clarify the vaccination status of COVID-19 patients with hypertension and to analyze the characteristics and risk factors of non-vaccinated patients to protect this vulnerable population in the future. The study ultimately enrolled 4576 hypertensive patients with Omicron infection from April 6, 2022, to May 15, 2022. Among them, 3556 patients (77.7%) had received at least one dose of vaccine, and 2058 patients (45.0%) received a booster dose. In the multivariate logistic analysis, male (OR 1.328, 95% CI 1.138-1.550, p < .001), age (60-69 years vs.18-49 years) (OR 0.348, 95% CI 0.270-0.448, p < .001), age (≥70 years vs.18-49 years) (OR 0.130, 95% CI 0.100-0.169, p < .001), diabetes mellitus (OR 0.553, 95% CI 0.463-0.661, p < .001), chronic pulmonary diseases (OR 0.474, 95% CI 0.260-0.863, p = .015), chronic kidney disease (OR 0.177, 95% CI 0.076-0.410, p < .001), and cancer (OR 0.225, 95% CI 0.094-0.535, p = .001) were associated with vaccinated status. The vaccine coverage rate, especially the booster vaccine, was low for hypertensive patients with Omicron infection. Females, increasing age, and coexisting chronic diseases were associated with more inadequate vaccine coverage in hypertensive COVID-19 patients. Targeted interventions are required to address the under-vaccination of diverse hypertensive populations.
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Affiliation(s)
- Kongbo Zhu
- Department of Cardiology, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, China
| | - Shaolei Ma
- Department of Emergency and Critical Care Medicine, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, China
| | - Hui Chen
- Department of Critical Care Medicine, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, China
| | - Jianfeng Xie
- Department of Critical Care Medicine, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, China
| | - Dan Huang
- Department of Cardiology, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, China
| | - Genshan Ma
- Department of Cardiology, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, China
| | - Yingzi Huang
- Department of Critical Care Medicine, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, China
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22
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Carazo S, Skowronski DM, Brisson M, Sauvageau C, Brousseau N, Fafard J, Gilca R, Talbot D, Ouakki M, Febriani Y, Deceuninck G, De Wals P, De Serres G. Effectiveness of previous infection-induced and vaccine-induced protection against hospitalisation due to omicron BA subvariants in older adults: a test-negative, case-control study in Quebec, Canada. Lancet Healthy Longev 2023; 4:e409-e420. [PMID: 37459879 DOI: 10.1016/s2666-7568(23)00099-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Revised: 05/23/2023] [Accepted: 05/24/2023] [Indexed: 08/07/2023] Open
Abstract
BACKGROUND Older adults (aged ≥60 years) were prioritised for COVID-19 booster vaccination due to severe outcome risk, but the risk for this group is also affected by previous SARS-CoV-2 infection and vaccination. We estimated vaccine effectiveness against omicron-associated hospitalisation in older adults by previously documented infection, time since last immunological event, and age group. METHODS This was a population-based test-negative case-control study done in Quebec, Canada, during BA.1 dominant (December, 2021, to March, 2022), BA.2 dominant (April to June, 2022), and BA.4/5 dominant (July to November, 2022) periods using provincial laboratory, immunisation, hospitalisation, and chronic disease surveillance databases. We included older adults (aged ≥60 years) with symptoms associated with COVID-19 who were tested for SARS-CoV-2 in acute-care hospitals. Cases were defined as patients who were hospitalised for COVID-19 within 14 days after testing positive; controls were patients who tested negative. Analyses spanned 3-14 months after last vaccine dose or previous infection. Logistic regression models compared COVID-19 hospitalisation risk by mRNA vaccine dose and previous infection versus unvaccinated and infection-naive participants. FINDINGS Between Dec 26, 2021, and Nov 5, 2022, we included 174 819 specimens (82 870 [47·4%] from men and 91 949 [52·6%] from women; from 8455 cases and 166 364 controls), taken from 2951 cases and 48 724 controls in the BA.1 period; 1897 cases and 41 702 controls in the BA.2 period; and 3607 cases and 75 938 controls in the BA.4/5 period. In participants who were infection naive, vaccine effectiveness against hospitalisation improved with dose number, consistent with a shorter median time since last dose, but decreased with more recent omicron subvariants. Four-dose vaccine effectiveness was 96% (95% CI 93-98) during the BA.1 period, 84% (81-87) during the BA.2 period, and 68% (63-72) during the BA.4/5 period. Regardless of dose number (two to five doses) or timing since previous infection, hybrid protection was more than 90%, persisted for at least 6-8 months, and did not decline with age. INTERPRETATION Older adults with both previous SARS-CoV-2 infection and two or more vaccine doses appear to be well protected for a prolonged period against hospitalisation due to omicron subvariants, including BA.4/5. Ensuring that older adults who are infection naive remain up to date with vaccination might reduce COVID-19 hospitalisations most efficiently. FUNDING Ministère de la Santé et des Services Sociaux du Québec. TRANSLATION For the French translation of the abstract see Supplementary Materials section.
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Affiliation(s)
- Sara Carazo
- Biological Risks Unit, Institut National de Santé Publique du Québec, Quebec, QC, Canada; Social and Preventive Medicine Department, Faculty of Medicine, Laval University, Quebec, QC, Canada.
| | - Danuta M Skowronski
- Communicable Diseases and Immunization Services, British Columbia Centre for Disease Control, Vancouver, BC, Canada
| | - Marc Brisson
- Social and Preventive Medicine Department, Faculty of Medicine, Laval University, Quebec, QC, Canada; Centre Hospitalier Universitaire de Québec-Université Laval Research Center, Quebec, QC, Canada
| | - Chantal Sauvageau
- Biological Risks Unit, Institut National de Santé Publique du Québec, Quebec, QC, Canada; Social and Preventive Medicine Department, Faculty of Medicine, Laval University, Quebec, QC, Canada; Centre Hospitalier Universitaire de Québec-Université Laval Research Center, Quebec, QC, Canada
| | - Nicholas Brousseau
- Biological Risks Unit, Institut National de Santé Publique du Québec, Quebec, QC, Canada; Social and Preventive Medicine Department, Faculty of Medicine, Laval University, Quebec, QC, Canada; Centre Hospitalier Universitaire de Québec-Université Laval Research Center, Quebec, QC, Canada
| | - Judith Fafard
- Laboratoire de Santé Publique du Québec, Institut National de Santé Publique du Québec, Sainte-Anne-de-Bellevue, Quebec, QC, Canada
| | - Rodica Gilca
- Biological Risks Unit, Institut National de Santé Publique du Québec, Quebec, QC, Canada; Social and Preventive Medicine Department, Faculty of Medicine, Laval University, Quebec, QC, Canada; Centre Hospitalier Universitaire de Québec-Université Laval Research Center, Quebec, QC, Canada
| | - Denis Talbot
- Social and Preventive Medicine Department, Faculty of Medicine, Laval University, Quebec, QC, Canada; Centre Hospitalier Universitaire de Québec-Université Laval Research Center, Quebec, QC, Canada
| | - Manale Ouakki
- Biological Risks Unit, Institut National de Santé Publique du Québec, Quebec, QC, Canada
| | - Yossi Febriani
- Centre Hospitalier Universitaire de Québec-Université Laval Research Center, Quebec, QC, Canada
| | - Geneviève Deceuninck
- Centre Hospitalier Universitaire de Québec-Université Laval Research Center, Quebec, QC, Canada
| | - Philippe De Wals
- Biological Risks Unit, Institut National de Santé Publique du Québec, Quebec, QC, Canada; Social and Preventive Medicine Department, Faculty of Medicine, Laval University, Quebec, QC, Canada; Centre Hospitalier Universitaire de Québec-Université Laval Research Center, Quebec, QC, Canada
| | - Gaston De Serres
- Biological Risks Unit, Institut National de Santé Publique du Québec, Quebec, QC, Canada; Social and Preventive Medicine Department, Faculty of Medicine, Laval University, Quebec, QC, Canada; Centre Hospitalier Universitaire de Québec-Université Laval Research Center, Quebec, QC, Canada
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23
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Pasquevich KA, Coria LM, Ceballos A, Mazzitelli B, Rodriguez JM, Demaría A, Pueblas Castro C, Bruno L, Saposnik L, Salvatori M, Varese A, González S, González Martínez VV, Geffner J, Álvarez D, Feleder E, Halabe K, Perez Lera PE, de Oca FM, Vega JC, Lombardo M, Yerino GA, Fló J, Cassataro J. Safety and immunogenicity of a SARS-CoV-2 Gamma variant RBD-based protein adjuvanted vaccine used as booster in healthy adults. Nat Commun 2023; 14:4551. [PMID: 37507392 PMCID: PMC10382514 DOI: 10.1038/s41467-023-40272-3] [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: 02/17/2023] [Accepted: 07/20/2023] [Indexed: 07/30/2023] Open
Abstract
A Gamma Variant RBD-based aluminum hydroxide adjuvanted vaccine called ARVAC CG was selected for a first in human clinical trial. Healthy male and female participants (18-55 years old) with a complete COVID-19-primary vaccine scheme were assigned to receive two intramuscular doses of either a low-dose or a high-dose of ARVAC CG. The primary endpoint was safety. The secondary objective was humoral immunogenicity. Cellular immune responses were studied as an exploratory objective. The trial was prospectively registered in PRIISA.BA (Registration Code 6564) and ANMAT and retrospectively registered in ClinicalTrials.gov (NCT05656508). Samples from participants of a surveillance strategy implemented by the Ministry of Health of the Province of Buenos Aires that were boosted with BNT162b2 were also analyzed to compare with the booster effect of ARVAC CG. ARVAC CG exhibits a satisfactory safety profile, a robust and broad booster response of neutralizing antibodies against the Ancestral strain of SARS-CoV-2 and the Gamma, Delta, Omicron BA.1 and Omicron BA.5 variants of concern and a booster effect on T cell immunity in individuals previously immunized with different COVID-19 vaccine platforms.
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Affiliation(s)
- Karina A Pasquevich
- Instituto de Investigaciones Biotecnológicas, Universidad Nacional de San Martín (UNSAM) - Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), San Martín (1650), Buenos Aires, Argentina.
- Escuela de Bio y Nanotecnologías (EByN), Universidad Nacional de San Martín, San Martín (1650), Buenos Aires, Argentina.
| | - Lorena M Coria
- Instituto de Investigaciones Biotecnológicas, Universidad Nacional de San Martín (UNSAM) - Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), San Martín (1650), Buenos Aires, Argentina
- Escuela de Bio y Nanotecnologías (EByN), Universidad Nacional de San Martín, San Martín (1650), Buenos Aires, Argentina
| | - Ana Ceballos
- Instituto de Investigaciones Biomédicas en Retrovirus y SIDA, INBIRS-CONICET, Facultad de Medicina UBA, Buenos Aires, Argentina
| | - Bianca Mazzitelli
- Instituto de Investigaciones Biomédicas en Retrovirus y SIDA, INBIRS-CONICET, Facultad de Medicina UBA, Buenos Aires, Argentina
| | - Juan Manuel Rodriguez
- Fundación Pablo Cassará - Unidad de I + D de Biofármacos, Saladillo 2452 C1440FFX, Ciudad Autónoma de Buenos Aires, Argentina
| | - Agostina Demaría
- Instituto de Investigaciones Biotecnológicas, Universidad Nacional de San Martín (UNSAM) - Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), San Martín (1650), Buenos Aires, Argentina
- Escuela de Bio y Nanotecnologías (EByN), Universidad Nacional de San Martín, San Martín (1650), Buenos Aires, Argentina
| | - Celeste Pueblas Castro
- Instituto de Investigaciones Biotecnológicas, Universidad Nacional de San Martín (UNSAM) - Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), San Martín (1650), Buenos Aires, Argentina
- Escuela de Bio y Nanotecnologías (EByN), Universidad Nacional de San Martín, San Martín (1650), Buenos Aires, Argentina
| | - Laura Bruno
- Instituto de Investigaciones Biotecnológicas, Universidad Nacional de San Martín (UNSAM) - Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), San Martín (1650), Buenos Aires, Argentina
- Escuela de Bio y Nanotecnologías (EByN), Universidad Nacional de San Martín, San Martín (1650), Buenos Aires, Argentina
| | - Lucas Saposnik
- Instituto de Investigaciones Biotecnológicas, Universidad Nacional de San Martín (UNSAM) - Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), San Martín (1650), Buenos Aires, Argentina
- Escuela de Bio y Nanotecnologías (EByN), Universidad Nacional de San Martín, San Martín (1650), Buenos Aires, Argentina
| | - Melina Salvatori
- Instituto de Investigaciones Biomédicas en Retrovirus y SIDA, INBIRS-CONICET, Facultad de Medicina UBA, Buenos Aires, Argentina
| | - Augusto Varese
- Instituto de Investigaciones Biomédicas en Retrovirus y SIDA, INBIRS-CONICET, Facultad de Medicina UBA, Buenos Aires, Argentina
| | - Soledad González
- Ministerio de Salud de la Provincia de Buenos Aires, Buenos Aires, Argentina
| | | | - Jorge Geffner
- Instituto de Investigaciones Biomédicas en Retrovirus y SIDA, INBIRS-CONICET, Facultad de Medicina UBA, Buenos Aires, Argentina
| | - Diego Álvarez
- Instituto de Investigaciones Biotecnológicas, Universidad Nacional de San Martín (UNSAM) - Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), San Martín (1650), Buenos Aires, Argentina
- Escuela de Bio y Nanotecnologías (EByN), Universidad Nacional de San Martín, San Martín (1650), Buenos Aires, Argentina
| | - Ethel Feleder
- FP CLINICAL PHARMA, Ciudad Autónoma de Buenos Aires, Buenos Aires, Argentina
| | - Karina Halabe
- FP CLINICAL PHARMA, Ciudad Autónoma de Buenos Aires, Buenos Aires, Argentina
| | - Pablo E Perez Lera
- FP CLINICAL PHARMA, Ciudad Autónoma de Buenos Aires, Buenos Aires, Argentina
| | - Federico Montes de Oca
- Laboratorio Pablo Cassará - Unidad de I + D de Biofármacos, Saladillo 2452 C1440FFX, Ciudad Autónoma de Buenos Aires, Argentina
| | - Julio C Vega
- Laboratorio Pablo Cassará - Unidad de I + D de Biofármacos, Saladillo 2452 C1440FFX, Ciudad Autónoma de Buenos Aires, Argentina
| | | | - Gustavo A Yerino
- FP CLINICAL PHARMA, Ciudad Autónoma de Buenos Aires, Buenos Aires, Argentina
| | - Juan Fló
- Laboratorio Pablo Cassará - Unidad de I + D de Biofármacos, Saladillo 2452 C1440FFX, Ciudad Autónoma de Buenos Aires, Argentina
| | - Juliana Cassataro
- Instituto de Investigaciones Biotecnológicas, Universidad Nacional de San Martín (UNSAM) - Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), San Martín (1650), Buenos Aires, Argentina.
- Escuela de Bio y Nanotecnologías (EByN), Universidad Nacional de San Martín, San Martín (1650), Buenos Aires, Argentina.
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24
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Cegolon L, Magnano G, Negro C, Larese Filon F. SARS-CoV-2 Reinfections in Health-Care Workers, 1 March 2020-31 January 2023. Viruses 2023; 15:1551. [PMID: 37515237 PMCID: PMC10384331 DOI: 10.3390/v15071551] [Citation(s) in RCA: 3] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Revised: 07/05/2023] [Accepted: 07/10/2023] [Indexed: 07/30/2023] Open
Abstract
Objective: To study SARS-CoV-2 reinfections in health-care workers (HCWs) of the University Health Agency Giuliano-Isontina (ASUGI), covering the provinces of Trieste and Gorizia (northeastern Italy) routinely screened for SARS-CoV-2 via nasopharyngeal swab. Design: Cohort study of HCWs (N = 8205) followed since the start of the pandemic (1 March 2020) through 31 January 2023. The risk of reinfection during the Omicron transmission period (after 30 November 2021) among HCWs previously infected by SARS-CoV-2 was estimated based on days since last dose of COVID-19 vaccine received, adjusting for age, sex, job task, workplace, number of doses of COVID-19 vaccines and number of swab tests performed. In the crude as well as adjusted incidence rate analysis, reinfections occurring 15+ days after a first dose of COVID-19 vaccine or 8+ days following a second or more dose were counted. Results: In a highly vaccinated population, during the entire study period (1 March 2020-31 January 2023) 5253 HCWs incurred at least one SARS-CoV-2 infection, 4262 HCWs were infected only once, and 1091 were reinfected. Reinfections almost entirely (99.1% = 1071/1091) occurred after 30 November 2021, peaking in July 2022 (N = 161). Six hundred eighty-three reinfections followed a pre-Omicron primary event against 408 reinfections following an Omicron event. Reinfections during the Omicron transmission period occurred a mean of 400 ± 220 days after primary SARS-CoV-2 infection; 512 ± 205 days following a pre-Omicron primary event, as opposed to 218 ± 74 days after an Omicron primary infection. Thirty-four hospitalizations were observed, all before the Omicron wave, following 18 (0.4%) primary SARS-CoV-2 infections and 16 (1.5%) reinfections. By excluding events occurring <15 days after a first dose or <8 days after a further dose of COVID-19 vaccine, 605 reinfections followed a pre-Omicron primary event (raw incidence = 1.4 × 1000 person-days) against 404 after a primary Omicron infection (raw incidence = 0.3 × 1000 person-days). Apart from nurse aids (slightly enhanced biological risk) and academic HCWs (remarkably lower risk with pre-Omicron primary events), the effect of occupation in terms of job task and workplace was marginal. Furthermore, whilst the risk of reinfection was lower in males and HCWs < 60 years old following a pre-Omicron primary infection, HCWs aged 30-50 were more likely to be infected after an Omicron primary event. Regardless of timeline of primary SARS-CoV-2 event, the risk of reinfection decreased with higher number of doses of COVID-19 vaccines, being lowest after the second booster. In particular, VE was 16% for one dose, 51% for two doses, 76% for the booster and 92% for the second booster with a pre-Omicron primary SARS-CoV-2 event. The latter figures increased to 72%, 59%, 74% and 93%, respectively, with Omicron primary infections. Conclusions: SARS-CoV-2 reinfections were frequent during the Omicron transmission period, though featured by mild or no symptoms. Whilst the impact of occupation on biological risk was relatively marginal, COVID-19 vaccination had the strongest protective effect against reinfection, with a 93% VE by second booster following an Omicron primary infection.
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Affiliation(s)
- Luca Cegolon
- Department of Medical, Surgical & Health Sciences, University of Trieste, 34129 Trieste, Italy
- Occupational Medicine Unit, University Health Agency Giuliano-Isontina (ASUGI), 34129 Trieste, Italy
| | - Greta Magnano
- Department of Medical, Surgical & Health Sciences, University of Trieste, 34129 Trieste, Italy
| | - Corrado Negro
- Department of Medical, Surgical & Health Sciences, University of Trieste, 34129 Trieste, Italy
- Occupational Medicine Unit, University Health Agency Giuliano-Isontina (ASUGI), 34129 Trieste, Italy
| | - Francesca Larese Filon
- Department of Medical, Surgical & Health Sciences, University of Trieste, 34129 Trieste, Italy
- Occupational Medicine Unit, University Health Agency Giuliano-Isontina (ASUGI), 34129 Trieste, Italy
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25
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Franco-Luiz APM, Fernandes NMGS, Silva TBDS, Bernardes WPDOS, Westin MR, Santos TG, Fernandes GDR, Simões TC, Silva EFE, Gava SG, Alves BM, de Carvalho Melo M, da Silva-Pereira RA, Alves PA, Fonseca CT. Longitudinal study of humoral immunity against SARS-CoV-2 of health professionals in Brazil: the impact of booster dose and reinfection on antibody dynamics. Front Immunol 2023; 14:1220600. [PMID: 37520570 PMCID: PMC10376701 DOI: 10.3389/fimmu.2023.1220600] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Accepted: 06/26/2023] [Indexed: 08/01/2023] Open
Abstract
Introduction The pandemic caused by SARS-CoV-2 has had a major impact on health systems. Vaccines have been shown to be effective in improving the clinical outcome of COVID-19, but they are not able to fully prevent infection and reinfection, especially that caused by new variants. Methods Here, we tracked for 450 days the humoral immune response and reinfection in 52 healthcare workers from Brazil. Infection and reinfection were confirmed by RT-qPCR, while IgM and IgG antibody levels were monitored by rapid test. Results Of the 52 participants, 19 (36%) got reinfected during the follow-up period, all presenting mild symptoms. For all participants, IgM levels dropped sharply, with over 47% of them becoming seronegative by the 60th day. For IgG, 90% of the participants became seropositive within the first 30 days of follow-up. IgG antibodies also dropped after this period reaching the lowest level on day 270 (68.5 ± 72.3, p<0.0001). Booster dose and reinfection increased the levels of both antibodies, with the interaction between them resulting in an increase in IgG levels of 130.3 arbitrary units. Conclusions Overall, our data indicate that acquired humoral immunity declines over time and suggests that IgM and IgG antibody levels are not associated with the prevention of reinfection.
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Affiliation(s)
- Ana Paula Moreira Franco-Luiz
- Grupo de Pesquisa em Biologia e Imunologia de Doenças Infecciosas e Parasitárias, Instituto René Rachou, Fundação Oswaldo Cruz, Belo Horizonte, Minas Gerais, Brazil
| | - Nubia Monteiro Gonçalves Soares Fernandes
- Grupo de Pesquisa em Biologia e Imunologia de Doenças Infecciosas e Parasitárias, Instituto René Rachou, Fundação Oswaldo Cruz, Belo Horizonte, Minas Gerais, Brazil
| | - Thais Bárbara de Souza Silva
- Grupo de Imunologia de Doenças Virais, Instituto René Rachou, Fundação Oswaldo Cruz, Belo Horizonte, Minas Gerais, Brazil
| | | | - Mateus Rodrigues Westin
- Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Thais Garcia Santos
- Grupo de Pesquisa em Biologia e Imunologia de Doenças Infecciosas e Parasitárias, Instituto René Rachou, Fundação Oswaldo Cruz, Belo Horizonte, Minas Gerais, Brazil
| | - Gabriel da Rocha Fernandes
- Grupo de Pesquisa em Informática de Biossistemas, Instituto René Rachou, Fundação Oswaldo Cruz, Belo Horizonte, Minas Gerais, Brazil
| | - Taynãna César Simões
- Núcleo de Estudos em Saúde Pública e Envelhecimento, Instituto René Rachou, Fundação Oswaldo Cruz, Belo Horizonte, Minas Gerais, Brazil
| | - Eduardo Fernandes E. Silva
- Serviço de capacitação em métodos quantitativos -SAMeQ, Instituto René Rachou, Fundação Oswaldo Cruz, Belo Horizonte, Minas Gerais, Brazil
| | - Sandra Grossi Gava
- Grupo de Pesquisa em Helmintologia e Malacologia Médica, Instituto René Rachou, Fundação Oswaldo Cruz, Belo Horizonte, Minas Gerais, Brazil
| | - Breno Magalhães Alves
- Centro de Vigilância em Saúde e Segurança do Paciente, Hospital Metropolitano Doutor Célio de Castro, Belo Horizonte, Minas Gerais, Brazil
| | - Mariana de Carvalho Melo
- Serviço Especializado em Segurança e Medicina do Trabalho, Hospital Metropolitano Doutor Célio de Castro, Belo Horizonte, Minas Gerais, Brazil
| | - Rosiane A. da Silva-Pereira
- Grupo de Pesquisa em Biologia e Imunologia de Doenças Infecciosas e Parasitárias, Instituto René Rachou, Fundação Oswaldo Cruz, Belo Horizonte, Minas Gerais, Brazil
| | - Pedro Augusto Alves
- Grupo de Imunologia de Doenças Virais, Instituto René Rachou, Fundação Oswaldo Cruz, Belo Horizonte, Minas Gerais, Brazil
| | - Cristina Toscano Fonseca
- Grupo de Pesquisa em Biologia e Imunologia de Doenças Infecciosas e Parasitárias, Instituto René Rachou, Fundação Oswaldo Cruz, Belo Horizonte, Minas Gerais, Brazil
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26
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Szekely J, Swangphon P, Nanakorn N, Chaimuti P, Nualnoi T, Wongwitwichot P, Somapa N, Somapa D, Pengsakul T. Breakthrough SARS-CoV-2 Omicron Variant in Individuals Primed with Heterologous Vaccines Enhances Inhibition Performance of Neutralizing Antibody to BA.2 Parental Lineage. Vaccines (Basel) 2023; 11:1230. [PMID: 37515045 PMCID: PMC10383937 DOI: 10.3390/vaccines11071230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Revised: 07/05/2023] [Accepted: 07/09/2023] [Indexed: 07/30/2023] Open
Abstract
This study aims to analyze the neutralization ability against Omicron parental variants in five clusters of individuals with different Coronavirus disease (COVID-19) immunity backgrounds, including individuals receiving a homologous or heterologous vaccine without prior infection, recovered patients with homologous or heterologous vaccination, and recovery patients without vaccination. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) surrogate virus neutralization assay was performed on serum samples. Spearman correlation analysis showed that the percent inhibition against Omicron B.1.1.529 and BA.2 was significantly related to the period of serum collection (r = 0.730 and 0.787, p < 0.001, respectively). Very strong correlation between percent inhibition of neutralizing antibody against Omicron B.1.1.529 and BA.2 variants (rs = 0.973, p < 0.001) was also observed. The neutralizing activity of the sera from recovery patients receiving homologous and heterologous vaccine against the wild-type, B.1.1.529, and BA.2 Omicron variants was significantly higher (p < 0.001) than that of recovery patients without vaccination. This study robustly showed that the breakthrough SARS-CoV-2 Omicron variant in individuals who received homologous and heterologous vaccines had a high level of neutralizing activity against B.1.1.529 and BA.2 parental lineage of XBB subvariants. Therefore, the next-generation COVID-19 vaccine against emerging variants is needed to improve resilience against ongoing variants, particularly for persons who have never been infected.
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Affiliation(s)
- Jidapa Szekely
- Faculty of Medical Technology, Prince of Songkla University, Hat Yai 90110, Thailand
| | - Piyawut Swangphon
- Faculty of Medical Technology, Prince of Songkla University, Hat Yai 90110, Thailand
| | - Natthaphon Nanakorn
- Faculty of Medical Technology, Prince of Songkla University, Hat Yai 90110, Thailand
| | - Panuttha Chaimuti
- Immunology and Virology Unit, Department of Medical Technology and Clinical Pathology, Hat Yai Hospital, Hat Yai 90110, Thailand
| | - Teerapat Nualnoi
- Department of Pharmaceutical Technology, Faculty of Pharmaceutical Sciences, Prince of Songkla University, Hat Yai 90110, Thailand
| | - Paweena Wongwitwichot
- Department of Pharmaceutical Chemistry, Faculty of Pharmaceutical Sciences, Prince of Songkla University, Hat Yai 90110, Thailand
| | - Namchoke Somapa
- Master Labs Incorporation Co., Ltd., Bangkok 10510, Thailand
| | - Denpong Somapa
- Master Labs Incorporation Co., Ltd., Bangkok 10510, Thailand
| | - Theerakamol Pengsakul
- Faculty of Environmental Management, Prince of Songkla University, Hat Yai 90110, Thailand
- Health and Environmental Research Center, Faculty of Environmental Management, Prince of Songkla University, Hat Yai 90110, Thailand
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27
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Gazit S, Saciuk Y, Perez G, Peretz A, Ben-Tov A, Stuart EA, Patalon T. Hybrid immunity against reinfection with SARS-CoV-2 following a previous SARS-CoV-2 infection and single dose of the BNT162b2 vaccine in children and adolescents: a target trial emulation. Lancet Microbe 2023; 4:e495-e505. [PMID: 37062294 PMCID: PMC10101759 DOI: 10.1016/s2666-5247(23)00103-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Revised: 03/05/2023] [Accepted: 03/07/2023] [Indexed: 04/18/2023]
Abstract
BACKGROUND Although most children and adolescents have had a previous SARS-CoV-2 infection and many continue to receive COVID-19 vaccinations, studies of the effectiveness of hybrid immunity against reinfection with the omicron (B.1.1.529) variant are scarce. We aimed to examine the effectiveness of vaccination in convalescent children and adolescents against reinfection with the delta (B.1.617.2) variant and the BA.1 and BA.2 and BA.4 and BA.5 omicron subvariants. METHODS This retrospective cohort study was devised to emulate a target randomised control trial using a retrospective dataset of anonymised health records of children (5-11 years old) and adolescents (12-16 years old) who were members of the Maccabi Healthcare Services, Israel. The design emulated 91 randomised trials by devising a series of multiple nested trials, compiling the results into a single dataset, and fitting Cox proportional hazards models to estimate adjusted hazard ratios (HRs) with 95% CIs of each measured outcome. The primary aim was to assess the protection from reinfection with the delta variant and the BA.1 and BA.2 and BA.4 and BA.5 omicron subvariants associated with hybrid immunity as a result of a previous SARS-CoV-2 infection followed by vaccination with the BNT162b2 (Pfizer-BioNTech) vaccine. FINDINGS Data from between from March 1, 2020, to July 31, 2022, for 163 812 individuals (120 721 children [59 404 girls and 61 317 boys], median age 8·0 years [IQR 6·7 to 10·2]; and 43 091 adolescents [21 239 girls and 21 852 boys], median age 13·5 years [12·6 to 14·8]) were included in at least one trial. A single dose of the BNT162b2 vaccine in convalescent children and adolescents confers statistically significant protection against the delta variant (78% [95% CI 72 to 83] in adolescents and 64% [3 to 87] in children) and the omicron BA.1 and BA.2 subvariants (54% [50 to 57] in adolescents and 71% [67 to 73] in children) compared with children who had a previous infection but were unvaccinated. However, the vaccine was not found to confer statistically significant protection against the BA.4 and BA.5 omicron subvariants in adolescents (8% [-18 to 29]) and children (12% [-6 to 27]). INTERPRETATION Decision makers in BA.4 and BA.5 dominant regions should re-examine whether convalescent individuals aged 5-16 years should receive the BNT162b2 vaccine to prevent future reinfection, especially in light of reports that show that most children and adolescents have already been infected with SARS-CoV-2. FUNDING None.
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Affiliation(s)
- Sivan Gazit
- Kahn Sagol Maccabi Research & Innovation Center, Maccabi Healthcare Services, Tel Aviv, Israel; Maccabitech Institute for Research and Innovation, Maccabi Healthcare Services, Tel Aviv, Israel; Ben-Gurion University, Beersheba, Israel.
| | - Yaki Saciuk
- Maccabitech Institute for Research and Innovation, Maccabi Healthcare Services, Tel Aviv, Israel
| | - Galit Perez
- Maccabitech Institute for Research and Innovation, Maccabi Healthcare Services, Tel Aviv, Israel; Ben-Gurion University, Beersheba, Israel
| | - Asaf Peretz
- Maccabitech Institute for Research and Innovation, Maccabi Healthcare Services, Tel Aviv, Israel
| | - Amir Ben-Tov
- Maccabitech Institute for Research and Innovation, Maccabi Healthcare Services, Tel Aviv, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | | | - Tal Patalon
- Kahn Sagol Maccabi Research & Innovation Center, Maccabi Healthcare Services, Tel Aviv, Israel; Maccabitech Institute for Research and Innovation, Maccabi Healthcare Services, Tel Aviv, Israel
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28
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Niu J, Kim M, Jalal AT, Goldberg JE, Acevedo Martinez EM, Suarez Moscoso NP, Rubio-Gomez H, Mayer D, Visbal A, Sareli C, Eckardt PA, Sareli AE. Distinct Clinical Presentations and Outcomes of Hospitalized Adults with the SARS-CoV-2 Infection Occurring during the Omicron Variant Surge. Healthcare (Basel) 2023; 11:1703. [PMID: 37372821 DOI: 10.3390/healthcare11121703] [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: 04/26/2023] [Revised: 06/05/2023] [Accepted: 06/08/2023] [Indexed: 06/29/2023] Open
Abstract
The COVID-19 Omicron variant has imposed a tremendous burden on healthcare services. We characterized the types of the Omicron variant-associated hospitalizations and their associations with clinical outcomes. Consecutive adults hospitalized with COVID-19 during the Omicron variant surge period of 1-14 January 2022, were classified into one of three groups based on their clinical presentations on admission: Group 1-primary COVID-19; Group 2-extrapulmonary manifestations of COVID-19; and Group 3-incidental COVID-19. Of the 500 patients who were hospitalized, 51.4% fell into Group 1, 16.4% into Group 2, and 32.2% into Group 3. The patients in Groups 1 and 2 were older, with higher proportions of comorbidities than patients in Group 3. The Group 1 patients had the highest mortality rate (15.6%), followed by Group 2 (8.5%), and Group 3 (0.6%), with adjusted odds ratios (OR) of 22.65 (95% confidence interval [CI], 2.75-239.46; p = 0.004) and 10.95 (95% CI, 1.02-117.28; p = 0.048), respectively, compared to Group 3. Those in Group 1 showed a greater utilization of intensive care services (15.9%), followed by Group 2 (10.9%), and Group 3 (2.5%), with adjusted ORs of 7.95 (95% CI, 2.52-25.08; p < 0.001) and 5.07 (95% CI, 1.34-19.15; p = 0.017), respectively, compared to Group 3. The patients in Groups 1 and 2 had longer hospitalization stays than the patients in Group 3 (p < 0.001 and p = 0.002, respectively). Older age (≥65 years) was an independent factor associated with longer hospital stays (OR = 1.72, 95% CI, 1.07-2.77). These findings can help hospitals prioritize patient care and service planning for future SARS-CoV-2 variants.
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Affiliation(s)
- Jianli Niu
- Office of Human Research, Memorial Healthcare System, Hollywood, FL 33021, USA
| | - Myeongji Kim
- Department of Internal Medicine, Memorial Healthcare System, Hollywood, FL 33021, USA
| | - Ayesha T Jalal
- Department of Internal Medicine, Memorial Healthcare System, Hollywood, FL 33021, USA
| | - Jessica E Goldberg
- Department of Internal Medicine, Memorial Healthcare System, Hollywood, FL 33021, USA
| | | | | | - Heysu Rubio-Gomez
- Division of Infectious Disease, Memorial Healthcare System, Hollywood, FL 33021, USA
| | - Daniel Mayer
- Division of Critical Care Medicine, Memorial Healthcare System, Hollywood, FL 33021, USA
| | - Alvaro Visbal
- Division of Critical Care Medicine, Memorial Healthcare System, Hollywood, FL 33021, USA
| | - Candice Sareli
- Office of Human Research, Memorial Healthcare System, Hollywood, FL 33021, USA
| | - Paula A Eckardt
- Division of Infectious Disease, Memorial Healthcare System, Hollywood, FL 33021, USA
| | - Aharon E Sareli
- Division of Critical Care Medicine, Memorial Healthcare System, Hollywood, FL 33021, USA
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Song S, Madewell ZJ, Liu M, Longini IM, Yang Y. Effectiveness of SARS-CoV-2 vaccines against Omicron infection and severe events: a systematic review and meta-analysis of test-negative design studies. Front Public Health 2023; 11:1195908. [PMID: 37361171 PMCID: PMC10289159 DOI: 10.3389/fpubh.2023.1195908] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Accepted: 05/18/2023] [Indexed: 06/28/2023] Open
Abstract
Background A rapidly growing body was observed of literature evaluating the vaccine effectiveness (VE) against Omicron in test-negative design studies. Methods We systematically searched papers that evaluated VE of SARS-CoV-2 vaccines on PubMed, Web of Science, Cochrane Library, Google Scholar, Embase, Scopus, bioRxiv, and medRxiv published from November 26th, 2021, to June 27th, 2022 (full doses and the first booster), and to January 8th, 2023 (the second booster). The pooled VE against Omicron-associated infection and severe events were estimated. Results From 2,552 citations identified, 42 articles were included. The first booster provided stronger protection against Omicron than full doses alone, shown by VE estimates of 53.1% (95% CI: 48.0-57.8) vs. 28.6% (95% CI: 18.5-37.4) against infection and 82.5% (95% CI: 77.8-86.2) vs. 57.3% (95% CI: 48.5-64.7) against severe events. The second booster offered strong protection among adults within 60 days of vaccination against infection (VE=53.1%, 95% CI: 48.0-57.8) and severe events (VE=87.3% (95% CI: 75.5-93.4), comparable to the first booster with corresponding VE estimates of 59.9% against infection and 84.8% against severe events. The VE estimates of booster doses against severe events among adults sustained beyond 60 days, 77.6% (95% CI: 69.4-83.6) for first and 85.9% (95% CI: 80.3-89.9) for the second booster. The VE estimates against infection were less sustainable regardless of dose type. Pure mRNA vaccines provided comparable protection to partial mRNA vaccines, but both provided higher protection than non-mRNA vaccines. Conclusions One or two SARS-CoV-2 booster doses provide considerable protection against Omicron infection and substantial and sustainable protection against Omicron-induced severe clinical outcomes.
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Affiliation(s)
- Shangchen Song
- Department of Biostatistics, College of Public Health and Health professions and Emerging Pathogens Institute, University of Florida, Gainesville, FL, United States
| | - Zachary J. Madewell
- Department of Biostatistics, College of Public Health and Health professions and Emerging Pathogens Institute, University of Florida, Gainesville, FL, United States
| | - Mingjin Liu
- Department of Biostatistics, College of Public Health and Health professions and Emerging Pathogens Institute, University of Florida, Gainesville, FL, United States
| | - Ira M. Longini
- Department of Biostatistics, College of Public Health and Health professions and Emerging Pathogens Institute, University of Florida, Gainesville, FL, United States
| | - Yang Yang
- Department of Statistics, Franklin College of Arts and Sciences, University of Georgia, Athens, GA, United States
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Braeye T, van Loenhout JAF, Brondeel R, Stouten V, Hubin P, Billuart M, Chung PYJ, Vandromme M, Wyndham-Thomas C, Blot K, Catteau L. COVID-19 vaccine effectiveness against symptomatic infection and hospitalisation in Belgium, July 2021 to May 2022. Euro Surveill 2023; 28:2200768. [PMID: 37382885 PMCID: PMC10311948 DOI: 10.2807/1560-7917.es.2023.28.26.2200768] [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: 09/14/2022] [Accepted: 02/15/2023] [Indexed: 06/30/2023] Open
Abstract
BackgroundThe Belgian COVID-19 vaccination campaign aimed to reduce disease spread and severity.AimWe estimated SARS-CoV-2 variant-specific vaccine effectiveness against symptomatic infection (VEi) and hospitalisation (VEh), given time since vaccination and prior infection.MethodsNationwide healthcare records from July 2021 to May 2022 on testing and vaccination were combined with a clinical hospital survey. We used a test-negative design and proportional hazard regression to estimate VEi and VEh, controlling for prior infection, time since vaccination, age, sex, residence and calendar week of sampling.ResultsWe included 1,932,546 symptomatic individuals, of whom 734,115 tested positive. VEi against Delta waned from an initial estimate of 80% (95% confidence interval (CI): 80-81) to 55% (95% CI: 54-55) 100-150 days after the primary vaccination course. Booster vaccination increased initial VEi to 85% (95% CI: 84-85). Against Omicron, an initial VEi of 33% (95% CI: 30-36) waned to 17% (95% CI: 15-18), while booster vaccination increased VEi to 50% (95% CI: 49-50), which waned to 20% (95% CI: 19-21) 100-150 days after vaccination. Initial VEh for booster vaccination decreased from 96% (95% CI: 95-96) against Delta to 87% (95% CI: 86-89) against Omicron. VEh against Omicron waned to 73% (95% CI: 71-75) 100-150 days after booster vaccination. While recent prior infections conferred higher protection, infections occurring before 2021 remained associated with significant risk reduction against symptomatic infection. Vaccination and prior infection outperformed vaccination or prior infection only.ConclusionWe report waning and a significant decrease in VEi and VEh from Delta to Omicron-dominant periods. Booster vaccination and prior infection attenuated these effects.
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Affiliation(s)
- Toon Braeye
- Department of Epidemiology and public health, Sciensano, Brussels, Belgium
| | | | - Ruben Brondeel
- Department of Epidemiology and public health, Sciensano, Brussels, Belgium
| | - Veerle Stouten
- Department of Epidemiology and public health, Sciensano, Brussels, Belgium
| | - Pierre Hubin
- Department of Epidemiology and public health, Sciensano, Brussels, Belgium
| | - Matthieu Billuart
- Department of Epidemiology and public health, Sciensano, Brussels, Belgium
| | | | - Mathil Vandromme
- Department of Epidemiology and public health, Sciensano, Brussels, Belgium
| | | | - Koen Blot
- Department of Epidemiology and public health, Sciensano, Brussels, Belgium
| | - Lucy Catteau
- Department of Epidemiology and public health, Sciensano, Brussels, Belgium
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31
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Kodera S, Takada A, Rashed EA, Hirata A. Projection of COVID-19 Positive Cases Considering Hybrid Immunity: Case Study in Tokyo. Vaccines (Basel) 2023; 11:633. [PMID: 36992217 DOI: 10.3390/vaccines11030633] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Revised: 02/27/2023] [Accepted: 03/10/2023] [Indexed: 03/16/2023] Open
Abstract
Since the emergence of COVID-19, the forecasting of new daily positive cases and deaths has been one of the essential elements in policy setting and medical resource management worldwide. An essential factor in forecasting is the modeling of susceptible populations and vaccination effectiveness (VE) at the population level. Owing to the widespread viral transmission and wide vaccination campaign coverage, it becomes challenging to model the VE in an efficient and realistic manner, while also including hybrid immunity which is acquired through full vaccination combined with infection. Here, the VE model of hybrid immunity was developed based on an in vitro study and publicly available data. Computational replication of daily positive cases demonstrates a high consistency between the replicated and observed values when considering the effect of hybrid immunity. The estimated positive cases were relatively larger than the observed value without considering hybrid immunity. Replication of the daily positive cases and its comparison would provide useful information of immunity at the population level and thus serve as useful guidance for nationwide policy setting and vaccination strategies.
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Stein C, Nassereldine H, Sorensen RJD, Amlag JO, Bisignano C, Byrne S, Castro E, Coberly K, Collins JK, Dalos J, Daoud F, Deen A, Gakidou E, Giles JR, Hulland EN, Huntley BM, Kinzel KE, Lozano R, Mokdad AH, Pham T, Pigott DM, Reiner Jr. RC, Vos T, Hay SI, Murray CJL, Lim SS. Past SARS-CoV-2 infection protection against re-infection: a systematic review and meta-analysis. Lancet 2023; 401:833-842. [PMID: 36930674 PMCID: PMC9998097 DOI: 10.1016/s0140-6736(22)02465-5] [Citation(s) in RCA: 113] [Impact Index Per Article: 113.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Revised: 11/18/2022] [Accepted: 11/22/2022] [Indexed: 02/18/2023]
Abstract
BACKGROUND Understanding the level and characteristics of protection from past SARS-CoV-2 infection against subsequent re-infection, symptomatic COVID-19 disease, and severe disease is essential for predicting future potential disease burden, for designing policies that restrict travel or access to venues where there is a high risk of transmission, and for informing choices about when to receive vaccine doses. We aimed to systematically synthesise studies to estimate protection from past infection by variant, and where data allow, by time since infection. METHODS In this systematic review and meta-analysis, we identified, reviewed, and extracted from the scientific literature retrospective and prospective cohort studies and test-negative case-control studies published from inception up to Sept 31, 2022, that estimated the reduction in risk of COVID-19 among individuals with a past SARS-CoV-2 infection in comparison to those without a previous infection. We meta-analysed the effectiveness of past infection by outcome (infection, symptomatic disease, and severe disease), variant, and time since infection. We ran a Bayesian meta-regression to estimate the pooled estimates of protection. Risk-of-bias assessment was evaluated using the National Institutes of Health quality-assessment tools. The systematic review was PRISMA compliant and was registered with PROSPERO (number CRD42022303850). FINDINGS We identified a total of 65 studies from 19 different countries. Our meta-analyses showed that protection from past infection and any symptomatic disease was high for ancestral, alpha, beta, and delta variants, but was substantially lower for the omicron BA.1 variant. Pooled effectiveness against re-infection by the omicron BA.1 variant was 45·3% (95% uncertainty interval [UI] 17·3-76·1) and 44·0% (26·5-65·0) against omicron BA.1 symptomatic disease. Mean pooled effectiveness was greater than 78% against severe disease (hospitalisation and death) for all variants, including omicron BA.1. Protection from re-infection from ancestral, alpha, and delta variants declined over time but remained at 78·6% (49·8-93·6) at 40 weeks. Protection against re-infection by the omicron BA.1 variant declined more rapidly and was estimated at 36·1% (24·4-51·3) at 40 weeks. On the other hand, protection against severe disease remained high for all variants, with 90·2% (69·7-97·5) for ancestral, alpha, and delta variants, and 88·9% (84·7-90·9) for omicron BA.1 at 40 weeks. INTERPRETATION Protection from past infection against re-infection from pre-omicron variants was very high and remained high even after 40 weeks. Protection was substantially lower for the omicron BA.1 variant and declined more rapidly over time than protection against previous variants. Protection from severe disease was high for all variants. The immunity conferred by past infection should be weighed alongside protection from vaccination when assessing future disease burden from COVID-19, providing guidance on when individuals should be vaccinated, and designing policies that mandate vaccination for workers or restrict access, on the basis of immune status, to settings where the risk of transmission is high, such as travel and high-occupancy indoor settings. FUNDING Bill & Melinda Gates Foundation, J Stanton, T Gillespie, and J and E Nordstrom.
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Moore SC, Kronsteiner B, Longet S, Adele S, Deeks AS, Liu C, Dejnirattisai W, Reyes LS, Meardon N, Faustini S, Al-Taei S, Tipton T, Hering LM, Angyal A, Brown R, Nicols AR, Dobson SL, Supasa P, Tuekprakhon A, Cross A, Tyerman JK, Hornsby H, Grouneva I, Plowright M, Zhang P, Newman TAH, Nell JM, Abraham P, Ali M, Malone T, Neale I, Phillips E, Wilson JD, Murray SM, Zewdie M, Shields A, Horner EC, Booth LH, Stafford L, Bibi S, Wootton DG, Mentzer AJ, Conlon CP, Jeffery K, Matthews PC, Pollard AJ, Brown A, Rowland-Jones SL, Mongkolsapaya J, Payne RP, Dold C, Lambe T, Thaventhiran JED, Screaton G, Barnes E, Hopkins S, Hall V, Duncan CJA, Richter A, Carroll M, de Silva TI, Klenerman P, Dunachie S, Turtle L. Evolution of long-term vaccine-induced and hybrid immunity in healthcare workers after different COVID-19 vaccine regimens. Med 2023; 4:191-215.e9. [PMID: 36863347 PMCID: PMC9933851 DOI: 10.1016/j.medj.2023.02.004] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Revised: 02/09/2023] [Accepted: 02/10/2023] [Indexed: 02/18/2023]
Abstract
BACKGROUND Both infection and vaccination, alone or in combination, generate antibody and T cell responses against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). However, the maintenance of such responses-and hence protection from disease-requires careful characterization. In a large prospective study of UK healthcare workers (HCWs) (Protective Immunity from T Cells in Healthcare Workers [PITCH], within the larger SARS-CoV-2 Immunity and Reinfection Evaluation [SIREN] study), we previously observed that prior infection strongly affected subsequent cellular and humoral immunity induced after long and short dosing intervals of BNT162b2 (Pfizer/BioNTech) vaccination. METHODS Here, we report longer follow-up of 684 HCWs in this cohort over 6-9 months following two doses of BNT162b2 or AZD1222 (Oxford/AstraZeneca) vaccination and up to 6 months following a subsequent mRNA booster vaccination. FINDINGS We make three observations: first, the dynamics of humoral and cellular responses differ; binding and neutralizing antibodies declined, whereas T and memory B cell responses were maintained after the second vaccine dose. Second, vaccine boosting restored immunoglobulin (Ig) G levels; broadened neutralizing activity against variants of concern, including Omicron BA.1, BA.2, and BA.5; and boosted T cell responses above the 6-month level after dose 2. Third, prior infection maintained its impact driving larger and broader T cell responses compared with never-infected people, a feature maintained until 6 months after the third dose. CONCLUSIONS Broadly cross-reactive T cell responses are well maintained over time-especially in those with combined vaccine and infection-induced immunity ("hybrid" immunity)-and may contribute to continued protection against severe disease. FUNDING Department for Health and Social Care, Medical Research Council.
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Affiliation(s)
- Shona C Moore
- NIHR Health Protection Research Unit in Emerging and Zoonotic Infections, Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Liverpool, UK
| | - Barbara Kronsteiner
- Peter Medawar Building for Pathogen Research, Nuffield Department of Clinical Medicine, University of Oxford, Oxford, UK; Oxford Centre for Global Health Research, Nuffield Department of Clinical Medicine, University of Oxford, Oxford, UK
| | - Stephanie Longet
- Pandemic Sciences Institute, Nuffield Department of Medicine, University of Oxford, Oxford, UK; Wellcome Centre for Human Genetics, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - Sandra Adele
- Peter Medawar Building for Pathogen Research, Nuffield Department of Clinical Medicine, University of Oxford, Oxford, UK; Oxford Centre for Global Health Research, Nuffield Department of Clinical Medicine, University of Oxford, Oxford, UK
| | - Alexandra S Deeks
- Peter Medawar Building for Pathogen Research, Nuffield Department of Clinical Medicine, University of Oxford, Oxford, UK; Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - Chang Liu
- Wellcome Centre for Human Genetics, Nuffield Department of Medicine, University of Oxford, Oxford, UK; Chinese Academy of Medical Science (CAMS) Oxford Institute (COI), University of Oxford, Oxford, UK
| | - Wanwisa Dejnirattisai
- Wellcome Centre for Human Genetics, Nuffield Department of Medicine, University of Oxford, Oxford, UK; Division of Emerging Infectious Disease, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Laura Silva Reyes
- Oxford Vaccine Group, Department of Paediatrics, University of Oxford, Oxford, UK
| | - Naomi Meardon
- Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK
| | - Sian Faustini
- Institute for Immunology and Immunotherapy, College of Medical and Dental Science, University of Birmingham, Birmingham, UK
| | - Saly Al-Taei
- Institute for Immunology and Immunotherapy, College of Medical and Dental Science, University of Birmingham, Birmingham, UK
| | - Tom Tipton
- Pandemic Sciences Institute, Nuffield Department of Medicine, University of Oxford, Oxford, UK; Wellcome Centre for Human Genetics, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - Luisa M Hering
- NIHR Health Protection Research Unit in Emerging and Zoonotic Infections, Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Liverpool, UK
| | - Adrienn Angyal
- Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, UK
| | - Rebecca Brown
- Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, UK
| | - Alexander R Nicols
- Translational and Clinical Research Institute, Immunity and Inflammation Theme, Newcastle University, Newcastle, UK
| | - Susan L Dobson
- NIHR Health Protection Research Unit in Emerging and Zoonotic Infections, Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Liverpool, UK
| | - Piyada Supasa
- Wellcome Centre for Human Genetics, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - Aekkachai Tuekprakhon
- Wellcome Centre for Human Genetics, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - Andrew Cross
- Liverpool University Hospitals NHS Foundation Trust, Liverpool, UK
| | - Jessica K Tyerman
- Translational and Clinical Research Institute, Immunity and Inflammation Theme, Newcastle University, Newcastle, UK
| | - Hailey Hornsby
- Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, UK
| | - Irina Grouneva
- Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, UK
| | - Megan Plowright
- Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK; Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, UK
| | - Peijun Zhang
- Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, UK
| | - Thomas A H Newman
- Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK; Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, UK
| | - Jeremy M Nell
- Department of Infection and Tropical Medicine, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
| | - Priyanka Abraham
- Peter Medawar Building for Pathogen Research, Nuffield Department of Clinical Medicine, University of Oxford, Oxford, UK; Oxford Centre for Global Health Research, Nuffield Department of Clinical Medicine, University of Oxford, Oxford, UK
| | - Mohammad Ali
- Peter Medawar Building for Pathogen Research, Nuffield Department of Clinical Medicine, University of Oxford, Oxford, UK; Oxford Centre for Global Health Research, Nuffield Department of Clinical Medicine, University of Oxford, Oxford, UK
| | - Tom Malone
- Peter Medawar Building for Pathogen Research, Nuffield Department of Clinical Medicine, University of Oxford, Oxford, UK
| | - Isabel Neale
- Peter Medawar Building for Pathogen Research, Nuffield Department of Clinical Medicine, University of Oxford, Oxford, UK; Oxford Centre for Global Health Research, Nuffield Department of Clinical Medicine, University of Oxford, Oxford, UK
| | - Eloise Phillips
- Peter Medawar Building for Pathogen Research, Nuffield Department of Clinical Medicine, University of Oxford, Oxford, UK
| | - Joseph D Wilson
- Peter Medawar Building for Pathogen Research, Nuffield Department of Clinical Medicine, University of Oxford, Oxford, UK; Oxford University Hospitals NHS Foundation Trust, Oxford, UK; Oxford University Medical School, Medical Sciences Division, University of Oxford, Oxford, UK
| | - Sam M Murray
- Peter Medawar Building for Pathogen Research, Nuffield Department of Clinical Medicine, University of Oxford, Oxford, UK
| | - Martha Zewdie
- Peter Medawar Building for Pathogen Research, Nuffield Department of Clinical Medicine, University of Oxford, Oxford, UK
| | - Adrian Shields
- Institute for Immunology and Immunotherapy, College of Medical and Dental Science, University of Birmingham, Birmingham, UK; University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | - Emily C Horner
- MRC Toxicology Unit, University of Cambridge, Cambridge, UK
| | - Lucy H Booth
- MRC Toxicology Unit, University of Cambridge, Cambridge, UK
| | - Lizzie Stafford
- Wellcome Centre for Human Genetics, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - Sagida Bibi
- Oxford Vaccine Group, Department of Paediatrics, University of Oxford, Oxford, UK
| | - Daniel G Wootton
- NIHR Health Protection Research Unit in Emerging and Zoonotic Infections, Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Liverpool, UK; Liverpool University Hospitals NHS Foundation Trust, Liverpool, UK; Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Liverpool, UK
| | - Alexander J Mentzer
- Wellcome Centre for Human Genetics, Nuffield Department of Medicine, University of Oxford, Oxford, UK; Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - Christopher P Conlon
- Oxford Centre for Global Health Research, Nuffield Department of Clinical Medicine, University of Oxford, Oxford, UK; Wellcome Centre for Human Genetics, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - Katie Jeffery
- Oxford University Hospitals NHS Foundation Trust, Oxford, UK; Radcliffe Department of Medicine, University of Oxford, Oxford, UK
| | - Philippa C Matthews
- Peter Medawar Building for Pathogen Research, Nuffield Department of Clinical Medicine, University of Oxford, Oxford, UK; The Francis Crick Institute, London, UK; Division of Infection and Immunity, University College London, London, UK; Department of Infectious Diseases, University College London Hospital NHS Foundation Trust, London, UK
| | - Andrew J Pollard
- Wellcome Centre for Human Genetics, Nuffield Department of Medicine, University of Oxford, Oxford, UK; Oxford Vaccine Group, Department of Paediatrics, University of Oxford, Oxford, UK; NIHR Oxford Biomedical Research Centre, University of Oxford, Oxford, UK
| | - Anthony Brown
- Peter Medawar Building for Pathogen Research, Nuffield Department of Clinical Medicine, University of Oxford, Oxford, UK
| | - Sarah L Rowland-Jones
- Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK; Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, UK
| | - Juthathip Mongkolsapaya
- Wellcome Centre for Human Genetics, Nuffield Department of Medicine, University of Oxford, Oxford, UK; Chinese Academy of Medical Science (CAMS) Oxford Institute (COI), University of Oxford, Oxford, UK
| | - Rebecca P Payne
- Translational and Clinical Research Institute, Immunity and Inflammation Theme, Newcastle University, Newcastle, UK
| | - Christina Dold
- Oxford Vaccine Group, Department of Paediatrics, University of Oxford, Oxford, UK; NIHR Oxford Biomedical Research Centre, University of Oxford, Oxford, UK
| | - Teresa Lambe
- Oxford Vaccine Group, Department of Paediatrics, University of Oxford, Oxford, UK; Chinese Academy of Medical Science (CAMS) Oxford Institute (COI), University of Oxford, Oxford, UK
| | | | - Gavin Screaton
- Wellcome Centre for Human Genetics, Nuffield Department of Medicine, University of Oxford, Oxford, UK; Chinese Academy of Medical Science (CAMS) Oxford Institute (COI), University of Oxford, Oxford, UK
| | - Eleanor Barnes
- Peter Medawar Building for Pathogen Research, Nuffield Department of Clinical Medicine, University of Oxford, Oxford, UK; Oxford University Hospitals NHS Foundation Trust, Oxford, UK; NIHR Oxford Biomedical Research Centre, University of Oxford, Oxford, UK; Translational Gastroenterology Unit, University of Oxford, Oxford, UK
| | - Susan Hopkins
- UK Health Security Agency, London, UK; Faculty of Medicine, Department of Infectious Disease, Imperial College London, London, UK; NIHR Health Protection Research Unit in Healthcare Associated Infection and Antimicrobial Resistance, University of Oxford, Oxford, UK
| | - Victoria Hall
- UK Health Security Agency, London, UK; NIHR Health Protection Research Unit in Healthcare Associated Infection and Antimicrobial Resistance, University of Oxford, Oxford, UK
| | - Christopher J A Duncan
- Translational and Clinical Research Institute, Immunity and Inflammation Theme, Newcastle University, Newcastle, UK; Department of Infection and Tropical Medicine, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
| | - Alex Richter
- Institute for Immunology and Immunotherapy, College of Medical and Dental Science, University of Birmingham, Birmingham, UK; University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | - Miles Carroll
- Pandemic Sciences Institute, Nuffield Department of Medicine, University of Oxford, Oxford, UK; Wellcome Centre for Human Genetics, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - Thushan I de Silva
- Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK; Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, UK
| | - Paul Klenerman
- Peter Medawar Building for Pathogen Research, Nuffield Department of Clinical Medicine, University of Oxford, Oxford, UK; Oxford University Hospitals NHS Foundation Trust, Oxford, UK; NIHR Oxford Biomedical Research Centre, University of Oxford, Oxford, UK; Translational Gastroenterology Unit, University of Oxford, Oxford, UK.
| | - Susanna Dunachie
- Peter Medawar Building for Pathogen Research, Nuffield Department of Clinical Medicine, University of Oxford, Oxford, UK; Oxford Centre for Global Health Research, Nuffield Department of Clinical Medicine, University of Oxford, Oxford, UK; Oxford University Hospitals NHS Foundation Trust, Oxford, UK; Mahidol-Oxford Tropical Medicine Research Unit, Bangkok, Thailand
| | - Lance Turtle
- NIHR Health Protection Research Unit in Emerging and Zoonotic Infections, Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Liverpool, UK; Liverpool University Hospitals NHS Foundation Trust, Liverpool, UK.
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Wu N, Joyal-Desmarais K, Ribeiro PAB, Vieira AM, Stojanovic J, Sanuade C, Yip D, Bacon SL. Long-term effectiveness of COVID-19 vaccines against infections, hospitalisations, and mortality in adults: findings from a rapid living systematic evidence synthesis and meta-analysis up to December, 2022. Lancet Respir Med 2023; 11:439-452. [PMID: 36780914 PMCID: PMC9917454 DOI: 10.1016/s2213-2600(23)00015-2] [Citation(s) in RCA: 51] [Impact Index Per Article: 51.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Revised: 01/05/2023] [Accepted: 01/05/2023] [Indexed: 02/12/2023]
Abstract
BACKGROUND Synthesising evidence on the long-term vaccine effectiveness of COVID-19 vaccines (BNT162b2 [Pfizer-BioNTech], mRNA-1273 [Moderna], ChAdOx1 nCoV-19 [AZD1222; Oxford-AstraZeneca], and Ad26.COV2.S [Janssen]) against infections, hospitalisations, and mortality is crucial to making evidence-based pandemic policy decisions. METHODS In this rapid living systematic evidence synthesis and meta-analysis, we searched EMBASE and the US National Institutes of Health's iSearch COVID-19 Portfolio, supplemented by manual searches of COVID-19-specific sources, until Dec 1, 2022, for studies that reported vaccine effectiveness immediately and at least 112 days after a primary vaccine series or at least 84 days after a booster dose. Single reviewers assessed titles, abstracts, and full-text articles, and extracted data, with a second reviewer verifying included studies. The primary outcomes were vaccine effectiveness against SARS-CoV-2 infections, hospitalisations, and mortality, which were assessed using three-level meta-analytic models. This study is registered with the National Collaborating Centre for Methods and Tools, review 473. FINDINGS We screened 16 696 records at the title and abstract level, appraised 832 (5·0%) full texts, and initially included 73 (0·4%) studies. Of these, we excluded five (7%) studies because of critical risk of bias, leaving 68 (93%) studies that were extracted for analysis. For infections caused by any SARS-CoV-2 strain, vaccine effectiveness for the primary series reduced from 83% (95% CI 80-86) at baseline (14-42 days) to 62% (53-69) by 112-139 days. Vaccine effectiveness at baseline was 92% (88-94) for hospitalisations and 91% (85-95) for mortality, and reduced to 79% (65-87) at 224-251 days for hospitalisations and 86% (73-93) at 168-195 days for mortality. Estimated vaccine effectiveness was lower for the omicron variant for infections, hospitalisations, and mortality at baseline compared with that of other variants, but subsequent reductions occurred at a similar rate across variants. For booster doses, which covered mostly omicron studies, vaccine effectiveness at baseline was 70% (56-80) against infections and 89% (82-93) against hospitalisations, and reduced to 43% (14-62) against infections and 71% (51-83) against hospitalisations at 112 days or later. Not enough studies were available to report on booster vaccine effectiveness against mortality. INTERPRETATION Our analyses indicate that vaccine effectiveness generally decreases over time against SARS-CoV-2 infections, hospitalisations, and mortality. The baseline vaccine effectiveness levels for the omicron variant were notably lower than for other variants. Therefore, other preventive measures (eg, face-mask wearing and physical distancing) might be necessary to manage the pandemic in the long term. FUNDING Canadian Institutes of Health Research and the Public Health Agency of Canada.
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Affiliation(s)
- Nana Wu
- META Group, Montreal Behavioural Medicine Centre, CIUSSS du Nord-de-l'Île-de-Montréal, Montreal, QC, Canada; Department of Health, Kinesiology, and Applied Physiology, Concordia University, Montreal, QC, Canada
| | - Keven Joyal-Desmarais
- META Group, Montreal Behavioural Medicine Centre, CIUSSS du Nord-de-l'Île-de-Montréal, Montreal, QC, Canada; Department of Health, Kinesiology, and Applied Physiology, Concordia University, Montreal, QC, Canada
| | - Paula A B Ribeiro
- META Group, Montreal Behavioural Medicine Centre, CIUSSS du Nord-de-l'Île-de-Montréal, Montreal, QC, Canada
| | - Ariany Marques Vieira
- META Group, Montreal Behavioural Medicine Centre, CIUSSS du Nord-de-l'Île-de-Montréal, Montreal, QC, Canada; Department of Health, Kinesiology, and Applied Physiology, Concordia University, Montreal, QC, Canada
| | - Jovana Stojanovic
- META Group, Montreal Behavioural Medicine Centre, CIUSSS du Nord-de-l'Île-de-Montréal, Montreal, QC, Canada; Canadian Agency for Drugs and Technologies in Health, Ottawa, ON, Canada
| | - Comfort Sanuade
- META Group, Montreal Behavioural Medicine Centre, CIUSSS du Nord-de-l'Île-de-Montréal, Montreal, QC, Canada; Department of Health, Kinesiology, and Applied Physiology, Concordia University, Montreal, QC, Canada
| | - Doro Yip
- META Group, Montreal Behavioural Medicine Centre, CIUSSS du Nord-de-l'Île-de-Montréal, Montreal, QC, Canada
| | - Simon L Bacon
- META Group, Montreal Behavioural Medicine Centre, CIUSSS du Nord-de-l'Île-de-Montréal, Montreal, QC, Canada; Department of Health, Kinesiology, and Applied Physiology, Concordia University, Montreal, QC, Canada.
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35
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Kang CK, Kim MG, Park SW, Kim YW, Lee CM, Choe PG, Park WB, Kim NJ, Kim M, Lee S, Kim IS, Lee CH, Shin HM, Kim HR, Oh MD. Comparable humoral and cellular immunity against Omicron variant BA.4/5 of once-boosted BA.1/2 convalescents and twice-boosted COVID-19-naïve individuals. J Med Virol 2023; 95:e28558. [PMID: 36755360 DOI: 10.1002/jmv.28558] [Citation(s) in RCA: 2] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Revised: 12/30/2022] [Accepted: 02/03/2023] [Indexed: 02/10/2023]
Abstract
The fourth vaccination dose confers additional protective immunity against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in individuals with no prior coronavirus disease-19 (COVID-19). However, its immunological benefit against currently circulating BA.4/5 is unclear in individuals who have received a booster shot and been infected with Omicron variant BA.1/2. We analyzed immune responses in whom had been boosted once and did not have COVID-19 (n = 16), boosted once and had COVID-19 when BA.1/2 was dominant in Korea (Hybrid-6M group, n = 27), and boosted twice and did not have COVID-19 (Vx4 group, n = 15). Antibody binding activities against RBDo BA.1 and RBDo BA.4/5 , antigen-specific memory CD4+ and CD8+ T-cell responses against BA.4/5, and B-cell responses against SARS-CoV-2 wild-type did not differ statistically between the Hybrid-6M and Vx4 groups. The humoral and cellular immune responses of the Hybrid-6M group against BA.4/5 were comparable to those of the Vx4 group. Individuals who had been boosted and had an Omicron infection in early 2022 may not have high priority for an additional vaccination.
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Affiliation(s)
- Chang Kyung Kang
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Min-Gang Kim
- Department of Biomedical Sciences, Seoul National University College of Medicine, Seoul, Republic of Korea.,Department of Anatomy & Cell Biology, Seoul National University College of Medicine, Seoul, Republic of Korea.,BK21 FOUR Biomedical Science Project, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Seong-Wook Park
- Department of Pharmacology, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Yong-Woo Kim
- Wide River Institute of Immunology, Seoul National University, Hongcheon, Republic of Korea
| | - Chan Mi Lee
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Pyoeng Gyun Choe
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Wan Beom Park
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Nam Joong Kim
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Minji Kim
- Department of Biomedical Sciences, Seoul National University College of Medicine, Seoul, Republic of Korea.,Department of Anatomy & Cell Biology, Seoul National University College of Medicine, Seoul, Republic of Korea.,BK21 FOUR Biomedical Science Project, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Soojin Lee
- Department of Biomedical Sciences, Seoul National University College of Medicine, Seoul, Republic of Korea.,Department of Anatomy & Cell Biology, Seoul National University College of Medicine, Seoul, Republic of Korea.,BK21 FOUR Biomedical Science Project, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Ik Soo Kim
- Department of Microbiology, School of Medicine, Gachon University, Incheon, Republic of Korea
| | - Chang-Han Lee
- Department of Biomedical Sciences, Seoul National University College of Medicine, Seoul, Republic of Korea.,BK21 FOUR Biomedical Science Project, Seoul National University College of Medicine, Seoul, Republic of Korea.,Department of Pharmacology, Seoul National University College of Medicine, Seoul, Republic of Korea.,Wide River Institute of Immunology, Seoul National University, Hongcheon, Republic of Korea.,Convergence Research Center for Dementia, Seoul National University Medical Research Center, Seoul, Republic of Korea.,Cancer Research Institute, Seoul National University, Seoul, Republic of Korea
| | - Hyun Mu Shin
- Department of Biomedical Sciences, Seoul National University College of Medicine, Seoul, Republic of Korea.,BK21 FOUR Biomedical Science Project, Seoul National University College of Medicine, Seoul, Republic of Korea.,Wide River Institute of Immunology, Seoul National University, Hongcheon, Republic of Korea
| | - Hang-Rae Kim
- Department of Biomedical Sciences, Seoul National University College of Medicine, Seoul, Republic of Korea.,Department of Anatomy & Cell Biology, Seoul National University College of Medicine, Seoul, Republic of Korea.,BK21 FOUR Biomedical Science Project, Seoul National University College of Medicine, Seoul, Republic of Korea.,Wide River Institute of Immunology, Seoul National University, Hongcheon, Republic of Korea.,Medical Research Institute, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Myoung-Don Oh
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
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36
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Tauzin A, Benlarbi M, Medjahed H, Grégoire Y, Perreault J, Gendron-Lepage G, Gokool L, Morrisseau C, Arlotto P, Tremblay C, Kaufmann DE, Martel-Laferrière V, Levade I, Côté M, De Serres G, Bazin R, Finzi A. Humoral Responses against BQ.1.1 Elicited after Breakthrough Infection and SARS-CoV-2 mRNA Vaccination. Vaccines (Basel) 2023; 11. [PMID: 36851122 DOI: 10.3390/vaccines11020242] [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: 12/20/2022] [Revised: 01/18/2023] [Accepted: 01/20/2023] [Indexed: 01/26/2023] Open
Abstract
The Omicron BQ.1.1 variant is now the major SARS-CoV-2 circulating strain in many countries. Because of the many mutations present in its Spike glycoprotein, this variant is resistant to humoral responses elicited by monovalent mRNA vaccines. With the goal to improve immune responses against Omicron subvariants, bivalent mRNA vaccines have recently been approved in several countries. In this study, we measure the capacity of plasma from vaccinated individuals, before and after a fourth dose of mono- or bivalent mRNA vaccine, to recognize and neutralize the ancestral (D614G) and the BQ.1.1 Spikes. Before and after the fourth dose, we observe a significantly better recognition and neutralization of the ancestral Spike. We also observe that fourth-dose vaccinated individuals who have been recently infected better recognize and neutralize the BQ.1.1 Spike, independently of the mRNA vaccine used, than donors who have never been infected or have an older infection. Our study supports that hybrid immunity, generated by vaccination and a recent infection, induces higher humoral responses than vaccination alone, independently of the mRNA vaccine used.
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Montes-González JA, Zaragoza-Jiménez CA, Antonio-Villa NE, Fermín-Martínez CA, Ramírez-García D, Vargas-Vázquez A, Gutiérrez-Vargas RI, García-Rodríguez G, López-Gatell H, Valdés-Ferrer SI, Bello-Chavolla OY. Protection of hybrid immunity against SARS-CoV-2 reinfection and severe COVID-19 during periods of Omicron variant predominance in Mexico. Front Public Health 2023; 11:1146059. [PMID: 37081954 PMCID: PMC10110947 DOI: 10.3389/fpubh.2023.1146059] [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: 01/16/2023] [Accepted: 03/07/2023] [Indexed: 04/22/2023] Open
Abstract
Background With the widespread transmission of the Omicron SARS-CoV-2 variant, reinfections have become increasingly common. Here, we explored the role of immunity, primary infection severity, and variant predominance in the risk of reinfection and severe COVID-19 during Omicron predominance in Mexico. Methods We analyzed reinfections in Mexico in individuals with a primary infection separated by at least 90 days from reinfection using a national surveillance registry of SARS-CoV-2 cases from March 3rd, 2020, to August 13th, 2022. Immunity-generating events included primary infection, partial or complete vaccination, and booster vaccines. Reinfections were matched by age and sex with controls with primary SARS-CoV-2 infection and negative RT-PCR or antigen test at least 90 days after primary infection to explore reinfection and severe disease risk factors. We also compared the protective efficacy of heterologous and homologous vaccine boosters against reinfection. Results We detected 231,202 SARS-CoV-2 reinfections in Mexico, most occurring in unvaccinated individuals (41.55%). Over 207,623 reinfections occurred during periods of Omicron (89.8%), BA.1 (36.74%), and BA.5 (33.67%) subvariant predominance and a case-fatality rate of 0.22%. Vaccination protected against reinfection, without significant influence of the order of immunity-generating events and provided >90% protection against severe reinfections. Heterologous booster schedules were associated with ~11% and ~ 54% lower risk for reinfection and reinfection-associated severe COVID-19, respectively, modified by time-elapsed since the last immunity-generating event, when compared against complete primary schedules. Conclusion SARS-CoV-2 reinfections increased during Omicron predominance. Hybrid immunity provides protection against reinfection and associated severe COVID-19, with potential benefit from heterologous booster schedules.
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Affiliation(s)
| | | | | | - Carlos A. Fermín-Martínez
- Dirección de Investigación, Instituto Nacional de Geriatría, Mexico City, Mexico
- MD/PhD (PECEM) Program, Facultad de Medicina, Universidad Nacional Autónoma de Mexico, Mexico City, Mexico
| | | | - Arsenio Vargas-Vázquez
- MD/PhD (PECEM) Program, Facultad de Medicina, Universidad Nacional Autónoma de Mexico, Mexico City, Mexico
| | | | | | - Hugo López-Gatell
- Subsecretaría de Prevención y Promoción de la Salud, Secretaría de Salud, Mexico City, Mexico
| | - Sergio Iván Valdés-Ferrer
- Departamento de Neurología, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | - Omar Yaxmehen Bello-Chavolla
- Dirección de Investigación, Instituto Nacional de Geriatría, Mexico City, Mexico
- *Correspondence: Omar Yaxmehen Bello-Chavolla,
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38
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Hsu CY, Chang JC, Chen SLS, Chang HH, Lin ATY, Yen AMF, Chen HH. Primary and booster vaccination in reducing severe clinical outcomes associated with Omicron Naïve infection. J Infect Public Health 2023; 16:55-63. [PMID: 36470007 PMCID: PMC9708104 DOI: 10.1016/j.jiph.2022.11.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Revised: 11/21/2022] [Accepted: 11/24/2022] [Indexed: 12/05/2022] Open
Abstract
BACKGROUND Little is known about long-term effectiveness of COVID-19 vaccine in reducing severity and deaths associated with Omicron VOC not perturbed by prior infection and independent of oral anti-viral therapy and non-pharmaceutical (NPI). METHODS A retrospective observational cohort study was applied to Taiwan community during the unprecedent large-scale outbreaks of Omicron BA.2 between April and August, 2022. Primary vaccination since March, 2021 and booster vaccination since January, 2022 were offered on population level. Oral Anti-viral therapy was also offered as of mid-May 2022. The population-based effectiveness of vaccination in reducing the risk of moderate and severe cases of and death from Omicron BA.2 with the consideration of NPI and oral anti-viral therapy were assessed by using Bayesian hierarchical models. RESULTS The risks of three clinical outcomes associated with Omicron VOC infection were lowest for booster vaccination, followed by primary vaccination, and highest for incomplete vaccination with the consistent trends of being at increased risk for three outcomes from the young people aged 12 years or below until the elderly people aged 75 years or older with 7 age groups. Before the period using oral anti-viral therapy, complete primary vaccination with the duration more than 9 months before outbreaks conferred the statistically significant 47 % (23-64 %) reduction of death, 48 % (30-61 %) of severe disease, and 46 % (95 % CI: 37-54 %) of moderate disease after adjusting for 10-20 % independent effect of NPI. The benefits of booster vaccination within three months were further enhanced to 76 % (95 % CI: 67-86 %), 74 % (95 % CI: 67-80 %), and 61 % (95 % CI: 56-65 %) for three corresponding outcomes. The additional effectiveness of oral anti-viral therapy in reducing moderate disease was 13 % for the booster group and 5.8 % for primary vaccination. CONCLUSIONS We corroborated population effectiveness of primary vaccination and its booster vaccination, independent of oral anti-viral therapy and NPI, in reducing severe clinical outcomes associated with Omicron BA.2 naïve infection population.
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Affiliation(s)
- Chen-Yang Hsu
- Master of Public Health Program, College of Public Health, National Taiwan University, Taipei, Taiwan; Daichung Hospital, Miaoli, Taiwan
| | - Jung-Chen Chang
- School of Nursing, College of Medicine, National Taiwan University, Taipei, Taiwan; Department of Nursing, National Taiwan University Hospital, Taipei,Taiwan
| | - Sam Li-Shen Chen
- School of Oral Hygiene, College of Oral Medicine, Taipei Medical University, Taipei, Taiwan
| | - Hao-Hsiang Chang
- Department of Family Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Abbie Ting-Yu Lin
- Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan
| | - Amy Ming-Feng Yen
- School of Oral Hygiene, College of Oral Medicine, Taipei Medical University, Taipei, Taiwan.
| | - Hsiu-Hsi Chen
- Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan.
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39
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Gupta E, Samal J, Gautam P, Agarwal R. Current surge of COVID-19 infection in China and its impact on India. Indian J Med Microbiol 2023; 42:46-48. [PMID: 36967215 PMCID: PMC9892875 DOI: 10.1016/j.ijmmb.2023.01.010] [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: 01/03/2023] [Revised: 01/16/2023] [Accepted: 01/19/2023] [Indexed: 02/05/2023]
Abstract
Background COVID-19, the pandemic caused by the SARS-CoV-2, is a global health calamity and one of the greatest challenges faced by the humankind across the globe. The virus originated in Wuhan, China and spread rapidly to more than 200 countries/nations, affected more than 600 billion individuals and caused around 65 lakh deaths worldwide. Since the start of the pandemic, SARS-CoV-2 mutates and accumulates genetic variations which constantly resulted in the emergence of new variants. Objective The current article discusses about the new omicron sub variant BF.7, and how this BF.7 variant may pose risk in India, if it overrides the current COVID-19 circulating variants. Content The emergence and potential consequences of the circulating SARS-CoV-2 variants usually augment virus transmissibility and host immune evasion. The current spurt in COVID-19 infections in China which has alarmed people around the world, is believed to be driven by an omicron sub variant BF.7. Although India has been reporting a "steady decline" in COVID-19 cases, we need constant surveillance to keep a track of the new emerging variants in circulation. Keeping in mind, the new surge in COVID-19 cases across many nations, we discuss about the new variant and its possible impact on India.
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Affiliation(s)
- Ekta Gupta
- Department of Clinical Virology, Institute of Liver and Biliary Sciences, New Delhi, India,Corresponding author
| | - Jasmine Samal
- Department of Clinical Virology, Institute of Liver and Biliary Sciences, New Delhi, India
| | - Pramod Gautam
- Genome Sequencing Laboratory, Institute of Liver and Biliary Sciences, New Delhi, India
| | - Reshu Agarwal
- Department of Clinical Virology, Institute of Liver and Biliary Sciences, New Delhi, India
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40
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Skowronski DM, Kaweski SE, Irvine MA, Kim S, Chuang ESY, Sabaiduc S, Fraser M, Reyes RC, Henry B, Levett PN, Petric M, Krajden M, Sekirov I. Serial cross-sectional estimation of vaccine-and infection-induced SARS-CoV-2 seroprevalence in British Columbia, Canada. CMAJ 2022; 194:E1599-E1609. [PMID: 36507788 PMCID: PMC9828974 DOI: 10.1503/cmaj.221335] [Citation(s) in RCA: 25] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/27/2022] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND The evolving proportion of the population considered immunologically naive versus primed for more efficient immune memory response to SARS-CoV-2 has implications for risk assessment. We sought to chronicle vaccine- and infection-induced seroprevalence across the first 7 waves of the COVID-19 pandemic in British Columbia, Canada. METHODS During 8 cross-sectional serosurveys conducted between March 2020 and August 2022, we obtained anonymized residual sera from children and adults who attended an outpatient laboratory network in the Lower Mainland (Greater Vancouver and Fraser Valley). We used at least 3 immunoassays per serosurvey to detect SARS-CoV-2 spike and nucleocapsid antibodies. We assessed any seroprevalence (vaccineor infection-induced, or both), defined by positivity on any 2 assays, and infection-induced seroprevalence, also defined by dual-assay positivity but requiring both antinucleocapsid and antispike detection. We used estimates of infection-induced seroprevalence to explore underascertainment of infections by surveillance case reports. RESULTS By January 2021, we estimated that any seroprevalence remained less than 5%, increasing with vaccine rollout to 56% by May-June 2021, 83% by September-October 2021 and 95% by March 2022. Infection-induced seroprevalence remained less than 15% through September-October 2021, increasing across Omicron waves to 42% by March 2022 and 61% by July-August 2022. By August 2022, 70%-80% of children younger than 20 years and 60%-70% of adults aged 20-59 years had been infected, but fewer than half of adults aged 60 years and older had been infected. Compared with estimates of infection-induced seroprevalence, surveillance case reports underestimated infections 12-fold between September 2021 and March 2022 and 92-fold between March 2022 and August 2022. INTERPRETATION By August 2022, most children and adults younger than 60 years had evidence of both SARS-CoV-2 vaccination and infection. As previous evidence suggests that a history of both exposures may induce stronger, more durable hybrid immunity than either exposure alone, older adults - who have the lowest infection rates but highest risk of severe outcomes - continue to warrant prioritized vaccination.
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Affiliation(s)
- Danuta M Skowronski
- British Columbia Centre for Disease Control, Communicable Diseases and Immunization Services (Skowronski, Kim, Chuang); University of British Columbia, School of Population and Public Health (Skowronski, Henry); BC Centre for Disease Control, Public Health Laboratory (Kaweski, Sabaiduc, Levett, Krajden, Sekirov); BC Centre for Disease Control, Data and Analytic Services (Irvine, Fraser), Vancouver, BC; Simon Fraser University, Faculty of Health Sciences (Irvine), Burnaby, BC; University of British Columbia, Department of Pathology and Laboratory Medicine (Reyes, Levett, Petric, Krajden, Sekirov), Vancouver, BC; LifeLabs (Reyes), Burnaby, BC; Office of the Provincial Health Officer (Henry), Ministry of Health, Victoria, BC
| | - Samantha E Kaweski
- British Columbia Centre for Disease Control, Communicable Diseases and Immunization Services (Skowronski, Kim, Chuang); University of British Columbia, School of Population and Public Health (Skowronski, Henry); BC Centre for Disease Control, Public Health Laboratory (Kaweski, Sabaiduc, Levett, Krajden, Sekirov); BC Centre for Disease Control, Data and Analytic Services (Irvine, Fraser), Vancouver, BC; Simon Fraser University, Faculty of Health Sciences (Irvine), Burnaby, BC; University of British Columbia, Department of Pathology and Laboratory Medicine (Reyes, Levett, Petric, Krajden, Sekirov), Vancouver, BC; LifeLabs (Reyes), Burnaby, BC; Office of the Provincial Health Officer (Henry), Ministry of Health, Victoria, BC
| | - Michael A Irvine
- British Columbia Centre for Disease Control, Communicable Diseases and Immunization Services (Skowronski, Kim, Chuang); University of British Columbia, School of Population and Public Health (Skowronski, Henry); BC Centre for Disease Control, Public Health Laboratory (Kaweski, Sabaiduc, Levett, Krajden, Sekirov); BC Centre for Disease Control, Data and Analytic Services (Irvine, Fraser), Vancouver, BC; Simon Fraser University, Faculty of Health Sciences (Irvine), Burnaby, BC; University of British Columbia, Department of Pathology and Laboratory Medicine (Reyes, Levett, Petric, Krajden, Sekirov), Vancouver, BC; LifeLabs (Reyes), Burnaby, BC; Office of the Provincial Health Officer (Henry), Ministry of Health, Victoria, BC
| | - Shinhye Kim
- British Columbia Centre for Disease Control, Communicable Diseases and Immunization Services (Skowronski, Kim, Chuang); University of British Columbia, School of Population and Public Health (Skowronski, Henry); BC Centre for Disease Control, Public Health Laboratory (Kaweski, Sabaiduc, Levett, Krajden, Sekirov); BC Centre for Disease Control, Data and Analytic Services (Irvine, Fraser), Vancouver, BC; Simon Fraser University, Faculty of Health Sciences (Irvine), Burnaby, BC; University of British Columbia, Department of Pathology and Laboratory Medicine (Reyes, Levett, Petric, Krajden, Sekirov), Vancouver, BC; LifeLabs (Reyes), Burnaby, BC; Office of the Provincial Health Officer (Henry), Ministry of Health, Victoria, BC
| | - Erica S Y Chuang
- British Columbia Centre for Disease Control, Communicable Diseases and Immunization Services (Skowronski, Kim, Chuang); University of British Columbia, School of Population and Public Health (Skowronski, Henry); BC Centre for Disease Control, Public Health Laboratory (Kaweski, Sabaiduc, Levett, Krajden, Sekirov); BC Centre for Disease Control, Data and Analytic Services (Irvine, Fraser), Vancouver, BC; Simon Fraser University, Faculty of Health Sciences (Irvine), Burnaby, BC; University of British Columbia, Department of Pathology and Laboratory Medicine (Reyes, Levett, Petric, Krajden, Sekirov), Vancouver, BC; LifeLabs (Reyes), Burnaby, BC; Office of the Provincial Health Officer (Henry), Ministry of Health, Victoria, BC
| | - Suzana Sabaiduc
- British Columbia Centre for Disease Control, Communicable Diseases and Immunization Services (Skowronski, Kim, Chuang); University of British Columbia, School of Population and Public Health (Skowronski, Henry); BC Centre for Disease Control, Public Health Laboratory (Kaweski, Sabaiduc, Levett, Krajden, Sekirov); BC Centre for Disease Control, Data and Analytic Services (Irvine, Fraser), Vancouver, BC; Simon Fraser University, Faculty of Health Sciences (Irvine), Burnaby, BC; University of British Columbia, Department of Pathology and Laboratory Medicine (Reyes, Levett, Petric, Krajden, Sekirov), Vancouver, BC; LifeLabs (Reyes), Burnaby, BC; Office of the Provincial Health Officer (Henry), Ministry of Health, Victoria, BC
| | - Mieke Fraser
- British Columbia Centre for Disease Control, Communicable Diseases and Immunization Services (Skowronski, Kim, Chuang); University of British Columbia, School of Population and Public Health (Skowronski, Henry); BC Centre for Disease Control, Public Health Laboratory (Kaweski, Sabaiduc, Levett, Krajden, Sekirov); BC Centre for Disease Control, Data and Analytic Services (Irvine, Fraser), Vancouver, BC; Simon Fraser University, Faculty of Health Sciences (Irvine), Burnaby, BC; University of British Columbia, Department of Pathology and Laboratory Medicine (Reyes, Levett, Petric, Krajden, Sekirov), Vancouver, BC; LifeLabs (Reyes), Burnaby, BC; Office of the Provincial Health Officer (Henry), Ministry of Health, Victoria, BC
| | - Romina C Reyes
- British Columbia Centre for Disease Control, Communicable Diseases and Immunization Services (Skowronski, Kim, Chuang); University of British Columbia, School of Population and Public Health (Skowronski, Henry); BC Centre for Disease Control, Public Health Laboratory (Kaweski, Sabaiduc, Levett, Krajden, Sekirov); BC Centre for Disease Control, Data and Analytic Services (Irvine, Fraser), Vancouver, BC; Simon Fraser University, Faculty of Health Sciences (Irvine), Burnaby, BC; University of British Columbia, Department of Pathology and Laboratory Medicine (Reyes, Levett, Petric, Krajden, Sekirov), Vancouver, BC; LifeLabs (Reyes), Burnaby, BC; Office of the Provincial Health Officer (Henry), Ministry of Health, Victoria, BC
| | - Bonnie Henry
- British Columbia Centre for Disease Control, Communicable Diseases and Immunization Services (Skowronski, Kim, Chuang); University of British Columbia, School of Population and Public Health (Skowronski, Henry); BC Centre for Disease Control, Public Health Laboratory (Kaweski, Sabaiduc, Levett, Krajden, Sekirov); BC Centre for Disease Control, Data and Analytic Services (Irvine, Fraser), Vancouver, BC; Simon Fraser University, Faculty of Health Sciences (Irvine), Burnaby, BC; University of British Columbia, Department of Pathology and Laboratory Medicine (Reyes, Levett, Petric, Krajden, Sekirov), Vancouver, BC; LifeLabs (Reyes), Burnaby, BC; Office of the Provincial Health Officer (Henry), Ministry of Health, Victoria, BC
| | - Paul N Levett
- British Columbia Centre for Disease Control, Communicable Diseases and Immunization Services (Skowronski, Kim, Chuang); University of British Columbia, School of Population and Public Health (Skowronski, Henry); BC Centre for Disease Control, Public Health Laboratory (Kaweski, Sabaiduc, Levett, Krajden, Sekirov); BC Centre for Disease Control, Data and Analytic Services (Irvine, Fraser), Vancouver, BC; Simon Fraser University, Faculty of Health Sciences (Irvine), Burnaby, BC; University of British Columbia, Department of Pathology and Laboratory Medicine (Reyes, Levett, Petric, Krajden, Sekirov), Vancouver, BC; LifeLabs (Reyes), Burnaby, BC; Office of the Provincial Health Officer (Henry), Ministry of Health, Victoria, BC
| | - Martin Petric
- British Columbia Centre for Disease Control, Communicable Diseases and Immunization Services (Skowronski, Kim, Chuang); University of British Columbia, School of Population and Public Health (Skowronski, Henry); BC Centre for Disease Control, Public Health Laboratory (Kaweski, Sabaiduc, Levett, Krajden, Sekirov); BC Centre for Disease Control, Data and Analytic Services (Irvine, Fraser), Vancouver, BC; Simon Fraser University, Faculty of Health Sciences (Irvine), Burnaby, BC; University of British Columbia, Department of Pathology and Laboratory Medicine (Reyes, Levett, Petric, Krajden, Sekirov), Vancouver, BC; LifeLabs (Reyes), Burnaby, BC; Office of the Provincial Health Officer (Henry), Ministry of Health, Victoria, BC
| | - Mel Krajden
- British Columbia Centre for Disease Control, Communicable Diseases and Immunization Services (Skowronski, Kim, Chuang); University of British Columbia, School of Population and Public Health (Skowronski, Henry); BC Centre for Disease Control, Public Health Laboratory (Kaweski, Sabaiduc, Levett, Krajden, Sekirov); BC Centre for Disease Control, Data and Analytic Services (Irvine, Fraser), Vancouver, BC; Simon Fraser University, Faculty of Health Sciences (Irvine), Burnaby, BC; University of British Columbia, Department of Pathology and Laboratory Medicine (Reyes, Levett, Petric, Krajden, Sekirov), Vancouver, BC; LifeLabs (Reyes), Burnaby, BC; Office of the Provincial Health Officer (Henry), Ministry of Health, Victoria, BC
| | - Inna Sekirov
- British Columbia Centre for Disease Control, Communicable Diseases and Immunization Services (Skowronski, Kim, Chuang); University of British Columbia, School of Population and Public Health (Skowronski, Henry); BC Centre for Disease Control, Public Health Laboratory (Kaweski, Sabaiduc, Levett, Krajden, Sekirov); BC Centre for Disease Control, Data and Analytic Services (Irvine, Fraser), Vancouver, BC; Simon Fraser University, Faculty of Health Sciences (Irvine), Burnaby, BC; University of British Columbia, Department of Pathology and Laboratory Medicine (Reyes, Levett, Petric, Krajden, Sekirov), Vancouver, BC; LifeLabs (Reyes), Burnaby, BC; Office of the Provincial Health Officer (Henry), Ministry of Health, Victoria, BC
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