1
|
Hill-Batorski L, Bowen R, Bielefeldt-Ohmann H, Moser MJ, Matejka SM, Marshall D, Kawaoka Y, Neumann G, Bilsel P. Mucosal immunization with dual influenza/COVID-19 single-replication virus vector protects hamsters from SARS-CoV-2 challenge. Vaccine 2024; 42:2770-2780. [PMID: 38508930 DOI: 10.1016/j.vaccine.2024.03.040] [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: 12/13/2023] [Revised: 03/15/2024] [Accepted: 03/16/2024] [Indexed: 03/22/2024]
Abstract
The COVID-19 pandemic has highlighted the need for mucosal vaccines as breakthrough infections, short-lived immune responses and emergence of new variants have challenged the efficacy provided by the first generation of vaccines against SARS-CoV-2 viruses. M2SR SARS-CoV-2, an M2-deleted single-replication influenza virus vector modified to encode the SARS-CoV-2 receptor binding domain, was evaluated following intranasal delivery in a hamster challenge model for protection against Wuhan SARS-CoV-2. An adjuvanted inactivated SARS-CoV-2 whole virus vaccine administered intramuscularly was also evaluated. The intranasal M2SR SARS-CoV-2 was more effective than the intramuscular adjuvanted inactivated whole virus vaccine in providing protection against SARS-CoV-2 challenge. M2SR SARS-CoV-2 elicited neutralizing serum antibodies against Wuhan and Omicron SARS-CoV-2 viruses in addition to cross-reactive mucosal antibodies. Furthermore, M2SR SARS-CoV-2 generated serum HAI and mucosal antibody responses against influenza similar to an H3N2 M2SR influenza vaccine. The intranasal dual influenza/COVID M2SR SARS-CoV-2 vaccine has the potential to provide protection against both influenza and COVID.
Collapse
|
2
|
Kumwichar P, Poonsiri C, Botwright S, Sirichumroonwit N, Loharjun B, Thawillarp S, Cheewaruangroj N, Chokchaisiripakdee A, Teerawattananon Y, Chongsuvivatwong V. Durability of the Effectiveness of Heterologous COVID-19 Vaccine Regimens in Thailand: Retrospective Cohort Study Using National Registration Data. JMIR Public Health Surveill 2024; 10:e48255. [PMID: 38441923 PMCID: PMC10951833 DOI: 10.2196/48255] [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: 04/17/2023] [Revised: 10/31/2023] [Accepted: 02/08/2024] [Indexed: 03/07/2024] Open
Abstract
BACKGROUND The durability of heterologous COVID-19 vaccine effectiveness (VE) has been primarily studied in high-income countries, while evaluation of heterologous vaccine policies in low- and middle-income countries remains limited. OBJECTIVE We aimed to evaluate the duration during which the VE of heterologous COVID-19 vaccine regimens in mitigating serious outcomes, specifically severe COVID-19 and death following hospitalization with COVID-19, remains over 50%. METHODS We formed a dynamic cohort by linking records of Thai citizens aged ≥18 years from citizen vital, COVID-19 vaccine, and COVID-19 cases registry databases between May 2021 and July 2022. Encrypted citizen identification numbers were used to merge the data between the databases. This study focuses on 8 common heterologous vaccine sequences: CoronaVac/ChAdOx1, ChAdOx1/BNT162b2, CoronaVac/CoronaVac/ChAdOx1, CoronaVac/ChAdOx1/ChAdOx1, CoronaVac/ChAdOx1/BNT162b2, BBIBP-CorV/BBIBP-CorV/BNT162b2, ChAdOx1/ChAdOx1/BNT162b2, and ChAdOx1/ChAdOx1/mRNA-1273. Nonimmunized individuals were considered for comparisons. The cohort was stratified according to the vaccination status, age, sex, province location, month of vaccination, and outcome. Data analysis employed logistic regression to determine the VE, accounting for potential confounders and durability over time, with data observed over a follow-up period of 7 months. RESULTS This study includes 52,580,841 individuals, with approximately 17,907,215 and 17,190,975 receiving 2- and 3-dose common heterologous vaccines (not mutually exclusive), respectively. The 2-dose heterologous vaccinations offered approximately 50% VE against severe COVID-19 and death following hospitalization with COVID-19 for 2 months; however, the protection significantly declined over time. The 3-dose heterologous vaccinations sustained over 50% VE against both outcomes for at least 8 months, as determined by logistic regression with durability time-interaction modeling. The vaccine sequence consisting of CoronaVac/CoronaVac/ChAdOx1 demonstrated >80% VE against both outcomes, with no evidence of VE waning. The final monthly measured VE of CoronaVac/CoronaVac/ChAdOx1 against severe COVID-19 and death following hospitalization at 7 months after the last dose was 82% (95% CI 80.3%-84%) and 86.3% (95% CI 83.6%-84%), respectively. CONCLUSIONS In Thailand, within a 7-month observation period, the 2-dose regimens could not maintain a 50% VE against severe and fatal COVID-19 for over 2 months, but all of the 3-dose regimens did. The CoronaVac/CoronaVac/ChAdOx1 regimen showed the best protective effect against severe and fatal COVID-19. The estimated durability of 50% VE for at least 8 months across all 3-dose heterologous COVID-19 vaccine regimens supports the adoption of heterologous prime-boost vaccination strategies, with a primary series of inactivated virus vaccine and boosting with either a viral vector or an mRNA vaccine, to prevent similar pandemics in low- and middle-income countries.
Collapse
Affiliation(s)
- Ponlagrit Kumwichar
- Department of Epidemiology, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand
| | - Chittawan Poonsiri
- Health Intervention and Technology Assessment Program, Ministry of Public Health, Nonthaburi, Thailand
| | - Siobhan Botwright
- Health Intervention and Technology Assessment Program, Ministry of Public Health, Nonthaburi, Thailand
| | - Natchalaikorn Sirichumroonwit
- Department of Medical Services, Institute of Medical Research and Technology Assessment, Ministry of Public Health, Nonthaburi, Thailand
| | - Bootsakorn Loharjun
- Department of Medical Services, Institute of Medical Research and Technology Assessment, Ministry of Public Health, Nonthaburi, Thailand
| | | | | | | | - Yot Teerawattananon
- Health Intervention and Technology Assessment Program, Ministry of Public Health, Nonthaburi, Thailand
| | | |
Collapse
|
3
|
Sevilla JP. COVID-19 vaccines should be evaluated from the societal perspective. J Med Econ 2024; 27:1-9. [PMID: 38014424 DOI: 10.1080/13696998.2023.2287935] [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: 07/28/2023] [Accepted: 11/22/2023] [Indexed: 11/29/2023]
Abstract
The COVID-19 pandemic demonstrates the importance of valuing vaccines from a broad societal perspective (SP), as opposed to a narrower health-payer perspective (HPP). COVID-19's catastrophic global impacts extend not only to its health-related effects, but also to the profound macroeconomic losses caused by lockdowns required for disease control, leading to the worst global economic crisis in a century. COVID-19 vaccination (CV) has been the central policy tool for resolving this economic crisis, and it has been hypothesized that this macroeconomic benefit alone justifies the cost of CV many times over. Yet HPP-based vaccine valuations are wholly insensitive to this enormous benefit, not allowing it to influence the allocation of given health budgets nor the determination of the magnitudes of such budgets, thereby risking inadequate societal spending on CV. HPP allocates given health budgets to maximize only health, giving no weight to macroeconomic outcomes, causing allocative inefficiency by not allowing welfare-improving trade-offs of health for wealth. HPP assumes health budgets are optimal, not scrutinizing whether their scale adequately reflects the macroeconomic benefits of health spending, thereby risking productive inefficiency by foregoing health spending increases such as on CV that could raise both population-level health and wealth. These allocative and productive inefficiencies in turn distort for-profit R&D incentives, risking dynamic inefficiency. And since the socio-economic and health burdens of COVID-19 are disproportionately borne by the worse off, HPP's failure to promote optimal levels of societal investment in CV may disproportionately burden the worse off as well, exacerbating inequality. Vaccine valuations from the societal perspective allow the allocation and determination of health budgets to reflect macroeconomic and distributional values, thereby promoting allocative, productive, and dynamic efficiency, as well as equity. These considerations of efficiency and equity support evaluating CV, and to ensure a level playing field, all vaccines, from a societal perspective.
Collapse
|
4
|
Kotronia E, Rosinska M, Stepien M, Czerwinski M, Sadkowska-Todys M. Willingness to vaccinate among adults, and factors associated with vaccine acceptance of COVID-19 vaccines in a nationwide study in Poland between March 2021 and April 2022. Front Public Health 2023; 11:1235585. [PMID: 38111477 PMCID: PMC10726053 DOI: 10.3389/fpubh.2023.1235585] [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: 06/06/2023] [Accepted: 11/07/2023] [Indexed: 12/20/2023] Open
Abstract
Introduction Despite the availability, safety and effectiveness of COVID-19 vaccines, Poland remains one of the six countries of the European Union with the lowest cumulative uptake of the vaccine's primary course in the general population. This study examined willingness to vaccinate and the associated factors in samples of unvaccinated and vaccinated adults between March 2021 and April 2022. Methods Data were collected using OBSER-CO, a nationwide, repeated cross-sectional study, conducted at four different time points (rounds). Data on willingness to vaccinate among the unvaccinated (at all rounds) and willingness to receive another dose in the vaccinated (at 2 rounds-after booster introduction), reasons for reluctance, sociodemographic, health, and behavioral factors were collected using a uniform questionnaire via computer-assisted telephone interviewing. In each round, more than 20,000 respondents were interviewed. To assess associations between factors and willingness to vaccinate, separate multivariable logistic regression models were fitted for each factor at each round and adjusted for confounders. Results Between rounds 1 and 4 (March 2021-April 2022), in the unvaccinated, willingness to vaccinate declined from 73 to 12%, whereas in the vaccinated, willingness to receive another dose declined from 90 to 53%. The highest magnitude of decline between subsequent rounds occurred during the Omicron wave. Overall, concerns about side effects, effectiveness, and vaccine adverse effects were common but decreased over time. Age, gender, employment, place of residence, COVID-19 diagnosis or exposure, hospitalization, and participation in social activities were among the factors associated with willingness. However, associations changed over rounds highlighting the influence of different pandemic waves and variants. Conclusion We observed a declining and multifactorial willingness to vaccinate in Poland, with vaccine attitudes dynamically changing across subsequent rounds. To address vaccine concerns, sustained health communication about COVID-19 vaccines is essential, especially after the emergence of new variants.
Collapse
Affiliation(s)
- Eftychia Kotronia
- Department of Epidemiology of Infectious Diseases and Surveillance, National Institute of Public Health - National Institute of Hygiene - National Research Institute, Warsaw, Poland
- ECDC Fellowship Programme, Field Epidemiology Path (EPIET), European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
| | - Magdalena Rosinska
- Department of Epidemiology of Infectious Diseases and Surveillance, National Institute of Public Health - National Institute of Hygiene - National Research Institute, Warsaw, Poland
- Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw, Poland
| | - Malgorzata Stepien
- Department of Epidemiology of Infectious Diseases and Surveillance, National Institute of Public Health - National Institute of Hygiene - National Research Institute, Warsaw, Poland
| | - Michal Czerwinski
- Department of Epidemiology of Infectious Diseases and Surveillance, National Institute of Public Health - National Institute of Hygiene - National Research Institute, Warsaw, Poland
| | - Malgorzata Sadkowska-Todys
- Department of Epidemiology of Infectious Diseases and Surveillance, National Institute of Public Health - National Institute of Hygiene - National Research Institute, Warsaw, Poland
| |
Collapse
|
5
|
Intawong K, Chariyalertsak S, Chalom K, Wonghirundecha T, Kowatcharakul W, Thongprachum A, Chotirosniramit N, Noppakun K, Khwanngern K, Teacharak W, Piamanant P, Khammawan P, Iamsirithaworng S. Heterologous booster vaccines reduce severity and mortality in COVID-19 during BA.2 and BA.4/BA.5 omicron predominance in Thailand. J Microbiol Immunol Infect 2023; 56:1178-1186. [PMID: 37880062 DOI: 10.1016/j.jmii.2023.10.001] [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] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Revised: 09/18/2023] [Accepted: 10/06/2023] [Indexed: 10/27/2023]
Abstract
BACKGROUND The COVID-19 pandemic has evolved quickly, with variants of concern resulting in the need to offer booster vaccinations. Unfortunately, the booster uptake has been slow and vaccine response has shown to wane over time. Therefore, it's critical to evaluate the role of vaccinations on outcomes with newer sub-lineages of omicron. METHODS Utilising a Hospital Information System established in Chiang Mai, Thailand, we conducted a cohort study by linking patient-level data of laboratory-confirmed COVID-19 cases to the national immunization records, during BA.2 and BA.4/BA.5 predominance. RESULTS In adjusted cox-proportional hazard models, BA.4/BA.5 was not associated with more severe COVID-19 outcomes or deaths as compared to BA.2. Risk of severe outcomes and deaths were significantly reduced with third (87% and 95%) and fourth (88% and 95%) dose vaccination, while events were not observed with a fifth dose. Across the regimens, vaccination within 14-90 days prior showed the highest level of protection. All the vaccine types used for boosting in Thailand offered similar protection against severe COVID-19. CONCLUSIONS Boosters provide high level of protection against severe COVID-19 outcomes and deaths with newer omicron sub-lineages. Booster campaigns should focus on improving coverage utilising all available vaccines to ensure optimal protection.
Collapse
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
| | | | | |
Collapse
|
6
|
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.
Collapse
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
| |
Collapse
|
7
|
Riefolo F, Castillo-Cano B, Martín-Pérez M, Messina D, Elbers R, Brink-Kwakkel D, Villalobos F, Ingrasciotta Y, Garcia-Poza P, Swart-Polinder K, Souverein P, Saiz LC, Bissacco CA, Leache L, Tari M, Crisafulli S, Grimaldi L, Vaz T, Gini R, Klungel O, Martín-Merino E. Effectiveness of homologous/heterologous booster COVID-19 vaccination schedules against severe illness in general population and clinical subgroups in three European countries. Vaccine 2023; 41:7007-7018. [PMID: 37858451 DOI: 10.1016/j.vaccine.2023.10.011] [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: 07/24/2023] [Revised: 09/22/2023] [Accepted: 10/04/2023] [Indexed: 10/21/2023]
Abstract
Using 4 data-sources (Spain, Italy, United Kingdom) data and a 1:1 matched cohort study, we aimed to estimate vaccine effectiveness (VE) in preventing SARS-CoV-2 infections with hospitalisations (±30 days) and death (±56 days) in general population and clinical subgroups with homologous/heterologous booster schedules (Comirnaty-BNT and Spikevax-MOD original COVID-19 vaccines) by comparison with unboosted individuals, during Delta and beginning of Omicron variants. Hazard Ratio (HR, by Cox models) and VE ([1-HR]*100) were calculated by inverse probability weights. Between December 2020-February 2022, in adults without prior SARS-CoV-2 infection, we matched 5.5 million people (>1 million with immunodeficiency, 343,727 with cancer) with a booster (3rd) dose by considering doses 1 and 2 vaccine brands and calendar time, age, sex, region, and comorbidities (immunodeficiency, cancer, severe renal disease, transplant recipient, Down Syndrome). We studied booster doses of BNT and MOD administered after doses 1 and 2 with BNT, MOD, or Oxford-AstraZeneca during a median follow-up between 9 and 16 weeks. BNT or MOD showed VE ranging from 70 to 86% across data sources as heterologous 3rd doses, whereas it was 42-88% as homologous 3rd doses. Depending on the severity and available follow-up, 3rd-dose effectiveness lasted between 1 and 5 months. In people with immunodeficiency and cancer, protection across data sources was detected with both heterologous (VE = 54-83%) and homologous (VE = 49-80%) 3rd doses. Overall, both heterologous and homologous 3rd doses with BTN or MOD showed additional protection against the severe effects of SARS-CoV-2 infections for the general population and for patients at potentially high risk of severe COVID-19 (elderly, people with immunodeficiency and cancer) in comparison with two doses schemes during Delta or early Omicron periods. The early VE after vaccination may be due to less testing among vaccinated pairs and unknown confounders, deserving cautious interpretation. The VE wane over time needs further in-depth research to properly envisage when or whether a booster of those vaccines should be administered.
Collapse
Affiliation(s)
- Fabio Riefolo
- Teamit Institute, Partnerships, Barcelona Health Hub, Barcelona, Spain; VAccine Monitoring Collaboration for Europe, Brussels, Belgium
| | | | - Mar Martín-Pérez
- Spanish Agency of Medicines and Medical Devices-AEMPS, Madrid, Spain
| | | | - Roel Elbers
- Department of Data Science and Biostatistics, University Medical Center Utrecht, the Netherlands
| | - Dorieke Brink-Kwakkel
- Department of Data Science and Biostatistics, University Medical Center Utrecht, the Netherlands
| | - Felipe Villalobos
- Fundació Institut Universitari per a la recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, Spain
| | - Ylenia Ingrasciotta
- Department of Diagnostics and Public Health, University of Verona, Verona, Italy
| | | | | | - Patrick Souverein
- Division of Pharmacoepidemiology & Clinical Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Utrecht University, the Netherlands
| | - Luis Carlos Saiz
- Unit of Innovation and Organization, Navarre Health Service, Pamplona, Spain
| | - Carlo Alberto Bissacco
- Fundació Institut Universitari per a la recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, Spain
| | - Leire Leache
- Unit of Innovation and Organization, Navarre Health Service, Pamplona, Spain
| | | | | | - Lamiae Grimaldi
- l'Assistance Publique-Hôpitaux de Paris (APHP), University Paris-Saclay, Paris, France
| | - Tiago Vaz
- Department of Data Science and Biostatistics, University Medical Center Utrecht, the Netherlands
| | - Rosa Gini
- VAccine Monitoring Collaboration for Europe, Brussels, Belgium; Agenzia Regionale di Sanita' Toscana, Florence, Italy
| | - Olaf Klungel
- Division of Pharmacoepidemiology & Clinical Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Utrecht University, the Netherlands
| | - Elisa Martín-Merino
- VAccine Monitoring Collaboration for Europe, Brussels, Belgium; Spanish Agency of Medicines and Medical Devices-AEMPS, Madrid, Spain.
| |
Collapse
|
8
|
Moradpour J, Shajarizadeh A, Carter J, Chit A, Grootendorst P. The impact of national income and vaccine hesitancy on country-level COVID-19 vaccine uptake. PLoS One 2023; 18:e0293184. [PMID: 37917650 PMCID: PMC10621822 DOI: 10.1371/journal.pone.0293184] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2023] [Accepted: 10/08/2023] [Indexed: 11/04/2023] Open
Abstract
BACKGROUND The rapid development and rollout of COVID-19 vaccines helped reduce the pandemic's mortality burden. The vaccine rollout, however, has been uneven; it is well known that vaccination rates tend to be lower in lower income countries. Vaccine uptake, however, ultimately depends on the willingness of individuals to get vaccinated. If vaccine confidence is low, then uptake will be low, regardless of country income level. We investigated the impact on country-level COVID-19 vaccination rates of both national income and vaccine hesitancy. METHODS We estimated a linear regression model of COVID-19 vaccine uptake across 145 countries; this cross-sectional model was estimated at each of four time points: 6, 12, 18, and 24 months after the onset of global vaccine distribution. Vaccine uptake reflects the percentage of the population that had completed their primary vaccination series at the time point. Covariates include per capita GDP, an estimate of the percentage of country residents who strongly disagreed that vaccines are safe, and a variety of control variables. Next, we estimated these models of vaccine uptake by country income (countries below, and above the international median per capita GDP) to examine whether the impact of vaccine hesitancy varies by country income. RESULTS We find that GDP per capita has a pronounced impact on vaccine uptake at 6 months after global rollout. After controlling for other factors, there was a 22 percentage point difference in vaccination rates between the top 20% and the bottom 20% of countries ranked by per capita GDP; this difference grew to 38% by 12 months. The deleterious impact of distrust of vaccine safety on vaccine uptake became apparent by 12 months and then increased over time. At 24 months, there was a 17% difference in vaccination rates between the top 20% and the bottom 20% of countries ranked by distrust. The income stratified models reveal that the deleterious impact of vaccine distrust on vaccine uptake at 12 and 24 months is particularly evident in lower income countries. CONCLUSIONS Our study highlights the important role of both national income and vaccine hesitancy in determining COVID-19 vaccine uptake globally. There is a need to increase the supply and distribution of pandemic vaccines to lower-income countries, and to take measures to improve vaccine confidence in these countries.
Collapse
Affiliation(s)
- Javad Moradpour
- Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Ontario, Canada
| | | | | | - Ayman Chit
- Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Ontario, Canada
- Sanofi Ltd, Lyon, France
| | - Paul Grootendorst
- Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Ontario, Canada
- Department of Economics, McMaster University, Hamilton, Ontario, Canada
| |
Collapse
|
9
|
Hernandez-Avila M, Ortiz-Brizuela E, Tamayo-Ortiz M, Zepeda-Tello R, Gutierrez-Diaz H, Barros-Sierra Cordera D, Vieyra-Romero W, Real-Ornelas GA, Méndez Aranda M, Heras Gómez A. Assessing the real-world effectiveness of five SARS-CoV-2 vaccines in a cohort of Mexican pensioners: a nationwide nested test-negative design study. Lancet Reg Health Am 2023; 27:100612. [PMID: 37886231 PMCID: PMC10597758 DOI: 10.1016/j.lana.2023.100612] [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] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Revised: 09/12/2023] [Accepted: 09/25/2023] [Indexed: 10/28/2023]
Abstract
Background Despite the extensive distribution of COVID-19 vaccines across Latin America, research on their real-world performance remains limited. We aimed to evaluate the effectiveness of five vaccines (BNT162b2, AZD1222, CoronaVac, Gam-COVID-Vac, and Ad5-nCoV) in a cohort of 2,559,792 pensioners covered by the Mexican Institute of Social Security. Methods We conducted a nested test-negative design study on 28,271 individuals tested for SARS-CoV-2 infection between April and November 2021, accounting for 29,226 separate episodes. We used mixed-effects logistic regression models to estimate the vaccine effectiveness (VE) in fully vaccinated individuals for symptomatic infection, hospitalization, severe disease, and death. Findings The median age of the study population was 70 years (interquartile range 65-76) and 76.4% (21,598/28,271) were male. VE rates were 56.3%, 75.3%, 79.7%, and 79.8% against symptomatic infection (95% confidence interval [CI]: 53.5-59.0), hospitalization (95% CI: 73.4-77.0), severe disease (95% CI: 78.0-81.3), and death (95% CI: 78.1-81.4), respectively. When evaluating vaccines individually, all showed moderate to high VE, with the best being BNT162b2 (symptomatic infection, 69.8%, 95% CI: 67.3-72.0; hospitalization, 84.1%, 95% CI: 82.5-85.6; severe disease, 88.2%, 95% CI: 86.7-89.5; and death, 88.3%, 95% CI: 86.9-89.6) and Gam-COVID-Vac (symptomatic infection, 70.0%, 95% CI: 64.8-74.4; hospitalization, 86.8%, 95% CI: 83.7-89.3; severe disease, 91.9%, 95% CI: 89.4-93.9; and death, 92.0%, 95% CI: 89.5-93.9). Interpretation All five SARS-CoV-2 vaccines available for this population showed moderate to high levels of protection against COVID-19 and its progression to severe outcomes. Funding Fundación IMSS, México.
Collapse
Affiliation(s)
- Mauricio Hernandez-Avila
- Directorate of Social and Economic Benefits, Instituto Mexicano del Seguro Social, Mexico City, Mexico
| | - Edgar Ortiz-Brizuela
- Directorate of Social and Economic Benefits, Instituto Mexicano del Seguro Social, Mexico City, Mexico
- Department of Infectious Diseases, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | - Marcela Tamayo-Ortiz
- Occupational Health Research Unit, Instituto Mexicano del Seguro Social, Mexico City, Mexico
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York City, USA
| | - Rodrigo Zepeda-Tello
- Directorate of Social and Economic Benefits, Instituto Mexicano del Seguro Social, Mexico City, Mexico
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York City, USA
| | - Héctor Gutierrez-Diaz
- Directorate of Social and Economic Benefits, Instituto Mexicano del Seguro Social, Mexico City, Mexico
| | | | - Waldo Vieyra-Romero
- Directorate of Social and Economic Benefits, Instituto Mexicano del Seguro Social, Mexico City, Mexico
| | | | - Mauricio Méndez Aranda
- Directorate of Social and Economic Benefits, Instituto Mexicano del Seguro Social, Mexico City, Mexico
| | - Antonio Heras Gómez
- Directorate of Social and Economic Benefits, Instituto Mexicano del Seguro Social, Mexico City, Mexico
| |
Collapse
|
10
|
Seccia TM, Shagjaa T, Morpurgo M, Caroccia B, Sanga V, Faoro S, Venturini F, Iadicicco G, Lococo S, Mazzitelli M, Farnia F, Fioretto P, Kobayashi Y, Gregori D, Rossi GP. RAndomized Clinical Trial Of NAfamostat Mesylate, A Potent Transmembrane Protease Serine 2 (TMPRSS2) Inhibitor, in Patients with COVID-19 Pneumonia. J Clin Med 2023; 12:6618. [PMID: 37892756 PMCID: PMC10607860 DOI: 10.3390/jcm12206618] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Revised: 10/02/2023] [Accepted: 10/10/2023] [Indexed: 10/29/2023] Open
Abstract
Even though SARS-CoV-2 was declared by WHO as constituting no longer a public health emergency, the development of effective treatments against SARS-CoV-2 infection remains a critical issue to prevent complications, particularly in fragile patients. The protease inhibitor nafamostat, currently used in Japan and Korea for pancreatitis, owing to its anticoagulant properties for disseminated intravascular coagulation (DIC), is appealing for the treatment of COVID-19 infection, because it potently inhibits the transmembrane protease serine 2 (TMPRSS2) that, after virus binding to ACE-2, allows virus entry into the cells and replication. Moreover, it could prevent the DIC and pulmonary embolism frequently associated with COVID-19 infection. The goal of the RAndomized Clinical Trial Of NAfamostat (RACONA) study, designed as a prospective randomized, double-blind placebo-controlled clinical trial, was to investigate the efficacy and safety of nafamostat mesylate (0.10 mg/kg/h iv for 7 days), on top of the optimal treatment, in COVID-19 hospitalized patients. We could screen 131 patients, but due to the predefined strict inclusion and exclusion criteria, only 15 could be randomized to group 1 (n = 7) or group 2 (n = 8). The results of an ad interim safety analysis showed similar overall trends for variables evaluating renal function, coagulation, and inflammation. No adverse events, including hyperkalemia, were found to be associated with nafamostat. Thus, the RACONA study showed a good safety profile of nafamostat, suggesting that it could be usefully used in COVID-19 hospitalized patients.
Collapse
Affiliation(s)
- Teresa Maria Seccia
- Internal Emergency Medicine Unit, Specialized Center for Blood Pressure Disorders-Regione Veneto, Department of Medicine—DIMED, University of Padua, 35128 Padua, Italy; (T.M.S.); (T.S.); (V.S.)
| | - Tungalagtamir Shagjaa
- Internal Emergency Medicine Unit, Specialized Center for Blood Pressure Disorders-Regione Veneto, Department of Medicine—DIMED, University of Padua, 35128 Padua, Italy; (T.M.S.); (T.S.); (V.S.)
| | - Margherita Morpurgo
- Department of Pharmaceutical & Pharmacological Sciences, University of Padua, 35131 Padua, Italy;
| | - Brasilina Caroccia
- Internal Emergency Medicine Unit, Specialized Center for Blood Pressure Disorders-Regione Veneto, Department of Medicine—DIMED, University of Padua, 35128 Padua, Italy; (T.M.S.); (T.S.); (V.S.)
| | - Viola Sanga
- Internal Emergency Medicine Unit, Specialized Center for Blood Pressure Disorders-Regione Veneto, Department of Medicine—DIMED, University of Padua, 35128 Padua, Italy; (T.M.S.); (T.S.); (V.S.)
| | - Sonia Faoro
- Pharmacy, University Hospital of Padua, 35126 Padua, Italy; (S.F.); (F.V.); (G.I.)
| | - Francesca Venturini
- Pharmacy, University Hospital of Padua, 35126 Padua, Italy; (S.F.); (F.V.); (G.I.)
| | - Girolama Iadicicco
- Pharmacy, University Hospital of Padua, 35126 Padua, Italy; (S.F.); (F.V.); (G.I.)
| | - Sara Lococo
- Pneumology, University Hospital of Padua, 35126 Padua, Italy;
| | - Maria Mazzitelli
- Infectious Diseases, University Hospital of Padua, 35126 Padua, Italy;
| | - Filippo Farnia
- Internal Medicine 3, University Hospital of Padua, 35128 Padua, Italy; (F.F.); (P.F.)
| | - Paola Fioretto
- Internal Medicine 3, University Hospital of Padua, 35128 Padua, Italy; (F.F.); (P.F.)
| | | | - Dario Gregori
- Biostatistics, Epidemiology and Public Health Unit, University of Padua, 35131 Padua, Italy;
| | - Gian Paolo Rossi
- Internal Emergency Medicine Unit, Specialized Center for Blood Pressure Disorders-Regione Veneto, Department of Medicine—DIMED, University of Padua, 35128 Padua, Italy; (T.M.S.); (T.S.); (V.S.)
| |
Collapse
|
11
|
Alzamil Y, Almeshari M, Alyahyawi A, Abanomy A, Al-Thomali AW, Alshomar B, Althomali OW, Barnawi H, Bazaid AS, Bin Sheeha B. Knowledge, attitude, and practice of the Saudi population toward COVID-19 vaccination: A cross-sectional study. Medicine (Baltimore) 2023; 102:e35360. [PMID: 37832045 PMCID: PMC10578756 DOI: 10.1097/md.0000000000035360] [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: 07/03/2023] [Accepted: 09/01/2023] [Indexed: 10/15/2023] Open
Abstract
Coronavirus Disease 2019 (COVID-19) vaccination is the most effective protective measure to control the spread of infections and provide protection against hospitalization and mortality during the pandemic. There was a necessity to measure public knowledge and acceptance for COVID-19 vaccines in different countries. Thus, the current study is aimed at evaluating the knowledge, attitude, and practice of the population in all regions of Saudi towards COVID-19 vaccination. This was a cross-sectional, online self-reported survey of Saudi residents that was conducted between March 2021 and April 2021. To be eligible for the study, participants had to be above 18 years old. All participants were adult, Arabic speakers and residents of Saudi Arabia. In total, 1658 adults participated in this study and showed high knowledge (81.8%), attitude (71.2%), and practice (59.3%). The level of knowledge, attitude, and practice differed based on different demographic characteristics. Regression analysis showed that having a low income, low education level, and middle-aged status, living in a village, and being married were associated with lower scores in knowledge, attitude, or practice. Targeted education and campaigns should be provided for these populations to increase their knowledge, attitude, and practice towards COVID-19 vaccination.
Collapse
Affiliation(s)
- Yasser Alzamil
- Department of Diagnostic Radiology, College of Applied Medical Sciences, University of Ha’il, Ha’IL, Saudi Arabia
| | - Meshari Almeshari
- Department of Diagnostic Radiology, College of Applied Medical Sciences, University of Ha’il, Ha’IL, Saudi Arabia
| | - Amjad Alyahyawi
- Department of Diagnostic Radiology, College of Applied Medical Sciences, University of Ha’il, Ha’IL, Saudi Arabia
- Centre for Nuclear and Radiation Physics, Department of Physics, University of Surrey, Guildford, UK
| | - Ahmad Abanomy
- Department of Radiological Sciences, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
| | - Asma W. Al-Thomali
- Department of Biology, College of Sciences, Taif University, Taif, Saudi Arabia
| | - Bader Alshomar
- Department of Health Informatics, College Public Health and Health Informatics, University of Ha’il, Ha’IL, Saudi Arabia
| | - Omar W. Althomali
- Department of Physiotherapy, College of Applied Medical Sciences, University of Ha’il, Ha’IL, Saudi Arabia
| | - Heba Barnawi
- Department of Medical Laboratory science, College of Applied Medical Sciences, University of Ha’il, Ha’IL, Saudi Arabia
| | - Abdulrahman S. Bazaid
- Department of Medical Laboratory science, College of Applied Medical Sciences, University of Ha’il, Ha’IL, Saudi Arabia
| | - Bodor Bin Sheeha
- Department of Rehabilitation Sciences, College of Health and Rehabilitation Sciences, Princess Nourah bint Abdulrahman University, Riyadh, Saudi Arabia
| |
Collapse
|
12
|
Tokunoh N, Tamiya S, Watanabe M, Okamoto T, Anindita J, Tanaka H, Ono C, Hirai T, Akita H, Matsuura Y, Yoshioka Y. A nasal vaccine with inactivated whole-virion elicits protective mucosal immunity against SARS-CoV-2 in mice. Front Immunol 2023; 14:1224634. [PMID: 37720231 PMCID: PMC10500122 DOI: 10.3389/fimmu.2023.1224634] [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: 05/18/2023] [Accepted: 08/14/2023] [Indexed: 09/19/2023] Open
Abstract
Introduction Vaccinations are ideal for reducing the severity of clinical manifestations and secondary complications of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2); however, SARS-CoV-2 continues to cause morbidity and mortality worldwide. In contrast to parenteral vaccines such as messenger RNA vaccines, nasal vaccines are expected to be more effective in preventing viral infections in the upper respiratory tract, the primary locus for viral infection and transmission. In this study, we examined the prospects of an inactivated whole-virion (WV) vaccine administered intranasally against SARS-CoV-2. Methods Mice were immunized subcutaneously (subcutaneous vaccine) or intranasally (nasal vaccine) with the inactivated WV of SARS-CoV-2 as the antigen. Results The spike protein (S)-specific IgA level was found to be higher upon nasal vaccination than after subcutaneous vaccination. The level of S-specific IgG in the serum was also increased by the nasal vaccine, although it was lower than that induced by the subcutaneous vaccine. The nasal vaccine exhibited a stronger defense against viral invasion in the upper respiratory tract than the subcutaneous vaccine and unimmunized control; however, both subcutaneous and nasal vaccines provided protection in the lower respiratory tract. Furthermore, we found that intranasally administered inactivated WV elicited robust production of S-specific IgA in the nasal mucosa and IgG in the blood of mice previously vaccinated with messenger RNA encoding the S protein. Discussion Overall, these results suggest that a nasal vaccine containing inactivated WV can be a highly effective means of protection against SARS-CoV-2 infection.
Collapse
Affiliation(s)
- Nagisa Tokunoh
- Innovative Vaccine Research and Development Center, The Research Foundation for Microbial Diseases of Osaka University, Osaka, Japan
- Vaccine Creation Group, BIKEN Innovative Vaccine Research Alliance Laboratories, Research Institute for Microbial Diseases, Osaka University, Suita, Osaka, Japan
| | - Shigeyuki Tamiya
- Vaccine Creation Group, BIKEN Innovative Vaccine Research Alliance Laboratories, Research Institute for Microbial Diseases, Osaka University, Suita, Osaka, Japan
- Department of Microbiology and Immunology, School of Pharmaceutical Sciences, Wakayama Medical University, Wakayama, Wakayama, Japan
| | - Masato Watanabe
- Innovative Vaccine Research and Development Center, The Research Foundation for Microbial Diseases of Osaka University, Osaka, Japan
| | - Toru Okamoto
- Institute for Advanced Co-Creation Studies, Research Institute for Microbial Diseases, Osaka University, Osaka, Japan
- Center for Infectious Disease Education and Research, Osaka University, Suita, Osaka, Japan
| | - Jessica Anindita
- Laboratory of DDS Design and Drug Disposition, Graduate School of Pharmaceutical Sciences, Tohoku University, Sendai, Miyagi, Japan
- Laboratory of DDS Design and Drug Disposition, Graduate School of Pharmaceutical Science, Chiba University, Chiba-shi, Chiba, Japan
| | - Hiroki Tanaka
- Laboratory of DDS Design and Drug Disposition, Graduate School of Pharmaceutical Sciences, Tohoku University, Sendai, Miyagi, Japan
| | - Chikako Ono
- Center for Infectious Disease Education and Research, Osaka University, Suita, Osaka, Japan
- Laboratory of Virus Control, Research Institute for Microbial Diseases, Osaka University, Suita, Osaka, Japan
| | - Toshiro Hirai
- Vaccine Creation Group, BIKEN Innovative Vaccine Research Alliance Laboratories, Research Institute for Microbial Diseases, Osaka University, Suita, Osaka, Japan
- BIKEN Innovative Vaccine Research Alliance Laboratories, Institute for Open and Transdisciplinary Research Initiatives, Osaka University, Suita, Osaka, Japan
- Laboratory of Nano-design for Innovative Drug Development, Graduate School of Pharmaceutical Sciences, Osaka University, Suita, Osaka, Japan
- Center for Advanced Modalities and DDS, Osaka University, Suita, Osaka, Japan
| | - Hidetaka Akita
- Laboratory of DDS Design and Drug Disposition, Graduate School of Pharmaceutical Sciences, Tohoku University, Sendai, Miyagi, Japan
| | - Yoshiharu Matsuura
- Center for Infectious Disease Education and Research, Osaka University, Suita, Osaka, Japan
- Laboratory of Virus Control, Research Institute for Microbial Diseases, Osaka University, Suita, Osaka, Japan
- Center for Advanced Modalities and DDS, Osaka University, Suita, Osaka, Japan
| | - Yasuo Yoshioka
- Innovative Vaccine Research and Development Center, The Research Foundation for Microbial Diseases of Osaka University, Osaka, Japan
- Vaccine Creation Group, BIKEN Innovative Vaccine Research Alliance Laboratories, Research Institute for Microbial Diseases, Osaka University, Suita, Osaka, Japan
- Center for Infectious Disease Education and Research, Osaka University, Suita, Osaka, Japan
- BIKEN Innovative Vaccine Research Alliance Laboratories, Institute for Open and Transdisciplinary Research Initiatives, Osaka University, Suita, Osaka, Japan
- Laboratory of Nano-design for Innovative Drug Development, Graduate School of Pharmaceutical Sciences, Osaka University, Suita, Osaka, Japan
- Center for Advanced Modalities and DDS, Osaka University, Suita, Osaka, Japan
- Global Center for Medical Engineering and Informatics, Osaka University, Suita, Osaka, Japan
| |
Collapse
|
13
|
Moser MJ, Hill-Batorski L, Bowen RA, Matejka SM, Marshall D, Kawaoka Y, Neumann G, Bilsel P. Intranasal Single-Replication Influenza Vector Induces Cross-Reactive Serum and Mucosal Antibodies against SARS-CoV-2 Variants. Vaccines (Basel) 2023; 11:1063. [PMID: 37376452 DOI: 10.3390/vaccines11061063] [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: 05/04/2023] [Revised: 05/27/2023] [Accepted: 05/31/2023] [Indexed: 06/29/2023] Open
Abstract
Current SARS-CoV-2 vaccines provide protection for COVID-19-associated hospitalization and death, but remain inefficient at inhibiting initial infection and transmission. Despite updated booster formulations, breakthrough infections and reinfections from emerging SARS-CoV-2 variants are common. Intranasal vaccination to elicit mucosal immunity at the site of infection can improve the performance of respiratory virus vaccines. We developed SARS-CoV-2 M2SR, a dual SARS-CoV-2 and influenza vaccine candidate, employing our live intranasal M2-deficient single replication (M2SR) influenza vector expressing the receptor binding domain (RBD) of the SARS-CoV-2 Spike protein of the prototype strain, first reported in January 2020. The intranasal vaccination of mice with this dual vaccine elicits both high serum IgG and mucosal IgA titers to RBD. Sera from inoculated mice show that vaccinated mice develop neutralizing SARS-CoV-2 antibody titers against the prototype and Delta virus strains, which are considered to be sufficient to protect against viral infection. Moreover, SARS-CoV-2 M2SR elicited cross-reactive serum and mucosal antibodies to the Omicron BA.4/BA.5 variant. The SARS-CoV-2 M2SR vaccine also maintained strong immune responses to influenza A with high titers of anti H3 serum IgG and hemagglutination inhibition (HAI) antibody titers corresponding to those seen from the control M2SR vector alone. With a proven safety record and robust immunological profile in humans that includes mucosal immunity, the M2SR influenza viral vector expressing key SARS-CoV-2 antigens could provide more efficient protection against influenza and SARS-CoV-2 variants.
Collapse
Affiliation(s)
| | | | - Richard A Bowen
- Department of Biomedical Sciences, Colorado State University, 1601 Campus Delivery, Fort Collins, CO 80523, USA
| | | | | | - Yoshihiro Kawaoka
- Department of Pathobiological Sciences, University of Wisconsin, 2015 Linden Dr., Madison, WI 53706, USA
| | - Gabriele Neumann
- Department of Pathobiological Sciences, University of Wisconsin, 2015 Linden Dr., Madison, WI 53706, USA
| | - Pamuk Bilsel
- FluGen, Inc., 597 Science Drive, Madison, WI 53711, USA
| |
Collapse
|
14
|
Intawong K, Chariyalertsak S, Chalom K, Wonghirundecha T, Kowatcharakul W, Thongprachum A, Chotirosniramit N, Teacharak W, Pimpinan Khammawan, Waneesorn J, Iamsirithaworn S. Effectiveness of heterologous third and fourth dose COVID-19 vaccine schedules for SARS-CoV-2 infection during delta and omicron predominance in Thailand: a test-negative, case-control study. Lancet Reg Health Southeast Asia 2023; 10:100121. [PMID: 36465090 PMCID: PMC9705195 DOI: 10.1016/j.lansea.2022.100121] [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] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Revised: 10/04/2022] [Accepted: 11/15/2022] [Indexed: 12/03/2022]
Abstract
Background The Coronavirus disease 2019 (COVID-19) pandemic has evolved quickly, with numerous waves of different variants of concern resulting in the need for countries to offer continued protection through booster vaccination. To ensure adequate vaccination coverage, Thailand has proactively adopted heterologous vaccination schedules. While randomised controlled trials have assessed homologous schedules in detail, limited data has been reported for heterologous vaccine effectiveness (VE). Methods Utilising a unique active surveillance network established in Chiang Mai, Northern Thailand, we conducted a test-negative case control study to assess the VE of heterologous third and fourth dose schedules against SARS-CoV-2 infection among suspect-cases during Oct 1-Dec 31, 2021 (delta-predominant) and Feb 1-Apr 10, 2022 (omicron-predominant) periods. Findings After a third dose, effectiveness against delta infection was high (adjusted VE 97%, 95% CI 94-99%) in comparison to moderate protection against omicron (adjusted VE 31%, 95% CI 26-36%). Good protection was observed after a fourth dose (adjusted VE 75%, 95% CI 71-80%). VE was consistent across age groups for both delta and omicron infection. The VE of third or fourth doses against omicron infection were equivalent for the three main vaccines used for boosting in Thailand, suggesting coverage, rather than vaccine type is a much stronger predictor of protection. Interpretation Appropriately timed booster doses have a high probability of preventing COVID-19 infection with both delta and omicron variants. Our evidence supports the need for ongoing national efforts to increase population coverage of booster doses. Funding This research was supported by the National Research Council of Thailand (NRCT) under The Smart Emergency Care Services Integration (SECSI) project to Faculty of Public Health Chiang Mai University.
Collapse
Affiliation(s)
- Kannikar Intawong
- Faculty of Public Health, Chiang Mai University, Chiang Mai, Thailand
| | | | - Kittipan Chalom
- Chiang Mai Provincial Health Office, Ministry of Public Health, Chiang Mai, Thailand
| | | | | | | | | | | | | | | | | |
Collapse
|
15
|
Joe CCD, Chopra N, Nestola P, Niemann J, Douglas AD. Rapid-response manufacturing of adenovirus-vectored vaccines. Nat Biotechnol 2023; 41:314-6. [PMID: 36890199 DOI: 10.1038/s41587-023-01682-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/10/2023]
|
16
|
Villar J, Soto Conti CP, Gunier RB, Ariff S, Craik R, Cavoretto PI, Rauch S, Gandino S, Nieto R, Winsey A, Menis C, Rodriguez GB, Savasi V, Tug N, Deantoni S, Fabre M, Martinez de Tejada B, Rodriguez-Sibaja MJ, Livio S, Napolitano R, Maiz N, Sobrero H, Peterson A, Deruelle P, Giudice C, Teji JS, Casale RA, Salomon LJ, Prefumo F, Cheikh Ismail L, Gravett MG, Vale M, Hernández V, Sentilhes L, Easter SR, Capelli C, Marler E, Cáceres DM, Albornoz Crespo G, Ernawati E, Lipschuetz M, Takahashi K, Vecchiarelli C, Hubka T, Ikenoue S, Tavchioska G, Bako B, Ayede AI, Eskenazi B, Thornton JG, Bhutta ZA, Kennedy SH, Papageorghiou AT. Pregnancy outcomes and vaccine effectiveness during the period of omicron as the variant of concern, INTERCOVID-2022: a multinational, observational study. Lancet 2023; 401:447-457. [PMID: 36669520 PMCID: PMC9910845 DOI: 10.1016/s0140-6736(22)02467-9] [Citation(s) in RCA: 54] [Impact Index Per Article: 54.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Revised: 11/22/2022] [Accepted: 11/24/2022] [Indexed: 01/19/2023]
Abstract
BACKGROUND In 2021, we showed an increased risk associated with COVID-19 in pregnancy. Since then, the SARS-CoV-2 virus has undergone genetic mutations. We aimed to examine the effects on maternal and perinatal outcomes of COVID-19 during pregnancy, and evaluate vaccine effectiveness, when omicron (B.1.1.529) was the variant of concern. METHODS INTERCOVID-2022 is a large, prospective, observational study, involving 41 hospitals across 18 countries. Each woman with real-time PCR or rapid test, laboratory-confirmed COVID-19 in pregnancy was compared with two unmatched women without a COVID-19 diagnosis who were recruited concomitantly and consecutively in pregnancy or at delivery. Mother and neonate dyads were followed until hospital discharge. Primary outcomes were maternal morbidity and mortality index (MMMI), severe neonatal morbidity index (SNMI), and severe perinatal morbidity and mortality index (SPMMI). Vaccine effectiveness was estimated, adjusted by maternal risk profile. FINDINGS We enrolled 4618 pregnant women from Nov 27, 2021 (the day after WHO declared omicron a variant of concern), to June 30, 2022: 1545 (33%) women had a COVID-19 diagnosis (median gestation 36·7 weeks [IQR 29·0-38·9]) and 3073 (67%) women, with similar demographic characteristics, did not have a COVID-19 diagnosis. Overall, women with a diagnosis had an increased risk for MMMI (relative risk [RR] 1·16 [95% CI 1·03-1·31]) and SPMMI (RR 1·21 [95% CI 1·00-1·46]). Women with a diagnosis, compared with those without a diagnosis, also had increased risks of SNMI (RR 1·23 [95% CI 0·88-1·71]), although the lower bounds of the 95% CI crossed unity. Unvaccinated women with a COVID-19 diagnosis had a greater risk of MMMI (RR 1·36 [95% CI 1·12-1·65]). Severe COVID-19 symptoms in the total sample increased the risk of severe maternal complications (RR 2·51 [95% CI 1·84-3·43]), perinatal complications (RR 1·84 [95% CI 1·02-3·34]), and referral, intensive care unit (ICU) admission, or death (RR 11·83 [95% CI 6·67-20·97]). Severe COVID-19 symptoms in unvaccinated women increased the risk of MMMI (RR 2·88 [95% CI 2·02-4·12]) and referral, ICU admission, or death (RR 20·82 [95% CI 10·44-41·54]). 2886 (63%) of 4618 total participants had at least a single dose of any vaccine, and 2476 (54%) of 4618 had either complete or booster doses. Vaccine effectiveness (all vaccines combined) for severe complications of COVID-19 for all women with a complete regimen was 48% (95% CI 22-65) and 76% (47-89) after a booster dose. For women with a COVID-19 diagnosis, vaccine effectiveness of all vaccines combined for women with a complete regimen was 74% (95% CI 48-87) and 91% (65-98) after a booster dose. INTERPRETATION COVID-19 in pregnancy, during the first 6 months of omicron as the variant of concern, was associated with increased risk of severe maternal morbidity and mortality, especially among symptomatic and unvaccinated women. Women with complete or boosted vaccine doses had reduced risk for severe symptoms, complications, and death. Vaccination coverage among pregnant women remains a priority. FUNDING None.
Collapse
Affiliation(s)
- Jose Villar
- Nuffield Department of Women's & Reproductive Health, University of Oxford, Oxford, UK; Oxford Maternal and Perinatal Health Institute, Green Templeton College, University of Oxford, Oxford, UK
| | | | - Robert B Gunier
- Center for Environmental Research and Community Health (CERCH), School of Public Health, University of California, Berkeley, CA, USA
| | - Shabina Ariff
- Department of Paediatrics and Child Health, The Aga Khan University Hospital, Karachi, Pakistan
| | - Rachel Craik
- Nuffield Department of Women's & Reproductive Health, University of Oxford, Oxford, UK
| | - Paolo I Cavoretto
- Vita-Salute San Raffaele University and IRCCS San Raffaele Scientific Institute, Obstetrics and Gynaecology Department, Milan, Italy
| | - Stephen Rauch
- Center for Environmental Research and Community Health (CERCH), School of Public Health, University of California, Berkeley, CA, USA
| | - Serena Gandino
- Nuffield Department of Women's & Reproductive Health, University of Oxford, Oxford, UK
| | - Ricardo Nieto
- Division Neonatología, Hospital Materno Infantil Ramón Sarda, Buenos Aires, Argentina
| | - Adele Winsey
- Nuffield Department of Women's & Reproductive Health, University of Oxford, Oxford, UK
| | - Camilla Menis
- Department of Clinical Sciences and Community Health, University of Milan, NICU, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Gabriel B Rodriguez
- Oxford Maternal and Perinatal Health Institute, Green Templeton College, University of Oxford, Oxford, UK
| | - Valeria Savasi
- Unit of Obstetrics and Gynecology, L- Sacco Hospital ASST Fatebenefratelli Sacco, Department of Biological and Clinical Sciences, University of Milan, Milan, Italy
| | - Niyazi Tug
- Department of Obstetrics and Gynecology, Sancaktepe Sehit Prof Dr Ilhan Varank Training and Research Hospital, University of Health Sciences, Istanbul, Türkiye
| | - Sonia Deantoni
- Neonatal Care Unit, Department of Public Health and Pediatrics, School of Medicine, University of Turin, Turin, Italy
| | - Marta Fabre
- Instituto de Investigación Sanitario de Aragón (IIS Aragon), Hospital Clínico Universitario Lozano Blesa Zaragoza, Zaragoza, Spain
| | - Begoña Martinez de Tejada
- Department of Pediatrics, Gynecology & Obstetrics, Hôpitaux Universitaires de Genève, Geneva, Switzerland
| | | | - Stefania Livio
- Children's Hospital V Buzzi, ASST Fatebenefratelli Sacco, Milan, Italy
| | - Raffaele Napolitano
- Elizabeth Garrett Anderson Institute for Women's Health, University College London, London, UK; Fetal Medicine Unit, University College London Hospitals NHS Foundation Trust, London, UK
| | - Nerea Maiz
- Maternal-Fetal Medicine Unit, Department of Obstetrics and Gynecology, Hospital Universitari Vall d'Hebron, Vall d'Hebron, Barcelona Hospital Campus, Universitat Autonoma de Barcelona, Barcelona, Spain
| | - Helena Sobrero
- Centro Hospitalario Pereira Rossell, Montevideo, Uruguay
| | | | - Philippe Deruelle
- Department of Obstetrics and Gynecology, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
| | - Carolina Giudice
- Servicio de Neonatologia, Hospital Italiano de Buenos Aires, Instituto Universitario Hospital Italiano, Buenos Aires, Argentina
| | - Jagjit S Teji
- Ann and Robert H Lurie Children's Hospital of Chicago, Chicago, IL, USA
| | - Roberto A Casale
- Maternal and Child Department, Hospital Nacional Profesor Alejandro Posadas, Buenos Aires, Argentina
| | | | - Federico Prefumo
- Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
| | - Leila Cheikh Ismail
- Department of Clinical Nutrition and Dietetics, College of Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
| | - Michael G Gravett
- Department of Obstetrics and Gynecology and Department of Global Health, University of Washington, Seattle, WA, USA
| | - Marynéa Vale
- Hospital Universitário da Universidade Federal do Maranhão, São Luís, Maranhão, Brazil
| | - Valeria Hernández
- Facultad de Ciencias Médicas, Universidad Nacional de Córdoba, Córdoba, Argentina
| | - Loïc Sentilhes
- Department of Obstetrics and Gynecology, Bordeaux University Hospital, Bordeaux, France
| | - Sarah R Easter
- Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Carola Capelli
- Servicio de Neonatología del Departamento Materno Infantil, Hospital Universitario Austral, Buenos Aires, Argentina
| | - Emily Marler
- St George's University Hospitals NHS Foundation Trust, London, UK
| | | | | | - Ernawati Ernawati
- Medical Faculty Universitas Airlangga - Dr Soetomo General Academic Hospital, Surabaya, Indonesia
| | - Michal Lipschuetz
- Obstetrics and Gynecology Division- Hadassah Medical Center Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Ken Takahashi
- Department of Obstetrics and Gynecology, The Jikei University School of Medicine, Tokyo, Japan
| | | | - Teresa Hubka
- Ascension-Resurrection Medical Center, Chicago, Illinois, USA
| | - Satoru Ikenoue
- Department of Obstetrics and Gynecology, Keio University School of Medicine, Tokyo, Japan
| | | | - Babagana Bako
- Department of Obstetrics and Gynaecology, College of Medical Sciences, Gombe State University, Gombe, Nigeria
| | - Adejumoke I Ayede
- College of Medicine, University of Ibadan and University College Hospital, Ibadan, Nigeria
| | - Brenda Eskenazi
- Center for Environmental Research and Community Health (CERCH), School of Public Health, University of California, Berkeley, CA, USA
| | - Jim G Thornton
- University of Nottingham Medical School, University of Nottingham, Nottingham, UK
| | - Zulfiqar A Bhutta
- Department of Paediatrics and Child Health, The Aga Khan University Hospital, Karachi, Pakistan; Center for Global Child Health, Hospital for Sick Children, Toronto, ON, Canada
| | - Stephen H Kennedy
- Nuffield Department of Women's & Reproductive Health, University of Oxford, Oxford, UK; Oxford Maternal and Perinatal Health Institute, Green Templeton College, University of Oxford, Oxford, UK
| | - Aris T Papageorghiou
- Nuffield Department of Women's & Reproductive Health, University of Oxford, Oxford, UK; Oxford Maternal and Perinatal Health Institute, Green Templeton College, University of Oxford, Oxford, UK; St George's University Hospitals NHS Foundation Trust, London, UK.
| |
Collapse
|
17
|
Wong MTJ, Dhaliwal SS, Balakrishnan V, Nordin F, Norazmi MN, Tye GJ. Effectiveness of Booster Vaccinations on the Control of COVID-19 during the Spread of Omicron Variant in Malaysia. Int J Environ Res Public Health 2023; 20:1647. [PMID: 36674401 PMCID: PMC9861773 DOI: 10.3390/ijerph20021647] [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] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Revised: 01/02/2023] [Accepted: 01/13/2023] [Indexed: 05/14/2023]
Abstract
(1) Background: The assessment of vaccine effectiveness against the Omicron variant is vital in the fight against COVID-19, but research on booster vaccine efficacy using nationwide data was lacking at the time of writing. This study investigates the effectiveness of booster doses on the Omicron wave in Malaysia against COVID-19 infections and deaths; (2) Methods: This study uses nationally representative data on COVID-19 from 1 January to 31 March 2022, when the Omicron variant was predominant in Malaysia. Daily new infections, deaths, ICU utilization and Rt values were compared. A screening method was used to predict the vaccine effectiveness against COVID-19 infections, whereas logistic regression was used to estimate vaccine effectiveness against COVID-19-related deaths, with efficacy comparison between AZD1222, BNT162b2 and CoronaVac; (3) Results: Malaysia's Omicron wave started at the end of January 2022, peaking on 5 March 2022. At the time of writing, statistics for daily new deaths, ICU utilization, and effective reproductive values (Rt) were showing a downtrend. Boosted vaccination is 95.4% (95% CI: 95.4, 95.4) effective in curbing COVID-19 infection, compared to non-boosted vaccination, which is 87.2% (95% CI: 87.2, 87.2). For symptomatic infection, boosted vaccination is 97.4% (95% CI: 97.4, 97.4) effective, and a non-boosted vaccination is 90.9% (95% CI: 90.9, 90.9). Against COVID-19-related death, boosted vaccination yields a vaccine effectiveness (VE) of 91.7 (95% CI: 90.6, 92.7) and full vaccination yields a VE of 65.7% (95% CI: 61.9, 69.1). Looking into the different vaccines as boosters, AZD1222 is 95.2% (CI 95%: 92.7, 96.8) effective, BNT162b2 is 91.8% (CI 95%: 90.7, 92.8) effective and CoronaVac is 88.8% (CI 95%: 84.9, 91.7) effective against COVID-19 deaths. (4) Conclusions: Boosters are effective in increasing protection against COVID-19, including the Omicron variant. Given that the VE observed was lower, CoronaVac recipients are encouraged to take boosters due to its lower VE.
Collapse
Affiliation(s)
- Matthew Tze Jian Wong
- Institute for Research in Molecular Medicine (INFORMM), Universiti Sains Malaysia, Minden 11800, Malaysia
| | - Satvinder Singh Dhaliwal
- Institute for Research in Molecular Medicine (INFORMM), Universiti Sains Malaysia, Minden 11800, Malaysia
- Curtin Health Innovation Research Institute, Faculty of Health Sciences, Curtin University, Perth 6102, Australia
- Duke-NUS Medical School, National University of Singapore, Singapore 119077, Singapore
- Office of the Provost, Singapore University of Social Sciences, Singapore 599494, Singapore
| | - Venugopal Balakrishnan
- Institute for Research in Molecular Medicine (INFORMM), Universiti Sains Malaysia, Minden 11800, Malaysia
| | - Fazlina Nordin
- Centre for Tissue Engineering and Regenerative Medicine (CTERM), Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur 56000, Malaysia
| | - Mohd Nor Norazmi
- School of Health Sciences, Universiti Sains Malaysia, Kubang Kerian 16150, Malaysia
- Malaysian Genome and Vaccine Institute, National Institutes of Biotechnology Malaysia, Kajang 43000, Malaysia
| | - Gee Jun Tye
- Institute for Research in Molecular Medicine (INFORMM), Universiti Sains Malaysia, Minden 11800, Malaysia
| |
Collapse
|
18
|
Intawong K, Chariyalertsak S, Chalom K, Wonghirundecha T, Kowatcharakul W, Ayood P, Thongprachum A, Chotirosniramit N, Noppakun K, Khwanngern K, Teacharak W, Piamanant P, Khammawan P. Reduction in severity and mortality in COVID-19 patients owing to heterologous third and fourth-dose vaccines during the periods of delta and omicron predominance in Thailand. Int J Infect Dis 2023; 126:31-38. [PMID: 36372363 PMCID: PMC9650516 DOI: 10.1016/j.ijid.2022.11.006] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Revised: 11/04/2022] [Accepted: 11/06/2022] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVES The COVID-19 pandemic has evolved quickly, with different variants of concern resulting in the need for countries to offer booster vaccinations. Although studies have assessed homologous schedules in detail, the effectiveness of heterologous booster vaccine schedules against severity and mortality with newer variants remains to be explored fully. METHODS Utilizing a Hospital Information System for COVID-19 established in Chiang Mai, Thailand, we conducted a cohort study by linking patient-level data on laboratory-confirmed COVID-19 cases to the national immunization records, during delta-predominant and omicron-predominant periods. RESULTS Compared to omicron, COVID-19 cases during the delta period were 10 times more likely to have severe outcomes and in-hospital deaths. During omicron, a third vaccine dose had an 89% reduced risk of both severe COVID-19 and death. The third dose received 14-90 days before the date of the positive test showed the highest protection (93%). Severe outcomes were not observed with the third dose during delta, and the fourth dose during the omicron period. All the vaccine types used for boosting in Thailand offered similar protection against severe COVID-19. CONCLUSION Booster doses provided a very high level of protection against severe COVID-19 outcomes and deaths. Booster campaigns should focus on improving coverage by utilizing all available vaccines to ensure optimal protection.
Collapse
Affiliation(s)
- Kannikar Intawong
- Faculty of Public Health, Chiang Mai University, Chiang Mai, Thailand
| | - Suwat Chariyalertsak
- Faculty of Public Health, Chiang Mai University, Chiang Mai, Thailand,Corresponding author: Suwat Chariyalertsak, Faculty of Public Health, Chiang Mai University, Thailand, 239, Huay Kaew Road, Muang District, Chiang Mai Thailand, 50200, Tel: +66-53-942501, Fax: +66-53-942525
| | | | | | | | | | | | | | | | - Krit Khwanngern
- Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | | | - Prapon Piamanant
- Nakornping Hospital, Ministry of Public Health, Chiang Mai, Thailand
| | | |
Collapse
|
19
|
Solante R, Alvarez-Moreno C, Burhan E, Chariyalertsak S, Chiu NC, Chuenkitmongkol S, Dung DV, Hwang KP, Ortiz Ibarra J, Kiertiburanakul S, Kulkarni PS, Lee C, Lee PI, Lobo RC, Macias A, Nghia CH, Ong-Lim AL, Rodriguez-Morales AJ, Richtmann R, Safadi MAP, Satari HI, Thwaites G. Expert review of global real-world data on COVID-19 vaccine booster effectiveness and safety during the omicron-dominant phase of the pandemic. Expert Rev Vaccines 2023; 22:1-16. [PMID: 36330971 DOI: 10.1080/14760584.2023.2143347] [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] [Indexed: 11/06/2022]
Abstract
INTRODUCTION COVID-19 vaccines have been highly effective in reducing morbidity and mortality during the pandemic. However, the emergence of the Omicron variant and subvariants as the globally dominant strains have raised doubts about the effectiveness of currently available vaccines and prompted debate about potential future vaccination strategies. AREAS COVERED Using the publicly available IVAC VIEW-hub platform, we reviewed 52 studies on vaccine effectiveness (VE) after booster vaccinations. VE were reported for SARS-CoV-2 symptomatic infection, severe disease and death and stratified by vaccine schedule and age. In addition, a non-systematic literature review of safety was performed to identify single or multi-country studies investigating adverse event rates for at least two of the currently available COVID-19 vaccines. EXPERT OPINION Booster shots of the current COVID-19 vaccines provide consistently high protection against Omicron-related severe disease and death. Additionally, this protection appears to be conserved for at least 3 months, with a small but significant waning after that. The positive risk-benefit ratio of these vaccines is well established, giving us confidence to administer additional doses as required. Future vaccination strategies will likely include a combination of schedules based on risk profile, as overly frequent boosting may be neither beneficial nor sustainable for the general population.
Collapse
Affiliation(s)
| | - Carlos Alvarez-Moreno
- Infectious Diseases Unit, Facultad de Medicina. Universidad Nacional de Colombia. Clinica Universitaria Colombia, Clínica Colsanitas, Colombia
| | - Erlina Burhan
- Faculty of Medicine Universitas Indonesia, RSUP Persahabatan, Jakarta, Indonesia
| | | | | | | | - D V Dung
- University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam
| | - Kao-Pin Hwang
- China Medical University Children's Hospital, Taichung, Taiwan
| | - Javier Ortiz Ibarra
- Médico Hospital Materno Perinatal Monica Pretelini Sáez, Toluca de Lerdo, México
| | | | | | | | - Ping-Ing Lee
- Department of Pediatrics, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
| | | | | | | | - Anna Lisa Ong-Lim
- College of Medicine - Philippine General Hospital, University of the Philippines, Manila, Philippines
| | - Alfonso J Rodriguez-Morales
- Faculty of Medicine, Fundacion Universitaria Autónoma de las Americas, Pereira, Risaralda, Colombia & Master of Clinical Epidemiology and Biostatistics, Universidad Cientifica del Sur, Lima, Peru
| | - Rosana Richtmann
- Santa Joana Hospital and Maternity, the Institute of Infectious Diseases Emílio Ribas in Sao Paulo, Brazil
| | | | - Hindra Irawan Satari
- Division of Infectious Diseases and Tropical Pediatrics, Department of Child Health Medical Faculty, Universitas Indonesia, Cipto Mangunkusumo Hospital, Indonesia
| | - Guy Thwaites
- Oxford University Clinical Research Unit, Ho Chi Minh City, Vietnam, and The Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| |
Collapse
|
20
|
An K, Zhu X, Yan J, Xu P, Hu L, Bai C. A systematic study on the binding affinity of SARS-CoV-2 spike protein to antibodies. AIMS Microbiol 2022; 8:595-611. [PMID: 36694585 PMCID: PMC9834082 DOI: 10.3934/microbiol.2022038] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Revised: 12/18/2022] [Accepted: 12/21/2022] [Indexed: 12/29/2022] Open
Abstract
The COVID-19 pandemic has caused a worldwide health crisis and economic recession. Effective prevention and treatment methods are urgently required to control the pandemic. However, the emergence of novel SARS-CoV-2 variants challenges the effectiveness of currently available vaccines and therapeutic antibodies. In this study, through the assessment of binding free energies, we analyzed the mutational effects on the binding affinity of the coronavirus spike protein to neutralizing antibodies, patient-derived antibodies, and artificially designed antibody mimics. We designed a scoring method to assess the immune evasion ability of viral variants. We also evaluated the differences between several targeting sites on the spike protein of antibodies. The results presented herein might prove helpful in the development of more effective therapies in the future.
Collapse
Affiliation(s)
- Ke An
- Warshel Institute for Computational Biology, School of Life and Health Sciences, School of Medicine, The Chinese University of Hong Kong, Shenzhen, Shenzhen, 518172, Guangdong, People's Republic of China,School of Chemistry and Materials Science, University of Science and Technology of China, Hefei, Anhui, 230026, P. R. China
| | - Xiaohong Zhu
- Warshel Institute for Computational Biology, School of Life and Health Sciences, School of Medicine, The Chinese University of Hong Kong, Shenzhen, Shenzhen, 518172, Guangdong, People's Republic of China,School of Chemistry and Materials Science, University of Science and Technology of China, Hefei, Anhui, 230026, P. R. China
| | - Junfang Yan
- Warshel Institute for Computational Biology, School of Life and Health Sciences, School of Medicine, The Chinese University of Hong Kong, Shenzhen, Shenzhen, 518172, Guangdong, People's Republic of China
| | - Peiyi Xu
- Warshel Institute for Computational Biology, School of Life and Health Sciences, School of Medicine, The Chinese University of Hong Kong, Shenzhen, Shenzhen, 518172, Guangdong, People's Republic of China
| | - Linfeng Hu
- Warshel Institute for Computational Biology, School of Life and Health Sciences, School of Medicine, The Chinese University of Hong Kong, Shenzhen, Shenzhen, 518172, Guangdong, People's Republic of China
| | - Chen Bai
- Warshel Institute for Computational Biology, School of Life and Health Sciences, School of Medicine, The Chinese University of Hong Kong, Shenzhen, Shenzhen, 518172, Guangdong, People's Republic of China,Chenzhu (MoMeD) Biotechnology Co., Ltd, Hangzhou, Zhejiang, 310005, P.R. China,* Correspondence:
| |
Collapse
|
21
|
Petráš M, Máčalík R, Janovská D, Čelko AM, Dáňová J, Selinger E, Doleček J, Neradová S, Franklová M, Dlouhý P, Rosina J, Lesná IK. Risk factors affecting COVID-19 vaccine effectiveness identified from 290 cross-country observational studies until February 2022: a meta-analysis and meta-regression. BMC Med 2022; 20:461. [PMID: 36434597 PMCID: PMC9701077 DOI: 10.1186/s12916-022-02663-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Accepted: 11/14/2022] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND Observational studies made it possible to assess the impact of risk factors on the long-term effectiveness of mRNA and adenoviral vector (AdV) vaccines against COVID-19. METHODS A computerized literature search was undertaken using the MEDLINE, EMBASE, and MedRxiv databases to identify eligible studies, with no language restrictions, published up to 28 February 2022. Eligible were observational studies assessing vaccine effectiveness (VE) by disease severity with reference groups of unvaccinated participants or participants immunized with one, two, or three vaccine doses. Our study was carried out in compliance with the PRISMA and MOOSE guidelines. The risk of study bias was identified using the Newcastle-Ottawa Quality Assessment Scale. The GRADE guidelines were applied to assess the strength of evidence for the primary outcome. The synthesis was conducted using a meta-analysis and meta-regression. RESULTS Out of a total of 14,155 publications, 290 studies were included. Early VE of full vaccination against COVID-19 of any symptomatology and severity decreased from 96% (95% CI, 95-96%) for mRNA and from 86% (95% CI, 83-89%) for AdV vaccines to 67% for both vaccine types in the last 2 months of 2021. A similar 1-year decline from 98 to 86% was found for severe COVID-19 after full immunization with mRNA, but not with AdV vaccines providing persistent 82-87% effectiveness. Variant-reduced VE was only associated with Omicron regardless of disease severity, vaccine type, or vaccination completeness. The level of protection was reduced in participants aged >65 years, with a comorbidity or those in long-term care or residential homes independently of the number of doses received. The booster effect of the third mRNA dose was unclear because incompletely restored effectiveness, regardless of disease severity, declined within a short-term interval of 4 months. CONCLUSIONS Full vaccination provided an early high, yet waning level of protection against COVID-19 of any severity with a strong impact on the high-risk population. Moreover, the potential risk of new antigenically distinct variants should not be underestimated, and any future immunization strategy should include variant-updated vaccines.
Collapse
Affiliation(s)
- Marek Petráš
- Department of Epidemiology and Biostatistics, Third Faculty of Medicine, Charles University, Ruská 87, 100 00, Prague, Czech Republic.
| | - Roman Máčalík
- Department of Epidemiology and Biostatistics, Third Faculty of Medicine, Charles University, Ruská 87, 100 00, Prague, Czech Republic
| | - Daniela Janovská
- Department of Epidemiology and Biostatistics, Third Faculty of Medicine, Charles University, Ruská 87, 100 00, Prague, Czech Republic
| | - Alexander M Čelko
- Department of Epidemiology and Biostatistics, Third Faculty of Medicine, Charles University, Ruská 87, 100 00, Prague, Czech Republic
| | - Jana Dáňová
- Department of Epidemiology and Biostatistics, Third Faculty of Medicine, Charles University, Ruská 87, 100 00, Prague, Czech Republic
| | - Eliška Selinger
- Department of Epidemiology and Biostatistics, Third Faculty of Medicine, Charles University, Ruská 87, 100 00, Prague, Czech Republic.,Centre for Public Health Promotion, National Institute of Public Health, 100 00, Prague, Czech Republic
| | - Jonáš Doleček
- Department of Epidemiology and Biostatistics, Third Faculty of Medicine, Charles University, Ruská 87, 100 00, Prague, Czech Republic
| | - Sylva Neradová
- Department of Epidemiology and Biostatistics, Third Faculty of Medicine, Charles University, Ruská 87, 100 00, Prague, Czech Republic
| | - Martina Franklová
- Department of Epidemiology and Biostatistics, Third Faculty of Medicine, Charles University, Ruská 87, 100 00, Prague, Czech Republic
| | - Pavel Dlouhý
- Department of Hygiene, Third Faculty of Medicine, Charles University, 100 00, Prague, Czech Republic
| | - Jozef Rosina
- Department of Medical Biophysics and Informatics, Third Faculty of Medicine, Charles University, 100 00, Prague, Czech Republic.,Department of Health Care and Population Protection, Faculty of Biomedical Engineering, Czech Technical University in Prague, 272 01, Kladno, Czech Republic
| | - Ivana Králová Lesná
- Laboratory for Atherosclerosis Research, Centre for Experimental Medicine, Institute for Clinical and Experimental Medicine, 140 21, Prague, Czech Republic.,Department of Anesthesia and Intensive Medicine, First Faculty of Medicine, Charles University and University Military Hospital, 100 00, Prague, Czech Republic
| |
Collapse
|
22
|
Solante R, Alvarez-Moreno C, Burhan E, Chariyalertsak S, Chiu NC, Chuenkitmongkol S, Do-Van D, Hwang KP, Kiertiburanakul S, Lee PI, Lobo RC, Macias A, Nghia CH, Ong-Lim A, Ortiz Ibarra J, Richtmann R, Rodriguez-Morales AJ, Safadi MAP, Satari HI. Further implications on the global real-world vaccine effectiveness against SARS-CoV-2. Expert Rev Vaccines 2022; 21:1355-1357. [PMID: 35968671 DOI: 10.1080/14760584.2022.2110073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
| | - Carlos Alvarez-Moreno
- Infectious Diseases Unit, Facultad de Medicina, Universidad Nacional de Colombia, Bogotá, Colombia
| | - Erlina Burhan
- Faculty of Medicine Universitas Indonesia, RSUP Persahabatan, Jakarta, Indonesia
| | | | | | | | - Dung Do-Van
- University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam
| | - Kao-Pin Hwang
- China Medical University Children's Hospital, Taichung, Taiwan
| | | | - Ping-Ing Lee
- Department of Pediatrics, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
| | | | | | | | - Anna Ong-Lim
- College of Medicine - Philippine General Hospital, University of the Philippines, Manila, Philippines
| | | | - Rosana Richtmann
- Santa Joana Hospital and Maternity, the Institute of Infectious Diseases Emílio Ribas in Sao Paulo, Sao Paulo, Brazil
| | - Alfonso J Rodriguez-Morales
- Grupo de Investigacion Biomedicina, Faculty of Medicine, Fundacion Universitaria Autónoma de las Americas, Pereira, Colombia.,Master of Clinical Epidemiology and Biostatistics, Universidad Cientifica del Sur, Lima, Peru
| | | | - Hindra Irawan Satari
- Division of Infectious Diseases and Tropical Pediatrics, Department of Child Health Medical Faculty, University of Indonesia, Cipto Mangunkusumo Hospital, Jakarta, Indonesia
| |
Collapse
|