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Verrienti M, Marino Picciola V, Ambrosio MR, Zatelli MC. Pituitary and COVID-19 vaccination: a systematic review. Pituitary 2024:10.1007/s11102-024-01402-2. [PMID: 38761322 DOI: 10.1007/s11102-024-01402-2] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/07/2024] [Indexed: 05/20/2024]
Abstract
PURPOSE This systematic review aims to examine the latest research findings and assess the impact of COVID-19 vaccination on the pituitary gland. METHOD PubMed and Tripdatabase were searched from January 1st, 2020 to February 12th, 2024. Case reports, case series and reviews related to post COVID-19 vaccination pituitary disease were included. Eligible articles were tabulated and analysed in the attempt to provide an overview on the epidemiology, clinical presentation, imaging, treatment, outcomes and pathophysiological background of post COVID-19 vaccination pituitary disease. RESULTS Among the 23 case reports included in this review, post COVID-19 vaccination hypophysitis was reported in 9 patients, pituitary apoplexy (PA) in 6 cases, SIADH in 5 cases and Isolated ACTH deficiency in 2 cases. Additionally, precipitating adrenal crisis was registered in 7 patients and pituitary tumor enlargement in 1 patient after receiving COVID-19 vaccination. CONCLUSION Despite the rarity of these events, our research findings suggest an association between COVID-19 vaccination and the subsequent development of pituitary diseases. The most common manifestations include hypophysitis with ADH deficiency, PA and SIADH, with symptoms typically emerging shortly after vaccine administration. Potential pathogenetic mechanisms include molecular mimicry, vaccine adjuvants and vaccine-induced thrombotic thrombocytopenia (VITT), with the presence of ACE2 receptors in the hypothalamus-pituitary system contributing to the process. These findings can aid in diagnostic and treatment decisions for patients presenting with these syndromes. Nevertheless, given the rarity of these events, safety and efficacy of the currently available COVID-19 vaccines remain robust and we strongly advocate continuing pursuing vaccination efforts.
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Affiliation(s)
- Martina Verrienti
- Unit of Endocrinology and Metabolic Diseases, Department of Specialty Medicines, University Hospital of Ferrara, Ferrara, Italy
| | - Valentino Marino Picciola
- Section of Endocrinology, Geriatrics and Internal Medicine, Department of Medical Sciences, University of Ferrara, Via Ariosto 35, Ferrara, 44100, Italy
| | - Maria Rosaria Ambrosio
- Unit of Endocrinology and Metabolic Diseases, Department of Specialty Medicines, University Hospital of Ferrara, Ferrara, Italy
- Section of Endocrinology, Geriatrics and Internal Medicine, Department of Medical Sciences, University of Ferrara, Via Ariosto 35, Ferrara, 44100, Italy
| | - Maria Chiara Zatelli
- Unit of Endocrinology and Metabolic Diseases, Department of Specialty Medicines, University Hospital of Ferrara, Ferrara, Italy.
- Section of Endocrinology, Geriatrics and Internal Medicine, Department of Medical Sciences, University of Ferrara, Via Ariosto 35, Ferrara, 44100, Italy.
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Đurić-Petković D, Šuljagić V, Begović-Kuprešanin V, Rančić N, Nikolić V. Vaccine Effectiveness against SARS-CoV-2 Infection during the Circulation of Alpha, Delta, or Omicron Variants: A Retrospective Cohort Study in a Tertiary Hospital in Serbia. Vaccines (Basel) 2024; 12:211. [PMID: 38400194 PMCID: PMC10893379 DOI: 10.3390/vaccines12020211] [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: 01/11/2024] [Revised: 02/13/2024] [Accepted: 02/14/2024] [Indexed: 02/25/2024] Open
Abstract
The COVID-19 pandemic prompted rapid vaccine development and deployment worldwide. Despite widespread vaccination efforts, understanding the effectiveness of vaccines in hospitalized patients remains a critical concern. This retrospective cohort study, conducted at a tertiary healthcare centre in Serbia, tracked patients hospitalized during different waves of COVID-19 variants-Alpha, Delta, and Omicron. Data collection included demographics, comorbidities, symptoms, and vaccination status. Among 3593 patients, those with prior exposure to COVID-19 cases or hospital treatment showed higher positivity rates. Symptom prevalence varied across waves, with coughs persisting. Patients without chronic diseases were more frequent among those testing negative. Vaccine effectiveness varied, with Sinopharm demonstrating a 45.6% effectiveness initially and Pfizer-BioNTech showing an effectiveness of up to 74.8% within 0-84 days after the second dose. Mixed-dose strategies, notably Sinopharm as a primary dose followed by a Pfizer-BioNTech booster, suggested increased protection. Despite substantial vaccination availability, a significant portion of hospitalized patients remained unvaccinated. This study underscores the dynamic nature of vaccine effectiveness and advocates for booster strategies to address evolving challenges in combating COVID-19, particularly in hospitalized patients.
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Affiliation(s)
| | - Vesna Šuljagić
- Department of Healthcare-Related Infection Control, Military Medical Academy, 11000 Belgrade, Serbia
- Medical Faculty, Military Medical Academy, University of Defence, 11000 Belgrade, Serbia; (V.B.-K.); (N.R.)
| | - Vesna Begović-Kuprešanin
- Medical Faculty, Military Medical Academy, University of Defence, 11000 Belgrade, Serbia; (V.B.-K.); (N.R.)
- Clinic for Infectious and Tropical Diseases, Military Medical Academy, 11000 Belgrade, Serbia
| | - Nemanja Rančić
- Medical Faculty, Military Medical Academy, University of Defence, 11000 Belgrade, Serbia; (V.B.-K.); (N.R.)
- Centre for Clinical Pharmacology, Military Medical Academy, 11000 Belgrade, Serbia
| | - Vladimir Nikolić
- Institute of Epidemiology, Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia;
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Lupu D, Tiganasu R. Does education influence COVID-19 vaccination? A global view. Heliyon 2024; 10:e24709. [PMID: 38314273 PMCID: PMC10837567 DOI: 10.1016/j.heliyon.2024.e24709] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Revised: 01/11/2024] [Accepted: 01/12/2024] [Indexed: 02/06/2024] Open
Abstract
After the recent hard attempts felt on a global scale, notably in the health sector, the steady efforts of scientists have been materialized in maybe one of the most expected findings of the last decades, i.e. the launching of the COVID-19 vaccines. Although it is not our goal to plead for vaccination, as the decision in this regard is a matter of individual choice, we believe it is necessary and enlightening to analyze how one's educational status interferes with COVID-19 vaccination. There are discrepancies between world states vis-à-vis their well-being and their feedback to crises, and from the collection of features that can segregate the states in handling vaccination, in this paper, the spotlight is on education. We are referring to this topic because, generally, researches converge rather on the linkage between economic issues and COVID-19 vaccination, while education levels are less tackled in relation to this. To notice the weight of each type of education (primary, secondary, tertiary) in this process, we employ an assortment of statistical methods, for three clusters: 45 low-income countries (LICs), 72 middle-income countries (MICs) and 53 high-income countries (HICs). The estimates suggest that education counts in the COVID-19 vaccination, the tertiary one having the greatest meaning in accepting it. It is also illustrated that the imprint of education on vaccination fluctuates across the country groups scrutinized, with HICs recording the upper rates. The heterogeneity of COVID-19 vaccination-related behaviors should determine health authorities to treat this subject differently. To expand the COVID-19 vaccines uptake, they should be in an ongoing dialogue with all population categories and, remarkably, with those belonging to vulnerable communities, originated mostly in LICs. Education is imperative for vaccination, and it would ought to be on the schedule of any state, for being assimilated into health strategies and policies.
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Affiliation(s)
- Dan Lupu
- "Alexandru Ioan Cuza" University of Iasi, Romania, Faculty of Economics and Business Administration, Romania
| | - Ramona Tiganasu
- "Alexandru Ioan Cuza" University of Iasi, Faculty of Law, Centre for European Studies, Romania
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Hossaini S, Keramat F, Cheraghi Z, Zareie B, Doosti-Irani A. Comparing the Efficacy and Adverse Events of Available COVID-19 Vaccines Through Randomized Controlled Trials: Updated Systematic Review and Network Meta-analysis. J Res Health Sci 2023; 23:e00593. [PMID: 38315908 PMCID: PMC10843317 DOI: 10.34172/jrhs.2023.128] [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: 09/30/2023] [Revised: 11/05/2023] [Accepted: 12/03/2023] [Indexed: 02/07/2024] Open
Abstract
BACKGROUND Different vaccines have so far been developed and approved to cope with COVID-19 in the world. The aim of this updated network meta-analysis (NMA) was to compare and rank all available vaccines in terms of efficacy and complications simultaneously. Study Design: A systematic review. METHODS Three major international databases, including Web of Science, Medline via PubMed, and Scopus, were searched through September 2023. The transitivity assumption was evaluated qualitatively in terms of epidemiologic effect modifiers. The exposure of interest in this study was receiving any available COVID-19 vaccine, and the primary outcome of interest was the incidence of symptomatic COVID-19. In this NMA, the relative risk of symptomatic COVID-19 was used to summarize the efficacy of vaccines in preventing COVID-19. The data were analyzed using the frequentist-based approach, and the results were reported using a random-effects model. Finally, the vaccines were ranked using a P-score. RESULTS In total, 34 randomized controlled trials (RCTs) met the eligibility criteria for this systematic review and NMA out of 3682 retrieved references. Based on the results of the NMA, mRNA-1273 was the most effective vaccine in preventing COVID-19 and demonstrated the highest P-score (0.93). The relative risk (RR) for mRNA-1273 versus placebo was 0.07 (95% confidence interval [CI]: 0.03, 0.17). The second and third-ranked vaccines were BNT-162b2 (RR=0.08; 95% CI: 0.04, 0.15; P-score=0.93) and Gam-COVID-Vac (0.09; 95% CI: 0.03, 0.25; 0.88). CONCLUSION Based on the results of this NMA, it seems that all available vaccines were effective in COVID-19 prevention. However, the top three ranked vaccines were mRNA-1273, BNT-162b2, and Gam-COVID-Vac, respectively.
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Affiliation(s)
- Shima Hossaini
- Department of Epidemiology, School of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Fariba Keramat
- Department of Infectious Disease, School of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Zahra Cheraghi
- Department of Epidemiology, School of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran
- Modeling of Noncommunicable Diseases Research Center, Hamadan University of Medical Sciences, Hamedan, Iran
| | - Bushra Zareie
- Department of Epidemiology, School of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Amin Doosti-Irani
- Department of Epidemiology, School of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran
- Research Center for Health Sciences, Hamadan University of Medical Sciences, Hamadan, Iran
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Tan-Lim CSC, Gonzales MLAM, Dans LF, Cordero CP, Alejandria MM, Dela Paz ECC, Dator MA, Infantado-Alejandro MAJ, Sulit MVV, Lansang MAD. Reinfection rates, change in antibody titers and adverse events after COVID-19 vaccination among patients previously infected with COVID-19 in Metro Manila, Philippines: a secondary analysis of a completed cohort study. BMC Infect Dis 2023; 23:750. [PMID: 37915006 PMCID: PMC10621145 DOI: 10.1186/s12879-023-08743-6] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Accepted: 10/24/2023] [Indexed: 11/03/2023] Open
Abstract
BACKGROUND Variation in immune response to COVID-19 vaccines is observed among different ethnicities. We aimed to describe the reinfection rates, change in antibody titers, and adverse events among Filipinos. METHODS This is a secondary analysis of a cohort study of 307 participants within one year of having COVID-19 infection. We measured COVID-19 antibody levels at pre-determined timepoints (Days 21, 90, 180, 270, and 360 from initial infection). We monitored for COVID-19 symptoms and obtained details on COVID-19 vaccination. An adjudication committee classified the participants as probable, possible, or unlikely COVID-19 reinfection. We determined the probable reinfection rate, adverse events, and the geometric mean titer (GMT) ratio of pre- and post-vaccination antibody levels according to type and brand of COVID-19 vaccine. RESULTS At the end of the follow-up period, 287 (93.5%) out of 307 study participants were fully vaccinated, 1 was partially vaccinated (0.3%), and 19 were unvaccinated (6.2%). Among the fully vaccinated participants, those given mRNA vaccines had the lowest reinfection rate (19.2 cases/100 person-years, 95% CI 9.6, 38.4), followed by viral vector vaccines (29.8 cases/100 person-years, 95% CI 16.9, 52.4). We observed the highest reinfection rate among those given inactivated virus vaccines (32.7 cases/100 person-years, 95% CI 23.6, 45.3). The reinfection rate was 8.6 cases/100 person-years (95% CI 4.1, 17.9) for unvaccinated participants and 3.6 cases/100 person-years (95% CI 0.5, 25.3) for partially vaccinated participants. We observed the largest rise in antibody titers among those given mRNA vaccines (GMT ratio 288.5), and the smallest rise among those given inactivated virus vaccines (GMT ratio 16.7). We observed the highest percentage of adverse events following immunization with viral vector vaccines (63.8%), followed by mRNA vaccines (62.7%), and the lowest for inactivated virus vaccines (34.7%). No serious adverse events were reported. CONCLUSION Vaccinees given the mRNA vaccines had the lowest reinfection rate and the highest rise in antibody titers. Vaccinees given inactivated virus vaccines had the highest reinfection rate, smallest rise in antibody titers, and lowest percentage of adverse events. The small sample size and imbalanced distribution of the type of vaccines received limits the external generalizability of our results. STUDY REGISTRATION The cohort study was registered at the Philippine Health Research Registry on December 14, 2020 (PHRR201214-003199).
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Affiliation(s)
- Carol Stephanie C Tan-Lim
- Department of Clinical Epidemiology, College of Medicine, University of the Philippines Manila, Pedro Gil Street, Ermita, Manila, Philippines.
| | - Ma Liza Antoinette M Gonzales
- Department of Pediatrics, College of Medicine, University of the Philippines Manila, Pedro Gil Street, Ermita, Manila, Philippines
| | - Leonila F Dans
- Department of Clinical Epidemiology, College of Medicine, University of the Philippines Manila, Pedro Gil Street, Ermita, Manila, Philippines
- Department of Pediatrics, College of Medicine, University of the Philippines Manila, Pedro Gil Street, Ermita, Manila, Philippines
| | - Cynthia P Cordero
- Department of Clinical Epidemiology, College of Medicine, University of the Philippines Manila, Pedro Gil Street, Ermita, Manila, Philippines
| | - Marissa M Alejandria
- Department of Clinical Epidemiology, College of Medicine, University of the Philippines Manila, Pedro Gil Street, Ermita, Manila, Philippines
| | - Eva C Cutiongco Dela Paz
- Institute of Human Genetics, National Institutes of Health, University of the Philippines Manila, Pedro Gil Street, Ermita, Manila, Philippines
| | - Melissa A Dator
- Department of Pediatrics, College of Medicine, University of the Philippines Manila, Pedro Gil Street, Ermita, Manila, Philippines
| | - Myzelle Anne J Infantado-Alejandro
- Department of Clinical Epidemiology, College of Medicine, University of the Philippines Manila, Pedro Gil Street, Ermita, Manila, Philippines
| | - Maria Vanessa V Sulit
- Institute of Clinical Epidemiology, National Institutes of Health, University of the Philippines Manila, Pedro Gil Street, Ermita, Manila, Philippines
| | - Mary Ann D Lansang
- Department of Clinical Epidemiology, College of Medicine, University of the Philippines Manila, Pedro Gil Street, Ermita, Manila, Philippines
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Tao Z, Xu C, Cheng L, Zhang M, Xu J, Zheng Q, Zhang J, Lu W, Sheng C, Tian J. Tracking trends in COVID-19 vaccines based on 47 different vaccines: A bibliometric review. Hum Vaccin Immunother 2023; 19:2242747. [PMID: 37585593 PMCID: PMC10416739 DOI: 10.1080/21645515.2023.2242747] [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: 04/24/2023] [Revised: 07/08/2023] [Accepted: 07/27/2023] [Indexed: 08/18/2023] Open
Abstract
The COVID-19 epidemic in December 2019 had a significant negative impact on people's health and economies all across the world. The most effective preventive measure against COVID-19 is vaccination. Therefore, the development and production of COVID-19 vaccines is booming worldwide. This study aimed to analyze the current state of that research and its development tendency by bibliometrics. We conducted a thorough search of the Web of Science Core Collection. VOSviewer1.6.18 was used to perform the bibliometric analysis of these papers. A total of 6,325 papers were finally included. The USA maintained a top position worldwide. Shimabukuro Tom T and Harvard University were the most prolific author and institution. The Vaccines was the most published journal. The research hotspots of COVID-19 vaccines can be classified into vaccine hesitancy, vaccine safety and effectiveness, vaccine immunogenicity, and adverse reactions to vaccines. Studies on various vaccination types have also concentrated on efficacy against continuously developing virus strains, immunogenicity, side effects, and safety.
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Affiliation(s)
- Zhongbin Tao
- Department of Paediatrics, First Hospital of Lanzhou University, Lanzhou, Gansu, China
| | - Caihua Xu
- Evidence-Based Medicine Center, Lanzhou University, Lanzhou, Gansu, China
- School of Basic Medical Sciences, Lanzhou University, Lanzhou, Gansu, China
| | - Luying Cheng
- Evidence-Based Nursing Center, School of Nursing, Lanzhou University, Lanzhou, Gansu, China
| | - Mingyue Zhang
- Evidence-Based Medicine Center, Lanzhou University, Lanzhou, Gansu, China
- School of Basic Medical Sciences, Lanzhou University, Lanzhou, Gansu, China
| | - Jianguo Xu
- Evidence-Based Medicine Center, Lanzhou University, Lanzhou, Gansu, China
- School of Basic Medical Sciences, Lanzhou University, Lanzhou, Gansu, China
| | - Qingyong Zheng
- Evidence-Based Nursing Center, School of Nursing, Lanzhou University, Lanzhou, Gansu, China
| | - Jun Zhang
- Evidence-Based Medicine Center, Lanzhou University, Lanzhou, Gansu, China
- School of Basic Medical Sciences, Lanzhou University, Lanzhou, Gansu, China
- School of Nursing, Gansu University of Chinese Medicine, Lanzhou, Gansu, China
| | - Wenjun Lu
- The First Clinical Medical College, Lanzhou University, Lanzhou, Gansu, China
| | - Caiyi Sheng
- The First Clinical Medical College, Lanzhou University, Lanzhou, Gansu, China
| | - Jinhui Tian
- Evidence-Based Medicine Center, Lanzhou University, Lanzhou, Gansu, China
- School of Basic Medical Sciences, Lanzhou University, Lanzhou, Gansu, China
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Relan P, Motaze NV, Kothari K, Askie L, Le Polain O, Van Kerkhove MD, Diaz J, Tirupakuzhi Vijayaraghavan BK. Severity and outcomes of Omicron variant of SARS-CoV-2 compared to Delta variant and severity of Omicron sublineages: a systematic review and metanalysis. BMJ Glob Health 2023; 8:e012328. [PMID: 37419502 PMCID: PMC10347449 DOI: 10.1136/bmjgh-2023-012328] [Citation(s) in RCA: 13] [Impact Index Per Article: 13.0] [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: 03/17/2023] [Accepted: 06/16/2023] [Indexed: 07/09/2023] Open
Abstract
OBJECTIVES To compare severity and clinical outcomes from Omicron as compared with the Delta variant and to compare outcomes between Omicron sublineages. METHODS We searched the WHO COVID-19 Research database for studies that compared clinical outcomes for patients with Omicron variant and the Delta variant, and separately Omicron sublineages BA.1 and BA.2. A random-effects meta-analysis was used to pool estimates of relative risk (RR) between variants and sublineages. Heterogeneity between studies was assessed using the I2 index. Risk of bias was assessed using the tool developed by the Clinical Advances through Research and Information Translation team. RESULTS Our search identified 1494 studies and 42 met the inclusion criteria. Eleven studies were published as preprints. Of the 42 studies, 29 adjusted for vaccination status; 12 had no adjustment; and for 1, the adjustment was unclear. Three of the included studies compared the sublineages of Omicron BA.1 versus BA.2. As compared with Delta, individuals infected with Omicron had 61% lower risk of death (RR 0.39, 95% CI 0.33 to 0.46) and 56% lower risk of hospitalisation (RR 0.44, 95% CI 0.34 to 0.56). Omicron was similarly associated with lower risk of intensive care unit (ICU) admission, oxygen therapy, and non-invasive and invasive ventilation. The pooled risk ratio for the outcome of hospitalisation when comparing sublineages BA.1 versus BA.2 was 0.55 (95% 0.23 to 1.30). DISCUSSION Omicron variant was associated with lower risk of hospitalisation, ICU admission, oxygen therapy, ventilation and death as compared with Delta. There was no difference in the risk of hospitalisation between Omicron sublineages BA.1 and BA.2. PROSPERO REGISTRATION NUMBER CRD42022310880.
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Affiliation(s)
- Pryanka Relan
- Health Emergencies Programme, WHO, Geneva, Switzerland
| | - Nkengafac Villyen Motaze
- Health Emergencies Programme, WHO, Geneva, Switzerland
- Medicine Usage in South Africa, School of Pharmacy, Faculty of Health Sciences, North-West University, Potchefstroom, South Africa
| | - Kavita Kothari
- Library and Digital Information Networks, World Health Organization, Kobe, Japan
| | - Lisa Askie
- Methods and Standards Unit, Science Division, World Health Organization, Geneva, Switzerland
| | - Olivier Le Polain
- Acute Response Coordination Department, World Health Organization, Geneva, Switzerland
| | - Maria D Van Kerkhove
- COVID-19 Health Operations, World Health Emergencies Programme, World Health Organization, Geneva, Switzerland
| | - Janet Diaz
- Health Emergencies Programme, WHO, Geneva, Switzerland
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Soheili M, Khateri S, Moradpour F, Mohammadzedeh P, Zareie M, Mortazavi SMM, Manifar S, Kohan HG, Moradi Y. The efficacy and effectiveness of COVID-19 vaccines around the world: a mini-review and meta-analysis. Ann Clin Microbiol Antimicrob 2023; 22:42. [PMID: 37208749 DOI: 10.1186/s12941-023-00594-y] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Accepted: 05/10/2023] [Indexed: 05/21/2023] Open
Abstract
OBJECTIVES This meta-analysis evaluated the Efficacy and Effectiveness of several COVID-19 vaccines, including AstraZeneca, Pfizer, Moderna, Bharat, and Johnson & Johnson, to better estimate their immunogenicity, benefits, or side effects. METHODS Studies reporting the Efficacy and Effectiveness of COVID-19 vaccines from November 2020 to April 2022 were included. The pooled Effectiveness/Efficacy with a 95% confidence interval (95% CI) with Metaprop order was calculated. The results were presented in forest plots. Predefined subgroup analyses and sensitivity analyses were also performed. RESULTS A total of twenty articles were included in this meta-analysis. After the first dose of the vaccine, the total effectiveness of all COVID-19 vaccines in our study was 71% (95% CI 0.65, 0.78). The total effectiveness of vaccines after the second dose was 91% (95% CI 0.88, 0.94)). The total efficacy of vaccines after the first and second doses was 81% (95% CI 0.70, 0.91) and 71% (95% CI 0.62, 0.79), respectively. The effectiveness of the Moderna vaccine after the first and second dose was the highest among other studied vaccines ((74% (95% CI, 0.65, 0.83) and 93% (95% CI, 0.89, 0.97), respectively). The highest first dose overall effectiveness of the studied vaccines was against the Gamma variant (74% (95% CI, 0.73, 0.75)), and the highest effectiveness after the second dose was observed against the Beta variant (96% (95% CI, 0.96, 0.96)). The Efficacy for AstraZeneca and Pfizer vaccines after the first dose was 78% (95% CI, 0.62, 0.95) and 84% (95% CI, 0.77, 0.92), respectively. The second dose Efficacy for AstraZeneca, Pfizer, and Bharat was 67% (95% CI, 0.54, 0.80), 93% (95% CI, 0.85, 1.00), and 71% (95% CI, 0.61, 0.82), respectively. The overall efficacy of first and second dose vaccination against the Alfa variant was 84% (95% CI, 0.84, 0.84) and 77% (95% CI, 0.57, 0.97), respectively, the highest among other variants. CONCLUSION mRNA-based vaccines against COVID-19 showed the highest total efficacy and effectiveness than other vaccines. In general, administering the second dose produced a more reliable response and higher effectiveness than a single dose.
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Affiliation(s)
- Marzieh Soheili
- Department of Pharmaceutical and Administrative Sciences, College of Pharmacy, Western New England University, 1215 Wilbraham Road, Springfield, MA, 01119, USA
| | - Sorour Khateri
- Department of Physical Medicine and Rehabilitation, School of Medicine, Hamedan University of Medical Sciences, Hamedan, Iran
| | - Farhad Moradpour
- Social Determinants of Health Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Pardis Mohammadzedeh
- Department of Epidemiology and Biostatistics, School of Medicine, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Mostafa Zareie
- Department of Epidemiology and Biostatistics, School of Medicine, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Seyede Maryam Mahdavi Mortazavi
- Pediatric Gastroenterology Fellowship, Department of Pediatrics, School of Medicine, Namazi teaching Hospital, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Sima Manifar
- Massachusetts College of Pharmacy and Health Sciences (MCPHS), 179 Longwood Avenue, Boston, MA, 02115, USA
| | - Hamed Gilzad Kohan
- Department of Pharmaceutical and Administrative Sciences, College of Pharmacy, Western New England University, 1215 Wilbraham Road, Springfield, MA, 01119, USA.
| | - Yousef Moradi
- Social Determinants of Health Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran.
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Barbetta LMDS, Correia ETDO, Gismondi RAOC, Mesquita ET. Influenza Vaccination to Prevention Therapy for Stable Coronary Artery Disease and Acute Coronary Syndrome: A Meta-Analysis of Randomized Trials. Am J Med 2023; 136:466-475. [PMID: 36809811 DOI: 10.1016/j.amjmed.2023.02.004] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Revised: 01/28/2023] [Accepted: 02/02/2023] [Indexed: 02/21/2023]
Abstract
BACKGROUND Influenza can cause a significant burden on patients with coronary artery disease. This meta-analysis assessed the effectiveness of influenza vaccination in patients with acute coronary syndrome and stable coronary artery disease. METHODS We searched the Cochrane Controlled Register of Trials (CENTRAL), Embase, MEDLINE, www. CLINICALTRIALS gov, and the World Health Organization International Clinical Trials Registry Platform from inception to September 2021. Estimates were summarized using the Mantel-Haenzel method and a random-effects model. To assess heterogeneity the I² statistic was used. RESULTS Five randomized trials, comprising 4187 patients, were included, 2 of which included patients with acute coronary syndrome and 3 that included patients with stable coronary artery disease and acute coronary syndrome. Influenza vaccination significantly reduced the risk for all-cause mortality (relative risk [RR] = 0.56; 95% confidence interval [CI], 0.38-0.84), cardiovascular mortality (RR = 0.54; 95% CI, 0.37-0.80), major acute cardiovascular events (RR = 0.66; 95% CI, 0.49-0.88), and acute coronary syndrome (RR = 0.63; 95% CI, 0.44-0.89). On subgroup analysis, influenza vaccination remained effective for these outcomes in acute coronary syndrome but did not meet statistical significance in coronary artery disease. Furthermore, influenza vaccination did not reduce the risk for revascularization (RR = 0.89; 95% CI, 0.54-1.45), stroke or transient ischemic attack (RR = 0.85; 95% CI, 0.31-2.32), or heart failure hospitalization (RR = 0.91; 95% CI, 0.21-4.00). CONCLUSIONS Influenza vaccine is a cheap and effective intervention to reduce the risk for all-cause mortality, cardiovascular mortality, major acute cardiovascular events, and acute coronary syndrome among coronary artery disease patients, especially in those with acute coronary syndrome.
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Affiliation(s)
- Letícia Mara Dos Santos Barbetta
- Fluminense Federal University, Niterói, Rio de Janeiro, Brazil; Cardiovascular Disease Doctoral Program, Fluminense Federal University, Niterói, Rio de Janeiro, Brazil.
| | - Eduardo Thadeu de Oliveira Correia
- Fluminense Federal University, Niterói, Rio de Janeiro, Brazil; Cardiovascular Disease Doctoral Program, Fluminense Federal University, Niterói, Rio de Janeiro, Brazil
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Oh S, Purja S, Shin H, Kim MS, Park S, Kronbichler A, Smith L, Eisenhut M, Shin JI, Kim E. Efficacy, Immunogenicity, and Safety of COVID-19 Vaccines in Randomized Control Trials in the Pre-Delta Era: A Systematic Review and Network Meta-Analysis. Vaccines (Basel) 2022; 10:vaccines10101572. [PMID: 36298440 PMCID: PMC9608197 DOI: 10.3390/vaccines10101572] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Revised: 09/14/2022] [Accepted: 09/16/2022] [Indexed: 11/16/2022] Open
Abstract
The most effective method of limiting the coronavirus disease pandemic of 2019 (COVID-19) is vaccination. For the determination of the comparative efficacy and safety of COVID-19 vaccines and their platforms during the pre-Delta era, a systematic review and network meta-analysis was conducted. The MEDLINE, Embase, and MedRxiv databases were searched, and the gray literature was manually searched up to 8 July 2021. The review includes the phase II and III randomized controlled trials (RCTs) that assessed the efficacy, immunogenicity, and safety of the COVID-19 vaccines. The network meta-analysis used a Bayesian model and used the surface under the cumulative ranking to rank the comparisons between the vaccines. All included studies were quality appraised according to their design, and the heterogeneity of the analyses was assessed using I2. In terms of vaccine efficacy, the mRNA-1273 vaccine ranked the highest, and the CoronaVac vaccine ranked the lowest. The mRNA-1273 ranked the highest for neutralizing antibody responses to live SARS-CoV-2. The WIV04 vaccine was associated with the lowest incidence of both local and systemic adverse reactions. All studies except one had a low to moderate risk of bias. The mRNA platform vaccines showed higher efficacy and more adverse reactions than the other vaccines.
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Affiliation(s)
- SuA Oh
- Data Science, Evidence-Based and Clinical Research Laboratory, Department of Health, Social and Clinical Pharmacy, College of Pharmacy, Chung-Ang University, Seoul 06974, Korea
| | - Sujata Purja
- Data Science, Evidence-Based and Clinical Research Laboratory, Department of Health, Social and Clinical Pharmacy, College of Pharmacy, Chung-Ang University, Seoul 06974, Korea
| | - Hocheol Shin
- Data Science, Evidence-Based and Clinical Research Laboratory, Department of Health, Social and Clinical Pharmacy, College of Pharmacy, Chung-Ang University, Seoul 06974, Korea
| | - Min Seo Kim
- Genomics and Digital Health, Samsung Advanced Institute for Health Sciences and Technology, Sungkyunkwan University, Seoul 03063, Korea
| | - Seoyeon Park
- Yonsei University College of Medicine, Seoul 03722, Korea
| | | | - Lee Smith
- Center for Health Performance and Wellbeing, Anglia Ruskin University, Cambridge CB2 1TN, UK
| | - Michael Eisenhut
- Luton & Dunstable University Hospital, NHS Foundation Trust, Luton LU40DZ, UK
| | - Jae Il Shin
- Department of Pediatrics, Yonsei University College of Medicine, Seoul 03722, Korea
- Correspondence: (J.I.S.); (E.K.)
| | - Eunyoung Kim
- Data Science, Evidence-Based and Clinical Research Laboratory, Department of Health, Social and Clinical Pharmacy, College of Pharmacy, Chung-Ang University, Seoul 06974, Korea
- Correspondence: (J.I.S.); (E.K.)
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