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Gaultier GN, McMillan B, Poloni C, Lo M, Cai B, Zheng JJ, Baer HM, Shulha HP, Simmons K, Márquez AC, Bartlett SR, Cook L, Levings MK, Steiner T, Sekirov I, Zlosnik JEA, Morshed M, Skowronski DM, Krajden M, Jassem AN, Sadarangani M. Adaptive immune responses to two-dose COVID-19 vaccine series in healthy Canadian adults ≥ 50 years: a prospective, observational cohort study. Sci Rep 2024; 14:8926. [PMID: 38637558 PMCID: PMC11026432 DOI: 10.1038/s41598-024-59535-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Accepted: 04/11/2024] [Indexed: 04/20/2024] Open
Abstract
To evaluate immune responses to COVID-19 vaccines in adults aged 50 years and older, spike protein (S)-specific antibody concentration, avidity, and function (via angiotensin-converting enzyme 2 (ACE2) inhibition surrogate neutralization and antibody dependent cellular phagocytosis (ADCP)), as well as S-specific T cells were quantified via activation induced marker (AIM) assay in response to two-dose series. Eighty-four adults were vaccinated with either: mRNA/mRNA (mRNA-1273 and/or BNT162b2); ChAdOx1-S/mRNA; or ChAdOx1-S/ChAdOx1-S. Anti-S IgG concentrations, ADCP scores and ACE2 inhibiting antibody concentrations were highest at one-month post-second dose and declined by four-months post-second dose for all groups. mRNA/mRNA and ChAdOx1-S/mRNA schedules had significantly higher antibody responses than ChAdOx1-S/ChAdOx1-S. CD8+ T-cell responses one-month post-second dose were associated with increased ACE2 surrogate neutralization. Antibody avidity (total relative avidity index) did not change between one-month and four-months post-second dose and did not significantly differ between groups by four-months post-second dose. In determining COVID-19 correlates of protection, a measure that considers both antibody concentration and avidity should be considered.
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Affiliation(s)
- Gabrielle N Gaultier
- Department of Pediatrics, University of British Columbia, 950 West 28th Avenue, Vancouver, BC, V5Z 4H4, Canada.
- Vaccine Evaluation Center, British Columbia Children's Hospital Research Institute, Vancouver, BC, Canada.
| | - Brynn McMillan
- Vaccine Evaluation Center, British Columbia Children's Hospital Research Institute, Vancouver, BC, Canada
- Experimental Medicine Program, University of British Columbia, Vancouver, BC, Canada
| | - Chad Poloni
- Department of Microbiology and Immunology, University of British Columbia, Vancouver, BC, Canada
- British Columbia Children's Hospital Research Institute, University of British Columbia, Vancouver, BC, Canada
| | - Mandy Lo
- Department of Pediatrics, University of British Columbia, 950 West 28th Avenue, Vancouver, BC, V5Z 4H4, Canada
- Vaccine Evaluation Center, British Columbia Children's Hospital Research Institute, Vancouver, BC, Canada
| | - Bing Cai
- Department of Pediatrics, University of British Columbia, 950 West 28th Avenue, Vancouver, BC, V5Z 4H4, Canada
- Vaccine Evaluation Center, British Columbia Children's Hospital Research Institute, Vancouver, BC, Canada
| | - Jean J Zheng
- Vaccine Evaluation Center, British Columbia Children's Hospital Research Institute, Vancouver, BC, Canada
- Department of Microbiology and Immunology, University of British Columbia, Vancouver, BC, Canada
| | - Hannah M Baer
- Department of Microbiology and Immunology, University of British Columbia, Vancouver, BC, Canada
- British Columbia Children's Hospital Research Institute, University of British Columbia, Vancouver, BC, Canada
- Institute of Infection, Inflammation & Immunity, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
| | - Hennady P Shulha
- Department of Pediatrics, University of British Columbia, 950 West 28th Avenue, Vancouver, BC, V5Z 4H4, Canada
- Vaccine Evaluation Center, British Columbia Children's Hospital Research Institute, Vancouver, BC, Canada
| | - Karen Simmons
- Department of Pediatrics, University of British Columbia, 950 West 28th Avenue, Vancouver, BC, V5Z 4H4, Canada
- Vaccine Evaluation Center, British Columbia Children's Hospital Research Institute, Vancouver, BC, Canada
| | | | - Sofia R Bartlett
- British Columbia Centre for Disease Control, Vancouver, BC, Canada
- School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada
| | - Laura Cook
- British Columbia Children's Hospital Research Institute, University of British Columbia, Vancouver, BC, Canada
- Department of Medicine, University of British Columbia, Vancouver, BC, Canada
- Department of Microbiology & Immunology, University of Melbourne at the Peter Doherty Institute for Infection and Immunity, Melbourne, VIC, Australia
| | - Megan K Levings
- British Columbia Children's Hospital Research Institute, University of British Columbia, Vancouver, BC, Canada
- Department of Surgery, University of British Columbia, Vancouver, BC, Canada
- School of Biomedical Engineering, University of British Columbia, Vancouver, BC, Canada
| | - Theodore Steiner
- British Columbia Children's Hospital Research Institute, University of British Columbia, Vancouver, BC, Canada
- Department of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Inna Sekirov
- British Columbia Centre for Disease Control, Vancouver, BC, Canada
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, BC, Canada
| | | | - Muhammad Morshed
- British Columbia Centre for Disease Control, Vancouver, BC, Canada
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Danuta M Skowronski
- British Columbia Centre for Disease Control, Vancouver, BC, Canada
- School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada
| | - Mel Krajden
- British Columbia Centre for Disease Control, Vancouver, BC, Canada
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Agatha N Jassem
- British Columbia Centre for Disease Control, Vancouver, BC, Canada
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Manish Sadarangani
- Department of Pediatrics, University of British Columbia, 950 West 28th Avenue, Vancouver, BC, V5Z 4H4, Canada
- Vaccine Evaluation Center, British Columbia Children's Hospital Research Institute, Vancouver, BC, Canada
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2
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Nikiforuk AM, Kuchinski KS, Short K, Roman S, Irvine MA, Prystajecky N, Jassem AN, Patrick DM, Sekirov I. Nasopharyngeal angiotensin converting enzyme 2 (ACE2) expression as a risk-factor for SARS-CoV-2 transmission in concurrent hospital associated outbreaks. BMC Infect Dis 2024; 24:262. [PMID: 38408924 PMCID: PMC10898082 DOI: 10.1186/s12879-024-09067-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Accepted: 01/28/2024] [Indexed: 02/28/2024] Open
Abstract
BACKGROUND Widespread human-to-human transmission of the severe acute respiratory syndrome coronavirus two (SARS-CoV-2) stems from a strong affinity for the cellular receptor angiotensin converting enzyme two (ACE2). We investigate the relationship between a patient's nasopharyngeal ACE2 transcription and secondary transmission within a series of concurrent hospital associated SARS-CoV-2 outbreaks in British Columbia, Canada. METHODS Epidemiological case data from the outbreak investigations was merged with public health laboratory records and viral lineage calls, from whole genome sequencing, to reconstruct the concurrent outbreaks using infection tracing transmission network analysis. ACE2 transcription and RNA viral load were measured by quantitative real-time polymerase chain reaction. The transmission network was resolved to calculate the number of potential secondary cases. Bivariate and multivariable analyses using Poisson and Negative Binomial regression models was performed to estimate the association between ACE2 transcription the number of SARS-CoV-2 secondary cases. RESULTS The infection tracing transmission network provided n = 76 potential transmission events across n = 103 cases. Bivariate comparisons found that on average ACE2 transcription did not differ between patients and healthcare workers (P = 0.86). High ACE2 transcription was observed in 98.6% of transmission events, either the primary or secondary case had above average ACE2. Multivariable analysis found that the association between ACE2 transcription (log2 fold-change) and the number of secondary transmission events differs between patients and healthcare workers. In health care workers Negative Binomial regression estimated that a one-unit change in ACE2 transcription decreases the number of secondary cases (β = -0.132 (95%CI: -0.255 to -0.0181) adjusting for RNA viral load. Conversely, in patients a one-unit change in ACE2 transcription increases the number of secondary cases (β = 0.187 (95% CI: 0.0101 to 0.370) adjusting for RNA viral load. Sensitivity analysis found no significant relationship between ACE2 and secondary transmission in health care workers and confirmed the positive association among patients. CONCLUSION Our study suggests that ACE2 transcription has a positive association with SARS-CoV-2 secondary transmission in admitted inpatients, but not health care workers in concurrent hospital associated outbreaks, and it should be further investigated as a risk-factor for viral transmission.
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Affiliation(s)
- Aidan M Nikiforuk
- British Columbia Centre for Disease Control, V5Z 4R4, Vancouver, BC, Canada
- School of Population and Public Health, University of British Columbia, V6T 1Z4, Vancouver, BC, Canada
| | - Kevin S Kuchinski
- British Columbia Centre for Disease Control, V5Z 4R4, Vancouver, BC, Canada
- Department of Pathology and Laboratory Medicine, University of British Columbia, V6T 1Z4, Vancouver, BC, Canada
| | - Katy Short
- Fraser Health Authority, V3L 3C2, New Westminster, BC, Canada
| | - Susan Roman
- Fraser Health Authority, V3L 3C2, New Westminster, BC, Canada
| | - Mike A Irvine
- British Columbia Centre for Disease Control, V5Z 4R4, Vancouver, BC, Canada
- Faculty of Health Sciences, Simon Fraser University, V5A 1S6, Burnaby, BC, Canada
| | - Natalie Prystajecky
- British Columbia Centre for Disease Control, V5Z 4R4, Vancouver, BC, Canada
- Department of Pathology and Laboratory Medicine, University of British Columbia, V6T 1Z4, Vancouver, BC, Canada
| | - Agatha N Jassem
- British Columbia Centre for Disease Control, V5Z 4R4, Vancouver, BC, Canada
- Department of Pathology and Laboratory Medicine, University of British Columbia, V6T 1Z4, Vancouver, BC, Canada
| | - David M Patrick
- British Columbia Centre for Disease Control, V5Z 4R4, Vancouver, BC, Canada
- School of Population and Public Health, University of British Columbia, V6T 1Z4, Vancouver, BC, Canada
| | - Inna Sekirov
- British Columbia Centre for Disease Control, V5Z 4R4, Vancouver, BC, Canada.
- Department of Pathology and Laboratory Medicine, University of British Columbia, V6T 1Z4, Vancouver, BC, Canada.
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3
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Skowronski DM, Zhan Y, Kaweski SE, Sabaiduc S, Khalid A, Olsha R, Carazo S, Dickinson JA, Mather RG, Charest H, Jassem AN, Levade I, Hasso M, Zelyas N, Gao R, Bastien N. 2023/24 mid-season influenza and Omicron XBB.1.5 vaccine effectiveness estimates from the Canadian Sentinel Practitioner Surveillance Network (SPSN). Euro Surveill 2024; 29:2400076. [PMID: 38362622 PMCID: PMC10986657 DOI: 10.2807/1560-7917.es.2024.29.7.2400076] [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: 02/03/2024] [Accepted: 02/14/2024] [Indexed: 02/17/2024] Open
Abstract
The Canadian Sentinel Practitioner Surveillance Network reports mid-season 2023/24 influenza vaccine effectiveness (VE) of 63% (95% CI: 51-72) against influenza A(H1N1)pdm09, lower for clade 5a.2a.1 (56%; 95% CI: 33-71) than clade 5a.2a (67%; 95% CI: 48-80), and lowest against influenza A(H3N2) (40%; 95% CI: 5-61). The Omicron XBB.1.5 vaccine protected comparably well, with VE of 47% (95% CI: 21-65) against medically attended COVID-19, higher among people reporting a prior confirmed SARS-CoV-2 infection at 67% (95% CI: 28-85).
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Affiliation(s)
- Danuta M Skowronski
- British Columbia Centre for Disease Control, Vancouver, Canada
- University of British Columbia, Vancouver, Canada
| | - Yuping Zhan
- British Columbia Centre for Disease Control, Vancouver, Canada
| | | | - Suzana Sabaiduc
- British Columbia Centre for Disease Control, Vancouver, Canada
| | - Ayisha Khalid
- British Columbia Centre for Disease Control, Vancouver, Canada
| | | | - Sara Carazo
- Institut National de Santé Publique du Québec, Québec, Canada
| | | | - Richard G Mather
- Public Health Ontario, Toronto, Canada
- Queen's University, Kingston, Canada
| | - Hugues Charest
- Institut National de Santé Publique du Québec, Québec, Canada
| | - Agatha N Jassem
- British Columbia Centre for Disease Control, Vancouver, Canada
| | - Inès Levade
- Institut National de Santé Publique du Québec, Québec, Canada
| | | | - Nathan Zelyas
- Public Health Laboratory, Alberta Precision Laboratories, Edmonton, Canada
| | - Ruimin Gao
- National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, Canada
| | - Nathalie Bastien
- National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, Canada
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4
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Silverberg SL, Shulha HP, McMillan B, He G, Lee A, Márquez AC, Bartlett SR, Gill V, Abu-Raya B, Bettinger JA, Cabrera A, Coombs D, Gantt S, Goldfarb DM, Sauvé L, Krajden M, Morshed M, Sekirov I, Jassem AN, Sadarangani M. Factors associated with SARS-CoV-2 infection in unvaccinated children and young adults. BMC Infect Dis 2024; 24:91. [PMID: 38225625 PMCID: PMC10790408 DOI: 10.1186/s12879-023-08950-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2023] [Accepted: 12/24/2023] [Indexed: 01/17/2024] Open
Abstract
BACKGROUND AND OBJECTIVES Pediatric COVID-19 cases are often mild or asymptomatic, which has complicated estimations of disease burden using existing testing practices. We aimed to determine the age-specific population seropositivity and risk factors of SARS-CoV-2 seropositivity among children and young adults during the pandemic in British Columbia (BC). METHODS We conducted two cross-sectional serosurveys: phase 1 enrolled children and adults < 25 years between November 2020-May 2021 and phase 2 enrolled children < 10 years between June 2021-May 2022 in BC. Participants completed electronic surveys and self-collected finger-prick dried blood spot (DBS) samples. Samples were tested for immunoglobulin G antibodies against ancestral spike protein (S). Descriptive statistics from survey data were reported and two multivariable analyses were conducted to evaluate factors associated with seropositivity. RESULTS A total of 2864 participants were enrolled, of which 95/2167 (4.4%) participants were S-seropositive in phase 1 across all ages, and 61/697 (8.8%) unvaccinated children aged under ten years were S-seropositive in phase 2. Overall, South Asian participants had a higher seropositivity than other ethnicities (13.5% vs. 5.2%). Of 156 seropositive participants in both phases, 120 had no prior positive SARS-CoV-2 test. Young infants and young adults had the highest reported seropositivity rates (7.0% and 7.2% respectively vs. 3.0-5.6% across other age groups). CONCLUSIONS SARS-CoV-2 seropositivity among unvaccinated children and young adults was low in May 2022, and South Asians were disproportionately infected. This work demonstrates the need for improved diagnostics and reporting strategies that account for age-specific differences in pandemic dynamics and acceptability of testing mechanisms.
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Affiliation(s)
- Sarah L Silverberg
- Vaccine Evaluation Center, BC Children's Hospital Research Institute, 950 West 28th Ave Vancouver, V5Z 4H4, Vancouver, BC, Canada
- Division of Infectious Diseases, Department of Pediatrics, University of Toronto, Toronto, ON, Canada
| | - Hennady P Shulha
- Vaccine Evaluation Center, BC Children's Hospital Research Institute, 950 West 28th Ave Vancouver, V5Z 4H4, Vancouver, BC, Canada
- Department of Pediatrics, University of British Columbia, Vancouver, BC, Canada
| | - Brynn McMillan
- Vaccine Evaluation Center, BC Children's Hospital Research Institute, 950 West 28th Ave Vancouver, V5Z 4H4, Vancouver, BC, Canada
- Experimental Medicine Program, Department of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Guanyuhui He
- Vaccine Evaluation Center, BC Children's Hospital Research Institute, 950 West 28th Ave Vancouver, V5Z 4H4, Vancouver, BC, Canada
| | - Amy Lee
- Vaccine Evaluation Center, BC Children's Hospital Research Institute, 950 West 28th Ave Vancouver, V5Z 4H4, Vancouver, BC, Canada
- Department of Pediatrics, University of British Columbia, Vancouver, BC, Canada
| | - Ana Citlali Márquez
- Public Health Laboratory, BC Centre for Disease Control, Vancouver, BC, Canada
| | - Sofia R Bartlett
- Public Health Laboratory, BC Centre for Disease Control, Vancouver, BC, Canada
| | - Vivek Gill
- Vaccine Evaluation Center, BC Children's Hospital Research Institute, 950 West 28th Ave Vancouver, V5Z 4H4, Vancouver, BC, Canada
- Department of Pediatrics, University of British Columbia, Vancouver, BC, Canada
| | - Bahaa Abu-Raya
- Vaccine Evaluation Center, BC Children's Hospital Research Institute, 950 West 28th Ave Vancouver, V5Z 4H4, Vancouver, BC, Canada
- Department of Pediatrics, University of British Columbia, Vancouver, BC, Canada
| | - Julie A Bettinger
- Vaccine Evaluation Center, BC Children's Hospital Research Institute, 950 West 28th Ave Vancouver, V5Z 4H4, Vancouver, BC, Canada
- Department of Pediatrics, University of British Columbia, Vancouver, BC, Canada
| | - Adriana Cabrera
- Vaccine Evaluation Center, BC Children's Hospital Research Institute, 950 West 28th Ave Vancouver, V5Z 4H4, Vancouver, BC, Canada
- Department of Pediatrics, University of British Columbia, Vancouver, BC, Canada
| | - Daniel Coombs
- Department of Mathematics, University of British Columbia, Vancouver, BC, Canada
| | - Soren Gantt
- Vaccine Evaluation Center, BC Children's Hospital Research Institute, 950 West 28th Ave Vancouver, V5Z 4H4, Vancouver, BC, Canada
- Centre de Recherche du CHU Sainte-Justine, Montreal, QC, Canada
| | - David M Goldfarb
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Laura Sauvé
- Vaccine Evaluation Center, BC Children's Hospital Research Institute, 950 West 28th Ave Vancouver, V5Z 4H4, Vancouver, BC, Canada
- Department of Pediatrics, University of British Columbia, Vancouver, BC, Canada
| | - Mel Krajden
- Public Health Laboratory, BC Centre for Disease Control, Vancouver, BC, Canada
| | - Muhammad Morshed
- Public Health Laboratory, BC Centre for Disease Control, Vancouver, BC, Canada
| | - Inna Sekirov
- Public Health Laboratory, BC Centre for Disease Control, Vancouver, BC, Canada
| | - Agatha N Jassem
- Public Health Laboratory, BC Centre for Disease Control, Vancouver, BC, Canada
| | - Manish Sadarangani
- Vaccine Evaluation Center, BC Children's Hospital Research Institute, 950 West 28th Ave Vancouver, V5Z 4H4, Vancouver, BC, Canada.
- Department of Pediatrics, University of British Columbia, Vancouver, BC, Canada.
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5
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Skowronski DM, Chuang ESY, Sabaiduc S, Kaweski SE, Kim S, Dickinson JA, Olsha R, Gubbay JB, Zelyas N, Charest H, Bastien N, Jassem AN, De Serres G. Vaccine effectiveness estimates from an early-season influenza A(H3N2) epidemic, including unique genetic diversity with reassortment, Canada, 2022/23. Euro Surveill 2023; 28:2300043. [PMID: 36729117 PMCID: PMC9896608 DOI: 10.2807/1560-7917.es.2023.28.5.2300043] [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] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
The Canadian Sentinel Practitioner Surveillance Network estimated vaccine effectiveness (VE) during the unusually early 2022/23 influenza A(H3N2) epidemic. Like vaccine, circulating viruses were clade 3C.2a1b.2a.2, but with genetic diversity affecting haemagglutinin positions 135 and 156, and reassortment such that H156 viruses acquired neuraminidase from clade 3C.2a1b.1a. Vaccine provided substantial protection with A(H3N2) VE of 54% (95% CI: 38 to 66) overall. VE was similar against H156 and vaccine-like S156 viruses, but with potential variation based on diversity at position 135.
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Affiliation(s)
- Danuta M Skowronski
- British Columbia Centre for Disease Control, Vancouver, Canada,University of British Columbia, Vancouver, Canada
| | - Erica SY Chuang
- British Columbia Centre for Disease Control, Vancouver, Canada
| | - Suzana Sabaiduc
- British Columbia Centre for Disease Control, Vancouver, Canada
| | | | - Shinhye Kim
- British Columbia Centre for Disease Control, Vancouver, Canada
| | | | | | - Jonathan B Gubbay
- Public Health Ontario, Toronto, Canada,University of Toronto, Toronto, Canada
| | - Nathan Zelyas
- Public Health Laboratory, Alberta Precision Laboratories, Edmonton, Canada
| | - Hugues Charest
- Institut National de Santé Publique du Québec, Québec, Canada
| | - Nathalie Bastien
- National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, Canada
| | - Agatha N Jassem
- British Columbia Centre for Disease Control, Vancouver, Canada,University of British Columbia, Vancouver, Canada
| | - Gaston De Serres
- Institut National de Santé Publique du Québec, Québec, Canada,Laval University, Quebec, Canada,Centre Hospitalier Universitaire de Québec, Québec, Canada
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6
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Asamoah-Boaheng M, Goldfarb D, Prusinkiewicz MA, Golding L, Karim ME, Barakauskas V, Wall N, Jassem AN, Marquez AC, MacDonald C, O'Brien SF, Lavoie P, Grunau B. Determining the Optimal SARS-CoV-2 mRNA Vaccine Dosing Interval for Maximum Immunogenicity. Cureus 2023; 15:e34465. [PMID: 36874687 PMCID: PMC9981229 DOI: 10.7759/cureus.34465] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/30/2023] [Indexed: 02/04/2023] Open
Abstract
OBJECTIVE Emerging evidence indicates that longer SARS-CoV-2 vaccine dosing intervals results in an enhanced immune response. However, the optimal vaccine dosing interval for achieving maximum immunogenicity is unclear. METHODS This study included samples from adult paramedics in Canada who received two doses of either BNT162b2 or mRNA-1273 vaccines and provided blood samples six months (170 to 190 days) after the first vaccine dose. The main exposure variable was vaccine dosing interval (days), categorized as "short" (first quartile), "moderate" (second quartile), "long" (third quartile), and "longest" interval (fourth quartile). The primary outcome was total spike antibody concentrations, measured using the Elecsys SARS-CoV-2 total antibody assay. Secondary outcomes included spike and receptor-binding domain (RBD) immunoglobulin G (IgG) antibody concentrations, and inhibition of angiotensin-converting enzyme 2 (ACE-2) binding to wild-type spike protein and several different Delta variant spike proteins. We fit a multiple log-linear regression model to investigate the association between vaccine dosing intervals and the antibody concentrations. RESULTS A total of 564 adult paramedics (mean age 40 years, SD=10) were included. Compared to "short interval" (≤30 days), vaccine dosing intervals of the long (39-73 days) group (β= 0.31, 95% Confidence interval (CI): 0.10-0.52) and the longest (≥74 days) group (β = 0.82. 95% CI: 0.36-1.28) were associated with increased spike total antibody concentration. Compared to the short interval, the longest interval quartile was associated with higher spike IgG antibodies, while the long and longest intervals were associated with higher RBD IgG antibody concentrations. Similarly, the longest dosing intervals increased inhibition of ACE-2 binding to viral spike protein. CONCLUSION Increased mRNA vaccine dosing intervals longer than 38 days result in higher levels of anti-spike antibodies and ACE-2 inhibition when assessed six months after the first COVID-19 vaccine.
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Affiliation(s)
| | - David Goldfarb
- Pathology and Laboratory Medicine, University of British Columbia, Vancouver, CAN
| | | | - Liam Golding
- Obstetrics and Gynecology, University of British Columbia, Vancouver, CAN
| | - Mohammad E Karim
- Centre for Health Evaluation & Outcome Sciences, University of British Columbia, Vancouver, CAN
| | - Vilte Barakauskas
- Pathology and Laboratory Medicine, University of British Columbia, Vancouver, CAN
| | - Nechelle Wall
- Emergency Health Services, British Columbia Emergency Health Services, Vancouver, CAN
| | - Agatha N Jassem
- Public Health Laboratory, British Columbia Centre for Disease Control, Vancouver, CAN
| | - Ana Citlali Marquez
- Public Health Laboratory, British Columbia Centre for Disease Control, Vancouver, CAN
| | - Chris MacDonald
- Dalla Lana School of Public Health, University of Toronto, Toronto, CAN
| | - Sheila F O'Brien
- School of Epidemiology & Public Health, University of Ottawa & Canadian Blood Services, Ottawa, CAN
| | - Pascal Lavoie
- Department of Pediatrics, University of British Columbia, Vancouver, CAN
| | - Brian Grunau
- Emergency Medicine, St. Paul's Hospital, University of British Columbia, Vancouver, CAN
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7
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Olmstead AD, Nikiforuk AM, Schwartz S, Márquez AC, Valadbeigy T, Flores E, Saran M, Goldfarb DM, Hayden A, Masud S, Russell SL, Prystajecky N, Jassem AN, Morshed M, Sekirov I. Characterizing Longitudinal Antibody Responses in Recovered Individuals Following COVID-19 Infection and Single-Dose Vaccination: A Prospective Cohort Study. Viruses 2022; 14:v14112416. [PMID: 36366515 PMCID: PMC9694471 DOI: 10.3390/v14112416] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Revised: 10/22/2022] [Accepted: 10/26/2022] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND Investigating antibody titers in individuals who have been both naturally infected with SARS-CoV-2 and vaccinated can provide insight into antibody dynamics and correlates of protection over time. METHODS Human coronavirus (HCoV) IgG antibodies were measured longitudinally in a prospective cohort of qPCR-confirmed, COVID-19 recovered individuals (k = 57) in British Columbia pre- and post-vaccination. SARS-CoV-2 and endemic HCoV antibodies were measured in serum collected between Nov. 2020 and Sept. 2021 (n = 341). Primary analysis used a linear mixed-effects model to understand the effect of single dose vaccination on antibody concentrations adjusting for biological sex, age, time from infection and vaccination. Secondary analysis investigated the cumulative incidence of high SARS-CoV-2 anti-spike IgG seroreactivity equal to or greater than 5.5 log10 AU/mL up to 105 days post-vaccination. No re-infections were detected in vaccinated participants, post-vaccination by qPCR performed on self-collected nasopharyngeal specimens. RESULTS Bivariate analysis (complete data for 42 participants, 270 samples over 472 days) found SARS-CoV-2 spike and RBD antibodies increased 14-56 days post-vaccination (p < 0.001) and vaccination prevented waning (regression coefficient, B = 1.66 [95%CI: 1.45-3.46]); while decline of nucleocapsid antibodies over time was observed (regression coefficient, B = -0.24 [95%CI: -1.2-(-0.12)]). A positive association was found between COVID-19 vaccination and endemic human β-coronavirus IgG titer 14-56 days post vaccination (OC43, p = 0.02 & HKU1, p = 0.02). On average, SARS-CoV-2 anti-spike IgG concentration increased in participants who received one vaccine dose by 2.06 log10 AU/mL (95%CI: 1.45-3.46) adjusting for age, biological sex, and time since infection. Cumulative incidence of high SARS-CoV-2 spike antibodies (>5.5 log10 AU/mL) was 83% greater in vaccinated compared to unvaccinated individuals. CONCLUSIONS Our study confirms that vaccination post-SARS-CoV-2 infection provides multiple benefits, such as increasing anti-spike IgG titers and preventing decay up to 85 days post-vaccination.
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Affiliation(s)
- Andrea D. Olmstead
- Department of Pathology and Laboratory Medicine, University of British Columbia, 2211 Wesbrook Mall, Vancouver, BC V6T 1Z7, Canada
- British Columbia Centre for Disease Control Public Health Laboratory, Provincial Health Services Authority, 655 West 12th Ave, Vancouver, BC V5Z 4R4, Canada
| | - Aidan M. Nikiforuk
- British Columbia Centre for Disease Control Public Health Laboratory, Provincial Health Services Authority, 655 West 12th Ave, Vancouver, BC V5Z 4R4, Canada
- School of Population and Public Health, University of British Columbia, 2206 E Mall, Vancouver, BC V6T 1Z3, Canada
| | - Sydney Schwartz
- British Columbia Centre for Disease Control Public Health Laboratory, Provincial Health Services Authority, 655 West 12th Ave, Vancouver, BC V5Z 4R4, Canada
| | - Ana Citlali Márquez
- British Columbia Centre for Disease Control Public Health Laboratory, Provincial Health Services Authority, 655 West 12th Ave, Vancouver, BC V5Z 4R4, Canada
| | - Tahereh Valadbeigy
- British Columbia Centre for Disease Control Public Health Laboratory, Provincial Health Services Authority, 655 West 12th Ave, Vancouver, BC V5Z 4R4, Canada
| | - Eri Flores
- British Columbia Centre for Disease Control Public Health Laboratory, Provincial Health Services Authority, 655 West 12th Ave, Vancouver, BC V5Z 4R4, Canada
| | - Monika Saran
- Department of Pathology and Laboratory Medicine, University of British Columbia, 2211 Wesbrook Mall, Vancouver, BC V6T 1Z7, Canada
| | - David M. Goldfarb
- Department of Pathology and Laboratory Medicine, University of British Columbia, 2211 Wesbrook Mall, Vancouver, BC V6T 1Z7, Canada
- Department of Pathology and Laboratory Medicine, British Columbia Children’s and Women’s Hospital, 4500 Oak Street, Vancouver, BC V6H 3N1, Canada
| | - Althea Hayden
- Office of the Chief Medical Health Officer, Vancouver Coastal Health, Vancouver, BC V5Z 4C2, Canada
| | - Shazia Masud
- Department of Pathology and Laboratory Medicine, University of British Columbia, 2211 Wesbrook Mall, Vancouver, BC V6T 1Z7, Canada
- Department of Pathology and Laboratory Medicine, Surrey Memorial Hospital, Surrey, BC V3V 1Z2, Canada
| | - Shannon L. Russell
- Department of Pathology and Laboratory Medicine, University of British Columbia, 2211 Wesbrook Mall, Vancouver, BC V6T 1Z7, Canada
- British Columbia Centre for Disease Control Public Health Laboratory, Provincial Health Services Authority, 655 West 12th Ave, Vancouver, BC V5Z 4R4, Canada
| | - Natalie Prystajecky
- Department of Pathology and Laboratory Medicine, University of British Columbia, 2211 Wesbrook Mall, Vancouver, BC V6T 1Z7, Canada
- British Columbia Centre for Disease Control Public Health Laboratory, Provincial Health Services Authority, 655 West 12th Ave, Vancouver, BC V5Z 4R4, Canada
| | - Agatha N. Jassem
- Department of Pathology and Laboratory Medicine, University of British Columbia, 2211 Wesbrook Mall, Vancouver, BC V6T 1Z7, Canada
- British Columbia Centre for Disease Control Public Health Laboratory, Provincial Health Services Authority, 655 West 12th Ave, Vancouver, BC V5Z 4R4, Canada
| | - Muhammad Morshed
- Department of Pathology and Laboratory Medicine, University of British Columbia, 2211 Wesbrook Mall, Vancouver, BC V6T 1Z7, Canada
- British Columbia Centre for Disease Control Public Health Laboratory, Provincial Health Services Authority, 655 West 12th Ave, Vancouver, BC V5Z 4R4, Canada
| | - Inna Sekirov
- Department of Pathology and Laboratory Medicine, University of British Columbia, 2211 Wesbrook Mall, Vancouver, BC V6T 1Z7, Canada
- British Columbia Centre for Disease Control Public Health Laboratory, Provincial Health Services Authority, 655 West 12th Ave, Vancouver, BC V5Z 4R4, Canada
- Correspondence:
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8
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Asamoah-Boaheng M, Goldfarb DM, Karim ME, O’Brien SF, Wall N, Drews SJ, Barakauskas V, Jassem AN, Grunau B. The Relationship Between Anti-Spike SARS-CoV-2 Antibody Levels and Risk of Breakthrough COVID-19 Among Fully Vaccinated Adults. J Infect Dis 2022; 227:339-343. [PMID: 36197948 PMCID: PMC9619727 DOI: 10.1093/infdis/jiac403] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Revised: 09/26/2022] [Accepted: 10/03/2022] [Indexed: 02/04/2023] Open
Abstract
The relationship between antibodies to wild-type severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) antigens and the risk of breakthrough infections is unclear, especially during circulation of the Omicron strain. We investigated the association of anti-spike and anti-receptor binding domain antibody levels and the risk of subsequent breakthrough coronavirus disease 2019 (COVID-19). We included adult paramedics from an observational cohort study who received 2 mRNA vaccines but did not have COVID-19 before the blood collection. Higher postvaccination antibody levels to wild-type SARS-CoV-2 antigens were associated with a reduced risk of COVID-19. Further research into clinical utility of antibody levels, to inform a threshold for protection and timing of boosters, should be prioritized.
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Affiliation(s)
- Michael Asamoah-Boaheng
- Correspondence: Dr Michael Asamoah-Boaheng, Department of Emergency Medicine, University of British Columbia, 1190 Horby Street, Vancouver, British Columbia V6Z 2K5, Canada ()
| | - David M Goldfarb
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Mohammad Ehsanul Karim
- Centre for Health Evaluation and Outcome Sciences, University of British Columbia, Vancouver, British Columbia, Canada,School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada
| | - Sheila F O’Brien
- Canadian Blood Services, Vancouver, British Columbia, Canada,School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada
| | - Nechelle Wall
- British Columbia Emergency Health Services, Vancouver, British Columbia, Canada
| | - Steven J Drews
- Canadian Blood Services, Vancouver, British Columbia, Canada,Division of Diagnostic and Applied Microbiology, Laboratory Medicine and Pathology, University of Alberta, Alberta, Canada
| | - Vilte Barakauskas
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Agatha N Jassem
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, British Columbia, Canada
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9
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Asamoah-Boaheng M, Grunau B, Karim ME, Jassem AN, Bolster J, Marquez AC, Scheuermeyer FX, Goldfarb DM. Are higher antibody levels against seasonal human coronaviruses associated with a more robust humoral immune response after SARS-CoV-2 vaccination? Front Immunol 2022; 13:954093. [PMID: 36159791 PMCID: PMC9493031 DOI: 10.3389/fimmu.2022.954093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Accepted: 08/19/2022] [Indexed: 11/16/2022] Open
Abstract
The SARS-CoV-2 belongs to the coronavirus family, which also includes common endemic coronaviruses (HCoVs). We hypothesized that immunity to HCoVs would be associated with stronger immunogenicity from SARS-CoV-2 vaccines. The study included samples from the COSRIP observational cohort study of adult paramedics in Canada. Participants provided blood samples, questionnaire data, and results of COVID-19 testing. Samples were tested for anti-spike IgG against SARS-CoV-2, HCoV-229E, HCoV-HKU1, HCoV-NL63, and HCoV-OC43 antigens. We first compared samples from vaccinated and unvaccinated participants, to determine which HCoV antibodies were affected by vaccination. We created scatter plots and performed correlation analysis to estimate the extent of the linear relationship between HCoVs and SARS-CoV-2 anti-spike antibodies. Further, using adjusted log-log multiple regression, we modeled the association between each strain of HCoV and SARS-CoV-2 antibodies. Of 1510 participants (mean age of 39 years), 94 (6.2%) had a history of COVID-19. There were significant differences between vaccinated and unvaccinated participant in anti-spike antibodies to HCoV-HKU1, and HCoV-OC43; however, levels for HCoV-229E and HCoV-NL63 were similar (suggesting that vaccination did not affect these baseline values). Among vaccinated individuals without prior COVID-19 infection, SARS-COV-2 anti-spike IgG demonstrated a weak positive relationship between both HCoV-229E (r = 0.11) and HCoV-NL63 (r = 0.12). From the adjusted log-log multiple regression model, higher HCoV-229E and HCoV-NL63 anti-spike IgG antibodies were associated with increased SARS-COV-2 anti-spike IgG antibodies. Vaccination appears to result in measurable increases in HCoV-HKU1, and HCoV-OC43 IgG levels. Anti-HCoV-229E and HCoV-NL63 antibodies were unaffected by vaccination, and higher levels were associated with significantly higher COVID-19 vaccine-induced SARS-COV-2 antibodies.
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Affiliation(s)
- Michael Asamoah-Boaheng
- Department of Emergency Medicine, University of British Columbia, Vancouver, BC, Canada
- Faculty of Medicine, Clinical Epidemiology, Memorial University of Newfoundland, St John’s, NL, Canada
| | - Brian Grunau
- Department of Emergency Medicine, University of British Columbia, Vancouver, BC, Canada
- Centre for Health Evaluation & Outcome Sciences, University of British Columbia, Vancouver, BC, Canada
- Clinical and Medical Programs, British Columbia Emergency Health Services, Vancouver, BC, Canada
| | - Mohammad Ehsanul Karim
- Centre for Health Evaluation & Outcome Sciences, University of British Columbia, Vancouver, BC, Canada
- School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada
| | - Agatha N. Jassem
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, BC, Canada
- Public Health Laboratory, British Columbia Centre for Disease Control, Vancouver, BC, Canada
| | - Jennifer Bolster
- Clinical and Medical Programs, British Columbia Emergency Health Services, Vancouver, BC, Canada
| | - Ana Citlali Marquez
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, BC, Canada
- Public Health Laboratory, British Columbia Centre for Disease Control, Vancouver, BC, Canada
| | - Frank X. Scheuermeyer
- Department of Emergency Medicine, University of British Columbia, Vancouver, BC, Canada
- Centre for Health Evaluation & Outcome Sciences, University of British Columbia, Vancouver, BC, Canada
| | - David M. Goldfarb
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, BC, Canada
- British Columbia Children’s Hospital Research Institute, British Columbia Children’s Hospital, Vancouver, BC, Canada
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10
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Kim S, Chuang ES, Sabaiduc S, Olsha R, Kaweski SE, Zelyas N, Gubbay JB, Jassem AN, Charest H, De Serres G, Dickinson JA, Skowronski DM. Influenza vaccine effectiveness against A(H3N2) during the delayed 2021/22 epidemic in Canada. Euro Surveill 2022; 27. [PMID: 36148674 PMCID: PMC9511683 DOI: 10.2807/1560-7917.es.2022.27.38.2200720] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [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] [Indexed: 11/20/2022]
Abstract
Influenza virus circulation virtually ceased in Canada during the COVID-19 pandemic, re-emerging with the relaxation of restrictions in spring 2022. Using a test-negative design, the Canadian Sentinel Practitioner Surveillance Network reports 2021/22 vaccine effectiveness of 36% (95% CI: −38 to 71) against late-season illness due to influenza A(H3N2) clade 3C.2a1b.2a.2 viruses, considered antigenically distinct from the 3C.2a1b.2a.1 vaccine strain. Findings reinforce the World Health Organization’s decision to update the 2022/23 northern hemisphere vaccine to a more representative A(H3N2) clade 3C.2a1b.2a.2 strain.
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Affiliation(s)
- Shinhye Kim
- British Columbia Centre for Disease Control, Vancouver, Canada
| | - Erica Sy Chuang
- British Columbia Centre for Disease Control, Vancouver, Canada
| | - Suzana Sabaiduc
- British Columbia Centre for Disease Control, Vancouver, Canada
| | | | | | - Nathan Zelyas
- Public Health Laboratory, Alberta Precision Laboratories, Edmonton, Canada
| | - Jonathan B Gubbay
- University of Toronto, Toronto, Canada.,Public Health Ontario, Toronto, Canada
| | - Agatha N Jassem
- University of British Columbia, Vancouver, Canada.,British Columbia Centre for Disease Control, Vancouver, Canada
| | - Hugues Charest
- Institut national de santé publique du Québec, Québec, Canada
| | - Gaston De Serres
- Centre Hospitalier Universitaire de Québec, Québec, Canada.,Laval University, Quebec, Canada.,Institut national de santé publique du Québec, Québec, Canada
| | | | - Danuta M Skowronski
- University of British Columbia, Vancouver, Canada.,British Columbia Centre for Disease Control, Vancouver, Canada
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11
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Grunau B, Asamoah-Boaheng M, Lavoie PM, Karim ME, Kirkham TL, Demers PA, Barakauskas V, Marquez AC, Jassem AN, O’Brien SF, Drews SJ, Haig S, Cheskes S, Goldfarb DM. A Higher Antibody Response Is Generated With a 6- to 7-Week (vs Standard) Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Vaccine Dosing Interval. Clin Infect Dis 2022; 75:e888-e891. [PMID: 34849655 PMCID: PMC8690265 DOI: 10.1093/cid/ciab938] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2021] [Indexed: 01/19/2023] Open
Abstract
The optimal dosing interval for severe acute respiratory syndrome coronavirus 2 vaccines remains controversial. In this prospective study, we compared serology results of paramedics vaccinated with mRNA vaccines at the recommended short (17-28 days) vs long (42-49 days) interval. We found that a long dosing interval resulted in higher spike, receptor binding domain, and spike N terminal domain antibody concentrations.
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Affiliation(s)
- Brian Grunau
- Centre for Health Evaluation & Outcome Sciences, University of British Columbia, Canada
- Department of Emergency Medicine, University of British Columbia, Canada
- British Columbia Emergency Health Services, British Columbia, Canada
| | - Michael Asamoah-Boaheng
- Department of Emergency Medicine, University of British Columbia, Canada
- Faculty of Medicine, Clinical Epidemiology, Memorial University of Newfoundland, Canada
| | - Pascal M Lavoie
- Department of Pediatrics, University of British Columbia, Canada
| | - Mohammad Ehsanul Karim
- Centre for Health Evaluation & Outcome Sciences, University of British Columbia, Canada
- School of Population and Public Health, University of British Columbia, Canada
| | - Tracy L Kirkham
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
- Ontario Occupational Cancer Research Centre, Ontario, Canada
| | - Paul A Demers
- School of Population and Public Health, University of British Columbia, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
- Ontario Occupational Cancer Research Centre, Ontario, Canada
| | - Vilte Barakauskas
- Department of Pathology and Laboratory Medicine, University of British Columbia, Canada
| | - Ana Citlali Marquez
- Department of Pathology and Laboratory Medicine, University of British Columbia, Canada
- Public Health Laboratory, British Columbia Centre for Disease Control, British Columbia, Canada
| | - Agatha N Jassem
- Department of Pathology and Laboratory Medicine, University of British Columbia, Canada
- Public Health Laboratory, British Columbia Centre for Disease Control, British Columbia, Canada
| | | | - Steven J Drews
- Canadian, Blood Services Canada
- Laboratory Medicine and Pathology, University of Alberta, Alberta, Canadaand
| | - Scott Haig
- British Columbia Emergency Health Services, British Columbia, Canada
| | - Sheldon Cheskes
- Li Ka Shing Knowledge Institute and Division of Emergency Medicine, Department of Family and Community Medicine, University of Toronto, Ontario, Canada
| | - David M Goldfarb
- Department of Pathology and Laboratory Medicine, University of British Columbia, Canada
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12
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Nikiforuk AM, Sekirov I, Jassem AN. Simple Approximation of Sample Size for Precise Estimates of SARS-CoV-2 Infection from Point-Seroprevalence StudiesAidan. Public Health 2022; 212:7-9. [PMID: 36174438 PMCID: PMC9395286 DOI: 10.1016/j.puhe.2022.08.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Revised: 08/03/2022] [Accepted: 08/16/2022] [Indexed: 11/18/2022]
Affiliation(s)
- A M Nikiforuk
- British Columbia Centre for Disease Control, Vancouver, British Columbia, Canada; School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada.
| | - I Sekirov
- British Columbia Centre for Disease Control, Vancouver, British Columbia, Canada; Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - A N Jassem
- British Columbia Centre for Disease Control, Vancouver, British Columbia, Canada; Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, British Columbia, Canada
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13
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Skowronski DM, Febriani Y, Ouakki M, Setayeshgar S, El Adam S, Zou M, Talbot D, Prystajecky N, Tyson JR, Gilca R, Brousseau N, Deceuninck G, Galanis E, Fjell CD, Sbihi H, Fortin E, Barkati S, Sauvageau C, Naus M, Patrick DM, Henry B, Hoang LMN, De Wals P, Garenc C, Carignan A, Drolet M, Jassem AN, Sadarangani M, Brisson M, Krajden M, De Serres G. Two-Dose Severe Acute Respiratory Syndrome Coronavirus 2 Vaccine Effectiveness With Mixed Schedules and Extended Dosing Intervals: Test-Negative Design Studies From British Columbia and Quebec, Canada. Clin Infect Dis 2022; 75:1980-1992. [PMID: 35438175 PMCID: PMC9047203 DOI: 10.1093/cid/ciac290] [Citation(s) in RCA: 54] [Impact Index Per Article: 27.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Indexed: 01/17/2023] Open
Abstract
BACKGROUND The Canadian coronavirus disease 2019 (COVID-19) immunization strategy deferred second doses and allowed mixed schedules. We compared 2-dose vaccine effectiveness (VE) by vaccine type (mRNA and/or ChAdOx1), interval between doses, and time since second dose in 2 of Canada's larger provinces. METHODS Two-dose VE against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection or hospitalization among adults ≥18 years, including due to Alpha, Gamma, and Delta variants of concern (VOCs), was assessed ≥14 days postvaccination by test-negative design studies separately conducted in British Columbia and Quebec, Canada, between 30 May and 27 November (epi-weeks 22-47) 2021. RESULTS In both provinces, all homologous or heterologous mRNA and/or ChAdOx1 2-dose schedules were associated with ≥90% reduction in SARS-CoV-2 hospitalization risk for ≥7 months. With slight decline from a peak of >90%, VE against infection was ≥80% for ≥6 months following homologous mRNA vaccination, lower by ∼10% when both doses were ChAdOx1 but comparably high following heterologous ChAdOx1 + mRNA receipt. Findings were similar by age group, sex, and VOC. VE was significantly higher with longer 7-8-week versus manufacturer-specified 3-4-week intervals between mRNA doses. CONCLUSIONS Two doses of any mRNA and/or ChAdOx1 combination gave substantial and sustained protection against SARS-CoV-2 hospitalization, spanning Delta-dominant circulation. ChAdOx1 VE against infection was improved by heterologous mRNA series completion. A 7-8-week interval between first and second doses improved mRNA VE and may be the optimal schedule outside periods of intense epidemic surge. Findings support interchangeability and extended intervals between SARS-CoV-2 vaccine doses, with potential global implications for low-coverage areas and, going forward, for children.
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Affiliation(s)
- Danuta M Skowronski
- Correspondence: D. M. Skowronski, BC Centre for Disease Control, 655 West 12th Avenue, Vancouver, BC, Canada V5Z 4R4 ()
| | - Yossi Febriani
- Centre Hospitalier Universitaire (CHU) de Québec-Université Laval Research Center, Quebec City, Quebec, Canada
| | - Manale Ouakki
- Institut National de Sante Publique du Québec, Biological and Occupational Risks, Quebec City, Quebec, Canada
| | - Solmaz Setayeshgar
- BC Centre for Disease Control, Communicable Diseases and Immunization Services, Vancouver, British Columbia, Canada
| | - Shiraz El Adam
- BC Centre for Disease Control, Communicable Diseases and Immunization Services, Vancouver, British Columbia, Canada
| | - Macy Zou
- BC Centre for Disease Control, Data and Analytics Services, Vancouver, British Columbia, Canada
| | - Denis Talbot
- Centre Hospitalier Universitaire (CHU) de Québec-Université Laval Research Center, Quebec City, Quebec, Canada,Laval University, Department of Social and Preventive Medicine, Faculty of Medicine, Quebec City, Quebec, Canada
| | - Natalie Prystajecky
- BC Centre for Disease Control, Public Health Laboratory, Vancouver, British Columbia, Canada,University of British Columbia, Department of Pathology and Laboratory Medicine, Vancouver, British Columbia, Canada
| | - John R Tyson
- BC Centre for Disease Control, Public Health Laboratory, Vancouver, British Columbia, Canada
| | - Rodica Gilca
- Centre Hospitalier Universitaire (CHU) de Québec-Université Laval Research Center, Quebec City, Quebec, Canada,Institut National de Sante Publique du Québec, Biological and Occupational Risks, Quebec City, Quebec, Canada,Laval University, Department of Social and Preventive Medicine, Faculty of Medicine, Quebec City, Quebec, Canada
| | - Nicholas Brousseau
- Centre Hospitalier Universitaire (CHU) de Québec-Université Laval Research Center, Quebec City, Quebec, Canada,Institut National de Sante Publique du Québec, Biological and Occupational Risks, Quebec City, Quebec, Canada,Laval University, Department of Social and Preventive Medicine, Faculty of Medicine, Quebec City, Quebec, Canada
| | - Geneviève Deceuninck
- Centre Hospitalier Universitaire (CHU) de Québec-Université Laval Research Center, Quebec City, Quebec, Canada
| | - Eleni Galanis
- BC Centre for Disease Control, Communicable Diseases and Immunization Services, Vancouver, British Columbia, Canada,University of British Columbia, School of Population and Public Health, Vancouver, British Columbia, Canada
| | - Chris D Fjell
- BC Centre for Disease Control, Public Health Laboratory, Vancouver, British Columbia, Canada
| | - Hind Sbihi
- University of British Columbia, School of Population and Public Health, Vancouver, British Columbia, Canada,BC Centre for Disease Control, Data and Analytics Services, Vancouver, British Columbia, Canada
| | - Elise Fortin
- Institut National de Sante Publique du Québec, Biological and Occupational Risks, Quebec City, Quebec, Canada,Laval University, Department of Social and Preventive Medicine, Faculty of Medicine, Quebec City, Quebec, Canada,Université de Montréal, Département de Microbiologie, Infectiologie et Immunologie, Montreal, Quebec, Canada
| | - Sapha Barkati
- McGill University, Department of Medicine, Division of Infectious Diseases, McGill University Health Center, Montreal, Quebec, Canada
| | - Chantal Sauvageau
- Centre Hospitalier Universitaire (CHU) de Québec-Université Laval Research Center, Quebec City, Quebec, Canada,Institut National de Sante Publique du Québec, Biological and Occupational Risks, Quebec City, Quebec, Canada,Laval University, Department of Social and Preventive Medicine, Faculty of Medicine, Quebec City, Quebec, Canada
| | - Monika Naus
- BC Centre for Disease Control, Communicable Diseases and Immunization Services, Vancouver, British Columbia, Canada,University of British Columbia, School of Population and Public Health, Vancouver, British Columbia, Canada
| | - David M Patrick
- BC Centre for Disease Control, Communicable Diseases and Immunization Services, Vancouver, British Columbia, Canada,University of British Columbia, School of Population and Public Health, Vancouver, British Columbia, Canada
| | - Bonnie Henry
- University of British Columbia, School of Population and Public Health, Vancouver, British Columbia, Canada,Office of the Provincial Health Officer, Ministry of Health, Victoria, British Columbia, Canada
| | - Linda M N Hoang
- BC Centre for Disease Control, Public Health Laboratory, Vancouver, British Columbia, Canada,University of British Columbia, Department of Pathology and Laboratory Medicine, Vancouver, British Columbia, Canada
| | - Philippe De Wals
- Centre Hospitalier Universitaire (CHU) de Québec-Université Laval Research Center, Quebec City, Quebec, Canada,Institut National de Sante Publique du Québec, Biological and Occupational Risks, Quebec City, Quebec, Canada,Laval University, Department of Social and Preventive Medicine, Faculty of Medicine, Quebec City, Quebec, Canada
| | - Christophe Garenc
- Centre Hospitalier Universitaire (CHU) de Québec-Université Laval Research Center, Quebec City, Quebec, Canada,Institut National de Sante Publique du Québec, Biological and Occupational Risks, Quebec City, Quebec, Canada
| | - Alex Carignan
- Sherbrooke University, Department of Microbiology and Infectious Diseases, Sherbrooke, Quebec, Canada
| | - Mélanie Drolet
- Centre Hospitalier Universitaire (CHU) de Québec-Université Laval Research Center, Quebec City, Quebec, Canada,Laval University, Department of Social and Preventive Medicine, Faculty of Medicine, Quebec City, Quebec, Canada
| | - Agatha N Jassem
- BC Centre for Disease Control, Public Health Laboratory, Vancouver, British Columbia, Canada,University of British Columbia, Department of Pathology and Laboratory Medicine, Vancouver, British Columbia, Canada
| | - Manish Sadarangani
- BC Children’s Hospital Research Institute, Vaccine Evaluation Center, Vancouver, British Columbia, Canada,University of British Columbia, Department of Pediatrics, Vancouver, British Columbia, Canada
| | - Marc Brisson
- Centre Hospitalier Universitaire (CHU) de Québec-Université Laval Research Center, Quebec City, Quebec, Canada,Laval University, Department of Social and Preventive Medicine, Faculty of Medicine, Quebec City, Quebec, Canada
| | - Mel Krajden
- BC Centre for Disease Control, Public Health Laboratory, Vancouver, British Columbia, Canada,University of British Columbia, Department of Pathology and Laboratory Medicine, Vancouver, British Columbia, Canada
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14
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Skowronski DM, Setayeshgar S, Zou M, Prystajecky N, Tyson JR, Galanis E, Naus M, Patrick DM, Sbihi H, El Adam S, Henry B, Hoang LMN, Sadarangani M, Jassem AN, Krajden M. Single-dose mRNA Vaccine Effectiveness Against Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), Including Alpha and Gamma Variants: A Test-negative Design in Adults 70 Years and Older in British Columbia, Canada. Clin Infect Dis 2022; 74:1158-1165. [PMID: 34244723 PMCID: PMC8406884 DOI: 10.1093/cid/ciab616] [Citation(s) in RCA: 26] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2021] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Randomized-controlled trials of messenger RNA (mRNA) vaccine protection against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) included relatively few elderly participants. We assess single-dose mRNA vaccine effectiveness (VE) in adults ≥ 70 years old in British Columbia, Canada, where second doses were deferred by up to 16 weeks and where a spring 2021 wave uniquely included codominant circulation of Alpha (B.1.1.7) and Gamma (P.1) variants of concern (VOC). METHODS Analyses included community-dwelling adults ≥ 70 years old with specimen collection between 4 April (epidemiological week 14) and 1 May (week 17) 2021. Adjusted VE was estimated by test-negative design. Cases were reverse-transcription polymerase chain reaction (RT-PCR) test-positive for SARS-CoV-2, and controls were test-negative. Vaccine status was defined by receipt of a single-dose ≥ 21 days before specimen collection, but a range of intervals was assessed. Variant-specific VE was estimated against viruses genetically characterized as Alpha, Gamma or non-VOC lineages. RESULTS VE analyses included 16 993 specimens: 1226 (7%) test-positive cases and 15 767 test-negative controls. Of 1131 (92%) genetically characterized viruses, 509 (45%), 314 (28%), and 276 (24%) were Alpha, Gamma, and non-VOC lineages, respectively. At 0-13 days postvaccination, VE was negligible at 14% (95% confidence interval [CI], 0-26) but increased from 43% (95% CI, 30-53) at 14-20 days to 75% (95% CI, 63-83) at 35-41 days postvaccination. VE at ≥ 21 days postvaccination was 65% (95% CI, 58-71) overall: 72% (95% CI, 58-81), 67% (95% CI, 57-75), and 61% (95% CI, 45-72) for non-VOC, Alpha, and Gamma variants, respectively. CONCLUSIONS A single dose of mRNA vaccine reduced the risk of SARS-CoV-2 by about two-thirds in adults ≥ 70 years old, with protection only minimally reduced against Alpha and Gamma variants.
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Affiliation(s)
- Danuta M Skowronski
- BC Centre for Disease Control, Communicable Diseases and Immunization Services, Vancouver, British Columbia, Canada
- University of British Columbia, School of Population and Public Health, Vancouver, British Columbia, Canada
| | - Solmaz Setayeshgar
- BC Centre for Disease Control, Communicable Diseases and Immunization Services, Vancouver, British Columbia, Canada
| | - Macy Zou
- BC Centre for Disease Control, Data and Analytics Services, Vancouver, British Columbia, Canada
| | - Natalie Prystajecky
- BC Centre for Disease Control, Public Health Laboratory, Vancouver, British Columbia, Canada
- University of British Columbia, Department of Pathology and Laboratory Medicine, Vancouver, British Columbia, Canada
| | - John R Tyson
- BC Centre for Disease Control, Public Health Laboratory, Vancouver, British Columbia, Canada
- University of British Columbia, Department of Pathology and Laboratory Medicine, Vancouver, British Columbia, Canada
| | - Eleni Galanis
- BC Centre for Disease Control, Communicable Diseases and Immunization Services, Vancouver, British Columbia, Canada
- University of British Columbia, School of Population and Public Health, Vancouver, British Columbia, Canada
| | - Monika Naus
- BC Centre for Disease Control, Communicable Diseases and Immunization Services, Vancouver, British Columbia, Canada
- University of British Columbia, School of Population and Public Health, Vancouver, British Columbia, Canada
| | - David M Patrick
- BC Centre for Disease Control, Communicable Diseases and Immunization Services, Vancouver, British Columbia, Canada
- University of British Columbia, School of Population and Public Health, Vancouver, British Columbia, Canada
| | - Hind Sbihi
- University of British Columbia, School of Population and Public Health, Vancouver, British Columbia, Canada
- BC Centre for Disease Control, Data and Analytics Services, Vancouver, British Columbia, Canada
| | - Shiraz El Adam
- BC Centre for Disease Control, Communicable Diseases and Immunization Services, Vancouver, British Columbia, Canada
| | - Bonnie Henry
- University of British Columbia, School of Population and Public Health, Vancouver, British Columbia, Canada
- Office of the Provincial Health Officer, Ministry of Health, Victoria, British Columbia, Canada
| | - Linda M N Hoang
- BC Centre for Disease Control, Public Health Laboratory, Vancouver, British Columbia, Canada
- University of British Columbia, Department of Pathology and Laboratory Medicine, Vancouver, British Columbia, Canada
| | - Manish Sadarangani
- BC Children’s Hospital Research Institute, Vaccine Evaluation Center, Vancouver, British Columbia, Canada
- University of British Columbia, Department of Pediatrics, Vancouver, British Columbia, Canada
| | - Agatha N Jassem
- BC Centre for Disease Control, Public Health Laboratory, Vancouver, British Columbia, Canada
- University of British Columbia, Department of Pathology and Laboratory Medicine, Vancouver, British Columbia, Canada
| | - Mel Krajden
- BC Centre for Disease Control, Public Health Laboratory, Vancouver, British Columbia, Canada
- University of British Columbia, Department of Pathology and Laboratory Medicine, Vancouver, British Columbia, Canada
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15
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Tanunliong G, Liu AC, Kaweski S, Irvine M, Reyes RC, Purych D, Krajden M, Morshed M, Sekirov I, Gantt S, Skowronski DM, Jassem AN. Age-Associated Seroprevalence of Coronavirus Antibodies: Population-Based Serosurveys in 2013 and 2020, British Columbia, Canada. Front Immunol 2022; 13:836449. [PMID: 35401521 PMCID: PMC8984254 DOI: 10.3389/fimmu.2022.836449] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Accepted: 02/28/2022] [Indexed: 11/13/2022] Open
Abstract
BackgroundOlder adults have been disproportionately affected during the SARS-CoV-2 pandemic, including higher risk of severe disease and long-COVID. Prior exposure to endemic human coronaviruses (HCoV) may modulate the response to SARS-CoV-2 infection and contribute to age-related observations. We hypothesized that cross-reactive antibodies to SARS-CoV-2 are associated with antibodies to HCoV and that both increase with age.MethodsTo assess SARS-CoV-2 unexposed individuals, we drew upon archived anonymized residual sero-surveys conducted in British Columbia (BC), Canada, including before SARS-CoV-2 emergence (May, 2013) and before widespread community circulation in BC (May, 2020). Fifty sera, sex-balanced per ten-year age band, were sought among individuals ≤10 to ≥80 years old, supplemented as indicated by sera from March and September 2020. Sera were tested on the Meso Scale Diagnostics (MSD) electrochemiluminescent multiplex immunoassay to quantify IgG antibody against the Spike proteins of HCoV, including alpha (HCoV-229E, HCoV-NL63) and beta (HCoV-HKU1, HCoV-OC43) viruses, and the 2003 epidemic beta coronavirus, SARS-CoV-1. Cross-reactive antibodies to Spike, Nucleocapsid, and the Receptor Binding Domain (RBD) of SARS-CoV-2 were similarly measured, with SARS-CoV-2 sero-positivity overall defined by positivity on ≥2 targets.ResultsSamples included 407 sera from 2013, of which 17 were children ≤10 years. The 2020 samples included 488 sera, of which 88 were children ≤10 years. Anti-Spike antibodies to all four endemic HCoV were acquired by 10 years of age. There were 20/407 (5%) sera in 2013 and 8/488 (2%) in 2020 that were considered sero-positive for SARS-CoV-2 based on MSD testing. Of note, antibody to the single SARS-CoV-2 RBD target was detected in 329/407 (81%) of 2013 sera and 91/488 (19%) of 2020 sera. Among the SARS-CoV-2 overall sero-negative population, age was correlated with anti-HCoV antibody levels and these, notably 229E and HKU1, were correlated with cross-reactive anti-SARS-CoV-2 RBD titres. SARS-CoV-2 overall sero-positive individuals showed higher titres to HCoV more generally.ConclusionMost people have an HCoV priming exposure by 10 years of age and IgG levels are stable thereafter. Anti-HCoV antibodies can cross-react with SARS-CoV-2 epitopes. These immunological interactions warrant further investigation with respect to their implications for COVID-19 clinical outcomes.
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Affiliation(s)
- Guadalein Tanunliong
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Aaron C. Liu
- Department of Experimental Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Samantha Kaweski
- British Columbia Centre for Disease Control Public Health Laboratory, Vancouver, BC, Canada
| | - Mike Irvine
- British Columbia Centre for Disease Control, Vancouver, BC, Canada
- Faculty of Health Sciences, Simon Fraser University, Burnaby, BC, Canada
| | - Romina C. Reyes
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, BC, Canada
- LifeLabs, Burnaby, BC, Canada
| | - Dale Purych
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, BC, Canada
- Surrey Memorial Hospital, Fraser Health Authority, Surrey, BC, Canada
| | - Mel Krajden
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, BC, Canada
- British Columbia Centre for Disease Control Public Health Laboratory, Vancouver, BC, Canada
| | - Muhammad Morshed
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, BC, Canada
- British Columbia Centre for Disease Control Public Health Laboratory, Vancouver, BC, Canada
| | - Inna Sekirov
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, BC, Canada
- British Columbia Centre for Disease Control Public Health Laboratory, Vancouver, BC, Canada
| | - Soren Gantt
- Departments of Pediatrics and Microbiology, Infectious Diseases & Immunology, University of Montreal, Montreal, QC, Canada
- Sainte-Justine University Hospital Centre, Montreal, QC, Canada
| | - Danuta M. Skowronski
- School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada
- Communicable Diseases and Immunization Services, British Columbia Centre for Disease Control, Vancouver, BC, Canada
| | - Agatha N. Jassem
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, BC, Canada
- British Columbia Centre for Disease Control Public Health Laboratory, Vancouver, BC, Canada
- *Correspondence: Agatha N. Jassem,
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16
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Tanunliong G, Liu A, Vijh R, Pidduck T, Kustra J, Márquez AC, Choi A, McLennan M, Hayden A, Kearney C, Gantt S, Krajden M, Morshed M, Jassem AN, Sekirov I. Persistence of Anti-SARS-CoV-2 Antibodies in Long Term Care Residents Over Seven Months After Two COVID-19 Outbreaks. Front Immunol 2022; 12:775420. [PMID: 35046939 PMCID: PMC8763385 DOI: 10.3389/fimmu.2021.775420] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Accepted: 12/10/2021] [Indexed: 01/08/2023] Open
Abstract
Background As part of the public health outbreak investigations, serological surveys were carried out following two COVID-19 outbreaks in April 2020 and October 2020 in one long term care facility (LTCF) in British Columbia, Canada. This study describes the serostatus of the LTCF residents and monitors changes in their humoral response to SARS-CoV-2 and other human coronaviruses (HCoV) over seven months. Methods A total of 132 serum samples were collected from all 106 consenting residents (aged 54-102) post-first outbreak (N=87) and post-second outbreak (N=45) in one LTCF; 26/106 participants provided their serum following both COVID-19 outbreaks, permitting longitudinal comparisons between surveys. Health-Canada approved commercial serologic tests and a pan-coronavirus multiplexed immunoassay were used to evaluate antibody levels against the spike protein, nucleocapsid, and receptor binding domain (RBD) of SARS-CoV-2, as well as the spike proteins of HCoV-229E, HCoV-HKU1, HCoV-NL63, and HCoV-OC43. Statistical analyses were performed to describe the humoral response to SARS-CoV-2 among residents longitudinally. Findings Survey findings demonstrated that among the 26 individuals that participated in both surveys, all 10 individuals seropositive after the first outbreak continued to be seropositive following the second outbreak, with no reinfections identified among them. SARS-CoV-2 attack rate in the second outbreak was lower (28.6%) than in the first outbreak (40.2%), though not statistically significant (P>0.05). Gradual waning of anti-nucleocapsid antibodies to SARS-CoV-2 was observed on commercial (median Δ=-3.7, P=0.0098) and multiplexed immunoassay (median Δ=-169579, P=0.014) platforms; however, anti-spike and anti-receptor binding domain (RBD) antibodies did not exhibit a statistically significant decline over 7 months. Elevated antibody levels for beta-HCoVs OC43 (P<0.0001) and HKU1 (P=0.0027) were observed among individuals seropositive for SARS-CoV-2 compared to seronegative individuals. Conclusion Our study utilized well-validated serological platforms to demonstrate that humoral responses to SARS-CoV-2 persisted for at least 7 months. Elevated OC43 and HKU1 antibodies among SARS-CoV-2 seropositive individuals may be attributed to cross reaction and/or boosting of humoral response.
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Affiliation(s)
- Guadalein Tanunliong
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Aaron Liu
- Department of Experimental Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Rohit Vijh
- Office of the Chief Medical Health Officer, Vancouver Coastal Health, Vancouver, BC, Canada
- School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada
| | - Tamara Pidduck
- British Columbia Centre for Disease Control (BCCDC) Public Health Laboratory, Vancouver, BC, Canada
| | - Jesse Kustra
- British Columbia Centre for Disease Control (BCCDC) Public Health Laboratory, Vancouver, BC, Canada
| | - Ana Citlali Márquez
- British Columbia Centre for Disease Control (BCCDC) Public Health Laboratory, Vancouver, BC, Canada
| | - Alexandra Choi
- Office of the Chief Medical Health Officer, Vancouver Coastal Health, Vancouver, BC, Canada
| | - Meghan McLennan
- British Columbia Centre for Disease Control (BCCDC) Public Health Laboratory, Vancouver, BC, Canada
| | - Althea Hayden
- Office of the Chief Medical Health Officer, Vancouver Coastal Health, Vancouver, BC, Canada
| | | | - Soren Gantt
- Centre de Recherche de Centre Hospitalier Universitaire (CHU) Sainte-Justine, Département de microbiologie, infectiologie et immunologie, Université de Montréal, Montréal, QC, Canada
| | - Mel Krajden
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, BC, Canada
- British Columbia Centre for Disease Control (BCCDC) Public Health Laboratory, Vancouver, BC, Canada
| | - Muhammad Morshed
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, BC, Canada
- British Columbia Centre for Disease Control (BCCDC) Public Health Laboratory, Vancouver, BC, Canada
| | - Agatha N. Jassem
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, BC, Canada
- British Columbia Centre for Disease Control (BCCDC) Public Health Laboratory, Vancouver, BC, Canada
| | - Inna Sekirov
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, BC, Canada
- British Columbia Centre for Disease Control (BCCDC) Public Health Laboratory, Vancouver, BC, Canada
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17
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Skowronski DM, Setayeshgar S, Zou M, Prystajecky N, Tyson JR, Sbihi H, Fjell CD, Galanis E, Naus M, Patrick DM, El Adam S, Ahmed MA, Kim S, Henry B, Hoang LMN, Sadarangani M, Jassem AN, Krajden M. OUP accepted manuscript. J Infect Dis 2022; 226:485-496. [PMID: 35084500 PMCID: PMC8807316 DOI: 10.1093/infdis/jiac023] [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] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Accepted: 01/25/2022] [Indexed: 11/13/2022] Open
Abstract
Background Methods Results Conclusions
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Affiliation(s)
- Danuta M Skowronski
- Correspondence: Danuta M. Skowronski, MD, FRCPC, BC Centre for Disease Control, 655 W 12th Ave, Vancouver, BC, Canada V5Z 4R4 ()
| | - Solmaz Setayeshgar
- Communicable Diseases and Immunization Services, BC Centre for Disease Control, Vancouver, British Columbia, Canada
| | - Macy Zou
- Data and Analytics Services, BC Centre for Disease Control, Vancouver, British Columbia, Canada
| | - Natalie Prystajecky
- Public Health Laboratory, BC Centre for Disease Control, Vancouver, British Columbia, Canada
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - John R Tyson
- Public Health Laboratory, BC Centre for Disease Control, Vancouver, British Columbia, Canada
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Hind Sbihi
- School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada
- Data and Analytics Services, BC Centre for Disease Control, Vancouver, British Columbia, Canada
| | - Chris D Fjell
- Public Health Laboratory, BC Centre for Disease Control, Vancouver, British Columbia, Canada
| | - Eleni Galanis
- Communicable Diseases and Immunization Services, BC Centre for Disease Control, Vancouver, British Columbia, Canada
- School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada
| | - Monika Naus
- Communicable Diseases and Immunization Services, BC Centre for Disease Control, Vancouver, British Columbia, Canada
- School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada
| | - David M Patrick
- Communicable Diseases and Immunization Services, BC Centre for Disease Control, Vancouver, British Columbia, Canada
- School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada
| | - Shiraz El Adam
- Communicable Diseases and Immunization Services, BC Centre for Disease Control, Vancouver, British Columbia, Canada
| | - May A Ahmed
- Communicable Diseases and Immunization Services, BC Centre for Disease Control, Vancouver, British Columbia, Canada
| | - Shinhye Kim
- Communicable Diseases and Immunization Services, BC Centre for Disease Control, Vancouver, British Columbia, Canada
| | - Bonnie Henry
- School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada
- Office of the Provincial Health Officer, Ministry of Health, Victoria, British Columbia, Canada
| | - Linda M N Hoang
- Public Health Laboratory, BC Centre for Disease Control, Vancouver, British Columbia, Canada
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Manish Sadarangani
- Vaccine Evaluation Center, BC Children’s Hospital Research Institute, Vancouver, British Columbia, Canada
- Department of Pediatrics, University of British Columbia, Vancouver, British Columbia, Canada
| | - Agatha N Jassem
- Public Health Laboratory, BC Centre for Disease Control, Vancouver, British Columbia, Canada
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Mel Krajden
- Public Health Laboratory, BC Centre for Disease Control, Vancouver, British Columbia, Canada
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, British Columbia, Canada
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18
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Kuchinski KS, Nguyen J, Lee TD, Hickman R, Jassem AN, Hoang LMN, Prystajecky NA, Tyson JR. Mutations in emerging variant of concern lineages disrupt genomic sequencing of SARS-CoV-2 clinical specimens. Int J Infect Dis 2021; 114:51-54. [PMID: 34757201 PMCID: PMC8555373 DOI: 10.1016/j.ijid.2021.10.050] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Revised: 09/24/2021] [Accepted: 10/26/2021] [Indexed: 11/28/2022] Open
Abstract
Mutations in emerging severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) lineages can interfere with laboratory methods used to generate viral genome sequences for public health surveillance. We identified 20 mutations that are widespread in variant of concern lineages and affect widely used sequencing protocols by the ARTIC network and Freed et al. Three of these mutations disrupted sequencing of P.1 lineage specimens during a recent outbreak in British Columbia, Canada. We provide laboratory validation of protocol modifications that restored sequencing performance. The study findings indicate that genomic sequencing protocols require immediate updating to address emerging mutations. This work also suggests that routine monitoring and protocol updates will be necessary as SARS-CoV-2 continues to evolve. The bioinformatic and laboratory approaches used here provide guidance for this kind of assay maintenance.
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Affiliation(s)
- Kevin S Kuchinski
- Department of Pathology and Laboratory Medicine, University of British Columbia, 2211 Wesbrook Mall, Vancouver, British Columbia, Canada, V6T 1Z7
| | - Jason Nguyen
- British Columbia Centre for Disease Control Public Health Laboratory, Provincial Health Services Authority, 655 West 12th Ave, Vancouver, British Columbia, Canada, V5Z 4R4
| | - Tracy D Lee
- British Columbia Centre for Disease Control Public Health Laboratory, Provincial Health Services Authority, 655 West 12th Ave, Vancouver, British Columbia, Canada, V5Z 4R4
| | - Rebecca Hickman
- British Columbia Centre for Disease Control Public Health Laboratory, Provincial Health Services Authority, 655 West 12th Ave, Vancouver, British Columbia, Canada, V5Z 4R4
| | - Agatha N Jassem
- Department of Pathology and Laboratory Medicine, University of British Columbia, 2211 Wesbrook Mall, Vancouver, British Columbia, Canada, V6T 1Z7; British Columbia Centre for Disease Control Public Health Laboratory, Provincial Health Services Authority, 655 West 12th Ave, Vancouver, British Columbia, Canada, V5Z 4R4
| | - Linda M N Hoang
- Department of Pathology and Laboratory Medicine, University of British Columbia, 2211 Wesbrook Mall, Vancouver, British Columbia, Canada, V6T 1Z7; British Columbia Centre for Disease Control Public Health Laboratory, Provincial Health Services Authority, 655 West 12th Ave, Vancouver, British Columbia, Canada, V5Z 4R4
| | - Natalie A Prystajecky
- Department of Pathology and Laboratory Medicine, University of British Columbia, 2211 Wesbrook Mall, Vancouver, British Columbia, Canada, V6T 1Z7; British Columbia Centre for Disease Control Public Health Laboratory, Provincial Health Services Authority, 655 West 12th Ave, Vancouver, British Columbia, Canada, V5Z 4R4
| | - John R Tyson
- British Columbia Centre for Disease Control Public Health Laboratory, Provincial Health Services Authority, 655 West 12th Ave, Vancouver, British Columbia, Canada, V5Z 4R4.
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19
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Leung WF, Chorlton S, Tyson J, Al-Rawahi GN, Jassem AN, Prystajecky N, Masud S, Deans GD, Chapman MG, Mirzanejad Y, Murray MCM, Wong PHP. COVID-19 in an Immunocompromised Host: Persistent Shedding of Viable SARS-CoV-2 and Emergence of Multiple Mutations, a Case Report. Int J Infect Dis 2021; 114:178-182. [PMID: 34757008 PMCID: PMC8553657 DOI: 10.1016/j.ijid.2021.10.045] [Citation(s) in RCA: 35] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2021] [Revised: 10/14/2021] [Accepted: 10/19/2021] [Indexed: 01/02/2023] Open
Abstract
This article reports a case of a 21-year-old woman with refractory B-cell acute lymphocytic leukaemia who presented with severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). She remained positive for SARS-CoV-2 by viral culture for 78 days and by polymerase chain reaction (PCR) for 97 days. Sequencing of repeat samples over time demonstrated an increasing and dynamic repertoire of mutations.
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Affiliation(s)
- Wayne F Leung
- Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Samuel Chorlton
- Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - John Tyson
- British Columbia Centre for Disease Control Public Health Laboratory, Vancouver, British Columbia, Canada
| | - Ghada N Al-Rawahi
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Agatha N Jassem
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, British Columbia, Canada; British Columbia Centre for Disease Control Public Health Laboratory, Vancouver, British Columbia, Canada
| | - Natalie Prystajecky
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, British Columbia, Canada; British Columbia Centre for Disease Control Public Health Laboratory, Vancouver, British Columbia, Canada
| | - Shazia Masud
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Gregory D Deans
- Division of Infectious Diseases, Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Michael G Chapman
- Division of Infectious Diseases, Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Yazdan Mirzanejad
- Division of Infectious Diseases, Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Melanie C M Murray
- Division of Infectious Diseases, Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Patrick H P Wong
- Division of Infectious Diseases, Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada.
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20
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Sherwood KR, Nicholl DDM, Fenninger F, Wu V, Wong P, Benedicto V, Cina DP, Wang M, Pobran TD, De Marco ML, Márquez AC, Jassem AN, Sekirov I, Morshed MG, Bardi M, Sekhon M, Keown P, Kadatz M, Lan JH. Comprehensive Immune Profiling of a Kidney Transplant Recipient With Peri-Operative SARS-CoV-2 Infection: A Case Report. Front Immunol 2021; 12:753558. [PMID: 34630432 PMCID: PMC8492986 DOI: 10.3389/fimmu.2021.753558] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Accepted: 09/02/2021] [Indexed: 12/22/2022] Open
Abstract
To date there is limited data on the immune profile and outcomes of solid organ transplant recipients who encounter COVID-19 infection early post-transplant. Here we present a unique case where the kidney recipient’s transplant surgery coincided with a positive SARS-CoV-2 test and the patient subsequently developed symptomatic COVID-19 perioperatively. We performed comprehensive immunological monitoring of cellular, proteomic, and serological changes during the first 4 critical months post-infection. We showed that continuation of basiliximab induction and maintenance of triple immunosuppression did not significantly impair the host’s ability to mount a robust immune response against symptomatic COVID-19 infection diagnosed within the first week post-transplant.
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Affiliation(s)
- Karen R Sherwood
- Department of Medicine, University of British Columbia, Vancouver, BC, Canada.,Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, BC, Canada
| | - David D M Nicholl
- Division of Nephrology, University of British Columbia, Vancouver, BC, Canada
| | - Franz Fenninger
- Department of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Vivian Wu
- Department of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Paaksum Wong
- Department of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Vince Benedicto
- British Columbia Provincial Immunology Laboratory, University of British Columbia, Vancouver, BC, Canada
| | - Davide P Cina
- Department of Urologic Sciences, University of British Columbia, Vancouver, BC, Canada
| | - Meng Wang
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Taylor D Pobran
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Mari L De Marco
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, BC, Canada.,Department of Pathology and Laboratory Medicine, Providence Health Care, Vancouver, BC, Canada
| | - Anna Citlali Márquez
- British Columbia Center for Disease Control Public Health Laboratory, Provincial Health Services Authority, Vancouver, BC, Canada
| | - Agatha N Jassem
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, BC, Canada.,British Columbia Center for Disease Control Public Health Laboratory, Provincial Health Services Authority, Vancouver, BC, Canada
| | - Inna Sekirov
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, BC, Canada.,British Columbia Center for Disease Control Public Health Laboratory, Provincial Health Services Authority, Vancouver, BC, Canada
| | - Muhammad G Morshed
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, BC, Canada.,British Columbia Center for Disease Control Public Health Laboratory, Provincial Health Services Authority, Vancouver, BC, Canada
| | - Mohammad Bardi
- Department of Medicine, University of British Columbia, Vancouver, BC, Canada.,Division of Rheumatology, University of British Columbia, Vancouver, BC, Canada
| | - Mypinder Sekhon
- Department of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Paul Keown
- Department of Medicine, University of British Columbia, Vancouver, BC, Canada.,Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Matthew Kadatz
- Department of Medicine, University of British Columbia, Vancouver, BC, Canada.,Division of Nephrology, University of British Columbia, Vancouver, BC, Canada
| | - James H Lan
- Department of Medicine, University of British Columbia, Vancouver, BC, Canada.,Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, BC, Canada.,Division of Nephrology, University of British Columbia, Vancouver, BC, Canada
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21
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Hogan CA, Jassem AN, Sbihi H, Joffres Y, Tyson JR, Noftall K, Taylor M, Lee T, Fjell C, Wilmer A, Galbraith J, Romney MG, Henry B, Krajden M, Galanis E, Prystajecky N, Hoang LM. Rapid Increase in SARS-CoV-2 P.1 Lineage Leading to Codominance with B.1.1.7 Lineage, British Columbia, Canada, January-April 2021. Emerg Infect Dis 2021; 27:2802-2809. [PMID: 34388358 PMCID: PMC8544957 DOI: 10.3201/eid2711.211190] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Several severe acute respiratory syndrome coronavirus 2 variants of concern (VOCs) emerged in late 2020; lineage B.1.1.7 initially dominated globally. However, lineages B.1.351 and P.1 represent potentially greater risk for transmission and immune escape. In British Columbia, Canada, B.1.1.7 and B.1.351 were first identified in December 2020 and P.1 in February 2021. We combined quantitative PCR and whole-genome sequencing to assess relative contribution of VOCs in nearly 67,000 infections during the first 16 weeks of 2021 in British Columbia. B.1.1.7 accounted for <10% of screened or sequenced specimens early on, increasing to >50% by week 8. P.1 accounted for <10% until week 10, increased rapidly to peak at week 12, and by week 13 codominated within 10% of rates of B.1.1.7. B.1.351 was a minority throughout. This rapid expansion of P.1 but suppression of B.1.351 expands our understanding of population-level VOC patterns and might provide clues to fitness determinants for emerging VOCs.
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22
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Nikiforuk AM, Karim ME, Patrick DM, Jassem AN. Influence of chronic hepatitis C infection on the monocyte-to-platelet ratio: data analysis from the National Health and Nutrition Examination Survey (2009-2016). BMC Public Health 2021; 21:1388. [PMID: 34256707 PMCID: PMC8278694 DOI: 10.1186/s12889-021-11267-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Accepted: 06/09/2021] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Hepatitis C virus (HCV) causes life-threatening chronic infections. Implementation of novel, economical or widely available screening tools can help detect unidentified cases and facilitate their linkage to care. We investigated the relationship between chronic HCV infection and a potential complete blood count biomarker (the monocyte-to-platelet ratio) in the United States. METHODS The analytic dataset was selected from cycle years 2009-2016 of the National Health and Nutrition Examination Survey. Complete case data- with no missingness- was available for n = 5281 observations, one-hundred and twenty-two (n = 122) of which were exposed to chronic HCV. The primary analysis used survey-weighted logistic regression to model the effect of chronic HCV on the monocyte-to-platelet ratio adjusting for demographic and biological confounders in a causal inference framework. Missing data and propensity score methods were respectively performed as a secondary and sensitivity analysis. RESULTS In the analytic dataset, outcome data was available for n = 5281 (n = 64,245,530 in the weighted sample) observations of which n = 122 (n = 1,067,882 in the weighted sample) tested nucleic acid positive for HCV. Those exposed to chronic HCV infection in the United States have 3.10 times the odds of a high monocyte-to-platelet ratio than those not exposed (OR = 3.10, [95% CI: 1.55-6.18]). CONCLUSION A relationship exists between chronic HCV infection and the monocyte-to-platelet ratio in the general population of the United States. Reversing the direction of this association to predict chronic HCV infection from complete blood counts, could provide an economically feasible and universal screening tool, which would help link patients with care.
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Affiliation(s)
- Aidan M Nikiforuk
- School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, V6T 1Z4, Canada
- British Columbia Centre for Disease Control Public Health Laboratory, Virology, Provincial Health Services Authority, Vancouver, British Columbia, V5Z 4R4, Canada
| | - Mohammad Ehsanul Karim
- School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, V6T 1Z4, Canada
- Centre for Health Evaluation and Outcome Sciences, Providence Health Care, Vancouver, British Columbia, V6Z 1Y6, Canada
| | - David M Patrick
- School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, V6T 1Z4, Canada
- British Columbia Centre for Disease Control, Communicable Diseases and Immunization Services, Provincial Health Services Authority, Vancouver, British Columbia, V5Z 4R4, Canada
| | - Agatha N Jassem
- British Columbia Centre for Disease Control Public Health Laboratory, Virology, Provincial Health Services Authority, Vancouver, British Columbia, V5Z 4R4, Canada.
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, British Columbia, V6T 1Z4, Canada.
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Majdoubi A, Michalski C, O'Connell SE, Dada S, Narpala S, Gelinas J, Mehta D, Cheung C, Winkler DF, Basappa M, Liu AC, Görges M, Barakauskas VE, Irvine M, Mehalko J, Esposito D, Sekirov I, Jassem AN, Goldfarb DM, Pelech S, Douek DC, McDermott AB, Lavoie PM. A majority of uninfected adults show preexisting antibody reactivity against SARS-CoV-2. JCI Insight 2021; 6:146316. [PMID: 33720905 PMCID: PMC8119195 DOI: 10.1172/jci.insight.146316] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Accepted: 03/12/2021] [Indexed: 12/24/2022] Open
Abstract
Preexisting cross-reactivity to SARS-CoV-2 occurs in the absence of prior viral exposure. However, this has been difficult to quantify at the population level due to a lack of reliably defined seroreactivity thresholds. Using an orthogonal antibody testing approach, we estimated that about 0.6% of nontriaged adults from the greater Vancouver, Canada, area between May 17 and June 19, 2020, showed clear evidence of a prior SARS-CoV-2 infection, after adjusting for false-positive and false-negative test results. Using a highly sensitive multiplex assay and positive/negative thresholds established in infants in whom maternal antibodies have waned, we determined that more than 90% of uninfected adults showed antibody reactivity against the spike protein, receptor-binding domain (RBD), N-terminal domain (NTD), or the nucleocapsid (N) protein from SARS-CoV-2. This seroreactivity was evenly distributed across age and sex, correlated with circulating coronaviruses' reactivity, and was partially outcompeted by soluble circulating coronaviruses' spike. Using a custom SARS-CoV-2 peptide mapping array, we found that this antibody reactivity broadly mapped to spike and to conserved nonstructural viral proteins. We conclude that most adults display preexisting antibody cross-reactivity against SARS-CoV-2, which further supports investigation of how this may impact the clinical severity of COVID-19 or SARS-CoV-2 vaccine responses.
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Affiliation(s)
- Abdelilah Majdoubi
- BC Children's Hospital Research Institute, Vancouver, British Columbia, Canada.,Department of Pediatrics, University of British Columbia, Vancouver, British Columbia, Canada
| | - Christina Michalski
- BC Children's Hospital Research Institute, Vancouver, British Columbia, Canada.,Department of Pediatrics, University of British Columbia, Vancouver, British Columbia, Canada
| | - Sarah E O'Connell
- Vaccine Research Center, National Institute of Allergy and Infectious Diseases, NIH, Bethesda, Maryland, USA
| | - Sarah Dada
- BC Children's Hospital Research Institute, Vancouver, British Columbia, Canada.,Department of Pediatrics, University of British Columbia, Vancouver, British Columbia, Canada
| | - Sandeep Narpala
- Vaccine Research Center, National Institute of Allergy and Infectious Diseases, NIH, Bethesda, Maryland, USA
| | - Jean Gelinas
- Department of Anesthesiology, Surrey Memorial Hospital (SMH), Surrey, British Columbia, Canada.,Department of Anesthesiology & Pain Medicine, University of Alberta, Edmonton, Alberta, Canada
| | - Disha Mehta
- Department of Anesthesiology, Surrey Memorial Hospital (SMH), Surrey, British Columbia, Canada.,Department of Anesthesiology, Pharmacology and Therapeutics, University of British Columbia, Vancouver, British Columbia, Canada
| | - Claire Cheung
- BC Children's Hospital Research Institute, Vancouver, British Columbia, Canada.,Department of Pediatrics, University of British Columbia, Vancouver, British Columbia, Canada
| | - Dirk Fh Winkler
- Kinexus Bioinformatics Corporation, Vancouver, British Columbia, Canada
| | - Manjula Basappa
- Vaccine Research Center, National Institute of Allergy and Infectious Diseases, NIH, Bethesda, Maryland, USA
| | - Aaron C Liu
- BC Children's Hospital Research Institute, Vancouver, British Columbia, Canada.,Department of Pediatrics, University of British Columbia, Vancouver, British Columbia, Canada.,Vaccine Evaluation Centre, BC Children's Hospital Research Institute, Vancouver, British Columbia
| | - Matthias Görges
- BC Children's Hospital Research Institute, Vancouver, British Columbia, Canada.,Department of Anesthesiology, Pharmacology and Therapeutics, University of British Columbia, Vancouver, British Columbia, Canada
| | - Vilte E Barakauskas
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Mike Irvine
- BC Children's Hospital Research Institute, Vancouver, British Columbia, Canada
| | - Jennifer Mehalko
- National Cancer Institute RAS Initiative, Cancer Research Technology Program, Frederick National Laboratory for Cancer Research, Leidos Biomedical Research Inc., Frederick, Maryland, USA
| | - Dominic Esposito
- National Cancer Institute RAS Initiative, Cancer Research Technology Program, Frederick National Laboratory for Cancer Research, Leidos Biomedical Research Inc., Frederick, Maryland, USA
| | - Inna Sekirov
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, British Columbia, Canada.,British Columbia Centre for Disease Control (CDC) Public Health Laboratory, Vancouver, British Columbia, Canada
| | - Agatha N Jassem
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, British Columbia, Canada.,British Columbia Centre for Disease Control (CDC) Public Health Laboratory, Vancouver, British Columbia, Canada
| | - David M Goldfarb
- BC Children's Hospital Research Institute, Vancouver, British Columbia, Canada.,Department of Pediatrics, University of British Columbia, Vancouver, British Columbia, Canada.,Division of Medical Microbiology, Department of Pathology and Laboratory Medicine, and
| | - Steven Pelech
- Kinexus Bioinformatics Corporation, Vancouver, British Columbia, Canada.,Department of Medicine, University of British Columbia, Vancouver, Canada
| | - Daniel C Douek
- Vaccine Research Center, National Institute of Allergy and Infectious Diseases, NIH, Bethesda, Maryland, USA
| | - Adrian B McDermott
- Vaccine Research Center, National Institute of Allergy and Infectious Diseases, NIH, Bethesda, Maryland, USA
| | - Pascal M Lavoie
- BC Children's Hospital Research Institute, Vancouver, British Columbia, Canada.,Department of Pediatrics, University of British Columbia, Vancouver, British Columbia, Canada
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24
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Majdoubi A, Michalski C, O'Connell SE, Dada S, Narpala S, Gelinas J, Mehta D, Cheung C, Basappa M, Liu AC, Gorges M, Barakauskas VE, Mehalko J, Esposito D, Sekirov I, Jassem AN, Goldfarb DM, Douek DC, McDermott AB, Lavoie PM. Antibody reactivity to SARS-CoV-2 is common in unexposed adults and infants under 6 months. medRxiv 2020:2020.10.05.20206664. [PMID: 33052362 PMCID: PMC7553187 DOI: 10.1101/2020.10.05.20206664] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
BACKGROUND Pre-existing antibody reactivity against SARS-CoV-2 in unexposed people is a potentially important consideration for COVID-19 severity and vaccine responses. However, it has been difficult to quantify due to a lack of reliable defined background titers in unexposed individuals. METHODS We measured IgG against multiple SARS-CoV-2 antigens, SARS-CoV and other circulating coronavirus spike proteins using a highly sensitive multiplex assay, and total SARS-CoV-2 spike-specific antibodies (IgG/M/A) using a commercial CLIA assay in 276 adults from the Vancouver area, Canada between May 17th and June 19th 2020. Reactivity threshold in unexposed individuals were defined comparing to pre-pandemic sera and to sera from infants under 6 months of age. RESULTS The seroprevalence from a SARS-CoV-2 exposure, adjusted for false-positive and false-negative test results, was 0.60% in our adult cohort. High antibody reactivity to circulating endemic coronaviruses was observed in all adults and was about 10-fold lower in infants under 6 months. Consistent with a waning of maternal antibodies, reactivity in infants decreased more than 50-fold eight months later. SARS-CoV-2 Spike, RBD, NTD or nucleocapsid antibody reactivity >100-fold above that of older infants was detected in the vast majority of unexposed adults and pre-pandemic sera. This antibody reactivity correlated with titers against circulating coronaviruses, but not with age, sex, or whether adults were healthcare workers. CONCLUSION A majority of unexposed adults have pre-existing antibody reactivity against SARS-CoV-2. The lack of similar antibody reactivity in infants where maternal antibodies have waned suggests that this cross-reactivity is acquired, likely from repeated exposures to circulating coronaviruses.
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25
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Kuchinski KS, Jassem AN, Prystajecky NA. Assessing oligonucleotide designs from early lab developed PCR diagnostic tests for SARS-CoV-2 using the PCR_strainer pipeline. J Clin Virol 2020; 131:104581. [PMID: 32889496 PMCID: PMC7441044 DOI: 10.1016/j.jcv.2020.104581] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Accepted: 08/03/2020] [Indexed: 11/01/2022]
Abstract
INTRODUCTION During the first month of the SARS-CoV-2 outbreak, rapid development of PCR-based diagnostic tests became a global priority so that timely diagnosis, isolation, and contact tracing could minimize the advancing pandemic surge. Designing these tests for broad, long-term detection was complicated by limited information about the novel virus' genome sequence and how it might mutate during global spread and adaptation to humans. METHODS We assessed eight widely adopted lab developed PCR tests for SARS-CoV-2 against 15,001 SARS-CoV-2 genome sequences. Using a custom bioinformatic pipeline called PCR_strainer, we identified all mismatches and sequence variants in genome locations targeted by 15 sets of primer/probe oligonucleotides from these assays. RESULTS For 12 out of 15 primer/probe sets, over 98 % of SARS-CoV-2 genomes had no mismatches. Two primer/probe sets contained a single mismatch in the reverse primer that was present in over 99 % of genomes. One primer/probe set targeted a location with extensive polymorphisms with 23 sequence observed variants at the forward primer location. One of these variants, which contains three nucleotide mismatches, arose in February as part of the emergence of a viral clade and was present in 18.8 % of the genomes we analyzed. DISCUSSION Most early PCR diagnostic tests for SARS-CoV-2 remain inclusive of circulating viral diversity, but three assays with extensive mismatches highlight assay design challenges for novel pathogens and provide valuable lessons for PCR assay design during future outbreaks. Our bioinformatics pipeline is also presented as a useful general-purpose tool for assessing PCR diagnostics assays against circulating strains.
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Affiliation(s)
| | - Agatha N Jassem
- University of British Columbia, Vancouver, British Columbia, Canada; British Columbia Centre for Disease Control Public Health Laboratory, Vancouver, British Columbia, Canada.
| | - Natalie A Prystajecky
- University of British Columbia, Vancouver, British Columbia, Canada; British Columbia Centre for Disease Control Public Health Laboratory, Vancouver, British Columbia, Canada
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26
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Himsworth CG, Duan J, Prystajecky N, Coombe M, Baticados W, Jassem AN, Tang P, Sanders E, Hsiao W. TARGETED RESEQUENCING OF WETLAND SEDIMENT AS A TOOL FOR AVIAN INFLUENZA VIRUS SURVEILLANCE. J Wildl Dis 2020; 56:397-408. [PMID: 31750776] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Surveillance methods for avian influenza virus (AIV) based upon collecting and testing samples from individual wild birds have several significant limitations primarily related to the difficulties associated with obtaining samples. Because AIVs are shed in waterfowl feces, the use of environmental substrates where waterfowl feces accumulate may overcome some of these limitations. However, these substrates are difficult to analyze using traditional diagnostic techniques, such as virus culture and PCR, because of virus inactivation, RNA degradation, low concentration of target RNA, microbial complexity, presence of inhibitory substances, and other factors. We investigated the use of a genomics-based approach called targeted resequencing to detect and characterize AIVs in wetland sediments during the 2014-15 North American highly pathogenic avian influenza outbreak. We identified AIV in 20.6% (71/345) sediment samples obtained from wetlands (n=15) and outdoor waterbodies on AIV-infected poultry farms (n=10) in British Columbia, Canada (the first area affected during the outbreak). Thirteen hemagglutinin (HA) and nine neuraminidase (NA) subtypes were detected, including H5, N1, and N8 sequences that clustered with other sequences associated with the North American outbreak. Additionally, as many as eight HA and eight NA subtypes could be detected in a single sediment sample. This proof-of-concept study shows the potential utility of sediment sampling coupled with genomics-based analysis as a tool for AIV surveillance.
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Affiliation(s)
- Chelsea G Himsworth
- Canadian Wildlife Health Cooperative British Columbia, 1767 Angus Campbell Road, Abbotsford, British Columbia V3G 2M3, Canada
- Animal Health Centre, British Columbia Ministry of Agriculture, 1767 Angus Campbell Road, Abbotsford, British Columbia V3G 2M3, Canada
- University of British Columbia, School of Population and Public Health, 2206 E Mall, Vancouver, British Columbia V6T 1Z9, Canada
| | - Jun Duan
- University of British Columbia, Department of Pathology and Laboratory Medicine, 2211 Wesbrook Mall, Vancouver, British Columbia V6T 2B5, Canada
| | - Natalie Prystajecky
- University of British Columbia, Department of Pathology and Laboratory Medicine, 2211 Wesbrook Mall, Vancouver, British Columbia V6T 2B5, Canada
- British Columbia Centre for Disease Control, Public Health Laboratory, 655 W 12th Avenue, Vancouver, British Columbia V5Z 4R4, Canada
| | - Michelle Coombe
- Canadian Wildlife Health Cooperative British Columbia, 1767 Angus Campbell Road, Abbotsford, British Columbia V3G 2M3, Canada
- Animal Health Centre, British Columbia Ministry of Agriculture, 1767 Angus Campbell Road, Abbotsford, British Columbia V3G 2M3, Canada
- University of British Columbia, School of Population and Public Health, 2206 E Mall, Vancouver, British Columbia V6T 1Z9, Canada
| | - Waren Baticados
- University of British Columbia, Department of Pathology and Laboratory Medicine, 2211 Wesbrook Mall, Vancouver, British Columbia V6T 2B5, Canada
| | - Agatha N Jassem
- University of British Columbia, Department of Pathology and Laboratory Medicine, 2211 Wesbrook Mall, Vancouver, British Columbia V6T 2B5, Canada
- British Columbia Centre for Disease Control, Public Health Laboratory, 655 W 12th Avenue, Vancouver, British Columbia V5Z 4R4, Canada
| | - Patrick Tang
- Sidra Medical and Research Center, PO Box 26999, Doha, Qatar
| | - Eric Sanders
- University of British Columbia, Department of Statistics, 2207 Main Mall, Vancouver, British Columbia V6T 1Z4, Canada
| | - William Hsiao
- University of British Columbia, Department of Pathology and Laboratory Medicine, 2211 Wesbrook Mall, Vancouver, British Columbia V6T 2B5, Canada
- British Columbia Centre for Disease Control, Public Health Laboratory, 655 W 12th Avenue, Vancouver, British Columbia V5Z 4R4, Canada
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27
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Skowronski DM, Chambers C, De Serres G, Dickinson JA, Winter AL, Hickman R, Chan T, Jassem AN, Drews SJ, Charest H, Gubbay JB, Bastien N, Li Y, Krajden M. Early season co-circulation of influenza A(H3N2) and B(Yamagata): interim estimates of 2017/18 vaccine effectiveness, Canada, January 2018. ACTA ACUST UNITED AC 2019; 23. [PMID: 29409570 PMCID: PMC5801641 DOI: 10.2807/1560-7917.es.2018.23.5.18-00035] [Citation(s) in RCA: 70] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Using a test-negative design, we assessed interim vaccine effectiveness (VE) for the 2017/18 epidemic of co-circulating influenza A(H3N2) and B(Yamagata) viruses. Adjusted VE for influenza A(H3N2), driven by a predominant subgroup of clade 3C.2a viruses with T131K + R142K + R261Q substitutions, was low at 17% (95% confidence interval (CI): −14 to 40). Adjusted VE for influenza B was higher at 55% (95% CI: 38 to 68) despite prominent use of trivalent vaccine containing lineage-mismatched influenza B(Victoria) antigen, suggesting cross-lineage protection.
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Affiliation(s)
- Danuta M Skowronski
- University of British Columbia, Vancouver, Canada.,British Columbia Centre for Disease Control, Vancouver, Canada
| | | | - Gaston De Serres
- Centre Hospitalier Universitaire de Québec, Québec, Canada.,Laval University, Quebec, Canada.,Institut National de Santé Publique du Québec, Québec, Canada
| | | | | | - Rebecca Hickman
- British Columbia Centre for Disease Control, Vancouver, Canada
| | - Tracy Chan
- British Columbia Centre for Disease Control, Vancouver, Canada
| | - Agatha N Jassem
- University of British Columbia, Vancouver, Canada.,British Columbia Centre for Disease Control, Vancouver, Canada
| | - Steven J Drews
- University of Alberta, Edmonton, Canada.,Alberta Provincial Laboratory, Edmonton, Canada
| | - Hugues Charest
- Institut National de Santé Publique du Québec, Québec, Canada
| | - Jonathan B Gubbay
- University of Toronto, Toronto, Canada.,Public Health Ontario, Toronto, Canada
| | - Nathalie Bastien
- National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, Canada
| | - Yan Li
- National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, Canada
| | - Mel Krajden
- University of British Columbia, Vancouver, Canada.,British Columbia Centre for Disease Control, Vancouver, Canada
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28
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Terry J, Brown K, Hiebert J, Al-Rawahi GN, Moxham JP, Krajden M, Jassem AN, Tucker L. Measles Lymphadenopathy in a Child With PFAPA Syndrome. Pediatr Dev Pathol 2018; 21:497-501. [PMID: 28882091 DOI: 10.1177/1093526617727970] [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] [Indexed: 11/16/2022]
Abstract
Periodic fever, aphthous stomatitis, pharyngitis, and cervical adenitis (PFAPA) syndrome is a common cause of periodic fever in children. The pathogenesis of PFAPA is unknown but likely involves immune system dysregulation and may be initiated by an environmental trigger. Tonsillectomy resolves or improves symptoms in some patients, but the reason for this is unknown; moreover, specific abnormalities in tonsillectomy specimens from PFAPA patients have not been described. Here, we report measles virus in tonsil from a child with PFAPA. Measles-type viral cytopathic effect was discovered on histological examination of tonsillar tissue after therapeutic tonsillectomy for PFAPA. Molecular testing showed the left tonsil was positive for measles RNA by reverse transcription polymerase chain reaction (RT-PCR) while the right tonsil was inconclusive (weakly positive). Real-time RT-PCR specific for measles vaccine strain RNA (genotype A) was weakly reactive in the left tonsil tissue when tested in 3 independent replicates, but this result could not be confirmed with conventional genotyping by sequencing. The relationship and clinical significance between measles virus and PFAPA in this case is unclear but may be related to PFAPA-associated immune dysregulation. Additional investigation of measles virus in PFAPA patients would be helpful in further exploring this potential association.
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Affiliation(s)
- Jefferson Terry
- 1 Department of Pathology and Laboratory Medicine, University of British Columbia and British Columbia Children's Hospital, Vancouver, British Columbia, Canada
| | - Kelly Brown
- 2 Division of Pediatric Rheumatology, Department of Pediatrics, University of British Columbia and British Columbia Children's Hospital, Vancouver, British Columbia, Canada
| | - Joanne Hiebert
- 3 National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, Manitoba, Canada
| | - Ghada N Al-Rawahi
- 1 Department of Pathology and Laboratory Medicine, University of British Columbia and British Columbia Children's Hospital, Vancouver, British Columbia, Canada
| | - J Paul Moxham
- 4 Department of Surgery, University of British Columbia and British Columbia Children's Hospital, Vancouver, British Columbia, Canada
| | - Mel Krajden
- 1 Department of Pathology and Laboratory Medicine, University of British Columbia and British Columbia Children's Hospital, Vancouver, British Columbia, Canada
| | - Agatha N Jassem
- 1 Department of Pathology and Laboratory Medicine, University of British Columbia and British Columbia Children's Hospital, Vancouver, British Columbia, Canada
| | - Lori Tucker
- 2 Division of Pediatric Rheumatology, Department of Pediatrics, University of British Columbia and British Columbia Children's Hospital, Vancouver, British Columbia, Canada
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29
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Nunn A, Masud S, Krajden M, Naus M, Jassem AN. Diagnostic Yield of Laboratory Methods and Value of Viral Genotyping during an Outbreak of Mumps in a Partially Vaccinated Population in British Columbia, Canada. J Clin Microbiol 2018; 56:e01954-17. [PMID: 29491021 PMCID: PMC5925731 DOI: 10.1128/jcm.01954-17] [Citation(s) in RCA: 6] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2017] [Accepted: 02/26/2018] [Indexed: 11/20/2022] Open
Abstract
Mumps remains endemic in North America despite routine use of the measles, mumps, and rubella (MMR) vaccine. In 2016, an outbreak of mumps in British Columbia, Canada, provided an opportunity to determine the diagnostic utility of laboratory testing methods. Specimens from patients with clinical mumps were tested for infection using a commercial enzyme-linked immunosorbent assay (ELISA) for antibody detection and an in-house reverse transcriptase PCR (RT-PCR) targeting viral fusion and small hydrophobic (SH) genes. Viral genotyping was performed by SH gene sequencing. Laboratory data was linked with epidemiologic case data. Of the 139 confirmed cases, 94 (68%) had reported or documented history of MMR vaccination. Specimens were typically collected 1 day (for buccal and IgM tests) or 2 days (for urine tests) after symptom onset. Most confirmed cases (69%) were confirmed by buccal swab RT-PCR. Among cases tested by multiple methods, the percent positivity for buccal swab RT-PCR was 90% (96/107) compared to 43% (30/69) for both IgM ELISA and urine RT-PCR. Mumps IgM detection was higher in confirmed cases with no history of vaccination than in those with history (64% versus 34%, P = 0.02). The outbreak strain was identified as genotype G related to MuVi/Sheffield.GBR/1.05 but with conserved variations in five nucleotides within the SH gene that allowed linkage of geographically distinct cases. In conclusion, RT-PCR of buccal specimens had the highest diagnostic yield during a mumps outbreak in a partially vaccinated population. To optimize mumps diagnostic potential, clinicians should collect specimens depending on when the patient presents for care and their immunization history.
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Affiliation(s)
- Alexandra Nunn
- British Columbia Centre for Disease Control, Vancouver, British Columbia, Canada
| | - Shazia Masud
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Mel Krajden
- British Columbia Centre for Disease Control, Vancouver, British Columbia, Canada
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Monika Naus
- British Columbia Centre for Disease Control, Vancouver, British Columbia, Canada
- School of Population and Public Health, University of British Columbia, Vancouver, Canada
| | - Agatha N Jassem
- British Columbia Centre for Disease Control, Vancouver, British Columbia, Canada
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, British Columbia, Canada
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30
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Olmstead AD, Lee TD, Chow R, Gunadasa K, Auk B, Krajden M, Jassem AN. Development and validation of a real-time, reverse transcription PCR assay for rapid and low-cost genotyping of hepatitis C virus genotypes 1a, 1b, 2, and 3a. J Virol Methods 2017; 244:17-22. [PMID: 28219761 DOI: 10.1016/j.jviromet.2017.02.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2016] [Revised: 02/10/2017] [Accepted: 02/10/2017] [Indexed: 12/17/2022]
Abstract
Hepatitis C virus (HCV) infection affects millions of people and leads to liver fibrosis, cirrhosis, and hepatocellular carcinoma. Treatment regimen selection requires HCV genotype (Gt) and Gt 1 subtype determination. Use of a laboratory developed, reverse transcription (RT)-PCR assay was explored as a low-cost, high-throughput screening approach for the major HCV genotypes and subtypes in North America. A commercial line probe assay (LiPA) was used for comparison. Sequencing and/or an alternative PCR assay were used for discordant analyses. Testing of 155 clinical samples revealed that a paired, duplex real-time RT-PCR assay that targets Gts 1a and 3a in one reaction and Gts 1b and 2 in another had 95% overall sensitivity and individual Gt sensitivity and specificity of 98-100% and 85-98%, respectively. The RT-PCR assay detected mixed HCV Gts in clinical and spiked samples and no false-positive reactions occurred with rare Gts 3b, 4, 5, or 6. Implementation of the RT-PCR assay, with some reflex LiPA testing, would cost only a small portion of the cost of using LiPA alone, and can also save 1.5h of hands-on time. The use of a laboratory developed RT-PCR assay for HCV genotyping has the potential to reduce cost and labour burdens in high-volume testing settings.
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Affiliation(s)
- Andrea D Olmstead
- University of British Columbia Centre for Disease Control, Vancouver, British Columbia, Canada
| | - Tracy D Lee
- British Columbia Centre for Disease Control Public Health Laboratory, Provincial Health Services Authority, Vancouver, British Columbia, Canada
| | - Ron Chow
- British Columbia Centre for Disease Control Public Health Laboratory, Provincial Health Services Authority, Vancouver, British Columbia, Canada
| | - Kingsley Gunadasa
- British Columbia Centre for Disease Control Public Health Laboratory, Provincial Health Services Authority, Vancouver, British Columbia, Canada
| | - Brian Auk
- British Columbia Centre for Disease Control Public Health Laboratory, Provincial Health Services Authority, Vancouver, British Columbia, Canada
| | - Mel Krajden
- British Columbia Centre for Disease Control Public Health Laboratory, Provincial Health Services Authority, Vancouver, British Columbia, Canada; Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Agatha N Jassem
- British Columbia Centre for Disease Control Public Health Laboratory, Provincial Health Services Authority, Vancouver, British Columbia, Canada; Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, British Columbia, Canada.
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31
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Loutet SA, El-Halfawy OM, Jassem AN, López JMS, Medarde AF, Speert DP, Davies JE, Valvano MA. Identification of synergists that potentiate the action of polymyxin B against Burkholderia cenocepacia. Int J Antimicrob Agents 2015; 46:376-80. [PMID: 26187366 DOI: 10.1016/j.ijantimicag.2015.05.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [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: 03/06/2015] [Revised: 04/19/2015] [Accepted: 05/11/2015] [Indexed: 10/23/2022]
Abstract
Burkholderia cenocepacia and other members of the Burkholderia cepacia complex (BCC) are highly multidrug-resistant bacteria that cause severe pulmonary infections in patients with cystic fibrosis. A screen of 2686 compounds derived from marine organisms identified molecules that could synergise with polymyxin B (PMB) to inhibit the growth of B. cenocepacia. At 1 μg/mL, five compounds synergised with PMB and inhibited the growth of B. cenocepacia by ≥70% compared with growth in PMB alone. Follow-up testing revealed that one compound from the screen, the aminocoumarin antibiotic novobiocin, synergised with PMB and colistin against tobramycin-resistant clinical isolates of B. cenocepacia and Burkholderia multivorans. In parallel, we show that novobiocin sensitivity is common among BCC species and that these bacteria are even more susceptible to an alternative aminocoumarin, clorobiocin, which also had an additive effect with PMB against B. cenocepacia. These studies support using aminocoumarin antibiotics to treat BCC infections and show that synergisers can be found to increase the efficacy of antimicrobial peptides and polymyxins against BCC bacteria.
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Affiliation(s)
- Slade A Loutet
- Centre for Human Immunology, Department of Microbiology and Immunology, University of Western Ontario, London, Ontario, Canada; Department of Microbiology and Immunology, University of British Columbia, Vancouver, BC, Canada
| | - Omar M El-Halfawy
- Centre for Human Immunology, Department of Microbiology and Immunology, University of Western Ontario, London, Ontario, Canada; Department of Pharmaceutical Microbiology, Faculty of Pharmacy, Alexandria University, Alexandria, Egypt
| | - Agatha N Jassem
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, BC, Canada
| | | | | | - David P Speert
- Department of Pediatrics, University of British Columbia, Vancouver, BC, Canada; Department of Pathology, University of British Columbia, Vancouver, BC, Canada
| | - Julian E Davies
- Department of Microbiology and Immunology, University of British Columbia, Vancouver, BC, Canada
| | - Miguel A Valvano
- Centre for Human Immunology, Department of Microbiology and Immunology, University of Western Ontario, London, Ontario, Canada; Centre for Infection and Immunity, Queen's University Belfast, Belfast, UK.
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Jassem AN, Forbes CM, Speert DP. Investigation of aminoglycoside resistance inducing conditions and a putative AmrAB-OprM efflux system in Burkholderia vietnamiensis. Ann Clin Microbiol Antimicrob 2014; 13:2. [PMID: 24393536 PMCID: PMC4077030 DOI: 10.1186/1476-0711-13-2] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [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: 10/30/2013] [Accepted: 01/01/2014] [Indexed: 11/11/2022] Open
Abstract
Background Burkholderia cepacia complex (BCC) bacteria are highly virulent, typically multidrug-resistant, opportunistic pathogens in cystic fibrosis (CF) patients and other immunocompromised individuals. B. vietnamiensis is more often susceptible to aminoglycosides than other BCC species, and strains acquire aminoglycoside resistance during chronic CF infection and under tobramycin and azithromycin exposure in vitro, apparently from gain of antimicrobial efflux as determined through pump inhibition. The aims of the present study were to determine if oxidative stress could also induce aminoglycoside resistance and provide further observations in support of a role for antimicrobial efflux in aminoglycoside resistance in B. vietnamiensis. Findings Here we identified hydrogen peroxide as an additional aminoglycoside resistance inducing agent in B. vietnamiensis. After antibiotic and hydrogen peroxide exposure, isolates accumulated significantly less [3H] gentamicin than the susceptible isolate from which they were derived. Strains that acquired aminoglycoside resistance during infection and after exposure to tobramycin or azithromycin overexpressed a putative resistance-nodulation-division (RND) transporter gene, amrB. Missense mutations in the repressor of amrB, amrR, were identified in isolates that acquired resistance during infection, and not in those generated in vitro. Conclusions These data identify oxidative stress as an inducer of aminoglycoside resistance in B. vietnamiensis and further suggest that active efflux via a RND efflux system impairs aminoglycoside accumulation in clinical B. vietnamiensis strains that have acquired aminoglycoside resistance, and in those exposed to tobramycin and azithromycin, but not hydrogen peroxide, in vitro. Furthermore, the repressor AmrR is likely just one regulator of the putative AmrAB-OprM efflux system in B. vietnamiensis.
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Affiliation(s)
- Agatha N Jassem
- Department of Pathology and Laboratory Medicine, University of British Columbia, 950 W 28th Avenue, Vancouver, British Columbia V5Z 4H4, Canada.
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Jassem AN, Zlosnik JEA, Henry DA, Hancock REW, Ernst RK, Speert DP. In vitro susceptibility of Burkholderia vietnamiensis to aminoglycosides. Antimicrob Agents Chemother 2011; 55:2256-64. [PMID: 21321142 PMCID: PMC3088185 DOI: 10.1128/aac.01434-10] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2010] [Accepted: 02/01/2011] [Indexed: 11/20/2022] Open
Abstract
Burkholderia cepacia complex (BCC) bacteria are opportunistic pathogens that can cause severe disease in cystic fibrosis (CF) patients and other immunocompromised individuals and are typically multidrug resistant. Here we observed that unlike other BCC species, most environmental and clinical Burkholderia vietnamiensis isolates were intrinsically susceptible to aminoglycosides but not to cationic antimicrobial peptides or polymyxin B. Furthermore, strains acquired aminoglycoside resistance during chronic CF infection, a phenomenon that could be induced under tobramycin or azithromycin pressure in vitro. In comparing susceptible and resistant B. vietnamiensis isolates, no gross differences in lipopolysaccharide structure were observed, all had lipid A-associated 4-amino-4-deoxy-L-arabinose residues, and all were resistant to the permeabilizing effects of aminoglycosides, a measure of drug entry via self-promoted uptake. However, susceptible isolates accumulated 5 to 6 times more gentamicin than a resistant isolate, and aminoglycoside susceptibility increased in the presence of an efflux pump inhibitor. B. vietnamiensis is therefore unusual among BCC bacteria in its susceptibility to aminoglycosides and capacity to acquire resistance. Aminoglycoside resistance appears to be due to decreased cellular accumulation as a result of active efflux.
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Affiliation(s)
- Agatha N. Jassem
- Departments of Pathology and Laboratory Medicine
- Centre for Understanding and Preventing Infection in Children, University of British Columbia, Vancouver, British Columbia, Canada
| | - James E. A. Zlosnik
- Pediatrics
- Centre for Understanding and Preventing Infection in Children, University of British Columbia, Vancouver, British Columbia, Canada
| | - Deborah A. Henry
- Pediatrics
- Centre for Understanding and Preventing Infection in Children, University of British Columbia, Vancouver, British Columbia, Canada
| | - Robert E. W. Hancock
- Department of Microbiology and Immunology and Centre for Microbial Diseases and Immunity Research, University of British Columbia, Vancouver, British Columbia, Canada
| | - Robert K. Ernst
- Department of Microbial Pathogenesis, University of Maryland—Baltimore, Baltimore, Maryland
| | - David P. Speert
- Departments of Pathology and Laboratory Medicine
- Pediatrics
- Centre for Understanding and Preventing Infection in Children, University of British Columbia, Vancouver, British Columbia, Canada
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Donato KA, Zareie M, Jassem AN, Jandu N, Alingary N, Carusone SC, Johnson-Henry KC, Sherman PM. Escherichia albertii and Hafnia alvei are candidate enteric pathogens with divergent effects on intercellular tight junctions. Microb Pathog 2008; 45:377-85. [PMID: 18930803 DOI: 10.1016/j.micpath.2008.09.004] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2008] [Revised: 08/27/2008] [Accepted: 09/12/2008] [Indexed: 11/24/2022]
Abstract
Attaching-effacing lesion-inducing Escherichia albertii and the related, but non-attaching-effacing organism, Hafnia alvei, are both implicated as enteric pathogens in humans. However, effects of these bacteria on epithelial cells are not well-characterized. Related enteropathogens, including enterohemorrhagic Escherichia coli O157:H7, decrease epithelial barrier function by disrupting intercellular tight junctions in polarized epithelia. Therefore, this study assessed epithelial barrier function and tight junction protein distribution in polarized epithelia following bacterial infections. Polarized epithelial (MDCK-I and T84) cells grown on filter supports were infected apically with E. coli O157:H7, E. albertii, and H. alvei for 16h at 37 degrees C. All strains decreased transepithelial electrical resistance and increased permeability to a dextran probe in a host cell-dependent manner. Immunofluorescence microscopy showed that both E. coli O157:H7 and E. albertii, but not H. alvei, caused a redistribution of the tight junction protein zona occludens-1. In contrast to E. coli O157:H7, E. albertii and H. alvei did not redistribute claudin-1. Western blotting of whole cell protein extracts demonstrated that each bacterium caused differential changes in tight junction protein expression, dependent on the host cell. These findings demonstrate that E. albertii and H. alvei are candidate enteric pathogens that have both strain-specific and host epithelial cell-dependent effects.
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Affiliation(s)
- Kevin A Donato
- Cell Biology Program, Research Institute, Hospital for Sick Children, University of Toronto, Room 8409, 555 University Avenue, Toronto, Ontario, Canada M5G 1X8
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