1
|
Asdaq SMB, Alshehri S, Alajlan SA, Hasino FH, Alhammad SK, Anazi TSA, Alasfr RM, Otaibi MFA. Deciphering the correlation of depression, quality of life, and COVID-19 challenges in people with disability: A Saudi Arabian perspective. J Infect Public Health 2024; 17:1013-1022. [PMID: 38636312 DOI: 10.1016/j.jiph.2024.04.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2024] [Revised: 03/31/2024] [Accepted: 04/08/2024] [Indexed: 04/20/2024] Open
Abstract
BACKGROUND Disability is a serious health issue that can have a significant impact on both physical and mental health. This study attempted to investigate the relationship between depression, quality of life (QOL), and COVID-19 challenges faced by people with disabilities (PwD) from Saudi Arabia. METHODS A structured interview questionnaire to measure QOL (WHOQOL-BREF) and depression (PHQ-9) was used to conduct a cross-sectional study among PwDs in Saudi Arabia. Binary regression analysis was done using SPSS-IBM and predictors for depression, quality of life and COVID-19 challenges were determined. RESULTS Of the 111 study samples, two-thirds were male (67.6%), with only one-third employed (34.2%). Most of them (70%) reported moderate to severe disability-related difficulties. Only 28.8% of the samples were satisfied with the physical health domain of the quality of life, whereas 31.5%, 44.1%, and 50.5% were satisfied with the psychological, social, and environmental health domains, respectively. Approximately 62% of the participants had been diagnosed with depression. A significantly higher percentage of participants who had not received COVID-19 vaccination were depressed (P = 0.011), whereas the depression rate was lower among those who received three or four doses of vaccination (P = 0.006). Depression is 4.1 times more likely in people with comorbidities, and disability with increased difficulty (OR: 4.266). Furthermore, vaccinated people had a 5.3-fold higher chance of developing satisfactory QOL. CONCLUSION Regardless of the type, cause, or duration of disability, the degree of difficulty is a strong predictor of depression and a decrease in quality of life. A multidisciplinary approach is needed to improve the well-being of people with disabilities.
Collapse
Affiliation(s)
| | - Sultan Alshehri
- Department of Pharmaceutical Sciences, College of Pharmacy, AlMaarefa University, 13713 Ad Diriyah, Saudi Arabia,.
| | - Sarah Abdulrahman Alajlan
- Department of Pharmacy Practice, College of Pharmacy, AlMaarefa University, 13713 Ad Diriyah, Saudi Arabia.
| | - Fadah Hasan Hasino
- Department of Pharmacy Practice, College of Pharmacy, AlMaarefa University, 13713 Ad Diriyah, Saudi Arabia.
| | - Shatha Khalid Alhammad
- Department of Pharmacy Practice, College of Pharmacy, AlMaarefa University, 13713 Ad Diriyah, Saudi Arabia.
| | - Taraf Shati Al Anazi
- Department of Pharmacy Practice, College of Pharmacy, AlMaarefa University, 13713 Ad Diriyah, Saudi Arabia.
| | - Reham Mansour Alasfr
- Department of Pharmacy Practice, College of Pharmacy, AlMaarefa University, 13713 Ad Diriyah, Saudi Arabia.
| | - Munirah Fahad Al Otaibi
- Department of Pharmacy Practice, College of Pharmacy, AlMaarefa University, 13713 Ad Diriyah, Saudi Arabia.
| |
Collapse
|
2
|
Kim DH, Kim JH, Oh IS, Choe YJ, Choe SA, Shin JY. Adverse Events Following COVID-19 Vaccination in Adolescents: Insights From Pharmacovigilance Study of VigiBase. J Korean Med Sci 2024; 39:e76. [PMID: 38442719 PMCID: PMC10911943 DOI: 10.3346/jkms.2024.39.e76] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2023] [Accepted: 01/08/2024] [Indexed: 03/07/2024] Open
Abstract
BACKGROUND During coronavirus disease 2019 (COVID-19) pandemic, several COVID-19 vaccines were licensed with fast-track procedures. Although these vaccines have demonstrated high immunogenicity, there has been concerns on the serious adverse events (AEs) following COVID-19 vaccination among adolescents. We aimed to analyze comparative safety of COVID-19 vaccination in adolescents. METHODS In this pharmacovigilance study, we performed a disproportionality analysis using VigiBase, the World Health Organization's global individual case safety report (ICSR) database. To compare serious AEs reported following COVID-19 vaccines vs. all other vaccines in adolescents aged 12-17 years, ICSRs following any vaccines on adolescents aged 12-17 years were included, defining cases as reports with the AEs of interest, with all other AEs as non-cases. The AEs of interest were myocarditis/pericarditis, multisystem inflammatory syndrome/Kawasaki disease (MIS/KD), anaphylaxis, Guillain-Barré syndrome (GBS), and immune thrombocytopenia (ITP). We conducted a disproportionality analysis to estimate reporting odds ratio (ROR) with 95% confidence interval (CI) for each AE of interest, adjusted for sex by using logistic regression. RESULTS Of 99,735 AE reports after vaccination in adolescents, 80,018 reports were from COVID-19 vaccinated adolescents (52.9% females; 56.3% America). The AEs of interest were predominantly reported as serious AE (76.1%) with mRNA vaccines (99.4%). Generally, higher reporting odds for the AEs were identified following COVID-19 vaccination in adolescents; myocarditis/pericarditis (2,829 reports for the COVID-19 vaccine vs. 35 for all other vaccines, adjusted ROR [aROR], 19.61; 95% CI, 14.05-27.39), and MIS/KD (104 vs. 6, aROR, 4.33; 95% CI, 1.89-9.88). The reporting odds for anaphylaxis (515 vs. 165, aROR, 0.86; 95% CI, 0.72-1.02), GBS (94 vs. 40, aROR, 0.64; 95% CI, 0.44-0.92) and ITP (52 vs. 12, aROR, 1.12; 95% CI, 0.59-2.09) were not significantly higher following COVID-19 vaccination. CONCLUSION In this study, there were disproportionate reporting of immune-related AEs following COVID-19 vaccination. While awaiting definitive evidence, there is a need to closely monitor for any signs of immune-related AEs following COVID-19 vaccination among adolescents.
Collapse
Affiliation(s)
- Dong Hyuk Kim
- Department of Biohealth Regulatory Science, Sungkyunkwan University, Suwon, Korea
| | - Ju Hwan Kim
- Department of Biohealth Regulatory Science, Sungkyunkwan University, Suwon, Korea
- School of Pharmacy, Sungkyunkwan University, Suwon, Korea
| | - In-Sun Oh
- School of Pharmacy, Sungkyunkwan University, Suwon, Korea
- Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, Canada
- Centre for Clinical Epidemiology, Lady Davis Institute, Jewish General Hospital, Montreal, Canada
| | - Young June Choe
- Deparment of Pediatrics, Korea University Anam Hospital, Seoul, Korea
| | - Seung-Ah Choe
- Deparment of Preventive Medicine, Korea University College of Medicine, Seoul, Korea
| | - Ju-Young Shin
- Department of Biohealth Regulatory Science, Sungkyunkwan University, Suwon, Korea
- School of Pharmacy, Sungkyunkwan University, Suwon, Korea
- Department of Clinical Research Design & Evaluation, Samsung Advanced Institute for Health Sciences & Technology, Sungkyunkwan University, Seoul, Korea.
| |
Collapse
|
3
|
Benson BR, Rahman SA, Bleasdale J, Win S, Townsend-Kensinger K, Cole M, Jalal K, Yu J, Morse GD, Mohler JL, Ward RL. Trusted Information Sources About the COVID-19 Vaccine Vary in Underserved Communities. J Community Health 2024:10.1007/s10900-023-01319-0. [PMID: 38300477 DOI: 10.1007/s10900-023-01319-0] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/29/2023] [Indexed: 02/02/2024]
Abstract
The COVID-19 pandemic was one of the deadliest global public health events. In the United States, over 1.1 million individuals have died, and now COVID-19 is the third leading cause of death (CDC, 2023). Vaccine uptake has stalled among different demographics. Vaccine hesitancy, a delay in accepting or refusing vaccines, poses a significant challenge regardless of the availability of safe and effective COVID-19 vaccines. This study aimed to identify disparate COVID-19 vaccine uptake among individuals in Western New York. The primary objective was to identify the factors contributing to lower rates of COVID-19 vaccination within this population.Data were collected from 585 adults recruited from 20 Niagara and Erie Counties sites using a self-administered survey on vaccine hesitancy, vaccination status, and COVID-19-related characteristics. The survey included the adult Vaccine Hesitancy Scale (aVHS) and acquired information on demographic characteristics and COVID-19 impact, knowledge, and information sources. Data were analyzed using descriptive statistics, a chi-squared test, a Wilcoxon rank-sum test, and a logistic regression model.Findings suggest that unvaccinated participants (n = 35) were concerned about vaccine side effects (48.6%). For vaccinated/unboosted participants (n = 52), they (40.0%) reported clinical concerns. After adjusting for gender and age, healthcare provider guidance and family guidance remained significant predictors of vaccination status, while clinical research studies were significant predictors of booster status. Findings from this study suggest public health interventions that target vaccine education and facilitate well-informed decisions about COVID-19 vaccines lead to less vaccine hesitancy.
Collapse
Affiliation(s)
| | | | | | | | | | | | | | | | | | - James L Mohler
- Roswell Park Comprehensive Cancer Center (Urology, Pharmacology and Therapeutics), Buffalo, NY, USA
| | - Rolanda L Ward
- Department of Social Work, Niagara University, Niagara Falls, NY, USA.
| |
Collapse
|
4
|
Kang D, Choi A, Park S, Choe SA, Shin JY. Safety of COVID-19 Vaccination During Pregnancy and Lactation: A VigiBase Analysis. J Korean Med Sci 2024; 39:e3. [PMID: 38193325 PMCID: PMC10782038 DOI: 10.3346/jkms.2024.39.e3] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Accepted: 10/16/2023] [Indexed: 01/10/2024] Open
Abstract
BACKGROUND There is limited evidence on the safety of coronavirus disease 2019 (COVID-19) vaccination during pregnancy and lactation. Thus, we aimed to evaluate the association between COVID-19 vaccination during pregnancy and lactation and reporting risk of adverse pregnancy or lactation outcomes. METHODS Using VigiBase, we performed a disproportionality analysis with case/non case design. Cases were defined based on the Standardized MedDRA Queries (SMQs) of "pregnancy and neonatal topics" and non-cases were defined as all other adverse events. We included all reports with COVID-19 vaccines as the suspected cause. Using the full database as the comparators, reporting odds ratios (RORs) with 95% confidence intervals (CIs) were estimated by logistic regression while adjusting for maternal age. Infants' age and sex were additionally adjusted in analyzing the risk of COVID-19 vaccination during lactation. RESULTS We identified 10,266 and 6,474 reports with the SMQ of "pregnancy and neonatal topics" associated with COVID-19 vaccines during pregnancy and lactation, respectively. No significant RORs of adverse pregnancy outcomes associated with COVID-19 vaccines during pregnancy were observed; however, "functional lactation disorders" showed significant disproportionality during lactation with adjusted ROR of 1.48 (95% CI, 1.21-1.79). Further analysis that analyzed "functional lactation disorders" at a preferred term level, showed higher ROR in mastitis (2.76 [95% CI, 1.45-5.27]). CONCLUSION Overall, we did not observe a positive association between COVID-19 vaccination during pregnancy and risk of reporting adverse pregnancy outcomes. However, we found a significant disproportionate reporting association between COVID-19 vaccination during lactation and "functional lactation disorders", specifically mastitis. Continuous surveillance is warranted to confirm the safety of COVID-19 vaccine during pregnancy and lactation.
Collapse
Affiliation(s)
- Dayeon Kang
- Department of Biohealth Regulatory Science, Sungkyunkwan University, Suwon, Korea
| | - Ahhyung Choi
- School of Pharmacy, Sungkyunkwan University, Suwon, Korea
| | - Suneun Park
- School of Pharmacy, Sungkyunkwan University, Suwon, Korea
| | - Seung-Ah Choe
- Department of Preventive Medicine, Korea University College of Medicine, Seoul, Korea
| | - Ju-Young Shin
- Department of Biohealth Regulatory Science, Sungkyunkwan University, Suwon, Korea
- School of Pharmacy, Sungkyunkwan University, Suwon, Korea
- Department of Clinical Research Design & Evaluation, Samsung Advanced Institute for Health Sciences & Technology, Sungkyunkwan University, Seoul, Korea.
| |
Collapse
|
5
|
Al-Jahhafi AS, Al-Sawaai AA, Al-Bimani ZK, Al-Bulushi NK. Graves' disease post-COVID-19 m-RNA vaccine in pediatric age group. Asia Ocean J Nucl Med Biol 2024; 12:65-68. [PMID: 38164230 PMCID: PMC10757064 DOI: 10.22038/aojnmb.2023.73051.1510] [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] [Figures] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Revised: 07/28/2023] [Accepted: 10/25/2023] [Indexed: 01/03/2024]
Abstract
The surge of the COVID-19 pandemic (December / 2019 - May/2023) and its catastrophic effect worldwide have necessitated emergent intervention to reduce its influence on people's health and life. To eliminate and reduce the impact of COVID-19 infection, COVID-19 vaccination was emergently authorized in December 2020 which has established good safety and efficacy. Having said that, some adverse effects merged in a few individuals. We are reporting an adolescent patient a 17-year-old female who has been diagnosed with Graves' disease after post-COVID-19 vaccinations. In addition, she was a confirmed case of COVID-19 infection three months earlier. The patient presented with typical features of hyperthyroidism 30 days post receiving the first dose of the vaccination. Based on the patient's presentation relative to the administration of the vaccine and prior infection of the virus. We proposed the synergistic effect of both factors to induce Graves' disease in this young healthy female with no family history of autoimmune disease. We are reporting this case for pediatric endocrinologists to be aware of the interaction and possible impact of the COVID-19 vaccine on thyroid function.
Collapse
|
6
|
Kang KW, Kim J, Kim KT, Kim MK, Cho YW. Association Between Electronic Device Use at Bedtime and COVID-19 Vaccine-Related Adverse Events During the COVID-19 Pandemic in Korean Adults: A Nationwide Cross-Sectional Population-Based Study. J Korean Med Sci 2023; 38:e413. [PMID: 38111283 PMCID: PMC10727916 DOI: 10.3346/jkms.2023.38.e413] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Accepted: 09/14/2023] [Indexed: 12/20/2023] Open
Abstract
BACKGROUND The coronavirus disease 2019 (COVID-19) pandemic has led to heightened mood disturbances linked to increased electronic device use at bedtime (EUB). General anxiety may contribute to an increased likelihood of experiencing nocebo responses, which have been reported to be associated with COVID-19 vaccine-related adverse events (CAEs). However, no related studies have been conducted to examine this association to date. METHODS We executed a nationwide cross-sectional study to explore these correlations during the pandemic. Using data from the 2022 National Sleep Survey of South Korea, we analyzed the sleep health of 4,000 adults aged 20-69 years between January and February 2022. Shift workers and those with severe sleep disorders were excluded. Participants with EUB more than four days a week were labeled as high frequency EUB, and those reporting CAEs after both vaccine doses were marked as having a presence of CAEs. The survey also included details about anthropometric data, socioeconomic status, and sleep status. RESULTS Of the 3,702 participants, 92.6% had received two or more vaccine doses, with 41.2% experiencing CAEs. Furthermore, 73.7% had a high EUB frequency. Factors associated with CAE reporting included younger age, female sex, and high EUB frequency, while heavy alcohol use was found to be less likely to be associated with CAE reporting. Notably, a high EUB frequency was significantly associated with reported CAEs (odds ratio, 1.223; 95% confidence interval, 1.028-1.455; P = 0.023). CONCLUSION A nationwide online survey conducted in South Korea during the pandemic found that individuals who engaged in the relatively frequent use of electronic devices during bedtime had worse sleep quality and increased COVID-19-related adverse events compared with those using these devices less frequently. These findings have the potential to enhance our understanding of the impact of the use of electronic devices at bedtime on health.
Collapse
Affiliation(s)
- Kyung Wook Kang
- Department of Neurology, Chonnam National University Hospital, Chonnam National University School of Medicine, Gwangju, Korea
| | - Jiyoung Kim
- Department of Neurology, Pusan National University Hospital, Pusan National University School of Medicine, Busan, Korea
| | - Keun Tae Kim
- Department of Neurology, Keimyung University School of Medicine, Daegu, Korea
| | - Myeong-Kyu Kim
- Department of Neurology, Chonnam National University Hospital, Chonnam National University School of Medicine, Gwangju, Korea
| | - Yong Won Cho
- Department of Neurology, Keimyung University School of Medicine, Daegu, Korea.
| |
Collapse
|
7
|
Wie SH, Jung J, Kim WJ. Effective Vaccination and Education Strategies for Emerging Infectious Diseases Such as COVID-19. J Korean Med Sci 2023; 38:e371. [PMID: 37967881 PMCID: PMC10643251 DOI: 10.3346/jkms.2023.38.e371] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Accepted: 09/24/2023] [Indexed: 11/17/2023] Open
Abstract
Social isolation and control owing to coronavirus disease 2019 (COVID-19) are easing; however, concerns regarding new infectious diseases have not disappeared. Given epidemic experiences such as severe acute respiratory syndrome (SARS), the influenza pandemic, Middle East respiratory syndrome (MERS), and COVID-19, it is necessary to prepare for the outbreak of new infectious diseases and situations in which large-scale vaccinations are required. Although the development of vaccines against COVID-19 has contributed greatly to overcoming the pandemic, concerning vaccine side effects from the general public, including medical personnel, and decreased confidence in vaccine efficacy and side effects, present many challenges in promoting and educating vaccinations for new infectious diseases in the future. In addition to plans to develop vaccines for the outbreak of new infectious diseases, education and promotion plans are necessary to administer the latest developments of vaccines to the general public. Moreover, efforts are needed to secure the necessity, legitimacy, and evidence for rapid vaccination on a large scale at the national level. It is also necessary to carefully prepare scientific bases and explanatory statements so that the general public can easily understand them. This study aimed to establish vaccine strategies and vaccination education plans for new infectious diseases that may occur in the future. Many ways to promote vaccination to the general public and healthcare workers should be prepared to ensure that the latest vaccines against new infectious diseases are administered safely. Thus, education and promotion of vaccine efficacy and safety based on specific data from clinical studies are necessary.
Collapse
Affiliation(s)
- Seong-Heon Wie
- Division of Infectious Diseases, Department of Internal Medicine, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Suwon, Korea
| | - Jaehun Jung
- Department of Preventive Medicine, Gachon University College of Medicine, Incheon, Korea
| | - Woo Joo Kim
- Division of Infectious Diseases, Department of Internal Medicine, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea.
| |
Collapse
|
8
|
Wilkinson B, Patel KS, Smith K, Walker R, Wang C, Greene AM, Smith G, Smith ER, Gurwith M, Chen RT. A Brighton Collaboration standardized template with key considerations for a benefit/risk assessment for the Novavax COVID-19 Vaccine (NVX-CoV2373), a recombinant spike protein vaccine with Matrix-M adjuvant to prevent disease caused by SARS-CoV-2 viruses. Vaccine 2023; 41:6762-6773. [PMID: 37739888 DOI: 10.1016/j.vaccine.2023.07.040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Accepted: 07/20/2023] [Indexed: 09/24/2023]
Abstract
Novavax, a global vaccine company, began evaluating NVX-CoV2373 in human studies in May 2020 and the pivotal placebo-controlled phase 3 studies started in November 2020; five clinical studies provided adult and adolescent clinical data for over 31,000 participants who were administered NVX-CoV2373. This extensive data has demonstrated a well-tolerated response to NVX-CoV2373 and high vaccine efficacy against mild, moderate, or severe COVID-19 using a two-dose series (Dunkle et al., 2022) [1], (Heath et al., 2021) [2], (Keech et al., 2020) [3], (Mallory et al., 2022) [4]. The most common adverse events seen after administration with NVX-CoV2373 were injection site tenderness, injection site pain, fatigue, myalgia, headache, malaise, arthralgia, nausea, or vomiting. In addition, immunogenicity against variants of interest (VOI) and variants of concern (VOC) was established with high titers of ACE2 receptor-inhibiting and neutralizing antibodies in these studies (EMA, 2022) [5], (FDA, 2023) [6]. Further studies on correlates of protection determined that titers of anti-Spike IgG and neutralizing antibodies correlated with efficacy against symptomatic COVID-19 established in clinical trials (p < 0.001 for recombinant protein vaccine and p = 0.005 for mRNA vaccines for IgG levels) (Fong et al., 2022) [7]. Administration of a booster dose of the recombinant protein vaccine approximately 6 months following the primary two-dose series resulted in substantial increases in humoral antibodies against both the prototype strain and all evaluated variants, similar to or higher than the antibody levels observed in phase 3 studies that were associated with high vaccine efficacy (Dunkle et al., 2022) [1], (Mallory et al., 2022) [4]. These findings, together with the well tolerated safety profile, support use of the recombinant protein vaccine as primary series and booster regimens.
Collapse
Affiliation(s)
| | | | | | | | | | | | | | - Emily R Smith
- Brighton Collaboration, a program of the Task Force for Global Health, Decatur, GA, USA.
| | - Marc Gurwith
- Brighton Collaboration, a program of the Task Force for Global Health, Decatur, GA, USA
| | - Robert T Chen
- Brighton Collaboration, a program of the Task Force for Global Health, Decatur, GA, USA
| |
Collapse
|
9
|
Albedaiwi FB, Alshammari M, Algeffari M, Alfouzan A, Alfouzan Y, Siddiq H, Hussein O. Diabetic Ketoacidosis After COVID-19 Vaccine in Patients with Type 1 Diabetes Mellitus. Int J Endocrinol Metab 2023; 21:e135866. [PMID: 38694238 PMCID: PMC11061715 DOI: 10.5812/ijem-135866] [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] [Received: 02/28/2023] [Revised: 07/31/2023] [Accepted: 08/28/2023] [Indexed: 05/04/2024] Open
Abstract
Background The coronavirus disease 2019 (COVID-19) vaccine is one of the few vaccines that obtained emergency authorization to combat the fatal pandemic. Despite the fact that some available literature addressed its short-term side effects, there are still limitations on its effects on type 1 diabetes mellitus (T1DM). Objectives The aim of the present study was to assess the association between COVID-19 vaccination and diabetic ketoacidosis (DKA) among individuals with T1DM. Additionally, the study aimed to determine the effects of the vaccine on glucose control, variability, and risk of hypoglycemia. Methods This retrospective study was conducted at King Fahad Specialist Hospital (KFSH) in Qassim Region, Saudi Arabia. Diabetic ketoacidosis cases admitted to the hospital within February 2020 and August 2022 were included in the study based on specific inclusion criteria. Finally, a total of 49 patients were included in statistical analyses. Results Out of the 62 patients admitted to the hospital, 49 met the diagnostic criteria for DKA and agreed to participate in the study. The majority of the remaining patients (n = 13) refused to participate, and only a few of them lacked complete documentation. Of the 49 patients who were included in the study, 46 cases had a history of T1DM; nevertheless, 3 patients were newly diagnosed with T1DM. Additionally, among these participants, 16 (32.7%), 19 (38.8%), and 14 (28.6%) patients had mild, moderate, and severe DKA, respectively. There were 27 male (55.1%) and 22 female (44.9%) patients. About 91% of the patients were vaccinated against COVID-19, 30.6% of whom were vaccinated within 29 days of being diagnosed with DKA. The pH and bicarbonate levels were observed to be significantly high among those who were diagnosed with DKA within 29 days of vaccination, with p-values of 0.031 and 0.037, respectively. Similarly, pH and random blood sugar (RBS) were observed to be significantly higher among the vaccinated patients than in the non-vaccinated subjects (P = 0.044 and P = 0.032, respectively). Conclusions The study findings revealed that some of the DKA indicators were evident among the vaccinated patients. However, larger-scale and multi-center studies are recommended in order to have more conclusive evidence and generalize the findings.
Collapse
Affiliation(s)
| | | | - Metab Algeffari
- Department of Family and Community Medicine, Collage of Medicine, Qassim University, Buraydah, Saudi Arabia
| | | | - Yasmeen Alfouzan
- College of Medicine, Qassim University, Buraydah, Al-Qassim, Saudi Arabia
| | - Hassan Siddiq
- Diabetes and Endocrinology Center, Buraydah, Al-Qassim, Saudi Arabia
| | - Omaima Hussein
- Diabetes and Endocrinology Center, Buraydah, Al-Qassim, Saudi Arabia
| |
Collapse
|
10
|
Halabi S, Gostin LO, Aneja K, Nardi F, Gottschalk K, Monahan J. The Coalition for Epidemic Preparedness Innovations (CEPI) and the Partnerships of Equitable Vaccine Access. J Law Med Ethics 2023; 51:234-246. [PMID: 37655558 PMCID: PMC10881267 DOI: 10.1017/jme.2023.85] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/02/2023]
Abstract
This article highlights and evaluates the role of CEPI and its contribution to global equitable access to COVID-19 vaccines through its established partnerships for vaccine development. The article adds to the understanding of how and when such partnerships can work for public health, especially under emergency citations.
Collapse
Affiliation(s)
- Sam Halabi
- O'NEILL INSTITUTE FOR NATIONAL AND GLOBAL HEALTH LAW, WASHINGTON, DC, USA
- COLORADO STATE UNIVERSITY, FORT COLLINS, CO, USA
- COLORADO SCHOOL OF PUBLIC HEALTH, AURORA, CO, USA
| | - Lawrence O Gostin
- O'NEILL INSTITUTE FOR NATIONAL AND GLOBAL HEALTH LAW, WASHINGTON, DC, USA
- GEORGETOWN UNIVERSITY, WASHINGTON, DC, USA
| | - Kashish Aneja
- O'NEILL INSTITUTE FOR NATIONAL AND GLOBAL HEALTH LAW, WASHINGTON, DC, USA
| | - Francesca Nardi
- O'NEILL INSTITUTE FOR NATIONAL AND GLOBAL HEALTH LAW, WASHINGTON, DC, USA
| | - Katie Gottschalk
- O'NEILL INSTITUTE FOR NATIONAL AND GLOBAL HEALTH LAW, WASHINGTON, DC, USA
| | - John Monahan
- O'NEILL INSTITUTE FOR NATIONAL AND GLOBAL HEALTH LAW, WASHINGTON, DC, USA
- GEORGETOWN UNIVERSITY, WASHINGTON, DC, USA
| |
Collapse
|
11
|
Shin A, Kim DW, Kim YE, Kim DR, Jung J, Kim YJ. COVID-19 Vaccination Status Among Korean Pediatric Population With Comorbidities. J Korean Med Sci 2023; 38:e248. [PMID: 37582498 PMCID: PMC10427210 DOI: 10.3346/jkms.2023.38.e248] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Accepted: 06/20/2023] [Indexed: 08/17/2023] Open
Abstract
The pediatric population with comorbidities is a high-risk group for severe coronavirus disease 2019 (COVID-19). As of January 2023, the COVID-19 vaccination rate for at least two doses among Korean children 5-11 years is low at 1.1%. We summarized the COVID-19 vaccination status for the pediatric population (5-17 years) with comorbidities through July 2022 using the National Health Insurance Service database. Pediatric patients with comorbidities had higher vaccination rates than the general pediatric population (2.4% vs. 1.1% in 5-11-year-olds [P < 0.001], 76.5% vs. 66.1% in 12-17-year-olds [P < 0.001]). However, there were substantial differences according to comorbidity category, and the 2-dose vaccination rate was lowest among children with immunodeficiency in all age groups (1.1% in 5-11-year-olds, 51.2% in 12-17-year-olds). The COVID-19 vaccination rate among Korean children has remained stagnant at a low proportion despite ongoing outreach. Thus, more proactive strategies are needed alongside continuous surveillance.
Collapse
Affiliation(s)
- Areum Shin
- Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Dong Wook Kim
- Department of Information and Statistics, Department of Bio & Medical Big Data, Research Institute of Natural Science, Gyeongsang National University, Jinju, Korea
| | - Young-Eun Kim
- Department of Big Data Strategy, National Health Insurance Service, Wonju, Korea
| | - Doo Ri Kim
- Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jaehun Jung
- Department of Preventive Medicine, Gachon University College of Medicine, Incheon, Korea
- Artificial Intelligence and Big-Data Convergence Center, Gil Medical Center, Gachon University College of Medicine, Incheon, Korea.
| | - Yae-Jean Kim
- Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
- Samsung Advanced Institute for Health Sciences and Technology (SAIHST), Seoul, Korea.
| |
Collapse
|
12
|
Kim JW, Jung JY, Suh CH, Ye YM, Kim HA. Effects of COVID-19 and Influenza Vaccination on Rheumatic Diseases: Results From a Survey of Patient-Reported Outcomes After Vaccination. J Korean Med Sci 2023; 38:e247. [PMID: 37582497 PMCID: PMC10427213 DOI: 10.3346/jkms.2023.38.e247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Accepted: 04/05/2023] [Indexed: 08/17/2023] Open
Abstract
BACKGROUND This study aimed to compare the occurrence of adverse events (AEs) and disease flares after vaccination against coronavirus disease 2019 (COVID-19) and influenza in patients with autoimmune rheumatic diseases (ARDs). METHODS Between November 2021 and March 2022, a survey was conducted among patients with ARD who received COVID-19 and influenza vaccinations. The questionnaire included 11 mandatory and closed-ended questions, and the following items were collected: medical history, immunization history, type of vaccine, patient-reported AEs, flare-up of the underlying disease after vaccination, and a confirmed diagnosis of COVID-19 or influenza. We compared the occurrence of vaccine-related adverse reactions to the COVID-19 and influenza vaccines based on the survey results. Multivariate logistic regression analysis was used to identify the factors affecting AEs or disease flares and to compare the post-vaccine response to mixed and matched vaccines. RESULTS We analyzed 601 adults with ARD who received the COVID-19 vaccine, with a mean age of 49.6 years (80.5% female). A total of 255 participants (42.4%) received a complete course of primary vaccination, 342 (56.9%) completed the booster dose, and 132 (38.6%) received a mixed vaccine. The frequencies of AEs (188 [52.2%] vs. 21 [5.8%]; P < 0.001) and disease flares (58 [16.2%] vs. 5 [1.4%]; P < 0.001) after COVID-19 vaccination were significantly higher than those after influenza vaccination. In the risk factor analysis, previous allergic reaction to other vaccines (odds ratio, 1.95; confidence interval, 1.07-3.70; P = 0.034) was the only factor associated with the occurrence of AEs. There was no difference in the post-vaccine responses between the mixed and matched vaccines. CONCLUSION The results of the survey of patients with ARD revealed that patient-reported AEs and underlying disease flares after receiving the COVID-19 vaccine were significantly higher than those after the influenza vaccine.
Collapse
Affiliation(s)
- Ji-Won Kim
- Department of Rheumatology, Ajou University School of Medicine, Suwon, Korea
| | - Ju-Yang Jung
- Department of Rheumatology, Ajou University School of Medicine, Suwon, Korea
| | - Chang-Hee Suh
- Department of Rheumatology, Ajou University School of Medicine, Suwon, Korea
| | - Young-Min Ye
- Department of Allergy & Clinical Immunology, Ajou University School of Medicine, Suwon, Korea
| | - Hyoun-Ah Kim
- Department of Rheumatology, Ajou University School of Medicine, Suwon, Korea.
| |
Collapse
|
13
|
Dorney I, Bobak L, Otteson T, Kaelber DC. Prevalence of New-Onset Tinnitus after COVID-19 Vaccination with Comparison to Other Vaccinations. Laryngoscope 2023; 133:1722-1725. [PMID: 36098476 PMCID: PMC9539087 DOI: 10.1002/lary.30395] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2022] [Revised: 07/21/2022] [Accepted: 08/16/2022] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To investigate how often patients are diagnosed with new-onset tinnitus within 21 days after COVID-19 vaccination in comparison to after three other common vaccinations: influenza, Tdap (tetanus, diphtheria, and acellular pertussis), and polysaccharide pneumococcus. METHODS The TriNetX Analytics Network, a federated health research network that aggregates the de-identified electronic health record (EHR) data of over 78 million patients, was queried for patients receiving each vaccination. Instances of new-onset tinnitus within 21 days of vaccination were recorded and reported. RESULTS Out of 2,575,235 patients receiving a first dose of the mRNA COVID-19 vaccine without any prior tinnitus diagnosis, 0.038% (95% CI: 0.036%-0.041%) of patients had a new diagnosis of tinnitus within 21 days. There was a higher risk of a new tinnitus diagnosis after the influenza vaccine (RR: 1.95, 95% CI: 1.72-2.21), Tdap vaccine (RR: 2.36, 95% CI: 1.93-2.89), and pneumococcal vaccine (RR: 1.97, 95% CI: 1.48-2.64) than after the first dose of the COVID-19 vaccine. There was a lower risk of a new tinnitus diagnosis after the second dose of COVID-19 than after the first dose (RR: 0.80, 95% CI: 0.71-0.91). CONCLUSION The rate of newly diagnosed tinnitus acutely after the first dose of the COVID-19 vaccine is very low. There was a higher risk of newly diagnosed tinnitus after influenza, Tdap, and pneumococcal vaccinations than after the COVID-19 vaccine. The present findings can help to address COVID-19 vaccine hesitancy during the ongoing pandemic. LEVEL OF EVIDENCE Level 3 Laryngoscope, 133:1722-1725, 2023.
Collapse
Affiliation(s)
- Ian Dorney
- School of Medicine, Case Western Reserve University, Cleveland, Ohio, USA
| | - Lukas Bobak
- School of Medicine, Case Western Reserve University, Cleveland, Ohio, USA
| | - Todd Otteson
- School of Medicine, Case Western Reserve University, Cleveland, Ohio, USA
- Department of Otolaryngology-Head and Neck Surgery, University Hospitals Cleveland Medical Center, Cleveland, Ohio, USA
| | - David C Kaelber
- Departments of Internal Medicine, Pediatrics, and Population and Quantitative Health Sciences, Case Western Reserve University, Cleveland, Ohio, USA
- The Center for Clinical Informatics Research and Education, The MetroHealth System, Cleveland, Ohio, USA
| |
Collapse
|
14
|
Soh Y, Yoo EA, Kim ES, Kim SJ. MRI Features of Multiple Cranial Neuropathies in Guillain-Barré Syndrome Occurring after COVID-19 Vaccination: A Case Report. J Korean Soc Radiol 2023; 84:964-969. [PMID: 37559813 PMCID: PMC10407074 DOI: 10.3348/jksr.2022.0099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/26/2022] [Revised: 11/02/2022] [Accepted: 11/13/2022] [Indexed: 08/11/2023]
Abstract
Guillain-Barré syndrome (GBS) is an immune-mediated demyelinating polyneuropathy characterized by progressive, ascending, and symmetrical paralysis. It is known to be triggered by an antecedent infection or vaccination. Recently, GBS development following coronavirus disease 2019 (COVID-19) vaccination has been reported. Cranial neuropathies in typical GBS patients usually involve the facial and the lower cranial nerves (from IX to XII). We report a rare case of multiple cranial neuropathies involving trigeminal, abducens, and facial nerves in a patient who developed GBS following COVID-19 vaccination on the basis of obvious MRI features.
Collapse
|
15
|
Shen AK, Browne S, Srivastava T, Kornides ML, Tan ASL. Trusted messengers and trusted messages: The role for community-based organizations in promoting COVID-19 and routine immunizations. Vaccine 2023; 41:1994-2002. [PMID: 36803894 PMCID: PMC9932688 DOI: 10.1016/j.vaccine.2023.02.045] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Revised: 01/22/2023] [Accepted: 02/13/2023] [Indexed: 02/18/2023]
Abstract
We sought to explore the trust and influence community-based organizations have within the communities they serve to inform public health strategies in tailoring vaccine and other health messages. A qualitative study was conducted between March 15 - April 12, 2021 of key informants in community-based organizations serving communities in and around Philadelphia, Pennsylvania. These organizations serve communities with high Social Vulnerability Index scores. We explored four key questions including: (1) What was and continues to be the impact of COVID-19 on communities; (2) How have trust and influence been cultivated in the community; (3) Who are trusted sources of information and health messengers; and (4) What are the community's perceptions about vaccines, vaccinations, and intent to vaccinate in the context of the COVID-19 pandemic. Fifteen key informants from nine community-based organizations who serve vulnerable populations (e.g., mental health, homeless, substance use, medically complex, food insecurity) were interviewed. Five key findings include: (1) The pandemic has exacerbated disparities in existing social determinants of health for individuals and families and have created new concerns for these communities; (2) components of how to build the trust and influence (e.g., demonstrate empathy, create a safe space, deliver on results)resonated with key informants; (3) regardless of the source, presenting health information in a respectful and understandable manner is key to effective delivery; (4) trust and influence can be transferred by association to a secondary messenger connected to or introduced by the primary trusted source; and (5) increased awareness about vaccines and vaccinations offers opportunities to think differently, changing previously held beliefs or attitudes, as many individuals are now more cognizant of risks associated with vaccine-preventable diseases and the importance of vaccines. Community-based organizations offer unique opportunities to address population-level health disparities as trusted vaccine messengers to deliver public health messages.
Collapse
Affiliation(s)
- Angela K Shen
- Children's Hospital of Philadelphia, Vaccine Education Center, Philadelphia, United States; Leonard Davis Institute, University of Pennsylvania, Philadelphia, United States; University of Pennsylvania, Perelman School of Medicine, Department of Medical Bioethics and Health Policy, Philadelphia, United States.
| | - Safa Browne
- Children's Hospital of Philadelphia, Vaccine Education Center, Philadelphia, United States
| | - Tuhina Srivastava
- Leonard Davis Institute, University of Pennsylvania, Philadelphia, United States; University of Pennsylvania, Perelman School of Medicine, Department of Biostatistics, Epidemiology and Informatics, Philadelphia, United States
| | - Melanie L Kornides
- Leonard Davis Institute, University of Pennsylvania, Philadelphia, United States; University of Pennsylvania, School of Nursing, Department of Family and Community Health, United States; University of Pennsylvania, Perelman School of Medicine, Department of Pediatrics, Division of Adolescent Medicine, United States
| | - Andy S L Tan
- Leonard Davis Institute, University of Pennsylvania, Philadelphia, United States; University of Pennsylvania, Annenberg School for Communication, United States
| |
Collapse
|
16
|
Sangster-Carrasco L, Paz-Temoche R, Coronado-Arroyo J, Concepción-Zavaleta M, Roseboom P, Concepción-Urteaga L, Zavaleta-Gutiérrez F. Lipschütz acute vulvar ulcer related to COVID-19 vaccination: First case report in South America. Medwave 2023; 23. [PMID: 36947719 DOI: 10.5867/medwave.2023.02.2674] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/24/2023] Open
Abstract
Lipschütz ulcer is a non-sexually transmitted genital lesion of unknown etiology, which presents as a painful vulvar ulcer. Lipschütz ulcers have been described in most continents. This is the first case reported in Peru and South America. We present the case of a 33-year-old female patient with a Lipschütz ulcer after being vaccinated with the second dose of the AstraZeneca COVID-19 vaccine. She reported having had only one sexual partner in her lifetime. Laboratory results were negative for herpes simplex 2, Cytomegalovirus, Toxoplasma gondii, Epstein-Barr virus, and syphilis. The patient received symptomatic treatment. Ten days after the onset, the patient was significantly better during follow-up. This case report displays a potential adverse effect of the AstraZeneca COVID-19 vaccine as a Lipschütz ulcer triggered by the host humoral immune response. However, further research is needed to establish the causal relationship between these two.
Collapse
Affiliation(s)
| | | | - Julia Coronado-Arroyo
- Department of Obstetrics and Gynecology, Edgardo Rebagliati National Hospital, Lima, Peru
| | | | - Pela Roseboom
- Department of Medicine, Cesar Vallejo Mendoza Hospital, Santiago de Chuco, Peru
| | | | | |
Collapse
|
17
|
Borges LC, Zeferino de Menezes H, Crosbie E. More Pain, More Gain! The Delivery of COVID-19 Vaccines and the Pharmaceutical Industry's Role in Widening the Access Gap. Int J Health Policy Manag 2022; 11:3101-3113. [PMID: 36028975 PMCID: PMC10105197 DOI: 10.34172/ijhpm.2022.6942] [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: 11/14/2021] [Accepted: 08/01/2022] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND An effective response to the coronavirus disease 2019 (COVID-19) pandemic entails a comprehensive strategy that ensures equitable access to all COVID-19-fighting technologies. To achieve this goal, the international community has acknowledged immunization as a public good. However, a trend of grossly unequal dose distribution emerged, owing, among other factors, to pharmaceutical companies' profit-driven actions, jeopardizing the mechanisms built to increase vaccine access. The contradiction between public health interests and corporate discretion in determining vaccine dose distribution poses critical concerns about the health risks associated with lengthening the duration of the pandemic and the eventual liability of companies for violations of human rights. METHODS To evaluate the risks posed to the COVID-19 immunization program, data on vaccine allocation and delivery, vaccine dose application, immunized populations, and the volume of Advanced Purchase Agreements (APAs) between countries and pharmaceutical companies were compiled and assessed. A descriptive analysis was then conducted to analyze the role of pharmaceutical companies in providing equitable access to COVID-19 vaccines. RESULTS When the data is broken down by income (as of June 2021), it shows that high-income countries (HICs) have already crossed the COVID-19 Vaccine Global Access (COVAX) 20% immunization threshold. However, countries of all other income levels have yet to achieve this mark for fully vaccinated people. Upper-middle-income countries (UMICs) have approximately 3%, low- and middle-income countries (LMICs) have approximately 2% and low-income countries (LICs) have less than 0.1% of fully vaccinated people per hundred. The supply shortage is expected to last until the second half of 2021. CONCLUSION As a result of the COVAX failure, a health gap emerged with countries living in a pre-immunization period for an extended time. The existing conflict between the international response to tackle COVID-19 and corporate profit-driven behavior contributed to prolonging pandemic, especially in Africa. Accordingly, there is a need to approve an international treaty that targets the activities of all actors, including the pharmaceutical companies, in protecting human rights and the right to health realms.
Collapse
Affiliation(s)
| | | | - Eric Crosbie
- School of Public Health, University of Nevada Reno, Reno, NV, USA
- Ozmen Institute for Global Studies, University of Nevada Reno, Reno, NV, USA
| |
Collapse
|
18
|
Qashqari FSI, Dahlawi M, Assaggaf HM, Alsafi R, Gari A, Abudawood A, Al-Doboke A, Alsulami S, Bukhari R, Majeed SA, Salih EA, Alfelali M, Makhdoom H, Jalal NA. Effect of the COVID-19 Vaccine on the Menstrual Cycle among Females in Saudi Arabia. Ethiop J Health Sci 2022; 32:1083-1092. [PMID: 36475264 PMCID: PMC9692149 DOI: 10.4314/ejhs.v32i6.4] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Accepted: 08/28/2022] [Indexed: 12/13/2022] Open
Abstract
Background The number of reports of menstrual changes after COVID-19 vaccination in the Saudi population is still unknown. Therefore, this study aimed to assess the effect of the COVID-19 vaccine(Pfizer, AstraZeneca, and Moderna) on the menstrual cycle among females in Saudi Arabia. Methods This descriptive cross-sectional study was conducted in Saudi Arabia at Umm Al-Qura University (UQU) from August 2021 to February 2022. Data was collected through a previously validated online questionnaire. Results A total of 2338 participants who received the first dose of the COVID-19 vaccine participated in this study; 1606 (68.7%) of them received the second dose in addition to the first. The mean age of the study participants was 35.4±9.5 years. No significant associations were found between the type of COVID-19 vaccine and the impact on the menstrual cycle, either for the first or second dose (P-values > 0.05). A significant association was found only between the first dose vaccination day and the impact on the menstrual cycle in the second question of "After receiving the COVID-19 vaccine, your next period was" (P-value ≤ 0.05). Significant associations were found between the second dose vaccination day and the impact on the menstrual cycle in the first and second questions of "After receiving the COVID-19 vaccine, your next period was", and "After receiving the first dose, your next period was," respectively (P-values ≤ 0.05). Conclusion The study found a potential association between the COVID-19 vaccine and menstrual cycle irregularities, which could impact females' quality of life.
Collapse
Affiliation(s)
- Fadi S I Qashqari
- Department of Microbiology, College of Medicine, Umm Al-Qura University, Makkah 24381, Saudi Arabia
| | - Maryam Dahlawi
- College of Medicine, Umm Al-Qura University, Makkah 24381, Saudi Arabia
| | - Hamza M Assaggaf
- Department of Laboratory Medicine, Faculty of Applied Medical Sciences, Umm Al-Qura University, Makkah 21955, Saudi Arabia
| | - Radi Alsafi
- Department of Laboratory Medicine, Faculty of Applied Medical Sciences, Umm Al-Qura University, Makkah 21955, Saudi Arabia
| | - Abdulrahim Gari
- Department of Obstetrics and Gynecology, Faculty of Medicine, Umm Al-Qura University, Makkah, Saudi Arabia, Department of Obstetrics and Gynecology, King Faisal Specialist Hospital and Research Center, Jeddah, Saudi Arabia
| | - Abdulrahman Abudawood
- Department of Family and Community Medicine, Rabigh Medical College, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Amal Al-Doboke
- College of Medicine, Umm Al-Qura University, Makkah 24381, Saudi Arabia
| | - Seham Alsulami
- College of Medicine, Umm Al-Qura University, Makkah 24381, Saudi Arabia
| | - Rahaf Bukhari
- College of Medicine, Umm Al-Qura University, Makkah 24381, Saudi Arabia
| | | | - Elaf Abdullah Salih
- Department of Obstetrics and Gynecology, International Medical Center, Jeddah, Saudi Arabi
| | - Mohammad Alfelali
- Department of Family and Community Medicine, Faculty of Medicine in Rabigh, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Hatim Makhdoom
- Applied Medical Sciences College, Laboratory Technology Department, Taibah University, Almadinah Almunwarah, Jeddah, Saudi Arabia
| | - Naif A Jalal
- Department of Microbiology, College of Medicine, Umm Al-Qura University, Makkah 24381, Saudi Arabia
| |
Collapse
|
19
|
Lee HJ, Jeong YJ, Kim YJ, Kim SH. Multisystem Inflammatory Syndrome in an Adult Following COVID-19 mRNA Vaccination: Successful Treatment With Medium-Dose Steroids and Colchicine. J Korean Med Sci 2022; 37:e299. [PMID: 36281487 PMCID: PMC9592940 DOI: 10.3346/jkms.2022.37.e299] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2022] [Accepted: 08/17/2022] [Indexed: 11/29/2022] Open
Abstract
Multisystem inflammatory syndrome in children and adults (MIS-C/A) was rarely reported as a complication of coronavirus disease 2019 (COVID-19) and potential adverse events following COVID-19 vaccination. Recently, the case definition of MIS-C/A was developed by the Brighton Collaboration Network. However, only a limited number of adult patients with MIS-A following immunization have been reported, and there is still little evidence for adequate treatment. A 57-year-old man presented with fever, headache, vomiting, and hypotension 24 days after receiving the second COVID-19 vaccination with the Pfizer-BioNTech vaccine. According to the Brighton Collaboration Case Definition, the patient met a definitive case of MIS-A after vaccination (level 1 of diagnostic certainty). After administration of medium-dose prednisolone (20 mg/d) with colchicine (1.2 mg/d), all symptoms and signs improved rapidly. The dose of prednisolone was gradually tapered from the third week, and the patient confirmed a full recovery without medication after 8 weeks. This is the first report showing that low-dose steroids in combination with colchicine may be an effective treatment option for MIS-A after vaccination.
Collapse
Affiliation(s)
- Hyo-Jin Lee
- Division of Infectious Diseases, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Yeon Jeong Jeong
- Division of Infectious Diseases, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Youn Jeong Kim
- Division of Infectious Diseases, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Si-Hyun Kim
- Division of Infectious Diseases, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea.
| |
Collapse
|
20
|
Khare MM, Zimmermann K, Kazungu FK, Pluta D, Ng A, Mercadante AR, Law AV. COVID-19 Vaccine Attitudes and Barriers among Unvaccinated Residents in Rural Northern/Central Illinois. Ethn Dis 2022; 32:305-314. [PMID: 36388860 PMCID: PMC9590596 DOI: 10.18865/ed.32.4.305] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
Background Rural communities have lower COVID-19 vaccine uptake and poorer health outcomes compared to non-rural communities, including in rural, northern/central Illinois. Understanding community perceptions about vaccination is critical for developing targeted responses to improve vaccine uptake in rural communities and meet global vaccination targets. Purpose This study examines COVID-19 vaccine attitudes and barriers as well as the impact of COVID-19 on specific health behaviors of residents in rural northern/central Illinois to inform efforts to increase vaccine uptake. Methods In collaboration with community partners and local health departments, we conducted a 54-item, English-language, online questionnaire from Feb 11 to March 22, 2021; the questionnaire included the COVID behavioral questionnaire scale (CoBQ), as well as questions on intention to vaccinate, vaccination attitudes, and barriers to vaccine access. Descriptive and bivariate analyses assessed participant differences based on intention to vaccinate. Results Most unvaccinated survey respondents (n = 121) were White (89.3%) and female (78.5%), with an average age of 52.3±14.1 years. Lack of intention to vaccinate was negatively associated with trust in the science behind vaccine development (P = .040), belief in the safety of the vaccine (P = .005) and belief that the vaccine was needed (P=.050). CoBQ scores of respondents who intended to get vaccinated differed significantly from those who did not (P<.001), showing a greater negative impact of COVID-19 on engaging in health behaviors for vaccine-hesitant participants. Conclusion Study findings show mistrust of science and lack of confidence in vaccine safety are barriers to vaccination in rural northern Illinois residents. Similar results have been reported in low- and middle-income countries.
Collapse
Affiliation(s)
- Manorama M. Khare
- Department of Family and Community Medicine, University of Illinois College of Medicine Rockford, Rockford, IL, Address correspondence to Manorama M. Khare, PhD, MS; Department of Family and Community Medicine, University of Illinois College of Medicine Rockford, Rockford, IL;
| | - Kristine Zimmermann
- Department of Family and Community Medicine, University of Illinois College of Medicine Rockford, Rockford, IL,Community Health Sciences Division, School of Public Health, University of Illinois Chicago, Chicago, IL
| | - Francis K. Kazungu
- Department of Family and Community Medicine, University of Illinois College of Medicine Rockford, Rockford, IL
| | - David Pluta
- Department of Family and Community Medicine, University of Illinois College of Medicine Rockford, Rockford, IL
| | - Alexia Ng
- Center for Research on Women and Gender, University of Illinois at Chicago, Chicago, IL
| | | | - Anandi V. Law
- College of Pharmacy, Western University of Health Sciences, Pomona, CA
| |
Collapse
|
21
|
Hatch M, Klevens RM. Massachusetts Flu Vaccination and Application for COVID-19 Routine Vaccination Planning. Vaccine X 2022; 12:100229. [PMID: 36276876 PMCID: PMC9578964 DOI: 10.1016/j.jvacx.2022.100229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Revised: 10/12/2022] [Accepted: 10/17/2022] [Indexed: 11/20/2022] Open
Abstract
Background SARS-CoV-2 has affected communities of color at disproportionate rates. In particular, Black Americans have higher COVID-19 mortality rates, rooted in health disparities and institutionalized racism. We describe Massachusetts (MA) influenza (flu) vaccination data by race and vaccination location to inform yearly COVID-19 vaccination plans. Methods We analyzed self-reported, pooled data from the 2017, 2018, and 2019 Massachusetts Behavioral Risk Factor Surveillance System (MA-BRFSS) of adults. Using the questions around race and ethnicity and flu vaccination, we calculated location types most visited as a percent of people receiving flu vaccine, stratified by race. Results The 3 years combined yielded 6,031 completed surveys. Compared to White non-Hispanics, Black non-Hispanics, Hispanics, and other non-White adults combined reported flu vaccination less frequently (p<0.01). Doctor's office or a health maintenance organization (HMO) were the primary flu vaccination locations among all race subcategories. Within each race category, the top three locations covered 82.7% of White respondents, while covering only 75.9% of Hispanic respondents, and 71.0% of Black respondents. Fewer Hispanic (16.1%) and Black respondents (13.8%) were vaccinated at supermarkets or drug stores compared to White respondents (25.2%). Conclusion As COVID-19 vaccination will likely be a yearly occurrence, the above findings can help support future COVID-19 vaccination plans. Since the frequency and location of receipt of flu vaccination varied by race/ethnicity in Massachusetts, the state should ensure specific COVID-19 vaccination locations are available going forward.
Collapse
Affiliation(s)
- Megan Hatch
- Corresponding author at: Massachusetts Department of Public Health, 350 South Street, Jamaica Plain, Boston, MA, United States.
| | | |
Collapse
|
22
|
Iloh GU, Chukwuonye ME. COVID-19 Vaccine Hesitancy in a Medically-Challenged Context: A Cross-Sectional Study of Drivers, Dangers and Corrective Measures for Vaccine Hesitancy and Potential Penalties for Declining Vaccination among Adults in South-Eastern Nigeria. West Afr J Med 2022; 39:889-895. [PMID: 36116070] [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: 06/15/2023]
Abstract
BACKGROUND COVID-19 vaccine hesitancy is a global public health problem. It is a complex and context-specific phenomenon that varies within and across nations. Despite COVID-19 vaccine programmes in Nigeria, there are possibilities that vaccine uptake and coverage among adult citizens will suffer setbacks amidst various interventions by the Federal Government of Nigeria. AIM The study aimed to determine the drivers, dangers, and corrective measures for COVID-19 vaccine hesitancy and potential penalties for declining vaccination among adults in South-eastern Nigeria. METHODS A descriptive study was carried out from March to April, 2021 on a cross section of 400 adults in South-eastern Nigeria. Data collection was done using a structured, pretested, and interviewer administered questionnaire. The questionnaire elicited information on drivers, dangers and corrective measures for COVID-19 vaccine hesitancy and potential penalties for declining vaccination. RESULTS The study participants were aged 18-86 (51±14.2) years. There were 227(56.8%) females. The most common driver of refusal of COVID-19 vaccination was the safety of COVID-19 vaccines(100.0%). The most perceived dangers of refusing the COVID-19 vaccine were the risks of contracting COVID-19 infection(100.0%) and dying from its complications(100.0%). The most common corrective measure for refusal of the COVID-19 vaccine was public health information and education on vaccine safety(100.0%). The predominant potential penalty for declining the COVID-19 vaccine was restricting access to air travel (100.0%). CONCLUSION This study has shown that the most common driver of vaccine hesitancy was vaccine safety while the most commonly perceived dangers were risks of contracting COVID-19 infection and dying from its complications. The most common corrective measure for refusal of the COVID-19 vaccine was public health information and education on vaccine safety. The most preeminent penalty for declining the COVID-19 vaccine was restricting access to air travel. There is a need to address these context-specific drivers and dangers that promote vaccine hesitancy. Public health information and education strategies to reduce vaccine hesitancy should be the focus of intervention to improve uptake of COVID-19 vaccination and safeguard the health of Nigerians.
Collapse
Affiliation(s)
- G U Iloh
- Department of Family Medicine, Federal Medical Centre, Umuahia, Abia State, Nigeria
- Department of Medicine, College of Medicine and Health Sciences, Rhema University, Aba, Abia State, Nigeria
| | - M E Chukwuonye
- Department of Family Medicine, Federal Medical Centre, Umuahia, Abia State, Nigeria
| |
Collapse
|
23
|
Kim HY, Cho JY, Yoon HJ, Choi YD, Ahn Y, Jeong MH, Cho JG, Kim KH. A Case Report for Acute Myopericarditis After NVX-CoV2373 (Novavax ®) COVID-19 Vaccination. J Korean Med Sci 2022; 37:e265. [PMID: 36038960 PMCID: PMC9424696 DOI: 10.3346/jkms.2022.37.e265] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Accepted: 07/25/2022] [Indexed: 11/20/2022] Open
Abstract
Post-vaccination myocarditis after administration of the NVX-CoV2373 coronavirus disease 2019 (COVID-19) vaccine has been reported in a limited population. We report the first biopsy-proven case of myopericarditis after administration of second dose of NVX-CoV2373 COVID-19 vaccine (Novavax®) in Korea. A 30-year-old man was referred to emergency department with complaints of chest pain and mild febrile sense for two days. He received the second dose vaccine 17 days ago. Acute myopericarditis by the vaccination was diagnosed by cardiac endomyocardial biopsy. He was treated with corticosteroid 1 mg/kg/day for 5 days and tapered for one week. He successfully recovered and was discharged on the 12th day of hospitalization. The present case suggests acute myopericarditis as a vaccination complication by Novavax® in Korea.
Collapse
Affiliation(s)
- Hyung Yoon Kim
- Department of Cardiovascular Medicine, Chonnam National University Medical School/Hospital, Gwangju, Korea
| | - Jae Yeong Cho
- Department of Cardiovascular Medicine, Chonnam National University Medical School/Hospital, Gwangju, Korea
| | - Hyun Ju Yoon
- Department of Cardiovascular Medicine, Chonnam National University Medical School/Hospital, Gwangju, Korea
| | - Yoo-Duk Choi
- Department of Pathology, Chonnam National University Medical School, Gwangju, Korea
| | - Youngkeun Ahn
- Department of Cardiovascular Medicine, Chonnam National University Medical School/Hospital, Gwangju, Korea
| | - Myung Ho Jeong
- Department of Cardiovascular Medicine, Chonnam National University Medical School/Hospital, Gwangju, Korea
| | - Jeong Gwan Cho
- Department of Cardiovascular Medicine, Chonnam National University Medical School/Hospital, Gwangju, Korea
| | - Kye Hun Kim
- Department of Cardiovascular Medicine, Chonnam National University Medical School/Hospital, Gwangju, Korea.
| |
Collapse
|
24
|
Abstract
Since severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was noted to cause coronavirus disease 2019 (COVID-19) in 2019, there have been many trials to develop vaccines against the virus. Messenger ribonucleic acid (mRNA) vaccine as a type of the vaccine has been developed and commercialized rapidly, but there was not enough time to verify the long-term safety. An 82-year-old female patient was admitted to the emergency room with dyspnea accompanied by stridor three days after the 3rd COVID-19 mRNA vaccination (Comirnaty, Pfizer-BioNTech, USA). The patient was diagnosed with bilateral vocal fold paralysis (VFP) by laryngoscope. Respiratory distress was improved after the intubation and tracheostomy in sequence. The brain, chest, and neck imaging tests, serological tests, cardiological analysis, and immunological tests were performed to evaluate the cause of bilateral VFP. However, no definite cause was found except for the precedent vaccination. Because bilateral VFP can lead to a fatal condition, a quick evaluation is necessary in consideration of VFP when dyspnea with stridor occurs after vaccination.
Collapse
Affiliation(s)
- Soo Ah Son
- Department of Otorhinolaryngology-Head and Neck Surgery, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Yeon Ji Kim
- Department of Otorhinolaryngology-Head and Neck Surgery, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - So Yun Lim
- Department of Otorhinolaryngology-Head and Neck Surgery, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Hyun Bum Kim
- Department of Otorhinolaryngology-Head and Neck Surgery, College of Medicine, The Catholic University of Korea, Seoul, Korea.
| |
Collapse
|
25
|
Niyomnaitham S, Toh ZQ, Licciardi PV, Wongprompitak P, Srisutthisamphan K, Copeland KK, Chokephaibulkit K. Immunogenicity of a single dose of BNT162b2, ChAdOx1 nCoV-19, or CoronaVac against SARS-CoV-2 delta and omicron variants among previously infected adults: a randomized trial. J Infect 2022:S0163-4453(22)00370-X. [PMID: 35728642 DOI: 10.1016/j.jinf.2022.06.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2022] [Accepted: 06/15/2022] [Indexed: 11/23/2022]
|
26
|
Abstract
Coronavirus disease 2019 (COVID-19) is one of the most widespread viral infections in human history. As a breakthrough against infection, vaccines have been developed to achieve herd immunity. Here, we report the first case of microscopic polyangiitis (MPA) following BNT162b2 vaccination in Korea. A 42-year-old man presented to the emergency room with general weakness, dyspnea, and edema after the second BNT162b2 vaccination. He had no medical history other than being treated for tuberculosis last year. Although his renal function was normal at last year, acute kidney injury was confirmed at the time of admission to the emergency room. His serum creatinine was 3.05 mg/dL. Routine urinalysis revealed proteinuria (3+) and hematuria. When additional tests were performed for suspected glomerulonephritis, the elevation of myeloperoxidase (MPO) antibody (38.6 IU/mL) was confirmed. Renal biopsy confirmed pauci-immune anti-neutrophil cytoplasmic antibody (ANCA)-related glomerulonephritis and MPA was diagnosed finally. As an induction therapy, a combination of glucocorticoid and rituximab was administered, and plasmapheresis was performed twice. He was discharged after the induction therapy and admitted to the outpatient clinic 34 days after induction therapy. During outpatient examination, his renal function had improved with serum creatinine 1.51 mg/dL. We suggest that MPA needs to be considered if patients have acute kidney injury, proteinuria, and hematuria after vaccination.
Collapse
Affiliation(s)
- Daeyoung So
- Department of Internal Medicine, Hanyang University Guri Hospital, Guri, Korea
| | - Kyueng-Whan Min
- Department of Pathology, Hanyang University Guri Hospital, Guri, Korea
- Department of Pathology, Hanyang University College of Medicine, Seoul, Korea
| | - Woon Yong Jung
- Department of Pathology, Hanyang University Guri Hospital, Guri, Korea
- Department of Pathology, Hanyang University College of Medicine, Seoul, Korea
| | - Sang-Woong Han
- Department of Internal Medicine, Hanyang University Guri Hospital, Guri, Korea
- Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Korea
| | - Mi-Yeon Yu
- Department of Internal Medicine, Hanyang University Guri Hospital, Guri, Korea
- Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Korea.
| |
Collapse
|
27
|
Grafova IB, Pogorzelska-Maziarz M, Johansen ML, Manning ML, Crincoli S, de Cordova PB. Racial and ethnic differences in vaccine hesitancy Among registered nurses in New Jersey: A cross-sectional survey. Am J Infect Control 2022; 50:572-574. [PMID: 35158011 DOI: 10.1016/j.ajic.2022.02.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Revised: 02/01/2022] [Accepted: 02/02/2022] [Indexed: 11/29/2022]
Abstract
Nurses play an important role in the vaccine readiness process and high vaccination rates among nurses are essential to ensuring successful vaccination programs. This study sought to examine whether the intention to get vaccinated varied by race and/or ethnicity among a large sample of registered nurses in New Jersey.
Collapse
Affiliation(s)
- Irina B Grafova
- Department of Health Behavior, Society, and Policy, School of Public Health, Rutgers, The State University of New Jersey, Piscataway, NJ
| | | | - Mary L Johansen
- School of Nursing, Rutgers, The State University of New Jersey, Newark, NJ
| | - Mary Lou Manning
- College of Nursing, Thomas Jefferson University, Philadelphia, PA
| | - Suzanne Crincoli
- School of Nursing, Rutgers, The State University of New Jersey, Newark, NJ
| | | |
Collapse
|
28
|
Jarso G, Gebi W, Abdo M, Lemma M, Abebe E, Lemessa B, Deressa BT. Prevalence of COVID-19 Vaccine Side Effects among Early-Vaccinated Healthcare Workers in Eastern Ethiopia. Ethiop J Health Sci 2022; 32:473-484. [PMID: 35813681 PMCID: PMC9214739 DOI: 10.4314/ejhs.v32i3.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Accepted: 02/22/2022] [Indexed: 11/21/2022] Open
Abstract
Background The Ministry of Health of Ethiopia launched the COVID-19 vaccination campaign in March 2021, with frontline healthcare workers as first-round recipients and a goal of vaccinating 20% of the population by the end of 2021. The study aims to estimate the prevalence of COVID-19 vaccination side effects among early vaccinated healthcare workers in Adama hospital medical college. Methods A cross-sectional study was carried out between March and June 2021, following the vaccination of COVID-19 vaccine among healthcare workers in Adama hospital medical college. The study used a structured self-administered questionnaire and additional telephone surveys on items covering the participants' demographic data, local and systemic manifestations after vaccination. Results A total of 540 health care workers and supportive staff were enrolled in this study. The overall any-symptom report after the first dose of ChAdOx1 nCoV- 19 vaccine was 84.3%. The majority (39.6%) of participants had both systemic and local symptoms and 25.7% had only local and 18.9% had only systemic symptoms. Injection site pain was the most prevalent side effect symptom (64.1%), followed by fatigue (35.7%), headache (28.9%), joint pain (26.5%), and muscle pain (21.5%). Conclusion Vaccine side effects were common and found to be well-tolerated among the recipients of the first dose of ChAdOx1 nCoV-19 at Adama hospital medical college healthcare workers. The side effects were mainly mild to moderate. More side-effect profiles should be studied and disseminated to detect rare adverse reactions.
Collapse
|
29
|
Nasir S, Khan SR, Iqbal R, Hashmi AP, Moosajee M, Nasir N. Inactivated COVID-19 vaccine triggering hemophagocytic lymphohistiocytosis in an immunocompetent adult - A case report. J Clin Transl Res 2022; 8:143-146. [PMID: 35445160] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2022] [Revised: 02/10/2022] [Accepted: 03/11/2022] [Indexed: 06/14/2023] Open
Abstract
BACKGROUND AND AIM Hemophagocytic lymphohistiocytosis (HLH) is a severe hyperinflammatory syndrome that is induced by hyper-activated macrophages, cytotoxic T cells, and reduced natural killer cell activity. A 46-year-old gentleman presented to us with complaints of intermittent fever for the past 2 weeks associated with fatigue along with oral ulcers and skin rashes which resolved spontaneously. These symptoms started after he received the second dose of the BBIP-CorV COVID-19 vaccine. His complete blood picture showed pancytopenia. A detailed infectious disease workup was unrevealing; however, his bone marrow biopsy revealed increased histiocyte activity, with some showing hemophagocytosis and dysplasia. Immunohistochemistry profile demonstrated strong CD 68 positivity. Further investigations showed raised serum ferritin and fasting triglyceride levels. He was immediately started on dexamethasone acetate at a dose of 10 mg/m2, after which his clinical symptoms, as well as his blood parameters, improved remarkably. This is the first documented case in Pakistan. CONCLUSION The data from clinical trials support the general safety profile of inactivated COVID-19 vaccines. We endorse its mass implementation. However, we believe that robust data need to be generated to evidence any adverse events, especially those with serious outcomes. Physicians should be aware of inactivated COVID-19 vaccine as a possible trigger for HLH and start prompt treatment, resulting in favorable outcomes. RELEVANCE FOR PATIENTS The presentation of HLH may vary and can present in an immunocompetent patient with no underlying risk factor. HLH should be kept in differentials when a patient presents with pancytopenia with a recent history of receiving COVID-19 vaccination. Steroids play a major role in the treatment of HLH, and definitive diagnosis and early treatment improve clinical outcomes.
Collapse
Affiliation(s)
- Saad Nasir
- Department of Medical Oncology, Aga Khan University Hospital, Karachi, Pakistan
| | - Saqib Raza Khan
- Department of Medical Oncology, Aga Khan University Hospital, Karachi, Pakistan
| | - Rodaba Iqbal
- Department of Medical Oncology, Aga Khan University Hospital, Karachi, Pakistan
| | | | - Munira Moosajee
- Department of Medical Oncology, Aga Khan University Hospital, Karachi, Pakistan
| | - Noreen Nasir
- Department of Medical Oncology, Aga Khan University Hospital, Karachi, Pakistan
| |
Collapse
|
30
|
Giryes S, Bragazzi NL, Bridgewood C, De Marco G, McGonagle D. COVID-19 Vasculitis and vasculopathy-Distinct immunopathology emerging from the close juxtaposition of Type II Pneumocytes and Pulmonary Endothelial Cells. Semin Immunopathol 2022. [PMID: 35412072 DOI: 10.1007/s00281-022-00928-6] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Accepted: 02/25/2022] [Indexed: 02/06/2023]
Abstract
The SARS-CoV-2 virus ACE-2 receptor utilization for cellular entry and the defined ACE-2 receptor role in cardiovascular medicine hinted at dysregulated endothelial function or even direct viral endotheliitis as the key driver of severe COVID-19 vascular immunopathology including reports of vasculitis. In this article, we critically review COVID-19 immunopathology from the vasculitis perspective and highlight the non-infectious nature of vascular endothelial involvement in severe COVID-19. Whilst COVID-19 lung disease pathological changes included juxta-capillary and vascular macrophage and lymphocytic infiltration typical of vasculitis, we review the evidence reflecting that such “vasculitis” reflects an extension of pneumonic inflammatory pathology to encompass these thin-walled vessels. Definitive, extrapulmonary clinically discernible vasculitis including cutaneous and cardiac vasculitis also emerged- namely a dysregulated interferon expression or “COVID toes” and an ill-defined systemic Kawasaki-like disease. These two latter genuine vasculitis pathologies were not associated with severe COVID-19 pneumonia. This was distinct from cutaneous vasculitis in severe COVID-19 that demonstrated pauci-immune infiltrates and prominent immunothrombosis that appears to represent a novel immunothrombotic vasculitis mimic contributed to by RNAaemia or potentially diffuse pulmonary venous tree thrombosis with systemic embolization with small arteriolar territory occlusion, although the latter remains unproven. Herein, we also performed a systematic literature review of COVID-19 vasculitis and reports of post-SARS-CoV-2 vaccination related vasculitis with respect to the commonly classified pre-COVID vasculitis groupings. Across the vasculitis spectrum, we noted that Goodpasture’s syndrome was rarely linked to natural SARS-CoV-2 infection but not vaccines. Both the genuine vasculitis in the COVID-19 era and the proposed vasculitis mimic should advance the understanding of both pulmonary and systemic vascular immunopathology.
Collapse
|
31
|
Nasir S, Khan SR, Iqbal R, Hashmi AP, Moosajee M, Nasir N. Inactivated COVID-19 vaccine triggering hemophagocytic lymphohistiocytosis in an immunocompetent adult - A case report. J Clin Transl Res 2022; 8:152-155. [PMID: 35475272 PMCID: PMC9035139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2022] [Revised: 02/10/2022] [Accepted: 03/11/2022] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND AND AIM Hemophagocytic lymphohistiocytosis (HLH) is a severe hyperinflammatory syndrome that is induced by hyper-activated macrophages, cytotoxic T cells, and reduced natural killer cell activity. A 46-year-old gentleman presented to us with complaints of intermittent fever for the past 2 weeks associated with fatigue along with oral ulcers and skin rashes which resolved spontaneously. These symptoms started after he received the second dose of the BBIP-CorV COVID-19 vaccine. His complete blood picture showed pancytopenia. A detailed infectious disease workup was unrevealing; however, his bone marrow biopsy revealed increased histiocyte activity, with some showing hemophagocytosis and dysplasia. Immunohistochemistry profile demonstrated strong CD 68 positivity. Further investigations showed raised serum ferritin and fasting triglyceride levels. He was immediately started on dexamethasone acetate at a dose of 10 mg/m2, after which his clinical symptoms, as well as his blood parameters, improved remarkably. This is the first documented case in Pakistan. CONCLUSION The data from clinical trials support the general safety profile of inactivated COVID-19 vaccines. We endorse its mass implementation. However, we believe that robust data need to be generated to evidence any adverse events, especially those with serious outcomes. Physicians should be aware of inactivated COVID-19 vaccine as a possible trigger for HLH and start prompt treatment, resulting in favorable outcomes. RELEVANCE FOR PATIENTS The presentation of HLH may vary and can present in an immunocompetent patient with no underlying risk factor. HLH should be kept in differentials when a patient presents with pancytopenia with a recent history of receiving COVID-19 vaccination. Steroids play a major role in the treatment of HLH, and definitive diagnosis and early treatment improve clinical outcomes.
Collapse
Affiliation(s)
- Saad Nasir
- Department of Medical Oncology, Aga Khan University Hospital, Karachi, Pakistan
| | - Saqib Raza Khan
- Department of Medical Oncology, Aga Khan University Hospital, Karachi, Pakistan,Corresponding author: Saqib Raza Khan Aga Khan University Hospital, Karachi, Pakistan. E-mail:
| | - Rodaba Iqbal
- Department of Medical Oncology, Aga Khan University Hospital, Karachi, Pakistan
| | | | - Munira Moosajee
- Department of Medical Oncology, Aga Khan University Hospital, Karachi, Pakistan
| | - Noreen Nasir
- Department of Medical Oncology, Aga Khan University Hospital, Karachi, Pakistan
| |
Collapse
|
32
|
Um J, Choi YY, Kim G, Kim MK, Lee KS, Sung HK, Kim BC, Lee YK, Jang HC, Bang JH, Chung KH, Oh MD, Park JS, Jeon J. Booster BNT162b2 COVID-19 Vaccination Increases Neutralizing Antibody Titers Against the SARS-CoV-2 Omicron Variant in Both Young and Elderly Adults. J Korean Med Sci 2022; 37:e70. [PMID: 35257525 PMCID: PMC8901881 DOI: 10.3346/jkms.2022.37.e70] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Accepted: 02/07/2022] [Indexed: 11/20/2022] Open
Abstract
Concerns about the effectiveness of current vaccines against the rapidly spreading severe acute respiratory syndrome-coronavirus-2 omicron (B.1.1.529) variant are increasing. This study aimed to assess neutralizing antibody activity against the wild-type (BetaCoV/Korea/KCDC03/2020), delta, and omicron variants after full primary and booster vaccinations with BNT162b2. A plaque reduction neutralization test was employed to determine 50% neutralizing dilution (ND50) titers in serum samples. ND50 titers against the omicron variant (median [interquartile range], 5.3 [< 5.0-12.7]) after full primary vaccination were lower than those against the wild-type (144.8 [44.7-294.0]) and delta (24.3 [14.3-81.1]) variants. Furthermore, 19/30 participants (63.3%) displayed lower ND50 titers than the detection threshold (< 10.0) against omicron after full primary vaccination. However, the booster vaccine significantly increased ND50 titers against BetaCoV/Korea/KCDC03/2020, delta, and omicron, although titers against omicron remained lower than those against the other variants (P < 0.001). Our study suggests that booster vaccination with BNT162b2 significantly increases humoral immunity against the omicron variant.
Collapse
Affiliation(s)
- Jihye Um
- Research Institute of Public Health, National Medical Center, Seoul, Korea
| | - Youn Young Choi
- Research Institute of Public Health, National Medical Center, Seoul, Korea
- Department of Pediatrics, National Medical Center, Seoul, Korea
| | - Gayeon Kim
- Department of Infectious Diseases, National Medical Center, Seoul, Korea
| | - Min-Kyung Kim
- Department of Infectious Diseases, National Medical Center, Seoul, Korea
| | - Kyung-Shin Lee
- Research Institute of Public Health, National Medical Center, Seoul, Korea
| | - Ho Kyung Sung
- Research Institute of Public Health, National Medical Center, Seoul, Korea
| | - Byung Chul Kim
- National Institute of Infectious Diseases, National Institute of Health, Korea Disease Control and Prevention Agency, Cheongju, Korea
| | - Yoo-Kyoung Lee
- National Institute of Infectious Diseases, National Institute of Health, Korea Disease Control and Prevention Agency, Cheongju, Korea
| | - Hee-Chang Jang
- National Institute of Infectious Diseases, National Institute of Health, Korea Disease Control and Prevention Agency, Cheongju, Korea
| | - Ji Hwan Bang
- Division of Infectious Diseases, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul, Korea
| | - Ki-Hyun Chung
- Department of Pediatrics, National Medical Center, Seoul, Korea
| | - Myoung-Don Oh
- Department of Internal Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Jun-Sun Park
- Research Institute of Public Health, National Medical Center, Seoul, Korea.
| | - Jaehyun Jeon
- Research Institute of Public Health, National Medical Center, Seoul, Korea
- Department of Infectious Diseases, National Medical Center, Seoul, Korea.
| |
Collapse
|
33
|
Affiliation(s)
- Marlyn Wu
- Hackensack University Medical Center, Hackensack, NJ
| | - Maria Karim
- Hackensack University Medical Center, Hackensack, NJ
| | | |
Collapse
|
34
|
Eom H, Kim SW, Kim M, Kim YE, Kim JH, Shin HY, Lee HL. Case Reports of Acute Transverse Myelitis Associated With mRNA Vaccine for COVID-19. J Korean Med Sci 2022; 37:e52. [PMID: 35191229 PMCID: PMC8860770 DOI: 10.3346/jkms.2022.37.e52] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Accepted: 01/16/2022] [Indexed: 11/20/2022] Open
Abstract
Acute transverse myelitis (ATM) has been reported as rare complication of vaccination. Herein, we report 2 cases of ATM after the administration of an mRNA vaccine for coronavirus disease 2019 (COVID-19). The first one is an 81-year-old man who received the BNT162b2 vaccine. He presented with bilateral hand weakness. Spine magnetic resonance imaging (MRI) showed high signal intensity from the C1 to C3 vertebrae. The second is a 23-year-old woman who received the BNT162b2 vaccine and experienced tingling in her legs. Spine MRI showed a high signal intensity lesion at the conus medullaris. These patients were treated with intravenous methylprednisolone and their symptoms improved slightly. Careful follow-up is needed to identify adverse events after the administration of mRNA vaccines for COVID-19.
Collapse
Affiliation(s)
- Hyunjong Eom
- Department of Neurology, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea
| | - Seung Woo Kim
- Department of Neurology, Yonsei University College of Medicine, Seoul, Korea
| | - Minkyoung Kim
- Department of Neurology, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea
| | - Ye Eun Kim
- Department of Neurology, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea
| | - Ji Hyun Kim
- Department of Neurology, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea
| | - Ha Young Shin
- Department of Neurology, Yonsei University College of Medicine, Seoul, Korea
| | - Hye Lim Lee
- Department of Neurology, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea.
| |
Collapse
|
35
|
Tummalapalli SL, Cukor D, Bohmart A, Levine DM, Parker TS, Liu F, Perlman A, Srivatana V, Turchioe MR, Ibrahim SA, Silberzweig J. A Mobile Health-based Survey to Assess COVID-19 Vaccine Intent and Uptake Among Patients on Dialysis. Kidney Int Rep 2021; 7:633-637. [PMID: 34926872 PMCID: PMC8667463 DOI: 10.1016/j.ekir.2021.12.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2021] [Revised: 11/29/2021] [Accepted: 12/06/2021] [Indexed: 11/29/2022] Open
Affiliation(s)
- Sri Lekha Tummalapalli
- Division of Healthcare Delivery Science & Innovation, Department of Population Health Sciences, Weill Cornell Medicine, New York, NY.,The Rogosin Institute, New York, NY.,Division of Nephrology & Hypertension, Department of Medicine, Weill Cornell Medicine, New York, NY
| | | | - Andrew Bohmart
- The Rogosin Institute, New York, NY.,Division of Nephrology & Hypertension, Department of Medicine, Weill Cornell Medicine, New York, NY
| | - Daniel M Levine
- The Rogosin Institute, New York, NY.,Department of Biochemistry, Weill Cornell Medicine, New York, NY
| | - Thomas S Parker
- The Rogosin Institute, New York, NY.,Department of Biochemistry, Weill Cornell Medicine, New York, NY
| | - Frank Liu
- The Rogosin Institute, New York, NY.,Division of Nephrology & Hypertension, Department of Medicine, Weill Cornell Medicine, New York, NY
| | - Alan Perlman
- The Rogosin Institute, New York, NY.,Division of Nephrology & Hypertension, Department of Medicine, Weill Cornell Medicine, New York, NY
| | - Vesh Srivatana
- The Rogosin Institute, New York, NY.,Division of Nephrology & Hypertension, Department of Medicine, Weill Cornell Medicine, New York, NY
| | - Meghan Reading Turchioe
- Division of Health Informatics, Department of Population Health Sciences, Weill Cornell Medicine, New York, NY
| | - Said A Ibrahim
- Division of Healthcare Delivery Science & Innovation, Department of Population Health Sciences, Weill Cornell Medicine, New York, NY
| | - Jeffrey Silberzweig
- The Rogosin Institute, New York, NY.,Division of Nephrology & Hypertension, Department of Medicine, Weill Cornell Medicine, New York, NY
| |
Collapse
|
36
|
Peacock JG, Banks EA, McWhorter NE. 18F-Fluciclovine Avid Axillary Lymph Nodes After COVID-19 Vaccination on PET/CT for Suspected Recurrence of Prostate Cancer. J Nucl Med Technol 2021; 50:73-74. [PMID: 34872921 PMCID: PMC9178550 DOI: 10.2967/jnmt.121.263001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [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: 08/06/2021] [Revised: 10/22/2021] [Indexed: 11/16/2022] Open
Abstract
Abnormally increased 18F-FDG avidity of axillary lymph nodes has become a frequent diagnostic dilemma on PET/CT in the current climate of global vaccinations directed against severe acute respiratory syndrome coronavirus 2. This avidity is due to the inflammatory response evoked by vaccines and the nonspecific nature of 18F-FDG uptake, which is increased in both malignant and inflammatory processes. Similarly, 18F-fluciclovine, an amino acid analog indicated for the assessment of biochemical recurrence of prostate cancer, may also demonstrate nonspecific inflammatory uptake. We report a case of 18F-fluciclovine PET/CT obtained for concern about prostate cancer. In this case, isolated avid lymph nodes were seen in the left axilla. A screening questionnaire revealed that the patient had recently received the second dose of the Pfizer-BioNTech coronavirus disease 2019 vaccine in his left shoulder, and hence, the uptake was determined to be reactive.
Collapse
|
37
|
Kang YM, Minn D, Lim J, Lee KD, Jo DH, Choe KW, Kim MJ, Kim JM, Kim KN. Comparison of Antibody Response Elicited by ChAdOx1 and BNT162b2 COVID-19 Vaccine. J Korean Med Sci 2021; 36:e311. [PMID: 34845875 PMCID: PMC8629719 DOI: 10.3346/jkms.2021.36.e311] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Accepted: 10/26/2021] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND ChAdOx1 and BNT162b2 vaccines are currently commonly used against coronavirus disease 2019 worldwide. Our study was designed to determine the serostatus and relative levels of anti-S and neutralizing antibodies in patients who were administered either ChAdOx1 or BNT162b2 vaccine. In addition, we investigated whether the antibody response to each vaccine differed according to sex and age. METHODS Healthcare workers (HCWs) at a general hospital who were vaccinated with two doses of either ChAdOx1 or BNT162b2 were invited to participate in this prospective cohort study. Blood samples of HCWs vaccinated with both ChAdOx1 doses over a period of 12 weeks were collected at weeks 4 and 8 post first vaccination and 2 weeks post second vaccination. Blood samples of HCWs vaccinated with BNT162b2 were collected in the third week after the first dose, and the second dose was then administered on the same day; two weeks post second dose (5 weeks after the first dose), blood samples were collected to assess the antibody response. The titers of anti-S antibodies against the severe acute respiratory syndrome coronavirus 2 spike (S) protein receptor-binding domain and the neutralizing antibodies in the collected blood were evaluated. RESULTS Of the 309 HCWs enrolled in the study, 205 received ChAdOx1 and 104 received BNT162b2. Blood samples from participants receiving either the ChAdOx1 or BNT162b2 vaccine exhibited substantial anti-S and neutralizing antibody seropositivity subsequent to the second dose. All participants (100%) from both vaccine groups were seropositive for anti-S antibody, while 98% (201/205) of ChAdOx1-vaccinated individuals and 100% (104/104) of BNT162b2-vaccinated individuals were seropositive for neutralizing antibodies. The median levels of anti-S and neutralizing antibodies were significantly higher in the BNT162b2-vaccinated group than the ChAdOx1-vaccinated group; in particular, anti-S antibody titers of 1,020 (interquartile range, 571.0-1,631.0) U/mL vs. 2,360 (1,243-2,500) U/mL, P < 0.05, were recorded for the ChAdOx1 and BNT162b2 groups, respectively, and neutralizing antibody titers of 85.0 (65.9-92.1%) vs. 95.8 (94.4-96.6%), P < 0.05, were recorded for the ChAdOx1 and BNT162b2 groups, respectively. In the ChAdOx1 vaccine group, the neutralizing antibody level was significantly higher in women than in men (85.7 [70.3-92.5%] vs. 77.7 [59.2-91.0%], P < 0.05); however, the neutralizing antibody titer in the BNT162b2 vaccine group did not vary between the two sexes (95.9 [95.2-96.6%] vs. 95.2 [93.5-96.3%], P = 0.200). Analysis of the correlation of antibody profiles with age revealed that the levels of anti-S antibodies and signal inhibition rate (SIR) of neutralizing antibodies decreased significantly with age. CONCLUSION Both the ChAdOx1- and BNT162b2-vaccinated groups showed high seropositivity for anti-S and neutralizing antibodies. The SIR of neutralizing antibodies in the ChAdOx1 vaccine group was higher in women than in men. Enhanced antibody responses were observed in participants vaccinated with BNT162b2 compared to those vaccinated with the ChAdOx1 vaccine.
Collapse
Affiliation(s)
- Yu Min Kang
- Division of Infectious Diseases, Department of Internal Medicine, Myongji Hospital, Goyang, Korea
| | | | - Jaegyun Lim
- Department of Laboratory Medicine, Myongji Hospital, Goyang, Korea
| | - Ki-Deok Lee
- Division of Infectious Diseases, Department of Internal Medicine, Myongji Hospital, Goyang, Korea
| | - Dong Ho Jo
- Division of Infectious Diseases, Department of Internal Medicine, Myongji Hospital, Goyang, Korea
| | - Kang-Won Choe
- Division of Infectious Diseases, Department of Internal Medicine, Myongji Hospital, Goyang, Korea
| | - Moon Jung Kim
- Department of Laboratory Medicine, Myongji Hospital, Goyang, Korea
| | - Jong Min Kim
- Department of Pediatrics, Myongji Hospital, Goyang, Korea
| | - Kwang Nam Kim
- Department of Pediatrics, Myongji Hospital, Goyang, Korea.
| |
Collapse
|
38
|
Temsah MH, Alhuzaimi AN, Aljamaan F, Bahkali F, Al-Eyadhy A, Alrabiaah A, Alhaboob A, Bashiri FA, Alshaer A, Temsah O, Bassrawi R, Alshahrani F, Chaiah Y, Alaraj A, Assiri RA, Jamal A, Batais MA, Saddik B, Halwani R, Alzamil F, Memish ZA, Barry M, Al-Subaie S, Al-Tawfiq JA, Alhasan K. Parental Attitudes and Hesitancy About COVID-19 vs. Routine Childhood Vaccinations: A National Survey. Front Public Health 2021; 9:752323. [PMID: 34722451 PMCID: PMC8548678 DOI: 10.3389/fpubh.2021.752323] [Citation(s) in RCA: 79] [Impact Index Per Article: 26.3] [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: 08/02/2021] [Accepted: 09/15/2021] [Indexed: 11/13/2022] Open
Abstract
Objectives: To quantify parental acceptance of the COVID-19 vaccine and assess the vaccine hesitancy (VH) for COVID-19 vs. childhood vaccines. Methods: Eight vaccine hesitancy scale (VHS) items, adopted from WHO's Strategic Advisory Group of Immunization (SAGE), were used to assess VH for COVID-19 vaccine vs. routine childhood vaccines. We distributed the online survey to parents with the commence of the national childhood COVID-19 vaccination program in Saudi Arabia. Results: Among 3,167 parents, 47.6% are decided to vaccinate their children against COVID-19. The most common reasons for refusal were inadequate safety information (69%) and worry about side effects (60.6%). Parents have a significantly greater positive attitudes toward children's routine vaccines vs. the COVID-19 vaccine, with higher mean VHS (±SD) = 2.98 ± 0.58 vs. 2.63 ± 0.73, respectively (p-value < 0.001). Parents agreed more that routine childhood vaccines are more essential and effective as compared to the COVID-19 vaccine (Cohen's D: 0.946, and 0.826, consecutively; T-test p-value < 0.00). There is more parental anxiety about serious side effects of the COVID-19 vaccine vs. routine childhood vaccines (Cohen's D = 0.706, p-value < 0.001). Parents who relied on the Ministry of Health information were more predicted (OR = 1.28, p-value = 0.035) to intend to vaccinate as opposed to those who used the WHO website (OR = 0.47, −53%, p-value < 0.001). In a multivariate logistic regression analysis, the factors associated with intention to vaccinate children were parents who received COVID-19 vaccine, older parents, having children aged 12–18, and parents with lower education levels. Conclusions: Significant proportion of parents are hesitant about the COVID-19 vaccine because they are less confident in its effectiveness, safety, and whether it is essential for their children. Relying on the national official healthcare authority's website for the source of information was associated with increased acceptance of childhood COVID-19 vaccination. As parental intention to vaccinate children against COVID-19 is suboptimal, healthcare authorities could boost vaccine uptake by campaigns targeting hesitant parents.
Collapse
Affiliation(s)
- Mohamad-Hani Temsah
- Pediatric Department, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Abdullah N Alhuzaimi
- Division of Pediatric Cardiology, Department of Cardiac Sciences, College of Medicine, King Saud University, Riyadh, Saudi Arabia.,Division of Pediatric Cardiology, Department of Cardiac Sciences, King Saud University Medical City, Riyadh, Saudi Arabia
| | - Fadi Aljamaan
- Critical Care Department, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Feras Bahkali
- Pediatric Department, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Ayman Al-Eyadhy
- Pediatric Department, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Abdulkarim Alrabiaah
- Pediatric Department, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Ali Alhaboob
- Pediatric Department, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Fahad A Bashiri
- Pediatric Department, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Ahmad Alshaer
- Pediatric Department, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Omar Temsah
- College of Medicine, Alfaisal University, Riyadh, Saudi Arabia
| | - Rolan Bassrawi
- Pediatric Department, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Fatimah Alshahrani
- Division of Infectious Diseases, Department of Internal Medicine, College of Medicine, King Saud University and King Saud University Medical City, Riyadh, Saudi Arabia
| | - Yazan Chaiah
- College of Medicine, Alfaisal University, Riyadh, Saudi Arabia
| | - Ali Alaraj
- Department of Medicine, College of Medicine, Qassim University, Qassim, Saudi Arabia.,Dr Sulaiman Al Habib Medical Group, Riyadh, Saudi Arabia
| | - Rasha Assad Assiri
- Department of Basic Medical Sciences, College of Medicine, Princess Nourah bint Abdulrahman University, Riyadh, Saudi Arabia
| | - Amr Jamal
- Department of Family and Community Medicine, King Saud University Medical City, Riyadh, Saudi Arabia.,Evidence-Based Health Care & Knowledge Translation Research Chair, King Saud University, Riyadh, Saudi Arabia
| | - Mohammed A Batais
- Department of Family and Community Medicine, King Saud University Medical City, Riyadh, Saudi Arabia
| | - Basema Saddik
- Sharjah Institute of Medical Research, University of Sharjah, Sharjah, United Arab Emirates.,Department of Community and Family Medicine, College of Medicine, University of Sharjah, Sharjah, United Arab Emirates
| | - Rabih Halwani
- Sharjah Institute of Medical Research, University of Sharjah, Sharjah, United Arab Emirates.,Department of Clinical Sciences, College of Medicine, University of Sharjah, Sharjah, United Arab Emirates
| | - Fahad Alzamil
- Pediatric Department, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Ziad A Memish
- Research and Innovation Center, King Saud Medical City, Ministry of Health, Riyadh, Saudi Arabia.,College of Medicine, Alfaisal University, Riyadh, Saudi Arabia.,Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA, United States
| | - Mazin Barry
- Division of Infectious Diseases, Department of Internal Medicine, College of Medicine, King Saud University and King Saud University Medical City, Riyadh, Saudi Arabia
| | - Sarah Al-Subaie
- Pediatric Department, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Jaffar A Al-Tawfiq
- Specialty Internal Medicine and Quality Department, Johns Hopkins Aramco Healthcare, Dhahran, Saudi Arabia.,Infectious Disease Division, Department of Medicine, Indiana University School of Medicine, Indianapolis, IN, United States.,Infectious Disease Division, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Khalid Alhasan
- Pediatric Department, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| |
Collapse
|
39
|
Affiliation(s)
- Cathy McShane
- Department of Hepatology, Cork University Hospital, Cork, Ireland.
| | - Clifford Kiat
- Department of Hepatology, Cork University Hospital, Cork, Ireland
| | - Jonathan Rigby
- Department of Histopathology, Cork University Hospital, Cork, Ireland
| | - Órla Crosbie
- Department of Hepatology, Cork University Hospital, Cork, Ireland
| |
Collapse
|
40
|
Suliman DM, Nawaz FA, Mohanan P, Modber MAKA, Musa MK, Musa MB, El Chbib D, Elhadi YAM, Essar MY, Isa MA, Lucero-Prisno DE, Moonesar IA. UAE efforts in promoting COVID-19 vaccination and building vaccine confidence. Vaccine 2021; 39:6341-6345. [PMID: 34561138 PMCID: PMC8421098 DOI: 10.1016/j.vaccine.2021.09.015] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Revised: 08/18/2021] [Accepted: 09/03/2021] [Indexed: 11/01/2022]
Abstract
The United Arab Emirates (UAE) is leading globally in many indicators for tackling the COVID-19 pandemic. This ranges from taking adequate preventive measures to the free vaccination drive and viable public health strategy. As of 18 August 2021, the UAE has significantly reduced the number of cases and successfully administered 17,454,250 doses. Furthermore, efforts and plans are underway to provide the third dose to high-risk people three months after completing the second dose and six months later to others. The UAE is considered one of the leaders globally for vaccinating "medically eligible" residents against COVID-19, with over 70% of the population currently fully vaccinated in the drive towards achieving herd immunity. The UAE's vaccination program is on track, covering a significant part of the population. The massive efforts of the National Vaccination Program's roll-out made by the UAE government and the various health authorities and stakeholders were vital for the general public's active participation in its success.
Collapse
Affiliation(s)
- Duaa Mohamed Suliman
- Department of Academic Affairs (Health Policy), Mohammed Bin Rashid School of Government, Dubai, United Arab Emirates
| | - Faisal A Nawaz
- College of Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, United Arab Emirates
| | | | | | | | | | - Diala El Chbib
- Faculty of Medical Sciences, Lebanese University, Beirut, Lebanon
| | - Yasir Ahmed Mohammed Elhadi
- Department of Health Administration and Behavioral Sciences, High Institute of Public Health, Alexandria University, Alexandria, Egypt
| | | | - Mashkur Abdulhamid Isa
- School of Health and Related Research, University of Sheffield, Sheffield, United Kingdom
| | - Don Eliseo Lucero-Prisno
- Department of Global Health and Development, London School of Hygiene and Tropical Medicine, London, United Kingdom; University of the Philippines Open University, Los Baños, Laguna, Philippines
| | - Immanuel Azaad Moonesar
- Department of Academic Affairs (Health Policy), Mohammed Bin Rashid School of Government, Dubai, United Arab Emirates.
| |
Collapse
|
41
|
Abou-Foul AK, Ross E, Abou-Foul M, George AP. Cervical lymphadenopathy following coronavirus disease 2019 vaccine: clinical characteristics and implications for head and neck cancer services. J Laryngol Otol 2021; 135:1025-30. [PMID: 34526175 DOI: 10.1017/S0022215121002462] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Objective Patients with coronavirus disease vaccine associated lymphadenopathy are increasingly being referred to healthcare services. This work is the first to report on the incidence, clinical course and imaging features of coronavirus disease vaccine associated cervical lymphadenopathy, with special emphasis on the implications for head and neck cancer services. Methods This was a retrospective cohort study of all patients referred to our head and neck cancer clinics between 16 December 2020 and 12 March 2021. The main outcomes measured were the proportion of patients with vaccine-associated cervical lymphadenopathy, and the clinical and imaging characteristics. Results The incidence of vaccine-associated cervical lymphadenopathy referrals was 14.8 per cent (n = 13). Five patients (38.5 per cent) had abnormal-looking enlarged and rounded nodes with increased vascularity. Only seven patients (53.9 per cent) reported full resolution within an average of 3.1 ± 2.3 weeks. Conclusion Coronavirus disease vaccine associated cervical lymphadenopathy can mimic malignant lymphadenopathy and therefore might prove challenging to diagnose and manage correctly. Healthcare services may encounter a significant increase in referrals.
Collapse
|
42
|
Kang YM, Choe KW, Lee KD, Kim KN, Kim MJ, Lim J. SARS-CoV-2 Antibody Response to the BNT162b2 mRNA Vaccine in Persons with Past Natural Infection. J Korean Med Sci 2021; 36:e250. [PMID: 34490757 PMCID: PMC8422040 DOI: 10.3346/jkms.2021.36.e250] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Accepted: 08/22/2021] [Indexed: 11/20/2022] Open
Abstract
There are still no agreed guidelines on the vaccination of coronavirus disease 2019 (COVID-19) for previously infected patients. Here, we present two seropositive healthcare workers (HCWs) working in an isolation ward who recovered from COVID-19 in April 2020 and got vaccinated with BNT162b2 vaccine in March 2021. We have assessed the clinical course, vaccine-related adverse events, and antibody response after natural infection and after first and second dose vaccination. One of the two HCWs was asymptomatic during quarantine, but the other had mild upper respiratory infection symptoms 1 day before admission, and the symptoms continued for 9 days. There was no pneumonic infiltration in chest X-ray in both patients, and no COVID-19 specific treatment was administered. Total immunoglobulin antibody and neutralizing antibody to anti-spike protein receptor-binding domain of severe acute respiratory syndrome coronavirus 2 were confirmed to be present in both HCWs in blood tests performed at 2 weeks and 4 weeks after discharge. Antibody response to mRNA vaccination showed marked elevation after the first vaccination, which was 30-40 times higher than that of antibody titer after natural infection in each patient (83.2 U/mL vs. > 2,500 U/mL in patient 1; 61.6 U/mL vs. > 2,500 U/mL in patient 2). Signal inhibition rate of neutralizing antibodies was also increased to over 97%. Due to this increased effect, there was little difference in antibody levels after the first and second dose. Both patients 1 and 2 suffered more from adverse vaccine reactions after the second vaccination than from COVID-19 symptoms.
Collapse
Affiliation(s)
- Yu Min Kang
- Division of Infectious Diseases, Department of Internal Medicine, Myongji Hospital, Goyang, Korea
| | - Kang-Won Choe
- Division of Infectious Diseases, Department of Internal Medicine, Myongji Hospital, Goyang, Korea
| | - Ki-Deok Lee
- Division of Infectious Diseases, Department of Internal Medicine, Myongji Hospital, Goyang, Korea
| | - Kwang Nam Kim
- Department of Pediatrics, Myongji Hospital, Goyang, Korea
| | - Moon Jung Kim
- Department of Laboratory Medicine, Myongji Hospital, Goyang, Korea
| | - Jaegyun Lim
- Department of Laboratory Medicine, Myongji Hospital, Goyang, Korea.
| |
Collapse
|
43
|
Sariol CA, Pantoja P, Serrano-Collazo C, Rosa-Arocho T, Armina A, Cruz L, Stone ET, Arana T, Climent C, Latoni G, Atehortua D, Pabon-Carrero C, Pinto AK, Brien JD, Espino AM. Function is more reliable than quantity to follow up the humoral response to the Receptor Binding Domain of SARS- CoV-2 Spike protein after natural infection or COVID-19 vaccination. medRxiv 2021:2021.06.02.21257975. [PMID: 34100029 PMCID: PMC8183028 DOI: 10.1101/2021.06.02.21257975] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Both the SARS-CoV-2 pandemic and emergence of variants of concern have highlighted the need for functional antibody assays to monitor the humoral response over time. Antibodies directed against the spike (S) protein of SARS-CoV-2 are an important component of the neutralizing antibody response. In this work, we report that in a subset of patients-despite a decline in total S-specific antibodies-neutralizing antibody titers remain at a similar level for an average of 98 days in longitudinal sampling of a cohort of 59 Hispanic/Latino patients exposed to SARS-CoV-2. We also report that serum neutralization capacity correlates with IgG titers, wherein IgG1 was the predominant isotype (62.71%), followed by IgG4 (15.25%), IgG3 (13.56%), and IgG2 (8.47%) at the earliest tested timepoint. IgA titers were detectable in just 28.81% of subjects, and only 62.71% of subjects had detectable IgM in the first sample despite confirmation of infection by a molecular diagnostic assay. Our data suggests that 100% of seroconverting patients make detectable neutralizing antibody responses which can be quantified by a surrogate viral neutralization test. Examination of sera from 10 out of the 59 subjects which had received an initial first dose of mRNA-based vaccination revealed that both IgG titers and neutralizing activity of sera were higher after vaccination compared to a cohort of 21 SARS-CoV-2 naïve subjects. One dose was sufficient for induction of neutralizing antibody, but two doses were necessary to reach 100% surrogate virus neutralization in subjects irrespective of previous SARS-CoV-2 natural infection status. Like the pattern seen after natural infection, after the second vaccine dose, the total anti-S antibodies titers declined, however, neutralizing activity remained relatively constant for more than 80 days after the first vaccine dose. The decline in anti-S antibody titer, however, was significantly less in pre-exposed individuals, highlighting the potential for natural infection to prime a more robust immune response to the vaccine. Furthermore, our data indicates that-compared with mRNA vaccination-natural infection induces a more robust humoral immune response in unexposed subjects. However, this difference was significant only when neutralizing antibody titers were compared among the two groups. No differences were observed between naturally infected and vaccinated individuals when total anti-S antibodies and IgG titers were measured. This work is an important contribution to understanding the natural immune response to the novel coronavirus in a population severely impacted by SARS-CoV-2. Furthermore, by comparing the dynamics of the immune response after the natural infection vs. the vaccination, these findings suggest that a functional neutralizing antibody tests are more relevant indicators than the presence or absence of binding antibodies. In this context, our results also support standardizing methods of assessing the humoral response to SARS-CoV-2 when determining vaccine efficacy and describing the immune correlates of protection for SARS-CoV-2.
Collapse
Affiliation(s)
- Carlos A. Sariol
- Department of Microbiology and Medical Zoology, University of Puerto Rico-Medical Sciences Campus, San Juan, PR, USA
- Unit of Comparative Medicine, University of Puerto Rico-Medical Sciences Campus, San Juan, PR, USA
- Department of Internal medicine, University of Puerto Rico-Medical Sciences Campus, San Juan, PR, USA
| | | | - Crisanta Serrano-Collazo
- Unit of Comparative Medicine, University of Puerto Rico-Medical Sciences Campus, San Juan, PR, USA
| | - Tiffany Rosa-Arocho
- Unit of Comparative Medicine, University of Puerto Rico-Medical Sciences Campus, San Juan, PR, USA
| | - Albersy Armina
- Department of Microbiology and Medical Zoology, University of Puerto Rico-Medical Sciences Campus, San Juan, PR, USA
| | - Lorna Cruz
- Department of Microbiology and Medical Zoology, University of Puerto Rico-Medical Sciences Campus, San Juan, PR, USA
- Unit of Comparative Medicine, University of Puerto Rico-Medical Sciences Campus, San Juan, PR, USA
| | - E. Taylor Stone
- Department of Molecular Microbiology and Immunology, Saint Louis University, St Louis, Missouri, USA
| | - Teresa Arana
- Department of Microbiology and Medical Zoology, University of Puerto Rico-Medical Sciences Campus, San Juan, PR, USA
- Unit of Comparative Medicine, University of Puerto Rico-Medical Sciences Campus, San Juan, PR, USA
| | | | - Gerardo Latoni
- Banco de Sangre de Servicios Mutuos, Guaynabo, PR, USA, Puerto Rico Science, Technology and Research Trust, PR, USA
| | | | | | - Amelia K. Pinto
- Department of Molecular Microbiology and Immunology, Saint Louis University, St Louis, Missouri, USA
| | - James D. Brien
- Department of Molecular Microbiology and Immunology, Saint Louis University, St Louis, Missouri, USA
| | - Ana M. Espino
- Department of Microbiology and Medical Zoology, University of Puerto Rico-Medical Sciences Campus, San Juan, PR, USA
| |
Collapse
|
44
|
Abstract
COVID-19 vaccines are new brands of consumer health technology being introduced to the market. Considering consumer behaviour approaches in this time of crisis, the risk of vaccine hesitancy, the call for more transparency and effective messaging to gain trust, and equitable distribution of this vaccine, this is unexplored theoretical terrain. This commentary takes a multidisciplinary approach to understand and theoretically explore the marketing, distribution, and acceptance of the COVID-19 vaccine. The paper integrates marketing principles, including advertisement and branding of consumer health technology with supply chain management, public affairs, and public health. A theoretical framework was presented to illustrate this relationship and key areas of concerns. The practical implications relevant to equity, ethics, education, employment, and the economic impact was presented.
Collapse
Affiliation(s)
- Emmanuel Mogaji
- Department of Marketing, Events and Tourism, University of Greenwich, London, United Kingdom.
| |
Collapse
|
45
|
Hines AM, Murphy N, Mullin C, Barillas J, Barrientos JC. Henoch-Schönlein purpura presenting post COVID-19 vaccination. Vaccine 2021; 39:4571-4572. [PMID: 34247902 PMCID: PMC8241653 DOI: 10.1016/j.vaccine.2021.06.079] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Revised: 06/11/2021] [Accepted: 06/25/2021] [Indexed: 11/12/2022]
Affiliation(s)
- Adam M Hines
- Northwell Health Cancer Institute, New York, United States
| | - Neal Murphy
- Northwell Health Cancer Institute, New York, United States
| | - Christine Mullin
- North Shore University Division of Maternal Fetal Medicine, Northwell Health, New York, United States
| | - Julia Barillas
- Woodhull NYC Health + Hospitals, New York, United States
| | - Jacqueline C Barrientos
- Northwell Health Cancer Institute, New York, United States; Zucker School of Medicine at Hofstra/Northwell, New York, United States.
| |
Collapse
|
46
|
Ye P, Fry L, Liu H, Ledesma S, Champion JD. COVID outbreak after the 1st dose of COVID vaccine among the nursing home residents: What happened? Geriatr Nurs 2021; 42:1105-1108. [PMID: 34274688 PMCID: PMC8226105 DOI: 10.1016/j.gerinurse.2021.06.022] [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: 05/14/2021] [Revised: 06/14/2021] [Accepted: 06/18/2021] [Indexed: 11/16/2022]
Abstract
The purpose of this study was to assess the effectiveness of Pfizer-BioNTech COVID19 vaccine among nursing home residents by exploring the outcomes of a major COVID-19 outbreak following COVID-19 vaccination in a nursing home located at a metropolitan area of South-Central Texas. 91 residents resided in this nursing home during the outbreak, and 86 residents received the 1st dose of COVID-19 vaccine on January 4th, 2021. A retrospective chart review explored outcomes of this outbreak by accessing the electronic medical records from January 4th, 2021 thru February 28th, 2021. Residents partially vaccinated with COVID-19 vaccine were found less likely to be symptomatic during this outbreak. The risk of SARS-CoV-2 infection was significantly lower among residents who received both doses of the COVID-19 vaccine. Completion of both doses of COVID vaccination for all nursing home residents is essential and can prevent future COVID-19 outbreaks in nursing homes.
Collapse
Affiliation(s)
- Ping Ye
- The College of Nursing, Texas A&M University, Round Rock Campus, TX 78665, United States; Austin Geriatric Specialists, Austin, TX, United States.
| | - Liam Fry
- Dell Medical School, the University of Texas at Austin, Austin, TX, United States; Austin Geriatric Specialists, Austin, TX, United States.
| | - Haiyan Liu
- Austin Geriatric Specialists, Austin, TX, United States.
| | | | | |
Collapse
|
47
|
Qaid TS, Mazaar H, Alqahtani MS, Raweh AA, Alakwaa W. Deep sequence modelling for predicting COVID-19 mRNA vaccine degradation. PeerJ Comput Sci 2021; 7:e597. [PMID: 34239977 PMCID: PMC8237341 DOI: 10.7717/peerj-cs.597] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Accepted: 05/26/2021] [Indexed: 06/13/2023]
Abstract
The worldwide coronavirus (COVID-19) pandemic made dramatic and rapid progress in the year 2020 and requires urgent global effort to accelerate the development of a vaccine to stop the daily infections and deaths. Several types of vaccine have been designed to teach the immune system how to fight off certain kinds of pathogens. mRNA vaccines are the most important candidate vaccines because of their capacity for rapid development, high potency, safe administration and potential for low-cost manufacture. mRNA vaccine acts by training the body to recognize and response to the proteins produced by disease-causing organisms such as viruses or bacteria. This type of vaccine is the fastest candidate to treat COVID-19 but it currently facing several limitations. In particular, it is a challenge to design stable mRNA molecules because of the inefficient in vivo delivery of mRNA, its tendency for spontaneous degradation and low protein expression levels. This work designed and implemented a sequence deep model based on bidirectional GRU and LSTM models applied on the Stanford COVID-19 mRNA vaccine dataset to predict the mRNA sequences responsible for degradation by predicting five reactivity values for every position in the sequence. Four of these values determine the likelihood of degradation with/without magnesium at high pH (pH 10) and high temperature (50 degrees Celsius) and the fifth reactivity value is used to determine the likely secondary structure of the RNA sample. The model relies on two types of features, namely numerical and categorical features, where the categorical features are extracted from the mRNA sequences, structure and predicted loop. These features are represented and encoded by numbers, and then, the features are extracted using embedding layer learning. There are five numerical features depending on the likelihood for each pair of nucleotides in the RNA. The model gives promising results because it predicts the five reactivity values with a validation mean columnwise root mean square error (MCRMSE) of 0.125 using LSTM model with augmentation and the codon encoding method. Codon encoding outperforms Base encoding in MCRMSE validation error using the LSTM model meanwhile Base encoding outperforms codon encoding due to less over-fitting and the difference between the training and validation loss error is 0.008.
Collapse
Affiliation(s)
- Talal S. Qaid
- Computer Science Department, College of Computer Science, King Khalid University, Abha, Saudi Arabia
- Faculty of Computer Science, Hodeidah University, Hodeidah, Yemen
| | - Hussein Mazaar
- Computer Science Department, College of Science & Arts in Tanumah, King Khalid University, Abha, Saudi Arabia
| | - Mohammed S. Alqahtani
- Radiological Sciences Department, College of Applied Medical Sciences, King Khalid University, Abha, Saudi Arabia
| | - Abeer A. Raweh
- Computer Science Department, College of Computer Science, King Khalid University, Abha, Saudi Arabia
- Faculty of Computer Science, Hodeidah University, Hodeidah, Yemen
| | - Wafaa Alakwaa
- Computer Science Department, College of Science & Arts in Tanumah, King Khalid University, Abha, Saudi Arabia
| |
Collapse
|
48
|
Ma R, Suo L, Lu L, Pang X. Willingness of the General Public to Receive the COVID-19 Vaccine During a Second-Level Alert - Beijing Municipality, China, May 2020. China CDC Wkly 2021; 3:531-537. [PMID: 34594928 PMCID: PMC8393022 DOI: 10.46234/ccdcw2021.118] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Accepted: 05/18/2021] [Indexed: 01/21/2023] Open
Abstract
What is already known on this topic? Preclinical trials showed the effectiveness of domestic inactivated vaccine candidates for coronavirus disease 2019 (COVID-19). However, it is necessary to evaluate the willingness of the public to receive future domestic vaccines and to understand factors associated with willingness at the early stages of vaccine development. What is added by this report? Through May 25, 2020, 70.48% were willing to receive future domestic COVID-19 vaccines. Confidence in vaccines had the largest impact on public willingness, while age and presence of underlying chronic disease did not significantly increase public willingness. What are the implications for public health practice? It is necessary to increase awareness of COVID-19 vaccines among people with high risk of severe infection and to build public confidence in vaccines. Releasing accurate, timely, and reliable data to the public can help increase willingness to get vaccinated.
Collapse
Affiliation(s)
- Rui Ma
- Division of Expanded Program of Immunization (EPI), Beijing Center for Disease Control and Prevention/Beijing Center for Preventive Medicine Research, Beijing, China
| | - Luodan Suo
- Division of Expanded Program of Immunization (EPI), Beijing Center for Disease Control and Prevention/Beijing Center for Preventive Medicine Research, Beijing, China
| | - Li Lu
- Division of Expanded Program of Immunization (EPI), Beijing Center for Disease Control and Prevention/Beijing Center for Preventive Medicine Research, Beijing, China
| | - Xinghuo Pang
- Division of Expanded Program of Immunization (EPI), Beijing Center for Disease Control and Prevention/Beijing Center for Preventive Medicine Research, Beijing, China
| |
Collapse
|
49
|
Abstract
AIM To identify whether COVID-19 vaccines should be administered in pregnant and breastfeeding women by reviewing the guidance and other evidence. METHODS We reviewed the COVID-19 vaccination guidance for pregnant and breastfeeding women published to date and evidence from preclinical experimental and observational clinical studies, and discuss their implications. RESULTS Pregnant women were excluded from the initial phase 3 clinical trials of COVID-19 vaccines resulting in limited data on their efficacy and safety during pregnancy and postpartum. As a result, since December 2020, there has been conflicting advice from public health, governmental, and professional authorities on this matter. From the end of 2020 up to now, some consensus guidance has been published with a prevalent precautionary approach on the administration of vaccines in pregnant women, in breastfeeding ones, or for those who are planning a pregnancy (either spontaneously or with assisted technologies). After the first few months of vaccine administration in some countries, more permissiveness seems to prevail, although with inconsistencies. At the moment, the results obtained by preclinical experimental and observational clinical studies suggest that the risks of the maternal COVID-19 outweigh the undocumented and hypothetical risks of the COVID-19 vaccines in pregnancy. Also, until two viral vector COVID-19 vaccines were associated with very rare thromboembolic events, all guidance had agreed that all approved COVID-19 vaccines could be administered in pregnancy. Actually, some concern has been expressed. CONCLUSION COVID-19 vaccines administered in pregnancy can reduce the risk of severe COVID-19 and their serious consequences for mothers and their offspring. However, many aspects remain to be clarified.
Collapse
Affiliation(s)
- Eleonora Brillo
- Center for Research in Perinatal and Reproductive Medicine, University of Perugia, Perugia, Italy.,Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Rome, Italy
| | - Valentina Tosto
- Center for Research in Perinatal and Reproductive Medicine, University of Perugia, Perugia, Italy.,Department of Obstetrics and Gynecology, University of Perugia, Perugia, Italy
| | - Sandro Gerli
- Center for Research in Perinatal and Reproductive Medicine, University of Perugia, Perugia, Italy.,Department of Obstetrics and Gynecology, University of Perugia, Perugia, Italy
| | - Ersilia Buonomo
- Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Rome, Italy
| |
Collapse
|
50
|
Palacios R, Patiño EG, de Oliveira Piorelli R, Conde MTRP, Batista AP, Zeng G, Xin Q, Kallas EG, Flores J, Ockenhouse CF, Gast C. Double-Blind, Randomized, Placebo-Controlled Phase III Clinical Trial to Evaluate the Efficacy and Safety of treating Healthcare Professionals with the Adsorbed COVID-19 (Inactivated) Vaccine Manufactured by Sinovac - PROFISCOV: A structured summary of a study protocol for a randomised controlled trial. Trials 2020; 21:853. [PMID: 33059771 PMCID: PMC7558252 DOI: 10.1186/s13063-020-04775-4] [Citation(s) in RCA: 156] [Impact Index Per Article: 39.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Accepted: 09/24/2020] [Indexed: 12/23/2022] Open
Abstract
Objectives To evaluate the efficacy of two doses of the adsorbed vaccine COVID-19 (inactivated) produced by Sinovac in symptomatic individuals, with virological confirmation of COVID-19, two weeks after the completion of the two-dose vaccination regimen, aged 18 years or older who work as health professionals providing care to patients with possible or confirmed COVID-19. To describe the occurrence of adverse reactions associated with the administration of each of two doses of the adsorbed vaccine COVID-19 (inactivated) produced by Sinovac up to one week after vaccination in Adults (18-59 years of age) and Elderly (60 years of age or more). Trial design This is a Phase III, randomized, multicenter, endpoint driven, double-blind, placebo-controlled clinical trial to assess the efficacy and safety of the adsorbed vaccine COVID-19 (inactivated) produced by Sinovac. The adsorbed vaccine COVID-19 (inactivated) produced by Sinovac (product under investigation) will be compared to placebo. Voluntary participants will be randomized to receive two intramuscular doses of the investigational product or the placebo, in a 1: 1 ratio, stratified by age group (18 to 59 years and 60 years or more) and will be monitored for one year by active surveillance of COVID-19. Two databases will be established according to the age groups: one for adults (18-59 years) and one for the elderly (60 years of age or older). The threshold to consider the vaccine efficacious will be to reach a protection level of at least 50%, as proposed by the World Health Organization and the FDA. Success in this criterion will be defined by sequential monitoring with adjustment of the lower limit of the 95% confidence interval above 30% for the primary efficacy endpoint. Participants Healthy participants and / or participants with clinically controlled disease, of both genders, 18 years of age or older, working as health professionals performing care in units specialized in direct contact with people with possible or confirmed cases of COVID-19. Participation of pregnant women and those who are breastfeeding, as well as those intending to become pregnant within three months after vaccination will not be allowed. Participants will only be included after signing the voluntary Informed Consent Form and ensuring they undergo screening evaluation and conform to all the inclusion and exclusion criteria. All the clinical sites are located in Brazil. Intervention and comparator Experimental intervention: The vaccine was manufactured by Sinovac Life Sciences (Beijing, China) and contains 3 μg/0.5 mL (equivalent to 600 SU per dose) of inactivated SARS-CoV-2 virus, and aluminium hydroxide as adjuvant. Control comparator: The placebo contains aluminium hydroxide in a 0.5 mL solution The schedule of both, experimental intervention and placebo is two 0.5 mL doses IM (deltoid) with a two week interval. Main outcomes The primary efficacy endpoint is the incidence of symptomatic cases of virologically confirmed COVID-19 two weeks after the second vaccination. The virological diagnosis will be confirmed by detection of SARS-CoV-2 nucleic acid in a clinical sample. The primary safety endpoint is the frequency of solicited and unsolicited local and systemic adverse reactions during the period of one week after vaccination according to age group in adult (18-59 years old) and elder (60 years of age or older) subjects. Adverse reactions are defined as adverse events that have a reasonable causal relationship to vaccination. Randomisation There will be two randomization lists, one for each age group, based on the investigational products to be administered, i.e., vaccine or placebo at a 1: 1 ratio. Each randomization list will be made to include up to 11,800 (18-59 year-old) adults, and 1,260 elderly (60 y-o and older) participants, the maximum number of participants needed per age group. An electronic central randomization system will be used to designate the investigational product that each participant must receive. Blinding (masking) This trial is designed as a double-blind study to avoid introducing bias in the evaluation of efficacy, safety and immunogenicity. The clinical care team, the professionals responsible for the vaccination and the participants will not know which investigational product will be administered. Only pharmacists or nurses in the study who are responsible for the randomization, separation and blinding of the investigational product will have access to unblinded information. The sponsor's operational team will also remain blind. Numbers to be randomised (sample size) The total number of participants needed to evaluate efficacy, 13,060 participants, satisfies the needed sample size calculated to evaluate safety. Therefore, the total number obtained for efficacy will be the number retained for the study. Up to 13,060 participants are expected to enter the study, with up to 11,800 participants aged 18 to 59 years and 1,260 elderly participants aged 60 and over. Half of the participants of each group will receive the experimental vaccine and half of them will receive the placebo. The recruitment of participants may be modified as recommended by the Data Safety Monitoring Committee at time of the interim unblinded analysis or blind assessment of the COVID-19 attack rate during the study. Trial Status Protocol version 2.0 – 24-Aug-2020. Recruitment started on July 21st, 2020. The recruitment is expected to conclude in October 2020. Trial registration ClinicalTrials.gov Identifier: NCT0445659. Registry on 2 July 2020 Full protocol The full protocol is attached as an additional file, accessible from the Trials website (Additional file 1). In the interest in expediting dissemination of this material, the familiar formatting has been eliminated; this Letter serves as a summary of the key elements of the full protocol.
Collapse
Affiliation(s)
- Ricardo Palacios
- Center for Clinical Trials and Pharmacovigilance, Instituto Butantan, São Paulo, Brazil.
| | | | | | | | - Ana Paula Batista
- Center for Clinical Trials and Pharmacovigilance, Instituto Butantan, São Paulo, Brazil
| | - Gang Zeng
- Sinovac Life Sciences, Beijing, China
| | | | - Esper G Kallas
- Department of Infectious and Parasitic Diseases, School of Medicine, University of São Paulo, São Paulo, Brazil
| | | | | | | |
Collapse
|