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Ogilvie RP, Layton JB, Lloyd PC, Jiao Y, Djibo DA, Wong HL, Gruber JF, Parambi R, Deng J, Miller M, Song J, Weatherby LB, Peetluk L, Lo AC, Matuska K, Wernecke M, Bui CL, Clarke TC, Cho S, Bell EJ, Yang G, Amend KL, Forshee RA, Anderson SA, McMahill-Walraven CN, Chillarige Y, Anthony MS, Seeger JD, Shoaibi A. Effectiveness of BNT162b2 COVID-19 primary series vaccination in children aged 5-17 years in the United States: a cohort study. BMC Pediatr 2024; 24:276. [PMID: 38671379 DOI: 10.1186/s12887-024-04756-5] [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: 09/19/2023] [Accepted: 04/11/2024] [Indexed: 04/28/2024] Open
Abstract
BACKGROUND COVID-19 vaccines are authorized for use in children in the United States; real-world assessment of vaccine effectiveness in children is needed. This study's objective was to estimate the effectiveness of receiving a complete primary series of monovalent BNT162b2 (Pfizer-BioNTech) COVID-19 vaccine in US children. METHODS This cohort study identified children aged 5-17 years vaccinated with BNT162b2 matched with unvaccinated children. Participants and BNT162b2 vaccinations were identified in Optum and CVS Health insurance administrative claims databases linked with Immunization Information System (IIS) COVID-19 vaccination records from 16 US jurisdictions between December 11, 2020, and May 31, 2022 (end date varied by database and IIS). Vaccinated children were followed from their first BNT162b2 dose and matched to unvaccinated children on calendar date, US county of residence, and demographic and clinical factors. Censoring occurred if vaccinated children failed to receive a timely dose 2 or if unvaccinated children received any dose. Two COVID-19 outcome definitions were evaluated: COVID-19 diagnosis in any medical setting and COVID-19 diagnosis in hospitals/emergency departments (EDs). Propensity score-weighted hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated with Cox proportional hazards models, and vaccine effectiveness (VE) was estimated as 1 minus HR. VE was estimated overall, within age subgroups, and within variant-specific eras. Sensitivity, negative control, and quantitative bias analyses evaluated various potential biases. RESULTS There were 453,655 eligible vaccinated children one-to-one matched to unvaccinated comparators (mean age 12 years; 50% female). COVID-19 hospitalizations/ED visits were rare in children, regardless of vaccination status (Optum, 41.2 per 10,000 person-years; CVS Health, 44.1 per 10,000 person-years). Overall, vaccination was associated with reduced incidence of any medically diagnosed COVID-19 (meta-analyzed VE = 38% [95% CI, 36-40%]) and hospital/ED-diagnosed COVID-19 (meta-analyzed VE = 61% [95% CI, 56-65%]). VE estimates were lowest among children 5-11 years and during the Omicron-variant era. CONCLUSIONS Receipt of a complete BNT162b2 vaccine primary series was associated with overall reduced medically diagnosed COVID-19 and hospital/ED-diagnosed COVID-19 in children; observed VE estimates differed by age group and variant era. REGISTRATION The study protocol was publicly posted on the BEST Initiative website ( https://bestinitiative.org/wp-content/uploads/2022/03/C19-VX-Effectiveness-Protocol_2022_508.pdf ).
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Affiliation(s)
| | - J Bradley Layton
- RTI Health Solutions, 3040 East Cornwallis Rd, PO Box 12194, Research Triangle Park, NC, 27709, USA.
| | | | | | | | - Hui Lee Wong
- US Food and Drug Administration, Silver Spring, MD, USA
| | | | | | - Jie Deng
- Optum Epidemiology, Boston, MA, USA
| | | | | | | | | | | | | | | | - Christine L Bui
- RTI Health Solutions, 3040 East Cornwallis Rd, PO Box 12194, Research Triangle Park, NC, 27709, USA
| | | | - Sylvia Cho
- US Food and Drug Administration, Silver Spring, MD, USA
| | | | | | | | | | | | | | | | - Mary S Anthony
- RTI Health Solutions, 3040 East Cornwallis Rd, PO Box 12194, Research Triangle Park, NC, 27709, USA
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Hönning A, Tomczyk S, Hermes J, Grossegesse M, Hofmann N, Michel J, Neumann M, Nitsche A, Hoppe B, Eckmanns T, Schmidt-Traub H, Zappel K. Follow-up SARS-CoV-2 serological study of a health care worker cohort following COVID-19 booster vaccination. BMC Infect Dis 2024; 24:436. [PMID: 38658874 PMCID: PMC11040945 DOI: 10.1186/s12879-024-09338-5] [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: 01/19/2024] [Accepted: 04/21/2024] [Indexed: 04/26/2024] Open
Abstract
BACKGROUND Studies have shown that Omicron breakthrough infections can occur at higher SARS-CoV-2 antibody levels compared to previous variants. Estimating the magnitude of immunological protection induced from COVID-19 vaccination and previous infection remains important due to varying local pandemic dynamics and types of vaccination programmes, particularly among at-risk populations such as health care workers (HCWs). We analysed a follow-up SARS-CoV-2 serological survey of HCWs at a tertiary COVID-19 referral hospital in Germany following the onset of the Omicron variant. METHODS The serological survey was conducted in January 2022, one year after previous surveys in 2020 and the availability of COVID-19 boosters including BNT162b2, ChAdOx1-S, and mRNA-1273. HCWs voluntarily provided blood for serology and completed a comprehensive questionnaire. SARS-CoV-2 serological analyses were performed using an Immunoglobulin G (IgG) enzyme-linked immunosorbent assay (ELISA). Antibody levels were reported according to HCW demographic and occupational characteristics, COVID-19 vaccination and SARS-CoV-2 infection history, and multivariate linear regression was used to evaluate these associations. RESULTS In January 2022 (following the fourth COVID-19 wave in Germany including the onset of the Omicron variant), 1482/1517 (97.7%) HCWs tested SARS-CoV-2 seropositive, compared to 4.6% in December 2020 (second COVID-19 wave). Approximately 80% had received three COVID-19 vaccine doses and 15% reported a previous laboratory-confirmed SARS-CoV-2 infection. SARS-CoV-2 IgG geometric mean titres ranged from 335 (95% Confidence Intervals [CI]: 258-434) among those vaccinated twice and without previous infection to 2204 (95% CI: 1919-2531) among those vaccinated three times and with previous infection. Heterologous COVID-19 vaccination combinations including a mRNA-1273 booster were significantly associated with the highest IgG antibody levels compared to other schemes. There was an 8-to 10-fold increase in IgG antibody levels among 31 HCWs who reported a SARS-CoV-2 infection in May 2020 to January 2022 after COVID-19 booster vaccination. CONCLUSIONS Our findings demonstrate the importance of ongoing COVID-19 booster vaccination strategies in the context of variants such as Omicron and despite hybrid immunity from previous SARS-CoV-2 infections, particularly for at-risk populations such as HCWs. Where feasible, effective types of booster vaccination, such as mRNA vaccines, and the appropriate timing of administration should be carefully considered.
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Affiliation(s)
- Alexander Hönning
- Centre for Clinical Research, BG Klinikum Unfallkrankenhaus Berlin gGmbH, Berlin, Germany.
| | - Sara Tomczyk
- Department of Infectious Disease Epidemiology, Robert Koch Institute, Berlin, Germany
| | - Julia Hermes
- Department of Infectious Disease Epidemiology, Robert Koch Institute, Berlin, Germany
| | - Marica Grossegesse
- Highly Pathogenic Viruses, Centre for Biological Threats and Special Pathogens, WHO Reference Laboratory for SARS-CoV-2 and WHO Collaborating Centre for Emerging Infections and Biological Threats, Robert Koch Institute, Berlin, Germany
| | - Natalie Hofmann
- Highly Pathogenic Viruses, Centre for Biological Threats and Special Pathogens, WHO Reference Laboratory for SARS-CoV-2 and WHO Collaborating Centre for Emerging Infections and Biological Threats, Robert Koch Institute, Berlin, Germany
| | - Janine Michel
- Highly Pathogenic Viruses, Centre for Biological Threats and Special Pathogens, WHO Reference Laboratory for SARS-CoV-2 and WHO Collaborating Centre for Emerging Infections and Biological Threats, Robert Koch Institute, Berlin, Germany
| | - Markus Neumann
- Highly Pathogenic Viruses, Centre for Biological Threats and Special Pathogens, WHO Reference Laboratory for SARS-CoV-2 and WHO Collaborating Centre for Emerging Infections and Biological Threats, Robert Koch Institute, Berlin, Germany
| | - Andreas Nitsche
- Highly Pathogenic Viruses, Centre for Biological Threats and Special Pathogens, WHO Reference Laboratory for SARS-CoV-2 and WHO Collaborating Centre for Emerging Infections and Biological Threats, Robert Koch Institute, Berlin, Germany
| | - Berthold Hoppe
- Health and Medical University Potsdam, Potsdam, Germany
- Institute of Laboratory Medicine, BG Klinikum Unfallkrankenhaus Berlin gGmbH, Berlin, Germany
| | - Tim Eckmanns
- Department of Infectious Disease Epidemiology, Robert Koch Institute, Berlin, Germany
| | | | - Kristina Zappel
- Centre for Clinical Research, BG Klinikum Unfallkrankenhaus Berlin gGmbH, Berlin, Germany
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Chang YS, Huang K, Lee JM, Vagts CL, Ascoli C, Amin MR, Ghassemi M, Lora CM, Edafetanure-Ibeh R, Huang Y, Cherian RA, Sarup N, Warpecha SR, Hwang S, Goel R, Turturice BA, Schott C, Hernandez M, Chen Y, Jorgensen J, Wang W, Rasic M, Novak RM, Finn PW, Perkins DL. Altered transcriptomic immune responses of maintenance hemodialysis patients to the COVID-19 mRNA vaccine. eLife 2024; 13:e83641. [PMID: 38656290 DOI: 10.7554/elife.83641] [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: 09/22/2022] [Accepted: 03/29/2024] [Indexed: 04/26/2024] Open
Abstract
Background End-stage renal disease (ESRD) patients experience immune compromise characterized by complex alterations of both innate and adaptive immunity, and results in higher susceptibility to infection and lower response to vaccination. This immune compromise, coupled with greater risk of exposure to infectious disease at hemodialysis (HD) centers, underscores the need for examination of the immune response to the COVID-19 mRNA-based vaccines. Methods The immune response to the COVID-19 BNT162b2 mRNA vaccine was assessed in 20 HD patients and cohort-matched controls. RNA sequencing of peripheral blood mononuclear cells was performed longitudinally before and after each vaccination dose for a total of six time points per subject. Anti-spike antibody levels were quantified prior to the first vaccination dose (V1D0) and 7 d after the second dose (V2D7) using anti-spike IgG titers and antibody neutralization assays. Anti-spike IgG titers were additionally quantified 6 mo after initial vaccination. Clinical history and lab values in HD patients were obtained to identify predictors of vaccination response. Results Transcriptomic analyses demonstrated differing time courses of immune responses, with prolonged myeloid cell activity in HD at 1 wk after the first vaccination dose. HD also demonstrated decreased metabolic activity and decreased antigen presentation compared to controls after the second vaccination dose. Anti-spike IgG titers and neutralizing function were substantially elevated in both controls and HD at V2D7, with a small but significant reduction in titers in HD groups (p<0.05). Anti-spike IgG remained elevated above baseline at 6 mo in both subject groups. Anti-spike IgG titers at V2D7 were highly predictive of 6-month titer levels. Transcriptomic biomarkers after the second vaccination dose and clinical biomarkers including ferritin levels were found to be predictive of antibody development. Conclusions Overall, we demonstrate differing time courses of immune responses to the BTN162b2 mRNA COVID-19 vaccination in maintenance HD subjects comparable to healthy controls and identify transcriptomic and clinical predictors of anti-spike IgG titers in HD. Analyzing vaccination as an in vivo perturbation, our results warrant further characterization of the immune dysregulation of ESRD. Funding F30HD102093, F30HL151182, T32HL144909, R01HL138628. This research has been funded by the University of Illinois at Chicago Center for Clinical and Translational Science (CCTS) award UL1TR002003.
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Affiliation(s)
- Yi-Shin Chang
- Department of Medicine, University of Illinois at Chicago, Chicago, United States
- Department of Bioengineering, University of Illinois at Chicago, Chicago, United States
| | - Kai Huang
- Department of Medicine, University of Illinois at Chicago, Chicago, United States
- Department of Bioengineering, University of Illinois at Chicago, Chicago, United States
| | - Jessica M Lee
- Department of Medicine, University of Illinois at Chicago, Chicago, United States
- Department of Microbiology and Immunology, University of Illinois at Chicago, Chicago, United States
| | - Christen L Vagts
- Department of Medicine, University of Illinois at Chicago, Chicago, United States
| | - Christian Ascoli
- Department of Medicine, University of Illinois at Chicago, Chicago, United States
| | - Md-Ruhul Amin
- Department of Medicine, University of Illinois at Chicago, Chicago, United States
| | - Mahmood Ghassemi
- Department of Medicine, University of Illinois at Chicago, Chicago, United States
| | - Claudia M Lora
- Department of Medicine, University of Illinois at Chicago, Chicago, United States
| | | | - Yue Huang
- Department of Medicine, University of Illinois at Chicago, Chicago, United States
| | - Ruth A Cherian
- Department of Medicine, University of Illinois at Chicago, Chicago, United States
| | - Nandini Sarup
- Department of Medicine, University of Illinois at Chicago, Chicago, United States
| | - Samantha R Warpecha
- Department of Medicine, University of Illinois at Chicago, Chicago, United States
| | - Sunghyun Hwang
- Department of Medicine, University of Illinois at Chicago, Chicago, United States
| | - Rhea Goel
- Department of Medicine, University of Illinois at Chicago, Chicago, United States
| | - Benjamin A Turturice
- Department of Medicine, University of Illinois at Chicago, Chicago, United States
- Department of Microbiology and Immunology, University of Illinois at Chicago, Chicago, United States
- Department of Medicine, Stanford University, Palo Alto, United States
| | - Cody Schott
- Department of Medicine, University of Illinois at Chicago, Chicago, United States
- Department of Microbiology and Immunology, University of Illinois at Chicago, Chicago, United States
- Department of Medicine, University of Colorado Denver, Aurora, United States
| | - Montserrat Hernandez
- Department of Medicine, University of Illinois at Chicago, Chicago, United States
| | - Yang Chen
- Department of Medicine, University of Illinois at Chicago, Chicago, United States
- Department of Biological Sciences, University of Illinois at Chicago, Chicago, United States
| | - Julianne Jorgensen
- Department of Medicine, University of Illinois at Chicago, Chicago, United States
- Department of Bioengineering, University of Illinois at Chicago, Chicago, United States
| | - Wangfei Wang
- Department of Medicine, University of Illinois at Chicago, Chicago, United States
- Department of Bioengineering, University of Illinois at Chicago, Chicago, United States
| | - Mladen Rasic
- Department of Medicine, University of Illinois at Chicago, Chicago, United States
- Department of Bioengineering, University of Illinois at Chicago, Chicago, United States
| | - Richard M Novak
- Department of Medicine, University of Illinois at Chicago, Chicago, United States
| | - Patricia W Finn
- Department of Medicine, University of Illinois at Chicago, Chicago, United States
- Department of Bioengineering, University of Illinois at Chicago, Chicago, United States
- Department of Microbiology and Immunology, University of Illinois at Chicago, Chicago, United States
| | - David L Perkins
- Department of Medicine, University of Illinois at Chicago, Chicago, United States
- Department of Bioengineering, University of Illinois at Chicago, Chicago, United States
- Department of Biological Sciences, University of Illinois at Chicago, Chicago, United States
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Ibrahim KY, Moreira RM, dos Santos CF, Strabelli TMV, Belizário JDC, Pinto MIDM, Marinho AKBB, Pereira JM, de Mello LS, Ando MC, da Silva VGL, Sato PK, de Lima MA, França JID, Loch AP, Miyaji KT, Infante V, Precioso AR, Sartori AMC. Immunogenicity of COVID-19 adsorbed inactivated vaccine (CoronaVac) and additional doses of mRNA BNT162b2 vaccine in immunocompromised adults compared with immunocompetent persons. Rev Inst Med Trop Sao Paulo 2024; 66:e24. [PMID: 38656040 PMCID: PMC11027488 DOI: 10.1590/s1678-9946202466024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Accepted: 01/04/2024] [Indexed: 04/26/2024] Open
Abstract
Inactivated COVID-19 vaccines data in immunocompromised individuals are scarce. This trial assessed the immunogenicity of two CoronaVac doses and additional BNT162b2 mRNA vaccine doses in immunocompromised (IC) and immunocompetent (H) individuals. Adults with solid organ transplant (SOT), hematopoietic stem cell transplant, cancer, inborn immunity errors or rheumatic diseases were included in the IC group. Immunocompetent adults were used as control group for comparison. Participants received two CoronaVac doses within a 28-day interval. IC received two additional BNT162b2 doses and H received a third BNT162b2 dose (booster). Blood samples were collected at baseline, 28 days after each dose, pre-booster and at the trial end. We used three serological tests to detect antibodies to SARS-CoV-2 nucleocapsid (N), trimeric spike (S), and receptor binding domain (RBD). Outcomes included seroconversion rates (SCR), geometric mean titers (GMT) and GMT ratio (GMTR). A total of 241 IC and 100 H adults participated in the study. After two CoronaVac doses, IC had lower SCR than H: anti-N, 33.3% vs 79%; anti-S, 33.8% vs 86%, and anti-RBD, 48.5% vs 85%, respectively. IC also showed lower GMT than H: anti-N, 2.3 vs 15.1; anti-S, 58.8 vs 213.2 BAU/mL; and anti-RBD, 22.4 vs 168.0 U/mL, respectively. After the 3rd and 4th BNT162b2 doses, IC had significant anti-S and anti-RBD seroconversion, but still lower than H after the 3rd dose. After boosting, GMT increased in IC, but remained lower than in the H group. CoronaVac two-dose schedule immunogenicity was lower in IC than in H. BNT162b2 heterologous booster enhanced immune response in both groups.
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Affiliation(s)
- Karim Yaqub Ibrahim
- Universidade de São Paulo, Faculdade de Medicina, Hospital das Clínicas, Divisão de Moléstias Infecciosas e Parasitarias, São Paulo, São Paulo, Brazil
- Universidade de São Paulo, Faculdade de Medicina, Instituto do Câncer do Estado de São Paulo, Serviço de Controle de Infecção Hospitalar, São Paulo, São Paulo, Brazil
| | - Raquel Megale Moreira
- Universidade de São Paulo, Faculdade de Medicina, Hospital das Clinicas, Serviço de Transplante Renal, São Paulo, São Paulo, Brazil
| | - Carolina Ferreira dos Santos
- Universidade de São Paulo, Faculdade de Medicina, Hospital das Clinicas, Divisão de Clínica de Médica, Serviço de Hematologia, Hemoterapia e Terapia Celular, São Paulo, São Paulo, Brazil
| | - Tânia Mara Varejão Strabelli
- Universidade de São Paulo, Faculdade de Medicina, Hospital das Clinicas, Instituto do Coração, Subcomissão de Controle de Infecção Hospitalar, São Paulo, São Paulo, Brazil
| | - Juliana de Cássia Belizário
- Universidade de São Paulo, Faculdade de Medicina, Instituto do Câncer do Estado de São Paulo, Serviço de Controle de Infecção Hospitalar, São Paulo, São Paulo, Brazil
| | - Maria Isabel de Moraes Pinto
- Universidade Federal de São Paulo, Departamento de Pediatria, Disciplina de Alergia, Imunologia Clínica e Reumatologia, São Paulo, São Paulo, Brazil
| | - Ana Karolina Barreto Berselli Marinho
- Universidade de São Paulo, Faculdade de Medicina, Hospital das Clinicas, Departamento de Clínica Médica, Divisão de Imunologia Clínica, São Paulo, São Paulo, Brazil
| | - Juliana Marquezi Pereira
- Universidade de São Paulo, Faculdade de Medicina, Hospital das Clinicas, Divisão de Transplante de Fígado e Órgãos do Aparelho Digestivo, São Paulo, São Paulo, Brazil
| | - Liliane Saraiva de Mello
- Universidade de São Paulo, Faculdade de Medicina, Hospital das Clinicas, Instituto do Coração, Serviço de Pneumologia Unidade de Transplante de Pulmão, São Paulo, São Paulo, Brazil
| | - Mauricio Cesar Ando
- Instituto Butantan, Divisão de Ensaios Clínicos e Farmacovigilância, Laboratório Estratégico de Diagnóstico Molecular- Sorologia, São Paulo, São Paulo, Brazil
| | - Vitor Gabriel Lopes da Silva
- Universidade Federal de São Paulo, Disciplina de Infectologia Pediátrica, Laboratório de Pesquisas, São Paulo, São Paulo, Brazil
| | - Paula Keiko Sato
- Universidade de São Paulo, Faculdade de Medicina, Laboratório de Investigação Médica-Imunologia da Divisão de Clínica de Moléstias Infecciosas e Parasitárias (LIM-48), São Paulo, São Paulo, Brazil
| | - Marcos Alves de Lima
- Instituto Butantan, Divisão de Ensaios Clínicos e Farmacovigilância, Centro de Farmacovigilância, Segurança Clínica e Gestão de Risco, São Paulo, São Paulo, Brazil
| | - João Italo Dias França
- Instituto Butantan, Divisão de Ensaios Clínicos e Farmacovigilância, Centro de Farmacovigilância, Segurança Clínica e Gestão de Risco, São Paulo, São Paulo, Brazil
| | - Ana Paula Loch
- Instituto Butantan, Divisão de Ensaios Clínicos e Farmacovigilância, Centro de Farmacovigilância, Segurança Clínica e Gestão de Risco, São Paulo, São Paulo, Brazil
| | - Karina Takesaki Miyaji
- Instituto Butantan, Divisão de Ensaios Clínicos e Farmacovigilância, Centro de Farmacovigilância, Segurança Clínica e Gestão de Risco, São Paulo, São Paulo, Brazil
- Universidade de São Paulo, Faculdade de Medicina, Hospital das Clínicas, Centro de Referência para Imunobiológicos Especiais, São Paulo, São Paulo, Brazil
| | - Vanessa Infante
- Instituto Butantan, Divisão de Ensaios Clínicos e Farmacovigilância, Centro de Farmacovigilância, Segurança Clínica e Gestão de Risco, São Paulo, São Paulo, Brazil
| | - Alexander Roberto Precioso
- Instituto Butantan, Divisão de Ensaios Clínicos e Farmacovigilância, Centro de Farmacovigilância, Segurança Clínica e Gestão de Risco, São Paulo, São Paulo, Brazil
| | - Ana Marli Christovam Sartori
- Universidade de São Paulo, Faculdade de Medicina, Hospital das Clínicas, Centro de Referência para Imunobiológicos Especiais, São Paulo, São Paulo, Brazil
- Universidade de São Paulo, Faculdade de Medicina, Departamento de Moléstias Infecciosas e Parasitarias, São Paulo, São Paulo, Brazil
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Abdeen S, Abed Alah M, Al-Zaidan M, Mohamed Ibrahim MI, Abdulmajeed J, Al-Nuaimi AA, Al-Kuwari MG. Short-term side effects of BNT162b2 vaccine in primary care settings in Qatar: a retrospective study. Front Public Health 2024; 12:1384327. [PMID: 38660363 PMCID: PMC11039914 DOI: 10.3389/fpubh.2024.1384327] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2024] [Accepted: 03/20/2024] [Indexed: 04/26/2024] Open
Abstract
Background Despite the established effectiveness of the BNT162b2 Vaccine, the novel technology demands careful safety monitoring. While global studies have explored its safety, local data remains limited and exhibits some variability. This study investigated short-term side effects among BNT162b2 vaccinated individuals in Qatar. Methods A retrospective analysis was conducted using data extracted from the electronic health records of individuals aged 18 or older across 8 primary health centers who received either the first or second dose of the BNT162b2 vaccine during the period from December 23, 2020, to April 24, 2021. The proportions of individuals experiencing short-term side effects after each dose were calculated. Logistic regression and log binomial regression analyses were used to explore associations with the side effects. Results Among 7,764 participants, 5,489 received the first dose and 2,275 the second, with similar demographics between the groups. After the first dose, 5.5% reported at least one local side effect, compared to 3.9% after the second, with a 1.4 times higher incidence after the first dose (RR 1.4, 95% CI 1.14-1.75) compared to the second. Systemic side effects after the second dose were 2.6 times more common than after the first (RR 2.6, 95% CI 2.15-3.14). Gender, nationality, history of prior COVID-19 infection, and obesity were significantly associated with side effects after the first dose, while age, gender, and nationality, were significant factors after the second dose. Conclusion The rates of side effects following the BNT162b2 vaccine in Qatar were relatively low, with age, gender, nationality, previous infection, and obesity identified as significant predictors. These results emphasize the need for tailored vaccination strategies and contributes valuable insights for evidence-based decision-making in ongoing and future vaccination campaigns.
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Affiliation(s)
- Sami Abdeen
- Community Medicine Department, Hamad Medical Corporation (HMC), Doha, Qatar
| | - Muna Abed Alah
- Community Medicine Department, Hamad Medical Corporation (HMC), Doha, Qatar
| | - Manal Al-Zaidan
- Department of Pharmacy and Therapeutics Supply, Primary Health Care Corporation, Doha, Qatar
| | | | - Jazeel Abdulmajeed
- Strategy and Health Intelligence Department, Primary Health Care Corporation, Doha, Qatar
| | - Asma Ali Al-Nuaimi
- Strategy and Health Intelligence Department, Primary Health Care Corporation, Doha, Qatar
| | - Mohamed Ghaith Al-Kuwari
- Strategy and Health Intelligence Department, Primary Health Care Corporation, Doha, Qatar
- Collège of Medicine, Qatar University, Doha, Qatar
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Caldera F, Rolak S, Farraye FA, Necela BM, Cogen D, Zona EE, Schell TL, Ramirez OR, Almasry M, Chun K, Hayney MS, Knutson KL. Higher and Sustained Cell-Mediated Immune Responses After 3 Doses of mRNA COVID-19 Vaccine in Patients With Inflammatory Bowel Disease on Anti-Tumor Necrosis Factor Therapy. Clin Transl Gastroenterol 2024; 15:e00688. [PMID: 38349178 DOI: 10.14309/ctg.0000000000000688] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Accepted: 01/19/2024] [Indexed: 04/26/2024] Open
Abstract
INTRODUCTION Studies suggest that the generation of durable T-cell immunity following coronavirus disease 2019 (COVID-19) vaccination protects against severe disease. The aim of this study was to measure cell-mediated immune response (CMIR) 1-2 months and 6 months after a third dose of a COVID-19 mRNA vaccine. METHODS This prospective study (HumoRal and CellULar initial and Sustained immunogenicity in patients with inflammatory bowel disease [IBD]) evaluated CMIR at 28-65 days (t 1 ) after dose 2, 28-65 days (t 2 ) (n = 183) and 6 months (±45 days) (t 3 ) (n = 167) after a third dose of an mRNA COVID-19 vaccine. A small cohort had blood sample available 28-65 days (t 4 ) (n = 55) after a fourth dose. Primary outcomes were CMIR at (t 2 ) and (t 3 ). Secondary outcomes included the effect of immunosuppressing IBD medications on CMIR and response at (t 4 ). RESULTS All patients had measurable CMIR at all time points. CMIR increased at t 2 compared with that at t 1 (median 1,467 responding cells per million (interquartile range [IQR] 410-5,971) vs 313 (94-960) P < 0.001). There was no significant waning in t 2 vs t 3 or significant boosting at t 4 . Those on anti-tumor necrosis factor monotherapy had a higher CMIR compared with those not on this therapy at t 2 (4,132 [IQR 1,136-8,795] vs 869 [IQR 343-3,221] P < 0.001) and t 3 (2,843 [IQR 596-6,459] vs 654 [IQR 143-2,067] P < 0.001). In univariable analysis, anti-tumor necrosis factor monotherapy was associated with a higher CMIR at t 2 ( P < 0.001) and t 3 ( P < 0.001) and confirmed in a multivariable model ( P < 0.001). DISCUSSION A third dose of a COVID-19 vaccine boosts CMIR, and the response is sustained in patients with IBD.
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Affiliation(s)
- Freddy Caldera
- Department of Medicine, Division of Gastroenterology and Hepatology, University of Wisconsin School of Medicine & Public Health, Madison, Wisconsin, USA
| | - Stacey Rolak
- Department of Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | - Francis A Farraye
- Inflammatory Bowel Disease Center, Department of Gastroenterology and Hepatology, Mayo Clinic, Jacksonville, Florida, USA
| | - Brian M Necela
- Department of Immunology, Mayo Clinic, Jacksonville, Florida, USA
| | - Davitte Cogen
- Department of Immunology, Mayo Clinic, Jacksonville, Florida, USA
| | - Emily E Zona
- University of Wisconsin School of Medicine and Public Health, Madison, WI
| | - Trevor L Schell
- Department of Internal Medicine, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA
| | - Oscar Ramirez Ramirez
- Department of Internal Medicine, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA
| | - Mazen Almasry
- Department of Internal Medicine, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA
| | - Kelly Chun
- LabCorp, R&D and Specialty Medicine, Calabasas, CA, USA
| | - Mary S Hayney
- School of Pharmacy, University of Wisconsin School of Medicine & Public Health, Madison, Wisconsin, USA
| | - Keith L Knutson
- Department of Immunology, Mayo Clinic, Jacksonville, Florida, USA
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Muñoz FM, Sher LD, Sabharwal C, Gurtman A, Xu X, Kitchin N, Lockhart S, Riesenberg R, Sexter JM, Czajka H, Paulsen GC, Maldonado Y, Walter EB, Talaat KR, Englund JA, Sarwar UN, Hansen C, Iwamoto M, Webber C, Cunliffe L, Ukkonen B, Martínez SN, Pahud BA, Munjal I, Domachowske JB, Swanson KA, Ma H, Koury K, Mather S, Lu C, Zou J, Xie X, Shi PY, Cooper D, Türeci Ö, Şahin U, Jansen KU, Gruber WC. Evaluation of BNT162b2 Covid-19 Vaccine in Children Younger than 5 Years of Age. N Engl J Med 2023; 388:621-634. [PMID: 36791162 PMCID: PMC9947923 DOI: 10.1056/nejmoa2211031] [Citation(s) in RCA: 27] [Impact Index Per Article: 27.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/17/2023]
Abstract
BACKGROUND Safe and effective vaccines against coronavirus disease 2019 (Covid-19) are urgently needed in young children. METHODS We conducted a phase 1 dose-finding study and are conducting an ongoing phase 2-3 safety, immunogenicity, and efficacy trial of the BNT162b2 vaccine in healthy children 6 months to 11 years of age. We present results for children 6 months to less than 2 years of age and those 2 to 4 years of age through the data-cutoff dates (April 29, 2022, for safety and immunogenicity and June 17, 2022, for efficacy). In the phase 2-3 trial, participants were randomly assigned (in a 2:1 ratio) to receive two 3-μg doses of BNT162b2 or placebo. On the basis of preliminary immunogenicity results, a third 3-μg dose (≥8 weeks after dose 2) was administered starting in January 2022, which coincided with the emergence of the B.1.1.529 (omicron) variant. Immune responses at 1 month after doses 2 and 3 in children 6 months to less than 2 years of age and those 2 to 4 years of age were immunologically bridged to responses after dose 2 in persons 16 to 25 years of age who received 30 μg of BNT162b2 in the pivotal trial. RESULTS During the phase 1 dose-finding study, two doses of BNT162b2 were administered 21 days apart to 16 children 6 months to less than 2 years of age (3-μg dose) and 48 children 2 to 4 years of age (3-μg or 10-μg dose). The 3-μg dose level was selected for the phase 2-3 trial; 1178 children 6 months to less than 2 years of age and 1835 children 2 to 4 years of age received BNT162b2, and 598 and 915, respectively, received placebo. Immunobridging success criteria for the geometric mean ratio and seroresponse at 1 month after dose 3 were met in both age groups. BNT162b2 reactogenicity events were mostly mild to moderate, with no grade 4 events. Low, similar incidences of fever were reported after receipt of BNT162b2 (7% among children 6 months to <2 years of age and 5% among those 2 to 4 years of age) and placebo (6 to 7% among children 6 months to <2 years of age and 4 to 5% among those 2 to 4 years of age). The observed overall vaccine efficacy against symptomatic Covid-19 in children 6 months to 4 years of age was 73.2% (95% confidence interval, 43.8 to 87.6) from 7 days after dose 3 (on the basis of 34 cases). CONCLUSIONS A three-dose primary series of 3-μg BNT162b2 was safe, immunogenic, and efficacious in children 6 months to 4 years of age. (Funded by BioNTech and Pfizer; ClinicalTrials.gov number, NCT04816643.).
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Affiliation(s)
- Flor M Muñoz
- From Texas Children's Hospital, Baylor College of Medicine, Houston (F.M.M.), and the University of Texas Medical Branch, Galveston (J.Z., X. Xie, P.-Y.S.); Peninsula Research Associates, Rolling Hills Estates (L.D.S.), and Stanford University School of Medicine, Palo Alto (Y.M.) - both in California; Vaccine Research and Development, Pfizer, Pearl River (C.S., A.G., U.N.S., C.H., M.I., B.A.P., I.M., K.A.S., K.K., C.L., D.C., K.U.J., W.C.G.), and SUNY Upstate Medical University, Syracuse (J.B.D.) - both in New York; Vaccine Research and Development (X. Xu, H.M.), and Worldwide Safety, Safety Surveillance and Risk Management (S.M.), Pfizer, Collegeville, PA; Vaccine Research and Development, Pfizer, Hurley, United Kingdom (N.K., S.L., C.W., L.C.); Atlanta Center for Medical Research, Atlanta (R.R.); Spring Valley Pediatrics, Washington, DC (J.M.S.); Katedra Pediatrii, Instytut Nauk Medycznych, Kolegium Nauk Medycznych, Uniwersytet Rzeszowski, Rzeszow, Poland (H.C.); the Department of Pediatrics, University of Cincinnati College of Medicine, and the Division of Pediatric Infectious Diseases, Cincinnati Children's Hospital Medical Center, Cincinnati (G.C.P.); Duke Human Vaccine Institute, Durham, NC (E.B.W.); Johns Hopkins University, Baltimore (K.R.T.); Seattle Children's Hospital, Seattle (J.A.E.); Tampere University, Espoo Vaccine Research Clinic, Espoo, Finland (B.U.); Hospital Universitario HM Puerta del Sur, Madrid (S.N.M.); and BioNTech, Mainz, Germany (Ö.T., U.Ş.)
| | - Lawrence D Sher
- From Texas Children's Hospital, Baylor College of Medicine, Houston (F.M.M.), and the University of Texas Medical Branch, Galveston (J.Z., X. Xie, P.-Y.S.); Peninsula Research Associates, Rolling Hills Estates (L.D.S.), and Stanford University School of Medicine, Palo Alto (Y.M.) - both in California; Vaccine Research and Development, Pfizer, Pearl River (C.S., A.G., U.N.S., C.H., M.I., B.A.P., I.M., K.A.S., K.K., C.L., D.C., K.U.J., W.C.G.), and SUNY Upstate Medical University, Syracuse (J.B.D.) - both in New York; Vaccine Research and Development (X. Xu, H.M.), and Worldwide Safety, Safety Surveillance and Risk Management (S.M.), Pfizer, Collegeville, PA; Vaccine Research and Development, Pfizer, Hurley, United Kingdom (N.K., S.L., C.W., L.C.); Atlanta Center for Medical Research, Atlanta (R.R.); Spring Valley Pediatrics, Washington, DC (J.M.S.); Katedra Pediatrii, Instytut Nauk Medycznych, Kolegium Nauk Medycznych, Uniwersytet Rzeszowski, Rzeszow, Poland (H.C.); the Department of Pediatrics, University of Cincinnati College of Medicine, and the Division of Pediatric Infectious Diseases, Cincinnati Children's Hospital Medical Center, Cincinnati (G.C.P.); Duke Human Vaccine Institute, Durham, NC (E.B.W.); Johns Hopkins University, Baltimore (K.R.T.); Seattle Children's Hospital, Seattle (J.A.E.); Tampere University, Espoo Vaccine Research Clinic, Espoo, Finland (B.U.); Hospital Universitario HM Puerta del Sur, Madrid (S.N.M.); and BioNTech, Mainz, Germany (Ö.T., U.Ş.)
| | - Charu Sabharwal
- From Texas Children's Hospital, Baylor College of Medicine, Houston (F.M.M.), and the University of Texas Medical Branch, Galveston (J.Z., X. Xie, P.-Y.S.); Peninsula Research Associates, Rolling Hills Estates (L.D.S.), and Stanford University School of Medicine, Palo Alto (Y.M.) - both in California; Vaccine Research and Development, Pfizer, Pearl River (C.S., A.G., U.N.S., C.H., M.I., B.A.P., I.M., K.A.S., K.K., C.L., D.C., K.U.J., W.C.G.), and SUNY Upstate Medical University, Syracuse (J.B.D.) - both in New York; Vaccine Research and Development (X. Xu, H.M.), and Worldwide Safety, Safety Surveillance and Risk Management (S.M.), Pfizer, Collegeville, PA; Vaccine Research and Development, Pfizer, Hurley, United Kingdom (N.K., S.L., C.W., L.C.); Atlanta Center for Medical Research, Atlanta (R.R.); Spring Valley Pediatrics, Washington, DC (J.M.S.); Katedra Pediatrii, Instytut Nauk Medycznych, Kolegium Nauk Medycznych, Uniwersytet Rzeszowski, Rzeszow, Poland (H.C.); the Department of Pediatrics, University of Cincinnati College of Medicine, and the Division of Pediatric Infectious Diseases, Cincinnati Children's Hospital Medical Center, Cincinnati (G.C.P.); Duke Human Vaccine Institute, Durham, NC (E.B.W.); Johns Hopkins University, Baltimore (K.R.T.); Seattle Children's Hospital, Seattle (J.A.E.); Tampere University, Espoo Vaccine Research Clinic, Espoo, Finland (B.U.); Hospital Universitario HM Puerta del Sur, Madrid (S.N.M.); and BioNTech, Mainz, Germany (Ö.T., U.Ş.)
| | - Alejandra Gurtman
- From Texas Children's Hospital, Baylor College of Medicine, Houston (F.M.M.), and the University of Texas Medical Branch, Galveston (J.Z., X. Xie, P.-Y.S.); Peninsula Research Associates, Rolling Hills Estates (L.D.S.), and Stanford University School of Medicine, Palo Alto (Y.M.) - both in California; Vaccine Research and Development, Pfizer, Pearl River (C.S., A.G., U.N.S., C.H., M.I., B.A.P., I.M., K.A.S., K.K., C.L., D.C., K.U.J., W.C.G.), and SUNY Upstate Medical University, Syracuse (J.B.D.) - both in New York; Vaccine Research and Development (X. Xu, H.M.), and Worldwide Safety, Safety Surveillance and Risk Management (S.M.), Pfizer, Collegeville, PA; Vaccine Research and Development, Pfizer, Hurley, United Kingdom (N.K., S.L., C.W., L.C.); Atlanta Center for Medical Research, Atlanta (R.R.); Spring Valley Pediatrics, Washington, DC (J.M.S.); Katedra Pediatrii, Instytut Nauk Medycznych, Kolegium Nauk Medycznych, Uniwersytet Rzeszowski, Rzeszow, Poland (H.C.); the Department of Pediatrics, University of Cincinnati College of Medicine, and the Division of Pediatric Infectious Diseases, Cincinnati Children's Hospital Medical Center, Cincinnati (G.C.P.); Duke Human Vaccine Institute, Durham, NC (E.B.W.); Johns Hopkins University, Baltimore (K.R.T.); Seattle Children's Hospital, Seattle (J.A.E.); Tampere University, Espoo Vaccine Research Clinic, Espoo, Finland (B.U.); Hospital Universitario HM Puerta del Sur, Madrid (S.N.M.); and BioNTech, Mainz, Germany (Ö.T., U.Ş.)
| | - Xia Xu
- From Texas Children's Hospital, Baylor College of Medicine, Houston (F.M.M.), and the University of Texas Medical Branch, Galveston (J.Z., X. Xie, P.-Y.S.); Peninsula Research Associates, Rolling Hills Estates (L.D.S.), and Stanford University School of Medicine, Palo Alto (Y.M.) - both in California; Vaccine Research and Development, Pfizer, Pearl River (C.S., A.G., U.N.S., C.H., M.I., B.A.P., I.M., K.A.S., K.K., C.L., D.C., K.U.J., W.C.G.), and SUNY Upstate Medical University, Syracuse (J.B.D.) - both in New York; Vaccine Research and Development (X. Xu, H.M.), and Worldwide Safety, Safety Surveillance and Risk Management (S.M.), Pfizer, Collegeville, PA; Vaccine Research and Development, Pfizer, Hurley, United Kingdom (N.K., S.L., C.W., L.C.); Atlanta Center for Medical Research, Atlanta (R.R.); Spring Valley Pediatrics, Washington, DC (J.M.S.); Katedra Pediatrii, Instytut Nauk Medycznych, Kolegium Nauk Medycznych, Uniwersytet Rzeszowski, Rzeszow, Poland (H.C.); the Department of Pediatrics, University of Cincinnati College of Medicine, and the Division of Pediatric Infectious Diseases, Cincinnati Children's Hospital Medical Center, Cincinnati (G.C.P.); Duke Human Vaccine Institute, Durham, NC (E.B.W.); Johns Hopkins University, Baltimore (K.R.T.); Seattle Children's Hospital, Seattle (J.A.E.); Tampere University, Espoo Vaccine Research Clinic, Espoo, Finland (B.U.); Hospital Universitario HM Puerta del Sur, Madrid (S.N.M.); and BioNTech, Mainz, Germany (Ö.T., U.Ş.)
| | - Nicholas Kitchin
- From Texas Children's Hospital, Baylor College of Medicine, Houston (F.M.M.), and the University of Texas Medical Branch, Galveston (J.Z., X. Xie, P.-Y.S.); Peninsula Research Associates, Rolling Hills Estates (L.D.S.), and Stanford University School of Medicine, Palo Alto (Y.M.) - both in California; Vaccine Research and Development, Pfizer, Pearl River (C.S., A.G., U.N.S., C.H., M.I., B.A.P., I.M., K.A.S., K.K., C.L., D.C., K.U.J., W.C.G.), and SUNY Upstate Medical University, Syracuse (J.B.D.) - both in New York; Vaccine Research and Development (X. Xu, H.M.), and Worldwide Safety, Safety Surveillance and Risk Management (S.M.), Pfizer, Collegeville, PA; Vaccine Research and Development, Pfizer, Hurley, United Kingdom (N.K., S.L., C.W., L.C.); Atlanta Center for Medical Research, Atlanta (R.R.); Spring Valley Pediatrics, Washington, DC (J.M.S.); Katedra Pediatrii, Instytut Nauk Medycznych, Kolegium Nauk Medycznych, Uniwersytet Rzeszowski, Rzeszow, Poland (H.C.); the Department of Pediatrics, University of Cincinnati College of Medicine, and the Division of Pediatric Infectious Diseases, Cincinnati Children's Hospital Medical Center, Cincinnati (G.C.P.); Duke Human Vaccine Institute, Durham, NC (E.B.W.); Johns Hopkins University, Baltimore (K.R.T.); Seattle Children's Hospital, Seattle (J.A.E.); Tampere University, Espoo Vaccine Research Clinic, Espoo, Finland (B.U.); Hospital Universitario HM Puerta del Sur, Madrid (S.N.M.); and BioNTech, Mainz, Germany (Ö.T., U.Ş.)
| | - Stephen Lockhart
- From Texas Children's Hospital, Baylor College of Medicine, Houston (F.M.M.), and the University of Texas Medical Branch, Galveston (J.Z., X. Xie, P.-Y.S.); Peninsula Research Associates, Rolling Hills Estates (L.D.S.), and Stanford University School of Medicine, Palo Alto (Y.M.) - both in California; Vaccine Research and Development, Pfizer, Pearl River (C.S., A.G., U.N.S., C.H., M.I., B.A.P., I.M., K.A.S., K.K., C.L., D.C., K.U.J., W.C.G.), and SUNY Upstate Medical University, Syracuse (J.B.D.) - both in New York; Vaccine Research and Development (X. Xu, H.M.), and Worldwide Safety, Safety Surveillance and Risk Management (S.M.), Pfizer, Collegeville, PA; Vaccine Research and Development, Pfizer, Hurley, United Kingdom (N.K., S.L., C.W., L.C.); Atlanta Center for Medical Research, Atlanta (R.R.); Spring Valley Pediatrics, Washington, DC (J.M.S.); Katedra Pediatrii, Instytut Nauk Medycznych, Kolegium Nauk Medycznych, Uniwersytet Rzeszowski, Rzeszow, Poland (H.C.); the Department of Pediatrics, University of Cincinnati College of Medicine, and the Division of Pediatric Infectious Diseases, Cincinnati Children's Hospital Medical Center, Cincinnati (G.C.P.); Duke Human Vaccine Institute, Durham, NC (E.B.W.); Johns Hopkins University, Baltimore (K.R.T.); Seattle Children's Hospital, Seattle (J.A.E.); Tampere University, Espoo Vaccine Research Clinic, Espoo, Finland (B.U.); Hospital Universitario HM Puerta del Sur, Madrid (S.N.M.); and BioNTech, Mainz, Germany (Ö.T., U.Ş.)
| | - Robert Riesenberg
- From Texas Children's Hospital, Baylor College of Medicine, Houston (F.M.M.), and the University of Texas Medical Branch, Galveston (J.Z., X. Xie, P.-Y.S.); Peninsula Research Associates, Rolling Hills Estates (L.D.S.), and Stanford University School of Medicine, Palo Alto (Y.M.) - both in California; Vaccine Research and Development, Pfizer, Pearl River (C.S., A.G., U.N.S., C.H., M.I., B.A.P., I.M., K.A.S., K.K., C.L., D.C., K.U.J., W.C.G.), and SUNY Upstate Medical University, Syracuse (J.B.D.) - both in New York; Vaccine Research and Development (X. Xu, H.M.), and Worldwide Safety, Safety Surveillance and Risk Management (S.M.), Pfizer, Collegeville, PA; Vaccine Research and Development, Pfizer, Hurley, United Kingdom (N.K., S.L., C.W., L.C.); Atlanta Center for Medical Research, Atlanta (R.R.); Spring Valley Pediatrics, Washington, DC (J.M.S.); Katedra Pediatrii, Instytut Nauk Medycznych, Kolegium Nauk Medycznych, Uniwersytet Rzeszowski, Rzeszow, Poland (H.C.); the Department of Pediatrics, University of Cincinnati College of Medicine, and the Division of Pediatric Infectious Diseases, Cincinnati Children's Hospital Medical Center, Cincinnati (G.C.P.); Duke Human Vaccine Institute, Durham, NC (E.B.W.); Johns Hopkins University, Baltimore (K.R.T.); Seattle Children's Hospital, Seattle (J.A.E.); Tampere University, Espoo Vaccine Research Clinic, Espoo, Finland (B.U.); Hospital Universitario HM Puerta del Sur, Madrid (S.N.M.); and BioNTech, Mainz, Germany (Ö.T., U.Ş.)
| | - Joanna M Sexter
- From Texas Children's Hospital, Baylor College of Medicine, Houston (F.M.M.), and the University of Texas Medical Branch, Galveston (J.Z., X. Xie, P.-Y.S.); Peninsula Research Associates, Rolling Hills Estates (L.D.S.), and Stanford University School of Medicine, Palo Alto (Y.M.) - both in California; Vaccine Research and Development, Pfizer, Pearl River (C.S., A.G., U.N.S., C.H., M.I., B.A.P., I.M., K.A.S., K.K., C.L., D.C., K.U.J., W.C.G.), and SUNY Upstate Medical University, Syracuse (J.B.D.) - both in New York; Vaccine Research and Development (X. Xu, H.M.), and Worldwide Safety, Safety Surveillance and Risk Management (S.M.), Pfizer, Collegeville, PA; Vaccine Research and Development, Pfizer, Hurley, United Kingdom (N.K., S.L., C.W., L.C.); Atlanta Center for Medical Research, Atlanta (R.R.); Spring Valley Pediatrics, Washington, DC (J.M.S.); Katedra Pediatrii, Instytut Nauk Medycznych, Kolegium Nauk Medycznych, Uniwersytet Rzeszowski, Rzeszow, Poland (H.C.); the Department of Pediatrics, University of Cincinnati College of Medicine, and the Division of Pediatric Infectious Diseases, Cincinnati Children's Hospital Medical Center, Cincinnati (G.C.P.); Duke Human Vaccine Institute, Durham, NC (E.B.W.); Johns Hopkins University, Baltimore (K.R.T.); Seattle Children's Hospital, Seattle (J.A.E.); Tampere University, Espoo Vaccine Research Clinic, Espoo, Finland (B.U.); Hospital Universitario HM Puerta del Sur, Madrid (S.N.M.); and BioNTech, Mainz, Germany (Ö.T., U.Ş.)
| | - Hanna Czajka
- From Texas Children's Hospital, Baylor College of Medicine, Houston (F.M.M.), and the University of Texas Medical Branch, Galveston (J.Z., X. Xie, P.-Y.S.); Peninsula Research Associates, Rolling Hills Estates (L.D.S.), and Stanford University School of Medicine, Palo Alto (Y.M.) - both in California; Vaccine Research and Development, Pfizer, Pearl River (C.S., A.G., U.N.S., C.H., M.I., B.A.P., I.M., K.A.S., K.K., C.L., D.C., K.U.J., W.C.G.), and SUNY Upstate Medical University, Syracuse (J.B.D.) - both in New York; Vaccine Research and Development (X. Xu, H.M.), and Worldwide Safety, Safety Surveillance and Risk Management (S.M.), Pfizer, Collegeville, PA; Vaccine Research and Development, Pfizer, Hurley, United Kingdom (N.K., S.L., C.W., L.C.); Atlanta Center for Medical Research, Atlanta (R.R.); Spring Valley Pediatrics, Washington, DC (J.M.S.); Katedra Pediatrii, Instytut Nauk Medycznych, Kolegium Nauk Medycznych, Uniwersytet Rzeszowski, Rzeszow, Poland (H.C.); the Department of Pediatrics, University of Cincinnati College of Medicine, and the Division of Pediatric Infectious Diseases, Cincinnati Children's Hospital Medical Center, Cincinnati (G.C.P.); Duke Human Vaccine Institute, Durham, NC (E.B.W.); Johns Hopkins University, Baltimore (K.R.T.); Seattle Children's Hospital, Seattle (J.A.E.); Tampere University, Espoo Vaccine Research Clinic, Espoo, Finland (B.U.); Hospital Universitario HM Puerta del Sur, Madrid (S.N.M.); and BioNTech, Mainz, Germany (Ö.T., U.Ş.)
| | - Grant C Paulsen
- From Texas Children's Hospital, Baylor College of Medicine, Houston (F.M.M.), and the University of Texas Medical Branch, Galveston (J.Z., X. Xie, P.-Y.S.); Peninsula Research Associates, Rolling Hills Estates (L.D.S.), and Stanford University School of Medicine, Palo Alto (Y.M.) - both in California; Vaccine Research and Development, Pfizer, Pearl River (C.S., A.G., U.N.S., C.H., M.I., B.A.P., I.M., K.A.S., K.K., C.L., D.C., K.U.J., W.C.G.), and SUNY Upstate Medical University, Syracuse (J.B.D.) - both in New York; Vaccine Research and Development (X. Xu, H.M.), and Worldwide Safety, Safety Surveillance and Risk Management (S.M.), Pfizer, Collegeville, PA; Vaccine Research and Development, Pfizer, Hurley, United Kingdom (N.K., S.L., C.W., L.C.); Atlanta Center for Medical Research, Atlanta (R.R.); Spring Valley Pediatrics, Washington, DC (J.M.S.); Katedra Pediatrii, Instytut Nauk Medycznych, Kolegium Nauk Medycznych, Uniwersytet Rzeszowski, Rzeszow, Poland (H.C.); the Department of Pediatrics, University of Cincinnati College of Medicine, and the Division of Pediatric Infectious Diseases, Cincinnati Children's Hospital Medical Center, Cincinnati (G.C.P.); Duke Human Vaccine Institute, Durham, NC (E.B.W.); Johns Hopkins University, Baltimore (K.R.T.); Seattle Children's Hospital, Seattle (J.A.E.); Tampere University, Espoo Vaccine Research Clinic, Espoo, Finland (B.U.); Hospital Universitario HM Puerta del Sur, Madrid (S.N.M.); and BioNTech, Mainz, Germany (Ö.T., U.Ş.)
| | - Yvonne Maldonado
- From Texas Children's Hospital, Baylor College of Medicine, Houston (F.M.M.), and the University of Texas Medical Branch, Galveston (J.Z., X. Xie, P.-Y.S.); Peninsula Research Associates, Rolling Hills Estates (L.D.S.), and Stanford University School of Medicine, Palo Alto (Y.M.) - both in California; Vaccine Research and Development, Pfizer, Pearl River (C.S., A.G., U.N.S., C.H., M.I., B.A.P., I.M., K.A.S., K.K., C.L., D.C., K.U.J., W.C.G.), and SUNY Upstate Medical University, Syracuse (J.B.D.) - both in New York; Vaccine Research and Development (X. Xu, H.M.), and Worldwide Safety, Safety Surveillance and Risk Management (S.M.), Pfizer, Collegeville, PA; Vaccine Research and Development, Pfizer, Hurley, United Kingdom (N.K., S.L., C.W., L.C.); Atlanta Center for Medical Research, Atlanta (R.R.); Spring Valley Pediatrics, Washington, DC (J.M.S.); Katedra Pediatrii, Instytut Nauk Medycznych, Kolegium Nauk Medycznych, Uniwersytet Rzeszowski, Rzeszow, Poland (H.C.); the Department of Pediatrics, University of Cincinnati College of Medicine, and the Division of Pediatric Infectious Diseases, Cincinnati Children's Hospital Medical Center, Cincinnati (G.C.P.); Duke Human Vaccine Institute, Durham, NC (E.B.W.); Johns Hopkins University, Baltimore (K.R.T.); Seattle Children's Hospital, Seattle (J.A.E.); Tampere University, Espoo Vaccine Research Clinic, Espoo, Finland (B.U.); Hospital Universitario HM Puerta del Sur, Madrid (S.N.M.); and BioNTech, Mainz, Germany (Ö.T., U.Ş.)
| | - Emmanuel B Walter
- From Texas Children's Hospital, Baylor College of Medicine, Houston (F.M.M.), and the University of Texas Medical Branch, Galveston (J.Z., X. Xie, P.-Y.S.); Peninsula Research Associates, Rolling Hills Estates (L.D.S.), and Stanford University School of Medicine, Palo Alto (Y.M.) - both in California; Vaccine Research and Development, Pfizer, Pearl River (C.S., A.G., U.N.S., C.H., M.I., B.A.P., I.M., K.A.S., K.K., C.L., D.C., K.U.J., W.C.G.), and SUNY Upstate Medical University, Syracuse (J.B.D.) - both in New York; Vaccine Research and Development (X. Xu, H.M.), and Worldwide Safety, Safety Surveillance and Risk Management (S.M.), Pfizer, Collegeville, PA; Vaccine Research and Development, Pfizer, Hurley, United Kingdom (N.K., S.L., C.W., L.C.); Atlanta Center for Medical Research, Atlanta (R.R.); Spring Valley Pediatrics, Washington, DC (J.M.S.); Katedra Pediatrii, Instytut Nauk Medycznych, Kolegium Nauk Medycznych, Uniwersytet Rzeszowski, Rzeszow, Poland (H.C.); the Department of Pediatrics, University of Cincinnati College of Medicine, and the Division of Pediatric Infectious Diseases, Cincinnati Children's Hospital Medical Center, Cincinnati (G.C.P.); Duke Human Vaccine Institute, Durham, NC (E.B.W.); Johns Hopkins University, Baltimore (K.R.T.); Seattle Children's Hospital, Seattle (J.A.E.); Tampere University, Espoo Vaccine Research Clinic, Espoo, Finland (B.U.); Hospital Universitario HM Puerta del Sur, Madrid (S.N.M.); and BioNTech, Mainz, Germany (Ö.T., U.Ş.)
| | - Kawsar R Talaat
- From Texas Children's Hospital, Baylor College of Medicine, Houston (F.M.M.), and the University of Texas Medical Branch, Galveston (J.Z., X. Xie, P.-Y.S.); Peninsula Research Associates, Rolling Hills Estates (L.D.S.), and Stanford University School of Medicine, Palo Alto (Y.M.) - both in California; Vaccine Research and Development, Pfizer, Pearl River (C.S., A.G., U.N.S., C.H., M.I., B.A.P., I.M., K.A.S., K.K., C.L., D.C., K.U.J., W.C.G.), and SUNY Upstate Medical University, Syracuse (J.B.D.) - both in New York; Vaccine Research and Development (X. Xu, H.M.), and Worldwide Safety, Safety Surveillance and Risk Management (S.M.), Pfizer, Collegeville, PA; Vaccine Research and Development, Pfizer, Hurley, United Kingdom (N.K., S.L., C.W., L.C.); Atlanta Center for Medical Research, Atlanta (R.R.); Spring Valley Pediatrics, Washington, DC (J.M.S.); Katedra Pediatrii, Instytut Nauk Medycznych, Kolegium Nauk Medycznych, Uniwersytet Rzeszowski, Rzeszow, Poland (H.C.); the Department of Pediatrics, University of Cincinnati College of Medicine, and the Division of Pediatric Infectious Diseases, Cincinnati Children's Hospital Medical Center, Cincinnati (G.C.P.); Duke Human Vaccine Institute, Durham, NC (E.B.W.); Johns Hopkins University, Baltimore (K.R.T.); Seattle Children's Hospital, Seattle (J.A.E.); Tampere University, Espoo Vaccine Research Clinic, Espoo, Finland (B.U.); Hospital Universitario HM Puerta del Sur, Madrid (S.N.M.); and BioNTech, Mainz, Germany (Ö.T., U.Ş.)
| | - Janet A Englund
- From Texas Children's Hospital, Baylor College of Medicine, Houston (F.M.M.), and the University of Texas Medical Branch, Galveston (J.Z., X. Xie, P.-Y.S.); Peninsula Research Associates, Rolling Hills Estates (L.D.S.), and Stanford University School of Medicine, Palo Alto (Y.M.) - both in California; Vaccine Research and Development, Pfizer, Pearl River (C.S., A.G., U.N.S., C.H., M.I., B.A.P., I.M., K.A.S., K.K., C.L., D.C., K.U.J., W.C.G.), and SUNY Upstate Medical University, Syracuse (J.B.D.) - both in New York; Vaccine Research and Development (X. Xu, H.M.), and Worldwide Safety, Safety Surveillance and Risk Management (S.M.), Pfizer, Collegeville, PA; Vaccine Research and Development, Pfizer, Hurley, United Kingdom (N.K., S.L., C.W., L.C.); Atlanta Center for Medical Research, Atlanta (R.R.); Spring Valley Pediatrics, Washington, DC (J.M.S.); Katedra Pediatrii, Instytut Nauk Medycznych, Kolegium Nauk Medycznych, Uniwersytet Rzeszowski, Rzeszow, Poland (H.C.); the Department of Pediatrics, University of Cincinnati College of Medicine, and the Division of Pediatric Infectious Diseases, Cincinnati Children's Hospital Medical Center, Cincinnati (G.C.P.); Duke Human Vaccine Institute, Durham, NC (E.B.W.); Johns Hopkins University, Baltimore (K.R.T.); Seattle Children's Hospital, Seattle (J.A.E.); Tampere University, Espoo Vaccine Research Clinic, Espoo, Finland (B.U.); Hospital Universitario HM Puerta del Sur, Madrid (S.N.M.); and BioNTech, Mainz, Germany (Ö.T., U.Ş.)
| | - Uzma N Sarwar
- From Texas Children's Hospital, Baylor College of Medicine, Houston (F.M.M.), and the University of Texas Medical Branch, Galveston (J.Z., X. Xie, P.-Y.S.); Peninsula Research Associates, Rolling Hills Estates (L.D.S.), and Stanford University School of Medicine, Palo Alto (Y.M.) - both in California; Vaccine Research and Development, Pfizer, Pearl River (C.S., A.G., U.N.S., C.H., M.I., B.A.P., I.M., K.A.S., K.K., C.L., D.C., K.U.J., W.C.G.), and SUNY Upstate Medical University, Syracuse (J.B.D.) - both in New York; Vaccine Research and Development (X. Xu, H.M.), and Worldwide Safety, Safety Surveillance and Risk Management (S.M.), Pfizer, Collegeville, PA; Vaccine Research and Development, Pfizer, Hurley, United Kingdom (N.K., S.L., C.W., L.C.); Atlanta Center for Medical Research, Atlanta (R.R.); Spring Valley Pediatrics, Washington, DC (J.M.S.); Katedra Pediatrii, Instytut Nauk Medycznych, Kolegium Nauk Medycznych, Uniwersytet Rzeszowski, Rzeszow, Poland (H.C.); the Department of Pediatrics, University of Cincinnati College of Medicine, and the Division of Pediatric Infectious Diseases, Cincinnati Children's Hospital Medical Center, Cincinnati (G.C.P.); Duke Human Vaccine Institute, Durham, NC (E.B.W.); Johns Hopkins University, Baltimore (K.R.T.); Seattle Children's Hospital, Seattle (J.A.E.); Tampere University, Espoo Vaccine Research Clinic, Espoo, Finland (B.U.); Hospital Universitario HM Puerta del Sur, Madrid (S.N.M.); and BioNTech, Mainz, Germany (Ö.T., U.Ş.)
| | - Caitlin Hansen
- From Texas Children's Hospital, Baylor College of Medicine, Houston (F.M.M.), and the University of Texas Medical Branch, Galveston (J.Z., X. Xie, P.-Y.S.); Peninsula Research Associates, Rolling Hills Estates (L.D.S.), and Stanford University School of Medicine, Palo Alto (Y.M.) - both in California; Vaccine Research and Development, Pfizer, Pearl River (C.S., A.G., U.N.S., C.H., M.I., B.A.P., I.M., K.A.S., K.K., C.L., D.C., K.U.J., W.C.G.), and SUNY Upstate Medical University, Syracuse (J.B.D.) - both in New York; Vaccine Research and Development (X. Xu, H.M.), and Worldwide Safety, Safety Surveillance and Risk Management (S.M.), Pfizer, Collegeville, PA; Vaccine Research and Development, Pfizer, Hurley, United Kingdom (N.K., S.L., C.W., L.C.); Atlanta Center for Medical Research, Atlanta (R.R.); Spring Valley Pediatrics, Washington, DC (J.M.S.); Katedra Pediatrii, Instytut Nauk Medycznych, Kolegium Nauk Medycznych, Uniwersytet Rzeszowski, Rzeszow, Poland (H.C.); the Department of Pediatrics, University of Cincinnati College of Medicine, and the Division of Pediatric Infectious Diseases, Cincinnati Children's Hospital Medical Center, Cincinnati (G.C.P.); Duke Human Vaccine Institute, Durham, NC (E.B.W.); Johns Hopkins University, Baltimore (K.R.T.); Seattle Children's Hospital, Seattle (J.A.E.); Tampere University, Espoo Vaccine Research Clinic, Espoo, Finland (B.U.); Hospital Universitario HM Puerta del Sur, Madrid (S.N.M.); and BioNTech, Mainz, Germany (Ö.T., U.Ş.)
| | - Martha Iwamoto
- From Texas Children's Hospital, Baylor College of Medicine, Houston (F.M.M.), and the University of Texas Medical Branch, Galveston (J.Z., X. Xie, P.-Y.S.); Peninsula Research Associates, Rolling Hills Estates (L.D.S.), and Stanford University School of Medicine, Palo Alto (Y.M.) - both in California; Vaccine Research and Development, Pfizer, Pearl River (C.S., A.G., U.N.S., C.H., M.I., B.A.P., I.M., K.A.S., K.K., C.L., D.C., K.U.J., W.C.G.), and SUNY Upstate Medical University, Syracuse (J.B.D.) - both in New York; Vaccine Research and Development (X. Xu, H.M.), and Worldwide Safety, Safety Surveillance and Risk Management (S.M.), Pfizer, Collegeville, PA; Vaccine Research and Development, Pfizer, Hurley, United Kingdom (N.K., S.L., C.W., L.C.); Atlanta Center for Medical Research, Atlanta (R.R.); Spring Valley Pediatrics, Washington, DC (J.M.S.); Katedra Pediatrii, Instytut Nauk Medycznych, Kolegium Nauk Medycznych, Uniwersytet Rzeszowski, Rzeszow, Poland (H.C.); the Department of Pediatrics, University of Cincinnati College of Medicine, and the Division of Pediatric Infectious Diseases, Cincinnati Children's Hospital Medical Center, Cincinnati (G.C.P.); Duke Human Vaccine Institute, Durham, NC (E.B.W.); Johns Hopkins University, Baltimore (K.R.T.); Seattle Children's Hospital, Seattle (J.A.E.); Tampere University, Espoo Vaccine Research Clinic, Espoo, Finland (B.U.); Hospital Universitario HM Puerta del Sur, Madrid (S.N.M.); and BioNTech, Mainz, Germany (Ö.T., U.Ş.)
| | - Chris Webber
- From Texas Children's Hospital, Baylor College of Medicine, Houston (F.M.M.), and the University of Texas Medical Branch, Galveston (J.Z., X. Xie, P.-Y.S.); Peninsula Research Associates, Rolling Hills Estates (L.D.S.), and Stanford University School of Medicine, Palo Alto (Y.M.) - both in California; Vaccine Research and Development, Pfizer, Pearl River (C.S., A.G., U.N.S., C.H., M.I., B.A.P., I.M., K.A.S., K.K., C.L., D.C., K.U.J., W.C.G.), and SUNY Upstate Medical University, Syracuse (J.B.D.) - both in New York; Vaccine Research and Development (X. Xu, H.M.), and Worldwide Safety, Safety Surveillance and Risk Management (S.M.), Pfizer, Collegeville, PA; Vaccine Research and Development, Pfizer, Hurley, United Kingdom (N.K., S.L., C.W., L.C.); Atlanta Center for Medical Research, Atlanta (R.R.); Spring Valley Pediatrics, Washington, DC (J.M.S.); Katedra Pediatrii, Instytut Nauk Medycznych, Kolegium Nauk Medycznych, Uniwersytet Rzeszowski, Rzeszow, Poland (H.C.); the Department of Pediatrics, University of Cincinnati College of Medicine, and the Division of Pediatric Infectious Diseases, Cincinnati Children's Hospital Medical Center, Cincinnati (G.C.P.); Duke Human Vaccine Institute, Durham, NC (E.B.W.); Johns Hopkins University, Baltimore (K.R.T.); Seattle Children's Hospital, Seattle (J.A.E.); Tampere University, Espoo Vaccine Research Clinic, Espoo, Finland (B.U.); Hospital Universitario HM Puerta del Sur, Madrid (S.N.M.); and BioNTech, Mainz, Germany (Ö.T., U.Ş.)
| | - Luke Cunliffe
- From Texas Children's Hospital, Baylor College of Medicine, Houston (F.M.M.), and the University of Texas Medical Branch, Galveston (J.Z., X. Xie, P.-Y.S.); Peninsula Research Associates, Rolling Hills Estates (L.D.S.), and Stanford University School of Medicine, Palo Alto (Y.M.) - both in California; Vaccine Research and Development, Pfizer, Pearl River (C.S., A.G., U.N.S., C.H., M.I., B.A.P., I.M., K.A.S., K.K., C.L., D.C., K.U.J., W.C.G.), and SUNY Upstate Medical University, Syracuse (J.B.D.) - both in New York; Vaccine Research and Development (X. Xu, H.M.), and Worldwide Safety, Safety Surveillance and Risk Management (S.M.), Pfizer, Collegeville, PA; Vaccine Research and Development, Pfizer, Hurley, United Kingdom (N.K., S.L., C.W., L.C.); Atlanta Center for Medical Research, Atlanta (R.R.); Spring Valley Pediatrics, Washington, DC (J.M.S.); Katedra Pediatrii, Instytut Nauk Medycznych, Kolegium Nauk Medycznych, Uniwersytet Rzeszowski, Rzeszow, Poland (H.C.); the Department of Pediatrics, University of Cincinnati College of Medicine, and the Division of Pediatric Infectious Diseases, Cincinnati Children's Hospital Medical Center, Cincinnati (G.C.P.); Duke Human Vaccine Institute, Durham, NC (E.B.W.); Johns Hopkins University, Baltimore (K.R.T.); Seattle Children's Hospital, Seattle (J.A.E.); Tampere University, Espoo Vaccine Research Clinic, Espoo, Finland (B.U.); Hospital Universitario HM Puerta del Sur, Madrid (S.N.M.); and BioNTech, Mainz, Germany (Ö.T., U.Ş.)
| | - Benita Ukkonen
- From Texas Children's Hospital, Baylor College of Medicine, Houston (F.M.M.), and the University of Texas Medical Branch, Galveston (J.Z., X. Xie, P.-Y.S.); Peninsula Research Associates, Rolling Hills Estates (L.D.S.), and Stanford University School of Medicine, Palo Alto (Y.M.) - both in California; Vaccine Research and Development, Pfizer, Pearl River (C.S., A.G., U.N.S., C.H., M.I., B.A.P., I.M., K.A.S., K.K., C.L., D.C., K.U.J., W.C.G.), and SUNY Upstate Medical University, Syracuse (J.B.D.) - both in New York; Vaccine Research and Development (X. Xu, H.M.), and Worldwide Safety, Safety Surveillance and Risk Management (S.M.), Pfizer, Collegeville, PA; Vaccine Research and Development, Pfizer, Hurley, United Kingdom (N.K., S.L., C.W., L.C.); Atlanta Center for Medical Research, Atlanta (R.R.); Spring Valley Pediatrics, Washington, DC (J.M.S.); Katedra Pediatrii, Instytut Nauk Medycznych, Kolegium Nauk Medycznych, Uniwersytet Rzeszowski, Rzeszow, Poland (H.C.); the Department of Pediatrics, University of Cincinnati College of Medicine, and the Division of Pediatric Infectious Diseases, Cincinnati Children's Hospital Medical Center, Cincinnati (G.C.P.); Duke Human Vaccine Institute, Durham, NC (E.B.W.); Johns Hopkins University, Baltimore (K.R.T.); Seattle Children's Hospital, Seattle (J.A.E.); Tampere University, Espoo Vaccine Research Clinic, Espoo, Finland (B.U.); Hospital Universitario HM Puerta del Sur, Madrid (S.N.M.); and BioNTech, Mainz, Germany (Ö.T., U.Ş.)
| | - Silvina N Martínez
- From Texas Children's Hospital, Baylor College of Medicine, Houston (F.M.M.), and the University of Texas Medical Branch, Galveston (J.Z., X. Xie, P.-Y.S.); Peninsula Research Associates, Rolling Hills Estates (L.D.S.), and Stanford University School of Medicine, Palo Alto (Y.M.) - both in California; Vaccine Research and Development, Pfizer, Pearl River (C.S., A.G., U.N.S., C.H., M.I., B.A.P., I.M., K.A.S., K.K., C.L., D.C., K.U.J., W.C.G.), and SUNY Upstate Medical University, Syracuse (J.B.D.) - both in New York; Vaccine Research and Development (X. Xu, H.M.), and Worldwide Safety, Safety Surveillance and Risk Management (S.M.), Pfizer, Collegeville, PA; Vaccine Research and Development, Pfizer, Hurley, United Kingdom (N.K., S.L., C.W., L.C.); Atlanta Center for Medical Research, Atlanta (R.R.); Spring Valley Pediatrics, Washington, DC (J.M.S.); Katedra Pediatrii, Instytut Nauk Medycznych, Kolegium Nauk Medycznych, Uniwersytet Rzeszowski, Rzeszow, Poland (H.C.); the Department of Pediatrics, University of Cincinnati College of Medicine, and the Division of Pediatric Infectious Diseases, Cincinnati Children's Hospital Medical Center, Cincinnati (G.C.P.); Duke Human Vaccine Institute, Durham, NC (E.B.W.); Johns Hopkins University, Baltimore (K.R.T.); Seattle Children's Hospital, Seattle (J.A.E.); Tampere University, Espoo Vaccine Research Clinic, Espoo, Finland (B.U.); Hospital Universitario HM Puerta del Sur, Madrid (S.N.M.); and BioNTech, Mainz, Germany (Ö.T., U.Ş.)
| | - Barbara A Pahud
- From Texas Children's Hospital, Baylor College of Medicine, Houston (F.M.M.), and the University of Texas Medical Branch, Galveston (J.Z., X. Xie, P.-Y.S.); Peninsula Research Associates, Rolling Hills Estates (L.D.S.), and Stanford University School of Medicine, Palo Alto (Y.M.) - both in California; Vaccine Research and Development, Pfizer, Pearl River (C.S., A.G., U.N.S., C.H., M.I., B.A.P., I.M., K.A.S., K.K., C.L., D.C., K.U.J., W.C.G.), and SUNY Upstate Medical University, Syracuse (J.B.D.) - both in New York; Vaccine Research and Development (X. Xu, H.M.), and Worldwide Safety, Safety Surveillance and Risk Management (S.M.), Pfizer, Collegeville, PA; Vaccine Research and Development, Pfizer, Hurley, United Kingdom (N.K., S.L., C.W., L.C.); Atlanta Center for Medical Research, Atlanta (R.R.); Spring Valley Pediatrics, Washington, DC (J.M.S.); Katedra Pediatrii, Instytut Nauk Medycznych, Kolegium Nauk Medycznych, Uniwersytet Rzeszowski, Rzeszow, Poland (H.C.); the Department of Pediatrics, University of Cincinnati College of Medicine, and the Division of Pediatric Infectious Diseases, Cincinnati Children's Hospital Medical Center, Cincinnati (G.C.P.); Duke Human Vaccine Institute, Durham, NC (E.B.W.); Johns Hopkins University, Baltimore (K.R.T.); Seattle Children's Hospital, Seattle (J.A.E.); Tampere University, Espoo Vaccine Research Clinic, Espoo, Finland (B.U.); Hospital Universitario HM Puerta del Sur, Madrid (S.N.M.); and BioNTech, Mainz, Germany (Ö.T., U.Ş.)
| | - Iona Munjal
- From Texas Children's Hospital, Baylor College of Medicine, Houston (F.M.M.), and the University of Texas Medical Branch, Galveston (J.Z., X. Xie, P.-Y.S.); Peninsula Research Associates, Rolling Hills Estates (L.D.S.), and Stanford University School of Medicine, Palo Alto (Y.M.) - both in California; Vaccine Research and Development, Pfizer, Pearl River (C.S., A.G., U.N.S., C.H., M.I., B.A.P., I.M., K.A.S., K.K., C.L., D.C., K.U.J., W.C.G.), and SUNY Upstate Medical University, Syracuse (J.B.D.) - both in New York; Vaccine Research and Development (X. Xu, H.M.), and Worldwide Safety, Safety Surveillance and Risk Management (S.M.), Pfizer, Collegeville, PA; Vaccine Research and Development, Pfizer, Hurley, United Kingdom (N.K., S.L., C.W., L.C.); Atlanta Center for Medical Research, Atlanta (R.R.); Spring Valley Pediatrics, Washington, DC (J.M.S.); Katedra Pediatrii, Instytut Nauk Medycznych, Kolegium Nauk Medycznych, Uniwersytet Rzeszowski, Rzeszow, Poland (H.C.); the Department of Pediatrics, University of Cincinnati College of Medicine, and the Division of Pediatric Infectious Diseases, Cincinnati Children's Hospital Medical Center, Cincinnati (G.C.P.); Duke Human Vaccine Institute, Durham, NC (E.B.W.); Johns Hopkins University, Baltimore (K.R.T.); Seattle Children's Hospital, Seattle (J.A.E.); Tampere University, Espoo Vaccine Research Clinic, Espoo, Finland (B.U.); Hospital Universitario HM Puerta del Sur, Madrid (S.N.M.); and BioNTech, Mainz, Germany (Ö.T., U.Ş.)
| | - Joseph B Domachowske
- From Texas Children's Hospital, Baylor College of Medicine, Houston (F.M.M.), and the University of Texas Medical Branch, Galveston (J.Z., X. Xie, P.-Y.S.); Peninsula Research Associates, Rolling Hills Estates (L.D.S.), and Stanford University School of Medicine, Palo Alto (Y.M.) - both in California; Vaccine Research and Development, Pfizer, Pearl River (C.S., A.G., U.N.S., C.H., M.I., B.A.P., I.M., K.A.S., K.K., C.L., D.C., K.U.J., W.C.G.), and SUNY Upstate Medical University, Syracuse (J.B.D.) - both in New York; Vaccine Research and Development (X. Xu, H.M.), and Worldwide Safety, Safety Surveillance and Risk Management (S.M.), Pfizer, Collegeville, PA; Vaccine Research and Development, Pfizer, Hurley, United Kingdom (N.K., S.L., C.W., L.C.); Atlanta Center for Medical Research, Atlanta (R.R.); Spring Valley Pediatrics, Washington, DC (J.M.S.); Katedra Pediatrii, Instytut Nauk Medycznych, Kolegium Nauk Medycznych, Uniwersytet Rzeszowski, Rzeszow, Poland (H.C.); the Department of Pediatrics, University of Cincinnati College of Medicine, and the Division of Pediatric Infectious Diseases, Cincinnati Children's Hospital Medical Center, Cincinnati (G.C.P.); Duke Human Vaccine Institute, Durham, NC (E.B.W.); Johns Hopkins University, Baltimore (K.R.T.); Seattle Children's Hospital, Seattle (J.A.E.); Tampere University, Espoo Vaccine Research Clinic, Espoo, Finland (B.U.); Hospital Universitario HM Puerta del Sur, Madrid (S.N.M.); and BioNTech, Mainz, Germany (Ö.T., U.Ş.)
| | - Kena A Swanson
- From Texas Children's Hospital, Baylor College of Medicine, Houston (F.M.M.), and the University of Texas Medical Branch, Galveston (J.Z., X. Xie, P.-Y.S.); Peninsula Research Associates, Rolling Hills Estates (L.D.S.), and Stanford University School of Medicine, Palo Alto (Y.M.) - both in California; Vaccine Research and Development, Pfizer, Pearl River (C.S., A.G., U.N.S., C.H., M.I., B.A.P., I.M., K.A.S., K.K., C.L., D.C., K.U.J., W.C.G.), and SUNY Upstate Medical University, Syracuse (J.B.D.) - both in New York; Vaccine Research and Development (X. Xu, H.M.), and Worldwide Safety, Safety Surveillance and Risk Management (S.M.), Pfizer, Collegeville, PA; Vaccine Research and Development, Pfizer, Hurley, United Kingdom (N.K., S.L., C.W., L.C.); Atlanta Center for Medical Research, Atlanta (R.R.); Spring Valley Pediatrics, Washington, DC (J.M.S.); Katedra Pediatrii, Instytut Nauk Medycznych, Kolegium Nauk Medycznych, Uniwersytet Rzeszowski, Rzeszow, Poland (H.C.); the Department of Pediatrics, University of Cincinnati College of Medicine, and the Division of Pediatric Infectious Diseases, Cincinnati Children's Hospital Medical Center, Cincinnati (G.C.P.); Duke Human Vaccine Institute, Durham, NC (E.B.W.); Johns Hopkins University, Baltimore (K.R.T.); Seattle Children's Hospital, Seattle (J.A.E.); Tampere University, Espoo Vaccine Research Clinic, Espoo, Finland (B.U.); Hospital Universitario HM Puerta del Sur, Madrid (S.N.M.); and BioNTech, Mainz, Germany (Ö.T., U.Ş.)
| | - Hua Ma
- From Texas Children's Hospital, Baylor College of Medicine, Houston (F.M.M.), and the University of Texas Medical Branch, Galveston (J.Z., X. Xie, P.-Y.S.); Peninsula Research Associates, Rolling Hills Estates (L.D.S.), and Stanford University School of Medicine, Palo Alto (Y.M.) - both in California; Vaccine Research and Development, Pfizer, Pearl River (C.S., A.G., U.N.S., C.H., M.I., B.A.P., I.M., K.A.S., K.K., C.L., D.C., K.U.J., W.C.G.), and SUNY Upstate Medical University, Syracuse (J.B.D.) - both in New York; Vaccine Research and Development (X. Xu, H.M.), and Worldwide Safety, Safety Surveillance and Risk Management (S.M.), Pfizer, Collegeville, PA; Vaccine Research and Development, Pfizer, Hurley, United Kingdom (N.K., S.L., C.W., L.C.); Atlanta Center for Medical Research, Atlanta (R.R.); Spring Valley Pediatrics, Washington, DC (J.M.S.); Katedra Pediatrii, Instytut Nauk Medycznych, Kolegium Nauk Medycznych, Uniwersytet Rzeszowski, Rzeszow, Poland (H.C.); the Department of Pediatrics, University of Cincinnati College of Medicine, and the Division of Pediatric Infectious Diseases, Cincinnati Children's Hospital Medical Center, Cincinnati (G.C.P.); Duke Human Vaccine Institute, Durham, NC (E.B.W.); Johns Hopkins University, Baltimore (K.R.T.); Seattle Children's Hospital, Seattle (J.A.E.); Tampere University, Espoo Vaccine Research Clinic, Espoo, Finland (B.U.); Hospital Universitario HM Puerta del Sur, Madrid (S.N.M.); and BioNTech, Mainz, Germany (Ö.T., U.Ş.)
| | - Kenneth Koury
- From Texas Children's Hospital, Baylor College of Medicine, Houston (F.M.M.), and the University of Texas Medical Branch, Galveston (J.Z., X. Xie, P.-Y.S.); Peninsula Research Associates, Rolling Hills Estates (L.D.S.), and Stanford University School of Medicine, Palo Alto (Y.M.) - both in California; Vaccine Research and Development, Pfizer, Pearl River (C.S., A.G., U.N.S., C.H., M.I., B.A.P., I.M., K.A.S., K.K., C.L., D.C., K.U.J., W.C.G.), and SUNY Upstate Medical University, Syracuse (J.B.D.) - both in New York; Vaccine Research and Development (X. Xu, H.M.), and Worldwide Safety, Safety Surveillance and Risk Management (S.M.), Pfizer, Collegeville, PA; Vaccine Research and Development, Pfizer, Hurley, United Kingdom (N.K., S.L., C.W., L.C.); Atlanta Center for Medical Research, Atlanta (R.R.); Spring Valley Pediatrics, Washington, DC (J.M.S.); Katedra Pediatrii, Instytut Nauk Medycznych, Kolegium Nauk Medycznych, Uniwersytet Rzeszowski, Rzeszow, Poland (H.C.); the Department of Pediatrics, University of Cincinnati College of Medicine, and the Division of Pediatric Infectious Diseases, Cincinnati Children's Hospital Medical Center, Cincinnati (G.C.P.); Duke Human Vaccine Institute, Durham, NC (E.B.W.); Johns Hopkins University, Baltimore (K.R.T.); Seattle Children's Hospital, Seattle (J.A.E.); Tampere University, Espoo Vaccine Research Clinic, Espoo, Finland (B.U.); Hospital Universitario HM Puerta del Sur, Madrid (S.N.M.); and BioNTech, Mainz, Germany (Ö.T., U.Ş.)
| | - Susan Mather
- From Texas Children's Hospital, Baylor College of Medicine, Houston (F.M.M.), and the University of Texas Medical Branch, Galveston (J.Z., X. Xie, P.-Y.S.); Peninsula Research Associates, Rolling Hills Estates (L.D.S.), and Stanford University School of Medicine, Palo Alto (Y.M.) - both in California; Vaccine Research and Development, Pfizer, Pearl River (C.S., A.G., U.N.S., C.H., M.I., B.A.P., I.M., K.A.S., K.K., C.L., D.C., K.U.J., W.C.G.), and SUNY Upstate Medical University, Syracuse (J.B.D.) - both in New York; Vaccine Research and Development (X. Xu, H.M.), and Worldwide Safety, Safety Surveillance and Risk Management (S.M.), Pfizer, Collegeville, PA; Vaccine Research and Development, Pfizer, Hurley, United Kingdom (N.K., S.L., C.W., L.C.); Atlanta Center for Medical Research, Atlanta (R.R.); Spring Valley Pediatrics, Washington, DC (J.M.S.); Katedra Pediatrii, Instytut Nauk Medycznych, Kolegium Nauk Medycznych, Uniwersytet Rzeszowski, Rzeszow, Poland (H.C.); the Department of Pediatrics, University of Cincinnati College of Medicine, and the Division of Pediatric Infectious Diseases, Cincinnati Children's Hospital Medical Center, Cincinnati (G.C.P.); Duke Human Vaccine Institute, Durham, NC (E.B.W.); Johns Hopkins University, Baltimore (K.R.T.); Seattle Children's Hospital, Seattle (J.A.E.); Tampere University, Espoo Vaccine Research Clinic, Espoo, Finland (B.U.); Hospital Universitario HM Puerta del Sur, Madrid (S.N.M.); and BioNTech, Mainz, Germany (Ö.T., U.Ş.)
| | - Claire Lu
- From Texas Children's Hospital, Baylor College of Medicine, Houston (F.M.M.), and the University of Texas Medical Branch, Galveston (J.Z., X. Xie, P.-Y.S.); Peninsula Research Associates, Rolling Hills Estates (L.D.S.), and Stanford University School of Medicine, Palo Alto (Y.M.) - both in California; Vaccine Research and Development, Pfizer, Pearl River (C.S., A.G., U.N.S., C.H., M.I., B.A.P., I.M., K.A.S., K.K., C.L., D.C., K.U.J., W.C.G.), and SUNY Upstate Medical University, Syracuse (J.B.D.) - both in New York; Vaccine Research and Development (X. Xu, H.M.), and Worldwide Safety, Safety Surveillance and Risk Management (S.M.), Pfizer, Collegeville, PA; Vaccine Research and Development, Pfizer, Hurley, United Kingdom (N.K., S.L., C.W., L.C.); Atlanta Center for Medical Research, Atlanta (R.R.); Spring Valley Pediatrics, Washington, DC (J.M.S.); Katedra Pediatrii, Instytut Nauk Medycznych, Kolegium Nauk Medycznych, Uniwersytet Rzeszowski, Rzeszow, Poland (H.C.); the Department of Pediatrics, University of Cincinnati College of Medicine, and the Division of Pediatric Infectious Diseases, Cincinnati Children's Hospital Medical Center, Cincinnati (G.C.P.); Duke Human Vaccine Institute, Durham, NC (E.B.W.); Johns Hopkins University, Baltimore (K.R.T.); Seattle Children's Hospital, Seattle (J.A.E.); Tampere University, Espoo Vaccine Research Clinic, Espoo, Finland (B.U.); Hospital Universitario HM Puerta del Sur, Madrid (S.N.M.); and BioNTech, Mainz, Germany (Ö.T., U.Ş.)
| | - Jing Zou
- From Texas Children's Hospital, Baylor College of Medicine, Houston (F.M.M.), and the University of Texas Medical Branch, Galveston (J.Z., X. Xie, P.-Y.S.); Peninsula Research Associates, Rolling Hills Estates (L.D.S.), and Stanford University School of Medicine, Palo Alto (Y.M.) - both in California; Vaccine Research and Development, Pfizer, Pearl River (C.S., A.G., U.N.S., C.H., M.I., B.A.P., I.M., K.A.S., K.K., C.L., D.C., K.U.J., W.C.G.), and SUNY Upstate Medical University, Syracuse (J.B.D.) - both in New York; Vaccine Research and Development (X. Xu, H.M.), and Worldwide Safety, Safety Surveillance and Risk Management (S.M.), Pfizer, Collegeville, PA; Vaccine Research and Development, Pfizer, Hurley, United Kingdom (N.K., S.L., C.W., L.C.); Atlanta Center for Medical Research, Atlanta (R.R.); Spring Valley Pediatrics, Washington, DC (J.M.S.); Katedra Pediatrii, Instytut Nauk Medycznych, Kolegium Nauk Medycznych, Uniwersytet Rzeszowski, Rzeszow, Poland (H.C.); the Department of Pediatrics, University of Cincinnati College of Medicine, and the Division of Pediatric Infectious Diseases, Cincinnati Children's Hospital Medical Center, Cincinnati (G.C.P.); Duke Human Vaccine Institute, Durham, NC (E.B.W.); Johns Hopkins University, Baltimore (K.R.T.); Seattle Children's Hospital, Seattle (J.A.E.); Tampere University, Espoo Vaccine Research Clinic, Espoo, Finland (B.U.); Hospital Universitario HM Puerta del Sur, Madrid (S.N.M.); and BioNTech, Mainz, Germany (Ö.T., U.Ş.)
| | - Xuping Xie
- From Texas Children's Hospital, Baylor College of Medicine, Houston (F.M.M.), and the University of Texas Medical Branch, Galveston (J.Z., X. Xie, P.-Y.S.); Peninsula Research Associates, Rolling Hills Estates (L.D.S.), and Stanford University School of Medicine, Palo Alto (Y.M.) - both in California; Vaccine Research and Development, Pfizer, Pearl River (C.S., A.G., U.N.S., C.H., M.I., B.A.P., I.M., K.A.S., K.K., C.L., D.C., K.U.J., W.C.G.), and SUNY Upstate Medical University, Syracuse (J.B.D.) - both in New York; Vaccine Research and Development (X. Xu, H.M.), and Worldwide Safety, Safety Surveillance and Risk Management (S.M.), Pfizer, Collegeville, PA; Vaccine Research and Development, Pfizer, Hurley, United Kingdom (N.K., S.L., C.W., L.C.); Atlanta Center for Medical Research, Atlanta (R.R.); Spring Valley Pediatrics, Washington, DC (J.M.S.); Katedra Pediatrii, Instytut Nauk Medycznych, Kolegium Nauk Medycznych, Uniwersytet Rzeszowski, Rzeszow, Poland (H.C.); the Department of Pediatrics, University of Cincinnati College of Medicine, and the Division of Pediatric Infectious Diseases, Cincinnati Children's Hospital Medical Center, Cincinnati (G.C.P.); Duke Human Vaccine Institute, Durham, NC (E.B.W.); Johns Hopkins University, Baltimore (K.R.T.); Seattle Children's Hospital, Seattle (J.A.E.); Tampere University, Espoo Vaccine Research Clinic, Espoo, Finland (B.U.); Hospital Universitario HM Puerta del Sur, Madrid (S.N.M.); and BioNTech, Mainz, Germany (Ö.T., U.Ş.)
| | - Pei-Yong Shi
- From Texas Children's Hospital, Baylor College of Medicine, Houston (F.M.M.), and the University of Texas Medical Branch, Galveston (J.Z., X. Xie, P.-Y.S.); Peninsula Research Associates, Rolling Hills Estates (L.D.S.), and Stanford University School of Medicine, Palo Alto (Y.M.) - both in California; Vaccine Research and Development, Pfizer, Pearl River (C.S., A.G., U.N.S., C.H., M.I., B.A.P., I.M., K.A.S., K.K., C.L., D.C., K.U.J., W.C.G.), and SUNY Upstate Medical University, Syracuse (J.B.D.) - both in New York; Vaccine Research and Development (X. Xu, H.M.), and Worldwide Safety, Safety Surveillance and Risk Management (S.M.), Pfizer, Collegeville, PA; Vaccine Research and Development, Pfizer, Hurley, United Kingdom (N.K., S.L., C.W., L.C.); Atlanta Center for Medical Research, Atlanta (R.R.); Spring Valley Pediatrics, Washington, DC (J.M.S.); Katedra Pediatrii, Instytut Nauk Medycznych, Kolegium Nauk Medycznych, Uniwersytet Rzeszowski, Rzeszow, Poland (H.C.); the Department of Pediatrics, University of Cincinnati College of Medicine, and the Division of Pediatric Infectious Diseases, Cincinnati Children's Hospital Medical Center, Cincinnati (G.C.P.); Duke Human Vaccine Institute, Durham, NC (E.B.W.); Johns Hopkins University, Baltimore (K.R.T.); Seattle Children's Hospital, Seattle (J.A.E.); Tampere University, Espoo Vaccine Research Clinic, Espoo, Finland (B.U.); Hospital Universitario HM Puerta del Sur, Madrid (S.N.M.); and BioNTech, Mainz, Germany (Ö.T., U.Ş.)
| | - David Cooper
- From Texas Children's Hospital, Baylor College of Medicine, Houston (F.M.M.), and the University of Texas Medical Branch, Galveston (J.Z., X. Xie, P.-Y.S.); Peninsula Research Associates, Rolling Hills Estates (L.D.S.), and Stanford University School of Medicine, Palo Alto (Y.M.) - both in California; Vaccine Research and Development, Pfizer, Pearl River (C.S., A.G., U.N.S., C.H., M.I., B.A.P., I.M., K.A.S., K.K., C.L., D.C., K.U.J., W.C.G.), and SUNY Upstate Medical University, Syracuse (J.B.D.) - both in New York; Vaccine Research and Development (X. Xu, H.M.), and Worldwide Safety, Safety Surveillance and Risk Management (S.M.), Pfizer, Collegeville, PA; Vaccine Research and Development, Pfizer, Hurley, United Kingdom (N.K., S.L., C.W., L.C.); Atlanta Center for Medical Research, Atlanta (R.R.); Spring Valley Pediatrics, Washington, DC (J.M.S.); Katedra Pediatrii, Instytut Nauk Medycznych, Kolegium Nauk Medycznych, Uniwersytet Rzeszowski, Rzeszow, Poland (H.C.); the Department of Pediatrics, University of Cincinnati College of Medicine, and the Division of Pediatric Infectious Diseases, Cincinnati Children's Hospital Medical Center, Cincinnati (G.C.P.); Duke Human Vaccine Institute, Durham, NC (E.B.W.); Johns Hopkins University, Baltimore (K.R.T.); Seattle Children's Hospital, Seattle (J.A.E.); Tampere University, Espoo Vaccine Research Clinic, Espoo, Finland (B.U.); Hospital Universitario HM Puerta del Sur, Madrid (S.N.M.); and BioNTech, Mainz, Germany (Ö.T., U.Ş.)
| | - Özlem Türeci
- From Texas Children's Hospital, Baylor College of Medicine, Houston (F.M.M.), and the University of Texas Medical Branch, Galveston (J.Z., X. Xie, P.-Y.S.); Peninsula Research Associates, Rolling Hills Estates (L.D.S.), and Stanford University School of Medicine, Palo Alto (Y.M.) - both in California; Vaccine Research and Development, Pfizer, Pearl River (C.S., A.G., U.N.S., C.H., M.I., B.A.P., I.M., K.A.S., K.K., C.L., D.C., K.U.J., W.C.G.), and SUNY Upstate Medical University, Syracuse (J.B.D.) - both in New York; Vaccine Research and Development (X. Xu, H.M.), and Worldwide Safety, Safety Surveillance and Risk Management (S.M.), Pfizer, Collegeville, PA; Vaccine Research and Development, Pfizer, Hurley, United Kingdom (N.K., S.L., C.W., L.C.); Atlanta Center for Medical Research, Atlanta (R.R.); Spring Valley Pediatrics, Washington, DC (J.M.S.); Katedra Pediatrii, Instytut Nauk Medycznych, Kolegium Nauk Medycznych, Uniwersytet Rzeszowski, Rzeszow, Poland (H.C.); the Department of Pediatrics, University of Cincinnati College of Medicine, and the Division of Pediatric Infectious Diseases, Cincinnati Children's Hospital Medical Center, Cincinnati (G.C.P.); Duke Human Vaccine Institute, Durham, NC (E.B.W.); Johns Hopkins University, Baltimore (K.R.T.); Seattle Children's Hospital, Seattle (J.A.E.); Tampere University, Espoo Vaccine Research Clinic, Espoo, Finland (B.U.); Hospital Universitario HM Puerta del Sur, Madrid (S.N.M.); and BioNTech, Mainz, Germany (Ö.T., U.Ş.)
| | - Uğur Şahin
- From Texas Children's Hospital, Baylor College of Medicine, Houston (F.M.M.), and the University of Texas Medical Branch, Galveston (J.Z., X. Xie, P.-Y.S.); Peninsula Research Associates, Rolling Hills Estates (L.D.S.), and Stanford University School of Medicine, Palo Alto (Y.M.) - both in California; Vaccine Research and Development, Pfizer, Pearl River (C.S., A.G., U.N.S., C.H., M.I., B.A.P., I.M., K.A.S., K.K., C.L., D.C., K.U.J., W.C.G.), and SUNY Upstate Medical University, Syracuse (J.B.D.) - both in New York; Vaccine Research and Development (X. Xu, H.M.), and Worldwide Safety, Safety Surveillance and Risk Management (S.M.), Pfizer, Collegeville, PA; Vaccine Research and Development, Pfizer, Hurley, United Kingdom (N.K., S.L., C.W., L.C.); Atlanta Center for Medical Research, Atlanta (R.R.); Spring Valley Pediatrics, Washington, DC (J.M.S.); Katedra Pediatrii, Instytut Nauk Medycznych, Kolegium Nauk Medycznych, Uniwersytet Rzeszowski, Rzeszow, Poland (H.C.); the Department of Pediatrics, University of Cincinnati College of Medicine, and the Division of Pediatric Infectious Diseases, Cincinnati Children's Hospital Medical Center, Cincinnati (G.C.P.); Duke Human Vaccine Institute, Durham, NC (E.B.W.); Johns Hopkins University, Baltimore (K.R.T.); Seattle Children's Hospital, Seattle (J.A.E.); Tampere University, Espoo Vaccine Research Clinic, Espoo, Finland (B.U.); Hospital Universitario HM Puerta del Sur, Madrid (S.N.M.); and BioNTech, Mainz, Germany (Ö.T., U.Ş.)
| | - Kathrin U Jansen
- From Texas Children's Hospital, Baylor College of Medicine, Houston (F.M.M.), and the University of Texas Medical Branch, Galveston (J.Z., X. Xie, P.-Y.S.); Peninsula Research Associates, Rolling Hills Estates (L.D.S.), and Stanford University School of Medicine, Palo Alto (Y.M.) - both in California; Vaccine Research and Development, Pfizer, Pearl River (C.S., A.G., U.N.S., C.H., M.I., B.A.P., I.M., K.A.S., K.K., C.L., D.C., K.U.J., W.C.G.), and SUNY Upstate Medical University, Syracuse (J.B.D.) - both in New York; Vaccine Research and Development (X. Xu, H.M.), and Worldwide Safety, Safety Surveillance and Risk Management (S.M.), Pfizer, Collegeville, PA; Vaccine Research and Development, Pfizer, Hurley, United Kingdom (N.K., S.L., C.W., L.C.); Atlanta Center for Medical Research, Atlanta (R.R.); Spring Valley Pediatrics, Washington, DC (J.M.S.); Katedra Pediatrii, Instytut Nauk Medycznych, Kolegium Nauk Medycznych, Uniwersytet Rzeszowski, Rzeszow, Poland (H.C.); the Department of Pediatrics, University of Cincinnati College of Medicine, and the Division of Pediatric Infectious Diseases, Cincinnati Children's Hospital Medical Center, Cincinnati (G.C.P.); Duke Human Vaccine Institute, Durham, NC (E.B.W.); Johns Hopkins University, Baltimore (K.R.T.); Seattle Children's Hospital, Seattle (J.A.E.); Tampere University, Espoo Vaccine Research Clinic, Espoo, Finland (B.U.); Hospital Universitario HM Puerta del Sur, Madrid (S.N.M.); and BioNTech, Mainz, Germany (Ö.T., U.Ş.)
| | - William C Gruber
- From Texas Children's Hospital, Baylor College of Medicine, Houston (F.M.M.), and the University of Texas Medical Branch, Galveston (J.Z., X. Xie, P.-Y.S.); Peninsula Research Associates, Rolling Hills Estates (L.D.S.), and Stanford University School of Medicine, Palo Alto (Y.M.) - both in California; Vaccine Research and Development, Pfizer, Pearl River (C.S., A.G., U.N.S., C.H., M.I., B.A.P., I.M., K.A.S., K.K., C.L., D.C., K.U.J., W.C.G.), and SUNY Upstate Medical University, Syracuse (J.B.D.) - both in New York; Vaccine Research and Development (X. Xu, H.M.), and Worldwide Safety, Safety Surveillance and Risk Management (S.M.), Pfizer, Collegeville, PA; Vaccine Research and Development, Pfizer, Hurley, United Kingdom (N.K., S.L., C.W., L.C.); Atlanta Center for Medical Research, Atlanta (R.R.); Spring Valley Pediatrics, Washington, DC (J.M.S.); Katedra Pediatrii, Instytut Nauk Medycznych, Kolegium Nauk Medycznych, Uniwersytet Rzeszowski, Rzeszow, Poland (H.C.); the Department of Pediatrics, University of Cincinnati College of Medicine, and the Division of Pediatric Infectious Diseases, Cincinnati Children's Hospital Medical Center, Cincinnati (G.C.P.); Duke Human Vaccine Institute, Durham, NC (E.B.W.); Johns Hopkins University, Baltimore (K.R.T.); Seattle Children's Hospital, Seattle (J.A.E.); Tampere University, Espoo Vaccine Research Clinic, Espoo, Finland (B.U.); Hospital Universitario HM Puerta del Sur, Madrid (S.N.M.); and BioNTech, Mainz, Germany (Ö.T., U.Ş.)
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Chemaitelly H, AlMukdad S, Ayoub HH, Altarawneh HN, Coyle P, Tang P, Yassine HM, Al-Khatib HA, Smatti MK, Hasan MR, Al-Kanaani Z, Al-Kuwari E, Jeremijenko A, Kaleeckal AH, Latif AN, Shaik RM, Abdul-Rahim HF, Nasrallah GK, Al-Kuwari MG, Al-Romaihi HE, Butt AA, Al-Thani MH, Al-Khal A, Bertollini R, Abu-Raddad LJ. Covid-19 Vaccine Protection among Children and Adolescents in Qatar. N Engl J Med 2022; 387:1865-1876. [PMID: 36322837 PMCID: PMC9644642 DOI: 10.1056/nejmoa2210058] [Citation(s) in RCA: 27] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND The BNT162b2 vaccine against coronavirus disease 2019 (Covid-19) has been authorized for use in children 5 to 11 years of age and adolescents 12 to 17 years of age but in different antigen doses. METHODS We assessed the real-world effectiveness of the BNT162b2 vaccine against infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) among children and adolescents in Qatar. To compare the incidence of SARS-CoV-2 infection in the national cohort of vaccinated participants with the incidence in the national cohort of unvaccinated participants, we conducted three matched, retrospective, target-trial, cohort studies - one assessing data obtained from children 5 to 11 years of age after the B.1.1.529 (omicron) variant became prevalent and two assessing data from adolescents 12 to 17 years of age before the emergence of the omicron variant (pre-omicron study) and after the omicron variant became prevalent. Associations were estimated with the use of Cox proportional-hazards regression models. RESULTS Among children, the overall effectiveness of the 10-μg primary vaccine series against infection with the omicron variant was 25.7% (95% confidence interval [CI], 10.0 to 38.6). Effectiveness was highest (49.6%; 95% CI, 28.5 to 64.5) right after receipt of the second dose but waned rapidly thereafter and was negligible after 3 months. Effectiveness was 46.3% (95% CI, 21.5 to 63.3) among children 5 to 7 years of age and 16.6% (95% CI, -4.2 to 33.2) among those 8 to 11 years of age. Among adolescents, the overall effectiveness of the 30-μg primary vaccine series against infection with the omicron variant was 30.6% (95% CI, 26.9 to 34.1), but many adolescents had been vaccinated months earlier. Effectiveness waned over time since receipt of the second dose. Effectiveness was 35.6% (95% CI, 31.2 to 39.6) among adolescents 12 to 14 years of age and 20.9% (95% CI, 13.8 to 27.4) among those 15 to 17 years of age. In the pre-omicron study, the overall effectiveness of the 30-μg primary vaccine series against SARS-CoV-2 infection among adolescents was 87.6% (95% CI, 84.0 to 90.4) and waned relatively slowly after receipt of the second dose. CONCLUSIONS Vaccination in children was associated with modest, rapidly waning protection against omicron infection. Vaccination in adolescents was associated with stronger, more durable protection, perhaps because of the larger antigen dose. (Funded by Weill Cornell Medicine-Qatar and others.).
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Affiliation(s)
- Hiam Chemaitelly
- From the Infectious Disease Epidemiology Group (H.C., S.A., H.N.A., L.J.A.-R.) and the World Health Organization Collaborating Center for Disease Epidemiology Analytics on HIV/AIDS, Sexually Transmitted Infections, and Viral Hepatitis (H.C., S.A., H.N.A., L.J.A.-R.), Weill Cornell Medicine-Qatar, Cornell University, Qatar Foundation-Education City, the Mathematics Program, Department of Mathematics, Statistics, and Physics, College of Arts and Sciences, Qatar University (H.H.A.), and the Biomedical Research Center (P.C., H.M.Y., H.A.A.-K., M.K.S., G.K.N.) and the Departments of Biomedical Science (H.M.Y., H.A.A.-K., M.K.S., G.K.N.) and Public Health (H.F.A.-R., L.J.A.-R.), College of Health Sciences, QU Health, Qatar University, Hamad Medical Corporation (P.C., Z.A.-K., E.A.-K., A.J., A.H.K., A.N.L., R.M.S., A.A.B., A.A.-K.), the Department of Pathology, Sidra Medicine (P.T., M.R.H.), Primary Health Care Corporation (M.G.A.-K.), and the Ministry of Public Health (H.E.A.-R., M.H.A.-T., R.B.) - all in Doha, Qatar; the Departments of Population Health Sciences (H.C., H.N.A., A.A.B., L.J.A.-R.) and Medicine (A.A.B.), Weill Cornell Medicine, Cornell University, New York; and the Wellcome-Wolfson Institute for Experimental Medicine, Queen's University, Belfast, United Kingdom (P.C.)
| | - Sawsan AlMukdad
- From the Infectious Disease Epidemiology Group (H.C., S.A., H.N.A., L.J.A.-R.) and the World Health Organization Collaborating Center for Disease Epidemiology Analytics on HIV/AIDS, Sexually Transmitted Infections, and Viral Hepatitis (H.C., S.A., H.N.A., L.J.A.-R.), Weill Cornell Medicine-Qatar, Cornell University, Qatar Foundation-Education City, the Mathematics Program, Department of Mathematics, Statistics, and Physics, College of Arts and Sciences, Qatar University (H.H.A.), and the Biomedical Research Center (P.C., H.M.Y., H.A.A.-K., M.K.S., G.K.N.) and the Departments of Biomedical Science (H.M.Y., H.A.A.-K., M.K.S., G.K.N.) and Public Health (H.F.A.-R., L.J.A.-R.), College of Health Sciences, QU Health, Qatar University, Hamad Medical Corporation (P.C., Z.A.-K., E.A.-K., A.J., A.H.K., A.N.L., R.M.S., A.A.B., A.A.-K.), the Department of Pathology, Sidra Medicine (P.T., M.R.H.), Primary Health Care Corporation (M.G.A.-K.), and the Ministry of Public Health (H.E.A.-R., M.H.A.-T., R.B.) - all in Doha, Qatar; the Departments of Population Health Sciences (H.C., H.N.A., A.A.B., L.J.A.-R.) and Medicine (A.A.B.), Weill Cornell Medicine, Cornell University, New York; and the Wellcome-Wolfson Institute for Experimental Medicine, Queen's University, Belfast, United Kingdom (P.C.)
| | - Houssein H Ayoub
- From the Infectious Disease Epidemiology Group (H.C., S.A., H.N.A., L.J.A.-R.) and the World Health Organization Collaborating Center for Disease Epidemiology Analytics on HIV/AIDS, Sexually Transmitted Infections, and Viral Hepatitis (H.C., S.A., H.N.A., L.J.A.-R.), Weill Cornell Medicine-Qatar, Cornell University, Qatar Foundation-Education City, the Mathematics Program, Department of Mathematics, Statistics, and Physics, College of Arts and Sciences, Qatar University (H.H.A.), and the Biomedical Research Center (P.C., H.M.Y., H.A.A.-K., M.K.S., G.K.N.) and the Departments of Biomedical Science (H.M.Y., H.A.A.-K., M.K.S., G.K.N.) and Public Health (H.F.A.-R., L.J.A.-R.), College of Health Sciences, QU Health, Qatar University, Hamad Medical Corporation (P.C., Z.A.-K., E.A.-K., A.J., A.H.K., A.N.L., R.M.S., A.A.B., A.A.-K.), the Department of Pathology, Sidra Medicine (P.T., M.R.H.), Primary Health Care Corporation (M.G.A.-K.), and the Ministry of Public Health (H.E.A.-R., M.H.A.-T., R.B.) - all in Doha, Qatar; the Departments of Population Health Sciences (H.C., H.N.A., A.A.B., L.J.A.-R.) and Medicine (A.A.B.), Weill Cornell Medicine, Cornell University, New York; and the Wellcome-Wolfson Institute for Experimental Medicine, Queen's University, Belfast, United Kingdom (P.C.)
| | - Heba N Altarawneh
- From the Infectious Disease Epidemiology Group (H.C., S.A., H.N.A., L.J.A.-R.) and the World Health Organization Collaborating Center for Disease Epidemiology Analytics on HIV/AIDS, Sexually Transmitted Infections, and Viral Hepatitis (H.C., S.A., H.N.A., L.J.A.-R.), Weill Cornell Medicine-Qatar, Cornell University, Qatar Foundation-Education City, the Mathematics Program, Department of Mathematics, Statistics, and Physics, College of Arts and Sciences, Qatar University (H.H.A.), and the Biomedical Research Center (P.C., H.M.Y., H.A.A.-K., M.K.S., G.K.N.) and the Departments of Biomedical Science (H.M.Y., H.A.A.-K., M.K.S., G.K.N.) and Public Health (H.F.A.-R., L.J.A.-R.), College of Health Sciences, QU Health, Qatar University, Hamad Medical Corporation (P.C., Z.A.-K., E.A.-K., A.J., A.H.K., A.N.L., R.M.S., A.A.B., A.A.-K.), the Department of Pathology, Sidra Medicine (P.T., M.R.H.), Primary Health Care Corporation (M.G.A.-K.), and the Ministry of Public Health (H.E.A.-R., M.H.A.-T., R.B.) - all in Doha, Qatar; the Departments of Population Health Sciences (H.C., H.N.A., A.A.B., L.J.A.-R.) and Medicine (A.A.B.), Weill Cornell Medicine, Cornell University, New York; and the Wellcome-Wolfson Institute for Experimental Medicine, Queen's University, Belfast, United Kingdom (P.C.)
| | - Peter Coyle
- From the Infectious Disease Epidemiology Group (H.C., S.A., H.N.A., L.J.A.-R.) and the World Health Organization Collaborating Center for Disease Epidemiology Analytics on HIV/AIDS, Sexually Transmitted Infections, and Viral Hepatitis (H.C., S.A., H.N.A., L.J.A.-R.), Weill Cornell Medicine-Qatar, Cornell University, Qatar Foundation-Education City, the Mathematics Program, Department of Mathematics, Statistics, and Physics, College of Arts and Sciences, Qatar University (H.H.A.), and the Biomedical Research Center (P.C., H.M.Y., H.A.A.-K., M.K.S., G.K.N.) and the Departments of Biomedical Science (H.M.Y., H.A.A.-K., M.K.S., G.K.N.) and Public Health (H.F.A.-R., L.J.A.-R.), College of Health Sciences, QU Health, Qatar University, Hamad Medical Corporation (P.C., Z.A.-K., E.A.-K., A.J., A.H.K., A.N.L., R.M.S., A.A.B., A.A.-K.), the Department of Pathology, Sidra Medicine (P.T., M.R.H.), Primary Health Care Corporation (M.G.A.-K.), and the Ministry of Public Health (H.E.A.-R., M.H.A.-T., R.B.) - all in Doha, Qatar; the Departments of Population Health Sciences (H.C., H.N.A., A.A.B., L.J.A.-R.) and Medicine (A.A.B.), Weill Cornell Medicine, Cornell University, New York; and the Wellcome-Wolfson Institute for Experimental Medicine, Queen's University, Belfast, United Kingdom (P.C.)
| | - Patrick Tang
- From the Infectious Disease Epidemiology Group (H.C., S.A., H.N.A., L.J.A.-R.) and the World Health Organization Collaborating Center for Disease Epidemiology Analytics on HIV/AIDS, Sexually Transmitted Infections, and Viral Hepatitis (H.C., S.A., H.N.A., L.J.A.-R.), Weill Cornell Medicine-Qatar, Cornell University, Qatar Foundation-Education City, the Mathematics Program, Department of Mathematics, Statistics, and Physics, College of Arts and Sciences, Qatar University (H.H.A.), and the Biomedical Research Center (P.C., H.M.Y., H.A.A.-K., M.K.S., G.K.N.) and the Departments of Biomedical Science (H.M.Y., H.A.A.-K., M.K.S., G.K.N.) and Public Health (H.F.A.-R., L.J.A.-R.), College of Health Sciences, QU Health, Qatar University, Hamad Medical Corporation (P.C., Z.A.-K., E.A.-K., A.J., A.H.K., A.N.L., R.M.S., A.A.B., A.A.-K.), the Department of Pathology, Sidra Medicine (P.T., M.R.H.), Primary Health Care Corporation (M.G.A.-K.), and the Ministry of Public Health (H.E.A.-R., M.H.A.-T., R.B.) - all in Doha, Qatar; the Departments of Population Health Sciences (H.C., H.N.A., A.A.B., L.J.A.-R.) and Medicine (A.A.B.), Weill Cornell Medicine, Cornell University, New York; and the Wellcome-Wolfson Institute for Experimental Medicine, Queen's University, Belfast, United Kingdom (P.C.)
| | - Hadi M Yassine
- From the Infectious Disease Epidemiology Group (H.C., S.A., H.N.A., L.J.A.-R.) and the World Health Organization Collaborating Center for Disease Epidemiology Analytics on HIV/AIDS, Sexually Transmitted Infections, and Viral Hepatitis (H.C., S.A., H.N.A., L.J.A.-R.), Weill Cornell Medicine-Qatar, Cornell University, Qatar Foundation-Education City, the Mathematics Program, Department of Mathematics, Statistics, and Physics, College of Arts and Sciences, Qatar University (H.H.A.), and the Biomedical Research Center (P.C., H.M.Y., H.A.A.-K., M.K.S., G.K.N.) and the Departments of Biomedical Science (H.M.Y., H.A.A.-K., M.K.S., G.K.N.) and Public Health (H.F.A.-R., L.J.A.-R.), College of Health Sciences, QU Health, Qatar University, Hamad Medical Corporation (P.C., Z.A.-K., E.A.-K., A.J., A.H.K., A.N.L., R.M.S., A.A.B., A.A.-K.), the Department of Pathology, Sidra Medicine (P.T., M.R.H.), Primary Health Care Corporation (M.G.A.-K.), and the Ministry of Public Health (H.E.A.-R., M.H.A.-T., R.B.) - all in Doha, Qatar; the Departments of Population Health Sciences (H.C., H.N.A., A.A.B., L.J.A.-R.) and Medicine (A.A.B.), Weill Cornell Medicine, Cornell University, New York; and the Wellcome-Wolfson Institute for Experimental Medicine, Queen's University, Belfast, United Kingdom (P.C.)
| | - Hebah A Al-Khatib
- From the Infectious Disease Epidemiology Group (H.C., S.A., H.N.A., L.J.A.-R.) and the World Health Organization Collaborating Center for Disease Epidemiology Analytics on HIV/AIDS, Sexually Transmitted Infections, and Viral Hepatitis (H.C., S.A., H.N.A., L.J.A.-R.), Weill Cornell Medicine-Qatar, Cornell University, Qatar Foundation-Education City, the Mathematics Program, Department of Mathematics, Statistics, and Physics, College of Arts and Sciences, Qatar University (H.H.A.), and the Biomedical Research Center (P.C., H.M.Y., H.A.A.-K., M.K.S., G.K.N.) and the Departments of Biomedical Science (H.M.Y., H.A.A.-K., M.K.S., G.K.N.) and Public Health (H.F.A.-R., L.J.A.-R.), College of Health Sciences, QU Health, Qatar University, Hamad Medical Corporation (P.C., Z.A.-K., E.A.-K., A.J., A.H.K., A.N.L., R.M.S., A.A.B., A.A.-K.), the Department of Pathology, Sidra Medicine (P.T., M.R.H.), Primary Health Care Corporation (M.G.A.-K.), and the Ministry of Public Health (H.E.A.-R., M.H.A.-T., R.B.) - all in Doha, Qatar; the Departments of Population Health Sciences (H.C., H.N.A., A.A.B., L.J.A.-R.) and Medicine (A.A.B.), Weill Cornell Medicine, Cornell University, New York; and the Wellcome-Wolfson Institute for Experimental Medicine, Queen's University, Belfast, United Kingdom (P.C.)
| | - Maria K Smatti
- From the Infectious Disease Epidemiology Group (H.C., S.A., H.N.A., L.J.A.-R.) and the World Health Organization Collaborating Center for Disease Epidemiology Analytics on HIV/AIDS, Sexually Transmitted Infections, and Viral Hepatitis (H.C., S.A., H.N.A., L.J.A.-R.), Weill Cornell Medicine-Qatar, Cornell University, Qatar Foundation-Education City, the Mathematics Program, Department of Mathematics, Statistics, and Physics, College of Arts and Sciences, Qatar University (H.H.A.), and the Biomedical Research Center (P.C., H.M.Y., H.A.A.-K., M.K.S., G.K.N.) and the Departments of Biomedical Science (H.M.Y., H.A.A.-K., M.K.S., G.K.N.) and Public Health (H.F.A.-R., L.J.A.-R.), College of Health Sciences, QU Health, Qatar University, Hamad Medical Corporation (P.C., Z.A.-K., E.A.-K., A.J., A.H.K., A.N.L., R.M.S., A.A.B., A.A.-K.), the Department of Pathology, Sidra Medicine (P.T., M.R.H.), Primary Health Care Corporation (M.G.A.-K.), and the Ministry of Public Health (H.E.A.-R., M.H.A.-T., R.B.) - all in Doha, Qatar; the Departments of Population Health Sciences (H.C., H.N.A., A.A.B., L.J.A.-R.) and Medicine (A.A.B.), Weill Cornell Medicine, Cornell University, New York; and the Wellcome-Wolfson Institute for Experimental Medicine, Queen's University, Belfast, United Kingdom (P.C.)
| | - Mohammad R Hasan
- From the Infectious Disease Epidemiology Group (H.C., S.A., H.N.A., L.J.A.-R.) and the World Health Organization Collaborating Center for Disease Epidemiology Analytics on HIV/AIDS, Sexually Transmitted Infections, and Viral Hepatitis (H.C., S.A., H.N.A., L.J.A.-R.), Weill Cornell Medicine-Qatar, Cornell University, Qatar Foundation-Education City, the Mathematics Program, Department of Mathematics, Statistics, and Physics, College of Arts and Sciences, Qatar University (H.H.A.), and the Biomedical Research Center (P.C., H.M.Y., H.A.A.-K., M.K.S., G.K.N.) and the Departments of Biomedical Science (H.M.Y., H.A.A.-K., M.K.S., G.K.N.) and Public Health (H.F.A.-R., L.J.A.-R.), College of Health Sciences, QU Health, Qatar University, Hamad Medical Corporation (P.C., Z.A.-K., E.A.-K., A.J., A.H.K., A.N.L., R.M.S., A.A.B., A.A.-K.), the Department of Pathology, Sidra Medicine (P.T., M.R.H.), Primary Health Care Corporation (M.G.A.-K.), and the Ministry of Public Health (H.E.A.-R., M.H.A.-T., R.B.) - all in Doha, Qatar; the Departments of Population Health Sciences (H.C., H.N.A., A.A.B., L.J.A.-R.) and Medicine (A.A.B.), Weill Cornell Medicine, Cornell University, New York; and the Wellcome-Wolfson Institute for Experimental Medicine, Queen's University, Belfast, United Kingdom (P.C.)
| | - Zaina Al-Kanaani
- From the Infectious Disease Epidemiology Group (H.C., S.A., H.N.A., L.J.A.-R.) and the World Health Organization Collaborating Center for Disease Epidemiology Analytics on HIV/AIDS, Sexually Transmitted Infections, and Viral Hepatitis (H.C., S.A., H.N.A., L.J.A.-R.), Weill Cornell Medicine-Qatar, Cornell University, Qatar Foundation-Education City, the Mathematics Program, Department of Mathematics, Statistics, and Physics, College of Arts and Sciences, Qatar University (H.H.A.), and the Biomedical Research Center (P.C., H.M.Y., H.A.A.-K., M.K.S., G.K.N.) and the Departments of Biomedical Science (H.M.Y., H.A.A.-K., M.K.S., G.K.N.) and Public Health (H.F.A.-R., L.J.A.-R.), College of Health Sciences, QU Health, Qatar University, Hamad Medical Corporation (P.C., Z.A.-K., E.A.-K., A.J., A.H.K., A.N.L., R.M.S., A.A.B., A.A.-K.), the Department of Pathology, Sidra Medicine (P.T., M.R.H.), Primary Health Care Corporation (M.G.A.-K.), and the Ministry of Public Health (H.E.A.-R., M.H.A.-T., R.B.) - all in Doha, Qatar; the Departments of Population Health Sciences (H.C., H.N.A., A.A.B., L.J.A.-R.) and Medicine (A.A.B.), Weill Cornell Medicine, Cornell University, New York; and the Wellcome-Wolfson Institute for Experimental Medicine, Queen's University, Belfast, United Kingdom (P.C.)
| | - Einas Al-Kuwari
- From the Infectious Disease Epidemiology Group (H.C., S.A., H.N.A., L.J.A.-R.) and the World Health Organization Collaborating Center for Disease Epidemiology Analytics on HIV/AIDS, Sexually Transmitted Infections, and Viral Hepatitis (H.C., S.A., H.N.A., L.J.A.-R.), Weill Cornell Medicine-Qatar, Cornell University, Qatar Foundation-Education City, the Mathematics Program, Department of Mathematics, Statistics, and Physics, College of Arts and Sciences, Qatar University (H.H.A.), and the Biomedical Research Center (P.C., H.M.Y., H.A.A.-K., M.K.S., G.K.N.) and the Departments of Biomedical Science (H.M.Y., H.A.A.-K., M.K.S., G.K.N.) and Public Health (H.F.A.-R., L.J.A.-R.), College of Health Sciences, QU Health, Qatar University, Hamad Medical Corporation (P.C., Z.A.-K., E.A.-K., A.J., A.H.K., A.N.L., R.M.S., A.A.B., A.A.-K.), the Department of Pathology, Sidra Medicine (P.T., M.R.H.), Primary Health Care Corporation (M.G.A.-K.), and the Ministry of Public Health (H.E.A.-R., M.H.A.-T., R.B.) - all in Doha, Qatar; the Departments of Population Health Sciences (H.C., H.N.A., A.A.B., L.J.A.-R.) and Medicine (A.A.B.), Weill Cornell Medicine, Cornell University, New York; and the Wellcome-Wolfson Institute for Experimental Medicine, Queen's University, Belfast, United Kingdom (P.C.)
| | - Andrew Jeremijenko
- From the Infectious Disease Epidemiology Group (H.C., S.A., H.N.A., L.J.A.-R.) and the World Health Organization Collaborating Center for Disease Epidemiology Analytics on HIV/AIDS, Sexually Transmitted Infections, and Viral Hepatitis (H.C., S.A., H.N.A., L.J.A.-R.), Weill Cornell Medicine-Qatar, Cornell University, Qatar Foundation-Education City, the Mathematics Program, Department of Mathematics, Statistics, and Physics, College of Arts and Sciences, Qatar University (H.H.A.), and the Biomedical Research Center (P.C., H.M.Y., H.A.A.-K., M.K.S., G.K.N.) and the Departments of Biomedical Science (H.M.Y., H.A.A.-K., M.K.S., G.K.N.) and Public Health (H.F.A.-R., L.J.A.-R.), College of Health Sciences, QU Health, Qatar University, Hamad Medical Corporation (P.C., Z.A.-K., E.A.-K., A.J., A.H.K., A.N.L., R.M.S., A.A.B., A.A.-K.), the Department of Pathology, Sidra Medicine (P.T., M.R.H.), Primary Health Care Corporation (M.G.A.-K.), and the Ministry of Public Health (H.E.A.-R., M.H.A.-T., R.B.) - all in Doha, Qatar; the Departments of Population Health Sciences (H.C., H.N.A., A.A.B., L.J.A.-R.) and Medicine (A.A.B.), Weill Cornell Medicine, Cornell University, New York; and the Wellcome-Wolfson Institute for Experimental Medicine, Queen's University, Belfast, United Kingdom (P.C.)
| | - Anvar H Kaleeckal
- From the Infectious Disease Epidemiology Group (H.C., S.A., H.N.A., L.J.A.-R.) and the World Health Organization Collaborating Center for Disease Epidemiology Analytics on HIV/AIDS, Sexually Transmitted Infections, and Viral Hepatitis (H.C., S.A., H.N.A., L.J.A.-R.), Weill Cornell Medicine-Qatar, Cornell University, Qatar Foundation-Education City, the Mathematics Program, Department of Mathematics, Statistics, and Physics, College of Arts and Sciences, Qatar University (H.H.A.), and the Biomedical Research Center (P.C., H.M.Y., H.A.A.-K., M.K.S., G.K.N.) and the Departments of Biomedical Science (H.M.Y., H.A.A.-K., M.K.S., G.K.N.) and Public Health (H.F.A.-R., L.J.A.-R.), College of Health Sciences, QU Health, Qatar University, Hamad Medical Corporation (P.C., Z.A.-K., E.A.-K., A.J., A.H.K., A.N.L., R.M.S., A.A.B., A.A.-K.), the Department of Pathology, Sidra Medicine (P.T., M.R.H.), Primary Health Care Corporation (M.G.A.-K.), and the Ministry of Public Health (H.E.A.-R., M.H.A.-T., R.B.) - all in Doha, Qatar; the Departments of Population Health Sciences (H.C., H.N.A., A.A.B., L.J.A.-R.) and Medicine (A.A.B.), Weill Cornell Medicine, Cornell University, New York; and the Wellcome-Wolfson Institute for Experimental Medicine, Queen's University, Belfast, United Kingdom (P.C.)
| | - Ali N Latif
- From the Infectious Disease Epidemiology Group (H.C., S.A., H.N.A., L.J.A.-R.) and the World Health Organization Collaborating Center for Disease Epidemiology Analytics on HIV/AIDS, Sexually Transmitted Infections, and Viral Hepatitis (H.C., S.A., H.N.A., L.J.A.-R.), Weill Cornell Medicine-Qatar, Cornell University, Qatar Foundation-Education City, the Mathematics Program, Department of Mathematics, Statistics, and Physics, College of Arts and Sciences, Qatar University (H.H.A.), and the Biomedical Research Center (P.C., H.M.Y., H.A.A.-K., M.K.S., G.K.N.) and the Departments of Biomedical Science (H.M.Y., H.A.A.-K., M.K.S., G.K.N.) and Public Health (H.F.A.-R., L.J.A.-R.), College of Health Sciences, QU Health, Qatar University, Hamad Medical Corporation (P.C., Z.A.-K., E.A.-K., A.J., A.H.K., A.N.L., R.M.S., A.A.B., A.A.-K.), the Department of Pathology, Sidra Medicine (P.T., M.R.H.), Primary Health Care Corporation (M.G.A.-K.), and the Ministry of Public Health (H.E.A.-R., M.H.A.-T., R.B.) - all in Doha, Qatar; the Departments of Population Health Sciences (H.C., H.N.A., A.A.B., L.J.A.-R.) and Medicine (A.A.B.), Weill Cornell Medicine, Cornell University, New York; and the Wellcome-Wolfson Institute for Experimental Medicine, Queen's University, Belfast, United Kingdom (P.C.)
| | - Riyazuddin M Shaik
- From the Infectious Disease Epidemiology Group (H.C., S.A., H.N.A., L.J.A.-R.) and the World Health Organization Collaborating Center for Disease Epidemiology Analytics on HIV/AIDS, Sexually Transmitted Infections, and Viral Hepatitis (H.C., S.A., H.N.A., L.J.A.-R.), Weill Cornell Medicine-Qatar, Cornell University, Qatar Foundation-Education City, the Mathematics Program, Department of Mathematics, Statistics, and Physics, College of Arts and Sciences, Qatar University (H.H.A.), and the Biomedical Research Center (P.C., H.M.Y., H.A.A.-K., M.K.S., G.K.N.) and the Departments of Biomedical Science (H.M.Y., H.A.A.-K., M.K.S., G.K.N.) and Public Health (H.F.A.-R., L.J.A.-R.), College of Health Sciences, QU Health, Qatar University, Hamad Medical Corporation (P.C., Z.A.-K., E.A.-K., A.J., A.H.K., A.N.L., R.M.S., A.A.B., A.A.-K.), the Department of Pathology, Sidra Medicine (P.T., M.R.H.), Primary Health Care Corporation (M.G.A.-K.), and the Ministry of Public Health (H.E.A.-R., M.H.A.-T., R.B.) - all in Doha, Qatar; the Departments of Population Health Sciences (H.C., H.N.A., A.A.B., L.J.A.-R.) and Medicine (A.A.B.), Weill Cornell Medicine, Cornell University, New York; and the Wellcome-Wolfson Institute for Experimental Medicine, Queen's University, Belfast, United Kingdom (P.C.)
| | - Hanan F Abdul-Rahim
- From the Infectious Disease Epidemiology Group (H.C., S.A., H.N.A., L.J.A.-R.) and the World Health Organization Collaborating Center for Disease Epidemiology Analytics on HIV/AIDS, Sexually Transmitted Infections, and Viral Hepatitis (H.C., S.A., H.N.A., L.J.A.-R.), Weill Cornell Medicine-Qatar, Cornell University, Qatar Foundation-Education City, the Mathematics Program, Department of Mathematics, Statistics, and Physics, College of Arts and Sciences, Qatar University (H.H.A.), and the Biomedical Research Center (P.C., H.M.Y., H.A.A.-K., M.K.S., G.K.N.) and the Departments of Biomedical Science (H.M.Y., H.A.A.-K., M.K.S., G.K.N.) and Public Health (H.F.A.-R., L.J.A.-R.), College of Health Sciences, QU Health, Qatar University, Hamad Medical Corporation (P.C., Z.A.-K., E.A.-K., A.J., A.H.K., A.N.L., R.M.S., A.A.B., A.A.-K.), the Department of Pathology, Sidra Medicine (P.T., M.R.H.), Primary Health Care Corporation (M.G.A.-K.), and the Ministry of Public Health (H.E.A.-R., M.H.A.-T., R.B.) - all in Doha, Qatar; the Departments of Population Health Sciences (H.C., H.N.A., A.A.B., L.J.A.-R.) and Medicine (A.A.B.), Weill Cornell Medicine, Cornell University, New York; and the Wellcome-Wolfson Institute for Experimental Medicine, Queen's University, Belfast, United Kingdom (P.C.)
| | - Gheyath K Nasrallah
- From the Infectious Disease Epidemiology Group (H.C., S.A., H.N.A., L.J.A.-R.) and the World Health Organization Collaborating Center for Disease Epidemiology Analytics on HIV/AIDS, Sexually Transmitted Infections, and Viral Hepatitis (H.C., S.A., H.N.A., L.J.A.-R.), Weill Cornell Medicine-Qatar, Cornell University, Qatar Foundation-Education City, the Mathematics Program, Department of Mathematics, Statistics, and Physics, College of Arts and Sciences, Qatar University (H.H.A.), and the Biomedical Research Center (P.C., H.M.Y., H.A.A.-K., M.K.S., G.K.N.) and the Departments of Biomedical Science (H.M.Y., H.A.A.-K., M.K.S., G.K.N.) and Public Health (H.F.A.-R., L.J.A.-R.), College of Health Sciences, QU Health, Qatar University, Hamad Medical Corporation (P.C., Z.A.-K., E.A.-K., A.J., A.H.K., A.N.L., R.M.S., A.A.B., A.A.-K.), the Department of Pathology, Sidra Medicine (P.T., M.R.H.), Primary Health Care Corporation (M.G.A.-K.), and the Ministry of Public Health (H.E.A.-R., M.H.A.-T., R.B.) - all in Doha, Qatar; the Departments of Population Health Sciences (H.C., H.N.A., A.A.B., L.J.A.-R.) and Medicine (A.A.B.), Weill Cornell Medicine, Cornell University, New York; and the Wellcome-Wolfson Institute for Experimental Medicine, Queen's University, Belfast, United Kingdom (P.C.)
| | - Mohamed G Al-Kuwari
- From the Infectious Disease Epidemiology Group (H.C., S.A., H.N.A., L.J.A.-R.) and the World Health Organization Collaborating Center for Disease Epidemiology Analytics on HIV/AIDS, Sexually Transmitted Infections, and Viral Hepatitis (H.C., S.A., H.N.A., L.J.A.-R.), Weill Cornell Medicine-Qatar, Cornell University, Qatar Foundation-Education City, the Mathematics Program, Department of Mathematics, Statistics, and Physics, College of Arts and Sciences, Qatar University (H.H.A.), and the Biomedical Research Center (P.C., H.M.Y., H.A.A.-K., M.K.S., G.K.N.) and the Departments of Biomedical Science (H.M.Y., H.A.A.-K., M.K.S., G.K.N.) and Public Health (H.F.A.-R., L.J.A.-R.), College of Health Sciences, QU Health, Qatar University, Hamad Medical Corporation (P.C., Z.A.-K., E.A.-K., A.J., A.H.K., A.N.L., R.M.S., A.A.B., A.A.-K.), the Department of Pathology, Sidra Medicine (P.T., M.R.H.), Primary Health Care Corporation (M.G.A.-K.), and the Ministry of Public Health (H.E.A.-R., M.H.A.-T., R.B.) - all in Doha, Qatar; the Departments of Population Health Sciences (H.C., H.N.A., A.A.B., L.J.A.-R.) and Medicine (A.A.B.), Weill Cornell Medicine, Cornell University, New York; and the Wellcome-Wolfson Institute for Experimental Medicine, Queen's University, Belfast, United Kingdom (P.C.)
| | - Hamad E Al-Romaihi
- From the Infectious Disease Epidemiology Group (H.C., S.A., H.N.A., L.J.A.-R.) and the World Health Organization Collaborating Center for Disease Epidemiology Analytics on HIV/AIDS, Sexually Transmitted Infections, and Viral Hepatitis (H.C., S.A., H.N.A., L.J.A.-R.), Weill Cornell Medicine-Qatar, Cornell University, Qatar Foundation-Education City, the Mathematics Program, Department of Mathematics, Statistics, and Physics, College of Arts and Sciences, Qatar University (H.H.A.), and the Biomedical Research Center (P.C., H.M.Y., H.A.A.-K., M.K.S., G.K.N.) and the Departments of Biomedical Science (H.M.Y., H.A.A.-K., M.K.S., G.K.N.) and Public Health (H.F.A.-R., L.J.A.-R.), College of Health Sciences, QU Health, Qatar University, Hamad Medical Corporation (P.C., Z.A.-K., E.A.-K., A.J., A.H.K., A.N.L., R.M.S., A.A.B., A.A.-K.), the Department of Pathology, Sidra Medicine (P.T., M.R.H.), Primary Health Care Corporation (M.G.A.-K.), and the Ministry of Public Health (H.E.A.-R., M.H.A.-T., R.B.) - all in Doha, Qatar; the Departments of Population Health Sciences (H.C., H.N.A., A.A.B., L.J.A.-R.) and Medicine (A.A.B.), Weill Cornell Medicine, Cornell University, New York; and the Wellcome-Wolfson Institute for Experimental Medicine, Queen's University, Belfast, United Kingdom (P.C.)
| | - Adeel A Butt
- From the Infectious Disease Epidemiology Group (H.C., S.A., H.N.A., L.J.A.-R.) and the World Health Organization Collaborating Center for Disease Epidemiology Analytics on HIV/AIDS, Sexually Transmitted Infections, and Viral Hepatitis (H.C., S.A., H.N.A., L.J.A.-R.), Weill Cornell Medicine-Qatar, Cornell University, Qatar Foundation-Education City, the Mathematics Program, Department of Mathematics, Statistics, and Physics, College of Arts and Sciences, Qatar University (H.H.A.), and the Biomedical Research Center (P.C., H.M.Y., H.A.A.-K., M.K.S., G.K.N.) and the Departments of Biomedical Science (H.M.Y., H.A.A.-K., M.K.S., G.K.N.) and Public Health (H.F.A.-R., L.J.A.-R.), College of Health Sciences, QU Health, Qatar University, Hamad Medical Corporation (P.C., Z.A.-K., E.A.-K., A.J., A.H.K., A.N.L., R.M.S., A.A.B., A.A.-K.), the Department of Pathology, Sidra Medicine (P.T., M.R.H.), Primary Health Care Corporation (M.G.A.-K.), and the Ministry of Public Health (H.E.A.-R., M.H.A.-T., R.B.) - all in Doha, Qatar; the Departments of Population Health Sciences (H.C., H.N.A., A.A.B., L.J.A.-R.) and Medicine (A.A.B.), Weill Cornell Medicine, Cornell University, New York; and the Wellcome-Wolfson Institute for Experimental Medicine, Queen's University, Belfast, United Kingdom (P.C.)
| | - Mohamed H Al-Thani
- From the Infectious Disease Epidemiology Group (H.C., S.A., H.N.A., L.J.A.-R.) and the World Health Organization Collaborating Center for Disease Epidemiology Analytics on HIV/AIDS, Sexually Transmitted Infections, and Viral Hepatitis (H.C., S.A., H.N.A., L.J.A.-R.), Weill Cornell Medicine-Qatar, Cornell University, Qatar Foundation-Education City, the Mathematics Program, Department of Mathematics, Statistics, and Physics, College of Arts and Sciences, Qatar University (H.H.A.), and the Biomedical Research Center (P.C., H.M.Y., H.A.A.-K., M.K.S., G.K.N.) and the Departments of Biomedical Science (H.M.Y., H.A.A.-K., M.K.S., G.K.N.) and Public Health (H.F.A.-R., L.J.A.-R.), College of Health Sciences, QU Health, Qatar University, Hamad Medical Corporation (P.C., Z.A.-K., E.A.-K., A.J., A.H.K., A.N.L., R.M.S., A.A.B., A.A.-K.), the Department of Pathology, Sidra Medicine (P.T., M.R.H.), Primary Health Care Corporation (M.G.A.-K.), and the Ministry of Public Health (H.E.A.-R., M.H.A.-T., R.B.) - all in Doha, Qatar; the Departments of Population Health Sciences (H.C., H.N.A., A.A.B., L.J.A.-R.) and Medicine (A.A.B.), Weill Cornell Medicine, Cornell University, New York; and the Wellcome-Wolfson Institute for Experimental Medicine, Queen's University, Belfast, United Kingdom (P.C.)
| | - Abdullatif Al-Khal
- From the Infectious Disease Epidemiology Group (H.C., S.A., H.N.A., L.J.A.-R.) and the World Health Organization Collaborating Center for Disease Epidemiology Analytics on HIV/AIDS, Sexually Transmitted Infections, and Viral Hepatitis (H.C., S.A., H.N.A., L.J.A.-R.), Weill Cornell Medicine-Qatar, Cornell University, Qatar Foundation-Education City, the Mathematics Program, Department of Mathematics, Statistics, and Physics, College of Arts and Sciences, Qatar University (H.H.A.), and the Biomedical Research Center (P.C., H.M.Y., H.A.A.-K., M.K.S., G.K.N.) and the Departments of Biomedical Science (H.M.Y., H.A.A.-K., M.K.S., G.K.N.) and Public Health (H.F.A.-R., L.J.A.-R.), College of Health Sciences, QU Health, Qatar University, Hamad Medical Corporation (P.C., Z.A.-K., E.A.-K., A.J., A.H.K., A.N.L., R.M.S., A.A.B., A.A.-K.), the Department of Pathology, Sidra Medicine (P.T., M.R.H.), Primary Health Care Corporation (M.G.A.-K.), and the Ministry of Public Health (H.E.A.-R., M.H.A.-T., R.B.) - all in Doha, Qatar; the Departments of Population Health Sciences (H.C., H.N.A., A.A.B., L.J.A.-R.) and Medicine (A.A.B.), Weill Cornell Medicine, Cornell University, New York; and the Wellcome-Wolfson Institute for Experimental Medicine, Queen's University, Belfast, United Kingdom (P.C.)
| | - Roberto Bertollini
- From the Infectious Disease Epidemiology Group (H.C., S.A., H.N.A., L.J.A.-R.) and the World Health Organization Collaborating Center for Disease Epidemiology Analytics on HIV/AIDS, Sexually Transmitted Infections, and Viral Hepatitis (H.C., S.A., H.N.A., L.J.A.-R.), Weill Cornell Medicine-Qatar, Cornell University, Qatar Foundation-Education City, the Mathematics Program, Department of Mathematics, Statistics, and Physics, College of Arts and Sciences, Qatar University (H.H.A.), and the Biomedical Research Center (P.C., H.M.Y., H.A.A.-K., M.K.S., G.K.N.) and the Departments of Biomedical Science (H.M.Y., H.A.A.-K., M.K.S., G.K.N.) and Public Health (H.F.A.-R., L.J.A.-R.), College of Health Sciences, QU Health, Qatar University, Hamad Medical Corporation (P.C., Z.A.-K., E.A.-K., A.J., A.H.K., A.N.L., R.M.S., A.A.B., A.A.-K.), the Department of Pathology, Sidra Medicine (P.T., M.R.H.), Primary Health Care Corporation (M.G.A.-K.), and the Ministry of Public Health (H.E.A.-R., M.H.A.-T., R.B.) - all in Doha, Qatar; the Departments of Population Health Sciences (H.C., H.N.A., A.A.B., L.J.A.-R.) and Medicine (A.A.B.), Weill Cornell Medicine, Cornell University, New York; and the Wellcome-Wolfson Institute for Experimental Medicine, Queen's University, Belfast, United Kingdom (P.C.)
| | - Laith J Abu-Raddad
- From the Infectious Disease Epidemiology Group (H.C., S.A., H.N.A., L.J.A.-R.) and the World Health Organization Collaborating Center for Disease Epidemiology Analytics on HIV/AIDS, Sexually Transmitted Infections, and Viral Hepatitis (H.C., S.A., H.N.A., L.J.A.-R.), Weill Cornell Medicine-Qatar, Cornell University, Qatar Foundation-Education City, the Mathematics Program, Department of Mathematics, Statistics, and Physics, College of Arts and Sciences, Qatar University (H.H.A.), and the Biomedical Research Center (P.C., H.M.Y., H.A.A.-K., M.K.S., G.K.N.) and the Departments of Biomedical Science (H.M.Y., H.A.A.-K., M.K.S., G.K.N.) and Public Health (H.F.A.-R., L.J.A.-R.), College of Health Sciences, QU Health, Qatar University, Hamad Medical Corporation (P.C., Z.A.-K., E.A.-K., A.J., A.H.K., A.N.L., R.M.S., A.A.B., A.A.-K.), the Department of Pathology, Sidra Medicine (P.T., M.R.H.), Primary Health Care Corporation (M.G.A.-K.), and the Ministry of Public Health (H.E.A.-R., M.H.A.-T., R.B.) - all in Doha, Qatar; the Departments of Population Health Sciences (H.C., H.N.A., A.A.B., L.J.A.-R.) and Medicine (A.A.B.), Weill Cornell Medicine, Cornell University, New York; and the Wellcome-Wolfson Institute for Experimental Medicine, Queen's University, Belfast, United Kingdom (P.C.)
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9
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Neerukonda SN, Wang R, Vassell R, Baha H, Lusvarghi S, Liu S, Wang T, Weiss CD, Wang W. Characterization of Entry Pathways, Species-Specific Angiotensin-Converting Enzyme 2 Residues Determining Entry, and Antibody Neutralization Evasion of Omicron BA.1, BA.1.1, BA.2, and BA.3 Variants. J Virol 2022; 96:e0114022. [PMID: 36000843 PMCID: PMC9472608 DOI: 10.1128/jvi.01140-22] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Accepted: 08/01/2022] [Indexed: 11/20/2022] Open
Abstract
The SARS-CoV-2 Omicron variants were first detected in November 2021, and several Omicron lineages (BA.1, BA.2, BA.3, BA.4, and BA.5) have since rapidly emerged. Studies characterizing the mechanisms of Omicron variant infection and sensitivity to neutralizing antibodies induced upon vaccination are ongoing by several groups. In the present study, we used pseudoviruses to show that the transmembrane serine protease 2 (TMPRSS2) enhances infection of BA.1, BA.1.1, BA.2, and BA.3 Omicron variants to a lesser extent than ancestral D614G. We further show that Omicron variants have higher sensitivity to inhibition by soluble angiotensin-converting enzyme 2 (ACE2) and the endosomal inhibitor chloroquine compared to D614G. The Omicron variants also more efficiently used ACE2 receptors from 9 out of 10 animal species tested, and unlike the D614G variant, used mouse ACE2 due to the Q493R and Q498R spike substitutions. Finally, neutralization of the Omicron variants by antibodies induced by three doses of Pfizer/BNT162b2 mRNA vaccine was 7- to 8-fold less potent than the D614G. These results provide insights into the transmissibility and immune evasion capacity of the emerging Omicron variants to curb their ongoing spread. IMPORTANCE The ongoing emergence of SARS-CoV-2 Omicron variants with an extensive number of spike mutations poses a significant public health and zoonotic concern due to enhanced transmission fitness and escape from neutralizing antibodies. We studied three Omicron lineage variants (BA.1, BA.2, and BA.3) and found that transmembrane serine protease 2 has less influence on Omicron entry into cells than on D614G, and Omicron exhibits greater sensitivity to endosomal entry inhibition compared to D614G. In addition, Omicron displays more efficient usage of diverse animal species ACE2 receptors than D614G. Furthermore, due to Q493R/Q498R substitutions in spike, Omicron, but not D614G, can use the mouse ACE2 receptor. Finally, three doses of Pfizer/BNT162b2 mRNA vaccination elicit high neutralization titers against Omicron variants, although the neutralization titers are still 7- to 8-fold lower those that against D614G. These results may give insights into the transmissibility and immune evasion capacity of the emerging Omicron variants to curb their ongoing spread.
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Affiliation(s)
- Sabari Nath Neerukonda
- US Food and Drug Administration, Office of Vaccine Research and Review, Center for Biologics Evaluation, Research and Review, Silver Spring, Maryland, USA
| | - Richard Wang
- US Food and Drug Administration, Office of Vaccine Research and Review, Center for Biologics Evaluation, Research and Review, Silver Spring, Maryland, USA
| | - Russell Vassell
- US Food and Drug Administration, Office of Vaccine Research and Review, Center for Biologics Evaluation, Research and Review, Silver Spring, Maryland, USA
| | - Haseebullah Baha
- US Food and Drug Administration, Office of Vaccine Research and Review, Center for Biologics Evaluation, Research and Review, Silver Spring, Maryland, USA
| | - Sabrina Lusvarghi
- US Food and Drug Administration, Office of Vaccine Research and Review, Center for Biologics Evaluation, Research and Review, Silver Spring, Maryland, USA
| | - Shufeng Liu
- US Food and Drug Administration, Office of Vaccine Research and Review, Center for Biologics Evaluation, Research and Review, Silver Spring, Maryland, USA
| | - Tony Wang
- US Food and Drug Administration, Office of Vaccine Research and Review, Center for Biologics Evaluation, Research and Review, Silver Spring, Maryland, USA
| | - Carol D. Weiss
- US Food and Drug Administration, Office of Vaccine Research and Review, Center for Biologics Evaluation, Research and Review, Silver Spring, Maryland, USA
| | - Wei Wang
- US Food and Drug Administration, Office of Vaccine Research and Review, Center for Biologics Evaluation, Research and Review, Silver Spring, Maryland, USA
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10
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Gupta SL, Mantus G, Manning KE, Ellis M, Patel M, Ciric CR, Lu A, Turner JS, O’Halloran JA, Presti RM, Joshi DJ, Ellebedy AH, Anderson EJ, Rostad CA, Suthar MS, Wrammert J. Loss of Pfizer (BNT162b2) Vaccine-Induced Antibody Responses against the SARS-CoV-2 Omicron Variant in Adolescents and Adults. J Virol 2022; 96:e0058222. [PMID: 35976000 PMCID: PMC9472620 DOI: 10.1128/jvi.00582-22] [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] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Accepted: 07/12/2022] [Indexed: 12/19/2022] Open
Abstract
Emerging variants, especially the recent Omicron variant, and gaps in vaccine coverage threaten mRNA vaccine mediated protection against SARS-CoV-2. While children have been relatively spared by the ongoing pandemic, increasing case numbers and hospitalizations are now evident among children. Thus, it is essential to better understand the magnitude and breadth of vaccine-induced immunity in children against circulating viral variant of concerns (VOCs). Here, we compared the magnitude and breadth of humoral immune responses in adolescents and adults 1 month after the two-dose Pfizer (BNT162b2) vaccination. We found that adolescents (aged 11 to 16) demonstrated more robust binding antibody and neutralization responses against the wild-type SARS-CoV-2 virus spike protein contained in the vaccine compared to adults (aged 27 to 55). The quality of the antibody responses against VOCs in adolescents were very similar to adults, with modest changes in binding and neutralization of Beta, Gamma, and Delta variants. In comparison, a significant reduction of binding titers and a striking lack of neutralization was observed against the newly emerging Omicron variant for both adolescents and adults. Overall, our data show that a two-dose BNT162b2 vaccine series may be insufficient to protect against the Omicron variant. IMPORTANCE While plasma binding and neutralizing antibody responses have been reported for cohorts of infected and vaccinated adults, much less is known about the vaccine-induced antibody responses to variants including Omicron in children. This illustrates the need to characterize vaccine efficacy in key vulnerable populations. A third (booster) dose of BNTb162b was approved for children 12 to 15 years of age by the Food and Drug Administration (FDA) on January 1, 2022, and pediatric clinical trials are under way to evaluate the safety, immunogenicity, and effectiveness of a third dose in younger children. Similarly, variant-specific booster doses and pan-coronavirus vaccines are areas of active research. Our data show adolescents mounted stronger humoral immune responses after vaccination than adults. It also highlights the need for future studies of antibody durability in adolescents and children as well as the need for future studies of booster vaccination and their efficacy against the Omicron variant.
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Affiliation(s)
- Sneh Lata Gupta
- Division of Infectious Diseases, Department of Pediatrics, School of Medicine, Emory University, Atlanta, Georgia, USA
- Emory Vaccine Center, Emory University School of Medicine, Atlanta, Georgia, USA
- Centers for Childhood Infections and Vaccines, Children's Healthcare of Atlanta, Atlanta, Georgia, USA
| | - Grace Mantus
- Division of Infectious Diseases, Department of Pediatrics, School of Medicine, Emory University, Atlanta, Georgia, USA
- Emory Vaccine Center, Emory University School of Medicine, Atlanta, Georgia, USA
- Centers for Childhood Infections and Vaccines, Children's Healthcare of Atlanta, Atlanta, Georgia, USA
| | - Kelly E. Manning
- Division of Infectious Diseases, Department of Pediatrics, School of Medicine, Emory University, Atlanta, Georgia, USA
- Emory Vaccine Center, Emory University School of Medicine, Atlanta, Georgia, USA
- National Primate Research Center, Atlanta, Georgia, USA
| | - Madison Ellis
- Division of Infectious Diseases, Department of Pediatrics, School of Medicine, Emory University, Atlanta, Georgia, USA
- Emory Vaccine Center, Emory University School of Medicine, Atlanta, Georgia, USA
- National Primate Research Center, Atlanta, Georgia, USA
| | - Mit Patel
- Division of Infectious Diseases, Department of Pediatrics, School of Medicine, Emory University, Atlanta, Georgia, USA
- Emory Vaccine Center, Emory University School of Medicine, Atlanta, Georgia, USA
- National Primate Research Center, Atlanta, Georgia, USA
| | - Caroline Rose Ciric
- Division of Infectious Diseases, Department of Pediatrics, School of Medicine, Emory University, Atlanta, Georgia, USA
- Centers for Childhood Infections and Vaccines, Children's Healthcare of Atlanta, Atlanta, Georgia, USA
| | - Austin Lu
- Division of Infectious Diseases, Department of Pediatrics, School of Medicine, Emory University, Atlanta, Georgia, USA
- Centers for Childhood Infections and Vaccines, Children's Healthcare of Atlanta, Atlanta, Georgia, USA
| | - Jackson S. Turner
- Department of Pathology and Immunology, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Jane A. O’Halloran
- Division of Infectious Diseases, Department of Internal Medicine, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Rachel M. Presti
- Center for Vaccines and Immunity to Microbial Pathogens, Washington University School of Medicine, St. Louis, Missouri, USA
- Division of Infectious Diseases, Department of Internal Medicine, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Devyani Jaideep Joshi
- Division of Infectious Diseases, Department of Pediatrics, School of Medicine, Emory University, Atlanta, Georgia, USA
- Emory Vaccine Center, Emory University School of Medicine, Atlanta, Georgia, USA
- Centers for Childhood Infections and Vaccines, Children's Healthcare of Atlanta, Atlanta, Georgia, USA
| | - Ali H. Ellebedy
- Department of Pathology and Immunology, Washington University School of Medicine, St. Louis, Missouri, USA
- The Andrew M. and Jane M. Bursky Center for Human Immunology & Immunotherapy Programs, Washington University School of Medicine, St. Louis, Missouri, USA
- Center for Vaccines and Immunity to Microbial Pathogens, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Evan J. Anderson
- Division of Infectious Diseases, Department of Pediatrics, School of Medicine, Emory University, Atlanta, Georgia, USA
- Centers for Childhood Infections and Vaccines, Children's Healthcare of Atlanta, Atlanta, Georgia, USA
- Department of Medicine, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Christina A. Rostad
- Division of Infectious Diseases, Department of Pediatrics, School of Medicine, Emory University, Atlanta, Georgia, USA
- Centers for Childhood Infections and Vaccines, Children's Healthcare of Atlanta, Atlanta, Georgia, USA
| | - Mehul S. Suthar
- Division of Infectious Diseases, Department of Pediatrics, School of Medicine, Emory University, Atlanta, Georgia, USA
- Emory Vaccine Center, Emory University School of Medicine, Atlanta, Georgia, USA
- Centers for Childhood Infections and Vaccines, Children's Healthcare of Atlanta, Atlanta, Georgia, USA
- Department of Microbiology and Immunology, Emory University, Atlanta, Georgia, USA
- National Primate Research Center, Atlanta, Georgia, USA
| | - Jens Wrammert
- Division of Infectious Diseases, Department of Pediatrics, School of Medicine, Emory University, Atlanta, Georgia, USA
- Emory Vaccine Center, Emory University School of Medicine, Atlanta, Georgia, USA
- Centers for Childhood Infections and Vaccines, Children's Healthcare of Atlanta, Atlanta, Georgia, USA
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11
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Sattler A, Thumfart J, Tóth L, Schrezenmeier E, Proß V, Stahl C, Siegle J, He A, Thole LML, Ludwig C, Straub-Hohenbleicher H, Friedersdorff F, Jahrsdörfer B, Schrezenmeier H, Bufler P, Kotsch K. SARS-CoV2 mRNA Vaccine-Specific B-, T- and Humoral Responses in Adolescents After Kidney Transplantation. Transpl Int 2022; 35:10677. [PMID: 35992746 PMCID: PMC9385879 DOI: 10.3389/ti.2022.10677] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Accepted: 07/11/2022] [Indexed: 11/13/2022]
Abstract
Protection of adult kidney transplant recipients against SARS-CoV2 was shown to be strongly impaired owing to low reactogenicity of available vaccines. So far, data on vaccination outcomes in adolescents are scarce due to later vaccination approval for this age group. We therefore comprehensively analyzed vaccination-specific humoral-, T- and B-cell responses in kidney transplanted adolescents aged 12–18 years in comparison to healthy controls 6 weeks after standard two-dose BNT162b2 (“Comirnaty”; Pfizer/BioNTech) vaccination. Importantly, 90% (18/20) of transplanted adolescents showed IgG seroconversion with 75% (15/20) developing neutralizing titers. Still, both features were significantly diminished in magnitude compared to controls. Correspondingly, spike-specific B cells were quantitatively reduced and enriched for non-isotype-class-switched IgD+27+ memory cells in patients. Whereas spike specific CD4+ T cell frequencies were similar in both groups, cytokine production and memory differentiation were significantly impaired in transplant recipients. Although our data identify limitations in all arms of vaccine-specific immunity, the majority of our adolescent patients showed robust humoral responses despite antimetabolite-based treatment being associated with poor vaccination outcomes in adults.
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Affiliation(s)
- Arne Sattler
- Department of General and Visceral Surgery, Charite-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
- *Correspondence: Arne Sattler, ; Katja Kotsch,
| | - Julia Thumfart
- Department of Pediatric Gastroenterology, Nephrology and Metabolic Diseases, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Laura Tóth
- Department of General and Visceral Surgery, Charite-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Eva Schrezenmeier
- Department of Nephrology and Medical Intensive Care, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
- Department of Rheumatology and Clinical Immunology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
- Berlin Institute of Health at Charité-Universitätsmedizin Berlin, BIH Academy, Clinician Scientist Program Universitätsmedizin Berlin, Berlin, Germany
| | - Vanessa Proß
- Department of General and Visceral Surgery, Charite-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Carolin Stahl
- Department of General and Visceral Surgery, Charite-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Janine Siegle
- Department of General and Visceral Surgery, Charite-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - An He
- Department of General and Visceral Surgery, Charite-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Linda Marie Laura Thole
- Department of General and Visceral Surgery, Charite-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Carolin Ludwig
- Institute of Transfusion Medicine, Ulm University, Ulm, Germany
- Institute for Clinical Transfusion Medicine and Immunogenetics, German Red Cross Blood Transfusion Service Baden-Württemberg—Hessen and University Hospital Ulm, Ulm, Germany
| | - Henriette Straub-Hohenbleicher
- Department of Nephrology and Medical Intensive Care, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Frank Friedersdorff
- Department of Urology, Evangelisches Krankenhaus Königin Elisabeth Herzberge, Berlin, Germany
- Department of Urology, Charite-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Bernd Jahrsdörfer
- Institute of Transfusion Medicine, Ulm University, Ulm, Germany
- Institute for Clinical Transfusion Medicine and Immunogenetics, German Red Cross Blood Transfusion Service Baden-Württemberg—Hessen and University Hospital Ulm, Ulm, Germany
| | - Hubert Schrezenmeier
- Institute of Transfusion Medicine, Ulm University, Ulm, Germany
- Institute for Clinical Transfusion Medicine and Immunogenetics, German Red Cross Blood Transfusion Service Baden-Württemberg—Hessen and University Hospital Ulm, Ulm, Germany
| | - Philip Bufler
- Department of Pediatric Gastroenterology, Nephrology and Metabolic Diseases, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Katja Kotsch
- Department of General and Visceral Surgery, Charite-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
- *Correspondence: Arne Sattler, ; Katja Kotsch,
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12
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Jackson EM, Harper S, Webb GJ, Thomas W. Severe refractory warm autoimmune haemolytic anaemia after the SARS-CoV-2 Pfizer-BioNTech vaccine (BNT162b2 mRNA) managed with emergency splenectomy and complement inhibition with eculizumab. BMJ Case Rep 2022; 15:15/8/e250774. [PMID: 36107725 PMCID: PMC9438040 DOI: 10.1136/bcr-2022-250774] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
A male in his teens with a history of liver transplant for biliary atresia (aged 2 years) and autoimmune haemolytic anaemia (AIHA, aged 6 years) presented with jaundice, dark urine, fatigue and chest discomfort that began 48 hours after the first dose of SARS-CoV-2 Pfizer-BioNTech vaccine (BNT162b2 mRNA). Investigations revealed a warm AIHA picture. Over 4 weeks the patient developed life-threatening anaemia culminating in haemoglobin of 35 g/L (after transfusion), lactate dehydrogenase of 1293 units/L and bilirubin of 228 µmol/L, refractory to standard treatment with corticosteroids and rituximab. An emergency splenectomy was performed that slowed haemolysis but did not completely ameliorate it. Eculizumab, a terminal complement pathway inhibitor, was initiated to arrest intravascular haemolysis and showed a favourable response. AIHA is rare but described after the SARS-CoV-2 Pfizer-BioNTech vaccine. This case highlights the rare complication of AIHA, the use of emergency splenectomy for disease control, and the use of eculizumab.
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Affiliation(s)
| | - Simon Harper
- Hepatopancreaticobiliary Surgery, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - Gwilym J Webb
- Department of hepatology, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - Will Thomas
- Department of haematology, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
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13
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Piotrowska M, Zieliński M, Tylicki L, Biedunkiewicz B, Kubanek A, Ślizień Z, Polewska K, Tylicki P, Muchlado M, Sakowska J, Renke M, Sudoł A, Dąbrowska M, Lichodziejewska-Niemierko M, Smiatacz T, Dębska-Ślizień A, Trzonkowski P. Local and Systemic Immunity Are Impaired in End-Stage-Renal-Disease Patients Treated With Hemodialysis, Peritoneal Dialysis and Kidney Transplant Recipients Immunized With BNT162b2 Pfizer-BioNTech SARS-CoV-2 Vaccine. Front Immunol 2022; 13:832924. [PMID: 35935974 PMCID: PMC9354587 DOI: 10.3389/fimmu.2022.832924] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Accepted: 06/21/2022] [Indexed: 01/14/2023] Open
Abstract
Vaccination against COVID-19 in patients with end-stage renal disease (ESRD) on replacement therapy and kidney transplant recipients (KTRs) is particularly important due to the high mortality rate. Here, we tested the local and systemic immunity to the novel Pfizer BioNTech (BNT162b2) messenger RNA (mRNA) in ESRD, KTR patients, and healthy individuals (150 subjects). The ESRD group was divided into: hemodialysis (HD) and peritoneal dialysis (PD). We investigated the local and systemic immunity based on anti-N (nucleoprotein) and anti-S (spike1/2) Immunoglobulin A (IgA) and Immunoglobulin G (IgG) antibodies, respectively. Additionally, we performed an Interferon gamma (IFN-γ) release test Interferon-gamma release assay (IGRA) to monitor the cellular component of vaccine response. The control group had the highest level of anti-S IgG antibodies (153/2,080 binding antibody units (BAU)/ml) among all analyzed patients after the 1st and 2nd dose, respectively. The HD group (48/926 BAU/ml) had a diminished antibody level compared to PD (93/1,607 BAU/ml). Moreover, the seroconversion rate after the 1st dose was lower in HD than PD (56% vs. 86%). KTRs had extremely low seroconversion (33%). IgA-mediated immunity was the most effective in the control group, while other patients had diminished IgA production. We observed a lower percentage of vaccine responders based on the IFN-γ level in all research participants (100% vs. 85% in control, 100% vs. 80% in PD, 97% vs. 64% in HD). 63% of seropositive KTRs had a positive IGRA, while 28% of seronegative patients produced IFN-γ. Collectively, PD patients had the strongest response among ESRD patients. Two doses of the Pfizer vaccine are ineffective, especially in HD and KTRs. A closer investigation of ESRD and KTRs is required to set the COVID-19 vaccine clinical guidance.
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Affiliation(s)
| | - Maciej Zieliński
- Department of Medical Immunology, Medical University of Gdansk, Gdansk, Poland
| | - Leszek Tylicki
- Department of Nephrology, Transplantology and Internal Medicine, Medical University of Gdansk, Gdansk, Poland
| | - Bogdan Biedunkiewicz
- Department of Nephrology, Transplantology and Internal Medicine, Medical University of Gdansk, Gdansk, Poland
| | - Alicja Kubanek
- Department of Occupational, Metabolic and Internal Diseases, Medical University of Gdansk, Gdansk, Poland
| | - Zuzanna Ślizień
- Department of Nephrology, Transplantology and Internal Medicine, Medical University of Gdansk, Gdansk, Poland
| | - Karolina Polewska
- Department of Nephrology, Transplantology and Internal Medicine, Medical University of Gdansk, Gdansk, Poland
| | - Piotr Tylicki
- Department of Nephrology, Transplantology and Internal Medicine, Medical University of Gdansk, Gdansk, Poland
| | - Marta Muchlado
- Department of Nephrology, Transplantology and Internal Medicine, Medical University of Gdansk, Gdansk, Poland
| | - Justyna Sakowska
- Department of Medical Immunology, Medical University of Gdansk, Gdansk, Poland
| | - Marcin Renke
- Department of Occupational, Metabolic and Internal Diseases, Medical University of Gdansk, Gdansk, Poland
| | - Adam Sudoł
- Clinical Laboratory, University Clinical Centre, Gdansk, Poland
| | | | - Monika Lichodziejewska-Niemierko
- Department of Nephrology, Transplantology and Internal Medicine, Medical University of Gdansk, Gdansk, Poland
- Department of Palliative Medicine, Medical University of Gdansk, Gdansk, Poland
| | - Tomasz Smiatacz
- Department of Infectious Diseases, Medical University of Gdansk, Gdansk, Poland
| | - Alicja Dębska-Ślizień
- Department of Nephrology, Transplantology and Internal Medicine, Medical University of Gdansk, Gdansk, Poland
| | - Piotr Trzonkowski
- Department of Medical Immunology, Medical University of Gdansk, Gdansk, Poland
- *Correspondence: Piotr Trzonkowski,
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14
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Abstract
Pfizer-BioNTech COVID-19 (BNT162b2) conferred a high level of protection against Covid-19 with a proven short-term safety profile. Although cases of vaccine-associated myopericarditis have been reported, the existence of rhabdomyolysis without myocarditis has not yet been published. A 16-year-old, healthy male patient, who did not use any herbal or illegal drugs before, was admitted with muscle pain that developed after the second dose of BNT162b2 vaccine. Cardiac examination and heart enzymes were normal and the patient had significantly higher creatinine kinase levels. The patient, whose enzymes returned to normal with only force hydration therapy, recovered without complications. Reporting the side effects of the vaccine, which has a short history of application to large populations, is of vital importance in the conduct of vaccine development studies and in identifying the risky group in terms of side effects.
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Affiliation(s)
- Murat Sutcu
- Istinye University Faculty of Medicine, Bahcesehir Liv Hospital, Pediatric Infectious Diseases, Istanbul, Turkey
| | - Doruk Gul
- Istinye University Faculty of Medicine, Bahcesehir Liv Hospital, Pediatric, Istanbul, Turkey
| | - Fatih Atik
- Istinye University Faculty of Medicine, Bahcesehir Liv Hospital, Pediatric Cardiology, Istanbul, Turkey
| | - Manolya Kara
- Istinye University Faculty of Medicine, Ulus Liv Hospital, Pediatric Infectious Diseases, Istanbul, Turkey
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15
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Zamfir MA, Moraru L, Dobrea C, Scheau AE, Iacob S, Moldovan C, Scheau C, Caruntu C, Caruntu A. Hematologic Malignancies Diagnosed in the Context of the mRNA COVID-19 Vaccination Campaign: A Report of Two Cases. Medicina (B Aires) 2022; 58:medicina58070874. [PMID: 35888593 PMCID: PMC9316988 DOI: 10.3390/medicina58070874] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Revised: 06/23/2022] [Accepted: 06/27/2022] [Indexed: 12/19/2022] Open
Abstract
Background: During the last two years, the COVID-19 pandemic led to millions of disease-related deaths worldwide. The efforts of the scientific community facing this global challenge resulted in outstanding achievements. Thus, within one year, new mRNA-based vaccines against SARS-CoV-2 viral infection were released, providing highly efficient protection and showing a very good safety profile in the general population. However, clinical data collection after vaccination is a continuous process for the long-term safety of any new medical product. The aim of our paper is to present two cases of hematological malignancies: diffuse large B-cell non-Hodgkin lymphoma and T/NK-cell lymphoma, diagnosed shortly after the administration of the mRNA COVID-19 vaccine. Methods and Results: Case 1: A female patient was admitted with a suspicious cervical mass that emerged within one week after the administration of second dose of the BNT162b2 COVID-19 vaccine. Surgical removal followed by pathology assessment of the specimen confirmed the diagnosis of diffuse large B-cell non-Hodgkin lymphoma. Case 2: A male patient was admitted with multiple ulcerative oral lesions arising on the third day after the initial dose of the BNT162b2 COVID-19 vaccine. These lesions had a progressive character and during the following months were complicated with repetitive episodes of heavy oral bleeding, requiring blood transfusions. The incisional biopsy of the lesions and pathological assessment of the specimens confirmed the diagnosis of T/NK-cell lymphoma. Conclusions: The safety profile of the mRNA-based vaccines is an undeniable fact. In most cases, suspicions of potentially aggressive side effects were ruled out, proving to be transient post-vaccine reactions. Clinicians should remain alert to report any potentially aggressive manifestations emerging in the context of mRNA COVID-19 vaccination, such as these cases of hematological malignancies, in order to promote additional investigations on the particular mechanisms of action of COVID-19 vaccines and to provide the best medical care to the patients.
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Affiliation(s)
- Maria-Alexandra Zamfir
- Department of Oral and Maxillofacial Surgery, “Carol Davila” Central Military Emergency Hospital, 010825 Bucharest, Romania; (M.-A.Z.); (L.M.); (A.C.)
| | - Liliana Moraru
- Department of Oral and Maxillofacial Surgery, “Carol Davila” Central Military Emergency Hospital, 010825 Bucharest, Romania; (M.-A.Z.); (L.M.); (A.C.)
- Department of Oral and Maxillofacial Surgery, Faculty of Dental Medicine, “Titu Maiorescu” University, 031593 Bucharest, Romania
| | - Camelia Dobrea
- Department of Hematology, Fundeni Clinical Institute, 022328 Bucharest, Romania;
- Department of Hematology, University of Medicine and Pharmacy “Carol Davila”, 050474 Bucharest, Romania
| | - Andreea-Elena Scheau
- Department of Radiology and Medical Imaging, Fundeni Clinical Institute, 022328 Bucharest, Romania;
| | - Simona Iacob
- Pathology Laboratory Personal Genetics, 010987 Bucharest, Romania;
| | - Cosmin Moldovan
- Faculty of Medicine, “Titu Maiorescu” University, 031593 Bucharest, Romania;
- General Surgery Ward, Witting Clinical Hospital, 010243 Bucharest, Romania
| | - Cristian Scheau
- Department of Physiology, “Carol Davila” University of Medicine and Pharmacy, 050474 Bucharest, Romania
- Correspondence: (C.S.); (C.C.)
| | - Constantin Caruntu
- Department of Physiology, “Carol Davila” University of Medicine and Pharmacy, 050474 Bucharest, Romania
- Department of Dermatology, “Prof. N.C. Paulescu” National Institute of Diabetes, Nutrition and Metabolic Diseases, 011233 Bucharest, Romania
- Correspondence: (C.S.); (C.C.)
| | - Ana Caruntu
- Department of Oral and Maxillofacial Surgery, “Carol Davila” Central Military Emergency Hospital, 010825 Bucharest, Romania; (M.-A.Z.); (L.M.); (A.C.)
- Department of Oral and Maxillofacial Surgery, Faculty of Dental Medicine, “Titu Maiorescu” University, 031593 Bucharest, Romania
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16
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Liu C, Lee J, Ta C, Soroush A, Rogers JR, Kim JH, Natarajan K, Zucker J, Perl Y, Weng C. Risk Factors Associated With SARS-CoV-2 Breakthrough Infections in Fully mRNA-Vaccinated Individuals: Retrospective Analysis. JMIR Public Health Surveill 2022; 8:e35311. [PMID: 35486806 PMCID: PMC9132195 DOI: 10.2196/35311] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Revised: 03/29/2022] [Accepted: 04/27/2022] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND COVID-19 messenger RNA (mRNA) vaccines have demonstrated efficacy and effectiveness in preventing symptomatic COVID-19, while being relatively safe in trial studies. However, vaccine breakthrough infections have been reported. OBJECTIVE This study aims to identify risk factors associated with COVID-19 breakthrough infections among fully mRNA-vaccinated individuals. METHODS We conducted a series of observational retrospective analyses using the electronic health records (EHRs) of the Columbia University Irving Medical Center/New York Presbyterian (CUIMC/NYP) up to September 21, 2021. New York City (NYC) adult residences with at least 1 polymerase chain reaction (PCR) record were included in this analysis. Poisson regression was performed to assess the association between the breakthrough infection rate in vaccinated individuals and multiple risk factors-including vaccine brand, demographics, and underlying conditions-while adjusting for calendar month, prior number of visits, and observational days in the EHR. RESULTS The overall estimated breakthrough infection rate was 0.16 (95% CI 0.14-0.18). Individuals who were vaccinated with Pfizer/BNT162b2 (incidence rate ratio [IRR] against Moderna/mRNA-1273=1.66, 95% CI 1.17-2.35) were male (IRR against female=1.47, 95% CI 1.11-1.94) and had compromised immune systems (IRR=1.48, 95% CI 1.09-2.00) were at the highest risk for breakthrough infections. Among all underlying conditions, those with primary immunodeficiency, a history of organ transplant, an active tumor, use of immunosuppressant medications, or Alzheimer disease were at the highest risk. CONCLUSIONS Although we found both mRNA vaccines were effective, Moderna/mRNA-1273 had a lower incidence rate of breakthrough infections. Immunocompromised and male individuals were among the highest risk groups experiencing breakthrough infections. Given the rapidly changing nature of the SARS-CoV-2 pandemic, continued monitoring and a generalizable analysis pipeline are warranted to inform quick updates on vaccine effectiveness in real time.
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Affiliation(s)
- Cong Liu
- Department of Biomedical Informatics, Columbia University Irving Medical Center, New York, NY, United States
| | - Junghwan Lee
- Department of Biomedical Informatics, Columbia University Irving Medical Center, New York, NY, United States
| | - Casey Ta
- Department of Biomedical Informatics, Columbia University Irving Medical Center, New York, NY, United States
| | - Ali Soroush
- Department of Biomedical Informatics, Columbia University Irving Medical Center, New York, NY, United States
| | - James R Rogers
- Department of Biomedical Informatics, Columbia University Irving Medical Center, New York, NY, United States
| | - Jae Hyun Kim
- School of Pharmacy, Jeonbuk National University, Jeonju, Republic of Korea
| | - Karthik Natarajan
- Department of Biomedical Informatics, Columbia University Irving Medical Center, New York, NY, United States
| | - Jason Zucker
- Department of Medicine, Columbia University Irving Medical Center, New York, NY, United States
| | - Yehoshua Perl
- Department of Computer Science, New Jersey Institute of Technology, Newark, NJ, United States
| | - Chunhua Weng
- Department of Biomedical Informatics, Columbia University Irving Medical Center, New York, NY, United States
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17
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Chandrashekar A, Yu J, McMahan K, Jacob-Dolan C, Liu J, He X, Hope D, Anioke T, Barrett J, Chung B, Hachmann NP, Lifton M, Miller J, Powers O, Sciacca M, Sellers D, Siamatu M, Surve N, VanWyk H, Wan H, Wu C, Pessaint L, Valentin D, Van Ry A, Muench J, Boursiquot M, Cook A, Velasco J, Teow E, Boon ACM, Suthar MS, Jain N, Martinot AJ, Lewis MG, Andersen H, Barouch DH. Vaccine protection against the SARS-CoV-2 Omicron variant in macaques. Cell 2022; 185:1549-1555.e11. [PMID: 35427477 PMCID: PMC8926910 DOI: 10.1016/j.cell.2022.03.024] [Citation(s) in RCA: 46] [Impact Index Per Article: 23.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Revised: 02/28/2022] [Accepted: 03/14/2022] [Indexed: 12/12/2022]
Abstract
The rapid spread of the SARS-CoV-2 Omicron (B.1.1.529) variant, including in highly vaccinated populations, has raised important questions about the efficacy of current vaccines. In this study, we show that the mRNA-based BNT162b2 vaccine and the adenovirus-vector-based Ad26.COV2.S vaccine provide robust protection against high-dose challenge with the SARS-CoV-2 Omicron variant in cynomolgus macaques. We vaccinated 30 macaques with homologous and heterologous prime-boost regimens with BNT162b2 and Ad26.COV2.S. Following Omicron challenge, vaccinated macaques demonstrated rapid control of virus in bronchoalveolar lavage, and most vaccinated animals also controlled virus in nasal swabs. However, 4 vaccinated animals that had moderate Omicron-neutralizing antibody titers and undetectable Omicron CD8+ T cell responses failed to control virus in the upper respiratory tract. Moreover, virologic control correlated with both antibody and T cell responses. These data suggest that both humoral and cellular immune responses contribute to vaccine protection against a highly mutated SARS-CoV-2 variant.
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Affiliation(s)
- Abishek Chandrashekar
- Center for Virology and Vaccine Research, Beth Israel Deaconess Medical Center, Boston, MA 02115, USA
| | - Jingyou Yu
- Center for Virology and Vaccine Research, Beth Israel Deaconess Medical Center, Boston, MA 02115, USA
| | - Katherine McMahan
- Center for Virology and Vaccine Research, Beth Israel Deaconess Medical Center, Boston, MA 02115, USA
| | - Catherine Jacob-Dolan
- Center for Virology and Vaccine Research, Beth Israel Deaconess Medical Center, Boston, MA 02115, USA; Ragon Institute of MGH, MIT, and Harvard, Cambridge, MA, USA
| | - Jinyan Liu
- Center for Virology and Vaccine Research, Beth Israel Deaconess Medical Center, Boston, MA 02115, USA
| | - Xuan He
- Center for Virology and Vaccine Research, Beth Israel Deaconess Medical Center, Boston, MA 02115, USA
| | - David Hope
- Center for Virology and Vaccine Research, Beth Israel Deaconess Medical Center, Boston, MA 02115, USA
| | - Tochi Anioke
- Center for Virology and Vaccine Research, Beth Israel Deaconess Medical Center, Boston, MA 02115, USA
| | - Julia Barrett
- Center for Virology and Vaccine Research, Beth Israel Deaconess Medical Center, Boston, MA 02115, USA
| | - Benjamin Chung
- Center for Virology and Vaccine Research, Beth Israel Deaconess Medical Center, Boston, MA 02115, USA
| | - Nicole P Hachmann
- Center for Virology and Vaccine Research, Beth Israel Deaconess Medical Center, Boston, MA 02115, USA
| | - Michelle Lifton
- Center for Virology and Vaccine Research, Beth Israel Deaconess Medical Center, Boston, MA 02115, USA
| | - Jessica Miller
- Center for Virology and Vaccine Research, Beth Israel Deaconess Medical Center, Boston, MA 02115, USA
| | - Olivia Powers
- Center for Virology and Vaccine Research, Beth Israel Deaconess Medical Center, Boston, MA 02115, USA
| | - Michaela Sciacca
- Center for Virology and Vaccine Research, Beth Israel Deaconess Medical Center, Boston, MA 02115, USA
| | - Daniel Sellers
- Center for Virology and Vaccine Research, Beth Israel Deaconess Medical Center, Boston, MA 02115, USA
| | - Mazuba Siamatu
- Center for Virology and Vaccine Research, Beth Israel Deaconess Medical Center, Boston, MA 02115, USA
| | - Nehalee Surve
- Center for Virology and Vaccine Research, Beth Israel Deaconess Medical Center, Boston, MA 02115, USA
| | - Haley VanWyk
- Center for Virology and Vaccine Research, Beth Israel Deaconess Medical Center, Boston, MA 02115, USA
| | - Huahua Wan
- Center for Virology and Vaccine Research, Beth Israel Deaconess Medical Center, Boston, MA 02115, USA
| | - Cindy Wu
- Center for Virology and Vaccine Research, Beth Israel Deaconess Medical Center, Boston, MA 02115, USA
| | | | | | | | | | | | | | | | | | | | | | - Neharika Jain
- Tufts University Cummings School of Veterinary Medicine, North Grafton, MA, USA
| | - Amanda J Martinot
- Tufts University Cummings School of Veterinary Medicine, North Grafton, MA, USA
| | | | | | - Dan H Barouch
- Center for Virology and Vaccine Research, Beth Israel Deaconess Medical Center, Boston, MA 02115, USA; Ragon Institute of MGH, MIT, and Harvard, Cambridge, MA, USA.
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18
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Friedensohn L, Levin D, Fadlon-Derai M, Gershovitz L, Fink N, Glassberg E, Gordon B. Myocarditis Following a Third BNT162b2 Vaccination Dose in Military Recruits in Israel. JAMA 2022; 327:1611-1612. [PMID: 35297962 PMCID: PMC8931670 DOI: 10.1001/jama.2022.4425] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
This study assessed whether a third vaccine dose was associated with the risk of myocarditis among military personnel in Israel.
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Affiliation(s)
| | - Dan Levin
- Medical Corps, Israel Defense Forces, Israel
| | | | | | - Noam Fink
- Medical Corps, Israel Defense Forces, Israel
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19
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Fowlkes AL, Yoon SK, Lutrick K, Gwynn L, Burns J, Grant L, Phillips AL, Ellingson K, Ferraris MV, LeClair LB, Mathenge C, Yoo YM, Thiese MS, Gerald LB, Solle NS, Jeddy Z, Odame-Bamfo L, Mak J, Hegmann KT, Gerald JK, Ochoa JS, Berry M, Rose S, Lamberte JM, Madhivanan P, Pubillones FA, Rai RP, Dunnigan K, Jones JT, Krupp K, Edwards LJ, Bedrick EJ, Sokol BE, Lowe A, McLeland-Wieser H, Jovel KS, Fleary DE, Khan SM, Poe B, Hollister J, Lopez J, Rivers P, Beitel S, Tyner HL, Naleway AL, Olsho LE, Caban-Martinez AJ, Burgess JL, Thompson MG, Gaglani M. Effectiveness of 2-Dose BNT162b2 (Pfizer BioNTech) mRNA Vaccine in Preventing SARS-CoV-2 Infection Among Children Aged 5-11 Years and Adolescents Aged 12-15 Years - PROTECT Cohort, July 2021-February 2022. MMWR Morb Mortal Wkly Rep 2022; 71:422-428. [PMID: 35298453 PMCID: PMC8942308 DOI: 10.15585/mmwr.mm7111e1] [Citation(s) in RCA: 99] [Impact Index Per Article: 49.5] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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20
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Prunas O, Warren JL, Crawford FW, Gazit S, Patalon T, Weinberger DM, Pitzer VE. Vaccination with BNT162b2 reduces transmission of SARS-CoV-2 to household contacts in Israel. Science 2022; 375:1151-1154. [PMID: 35084937 PMCID: PMC9261115 DOI: 10.1126/science.abl4292] [Citation(s) in RCA: 80] [Impact Index Per Article: 40.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Accepted: 01/21/2022] [Indexed: 12/17/2022]
Abstract
The effectiveness of vaccines against COVID-19 on the individual level is well established. However, few studies have examined vaccine effectiveness against transmission. We used a chain binomial model to estimate the effectiveness of vaccination with BNT162b2 [Pfizer-BioNTech messenger RNA (mRNA)-based vaccine] against household transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in Israel before and after emergence of the B.1.617.2 (Delta) variant. Vaccination reduced susceptibility to infection by 89.4% [95% confidence interval (CI): 88.7 to 90.0%], whereas vaccine effectiveness against infectiousness given infection was 23.0% (95% CI: -11.3 to 46.7%) during days 10 to 90 after the second dose, before 1 June 2021. Total vaccine effectiveness was 91.8% (95% CI: 88.1 to 94.3%). However, vaccine effectiveness is reduced over time as a result of the combined effect of waning of immunity and emergence of the Delta variant.
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Affiliation(s)
- Ottavia Prunas
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, Yale University, New Haven, CT, USA
- Public Health Modeling Unit, Yale School of Public Health, Yale University, New Haven, CT, USA
| | - Joshua L. Warren
- Public Health Modeling Unit, Yale School of Public Health, Yale University, New Haven, CT, USA
- Department of Biostatistics, Yale School of Public Health, Yale University, New Haven, CT, USA
| | - Forrest W. Crawford
- Public Health Modeling Unit, Yale School of Public Health, Yale University, New Haven, CT, USA
- Department of Biostatistics, Yale School of Public Health, Yale University, New Haven, CT, USA
- Department of Statistics and Data Science, Yale School of Public Health, Yale University, New Haven, CT, USA
- Department of Ecology and Evolutionary Biology, Yale School of Public Health, Yale University, New Haven, CT, USA
- Yale School of Management, Yale University, New Haven, CT, USA
| | - Sivan Gazit
- Maccabi Institute for Research and Innovation, Maccabi Healthcare Services, Tel Aviv, Israel
| | - Tal Patalon
- Maccabi Institute for Research and Innovation, Maccabi Healthcare Services, Tel Aviv, Israel
| | - Daniel M. Weinberger
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, Yale University, New Haven, CT, USA
- Public Health Modeling Unit, Yale School of Public Health, Yale University, New Haven, CT, USA
| | - Virginia E. Pitzer
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, Yale University, New Haven, CT, USA
- Public Health Modeling Unit, Yale School of Public Health, Yale University, New Haven, CT, USA
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21
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Hause AM, Baggs J, Marquez P, Abara WE, Olubajo B, Myers TR, Su JR, Thompson D, Gee J, Shimabukuro TT, Shay DK. Safety Monitoring of COVID-19 Vaccine Booster Doses Among Persons Aged 12-17 Years - United States, December 9, 2021-February 20, 2022. MMWR Morb Mortal Wkly Rep 2022; 71:347-351. [PMID: 35239637 PMCID: PMC8893335 DOI: 10.15585/mmwr.mm7109e2] [Citation(s) in RCA: 28] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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22
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Klein NP, Stockwell MS, Demarco M, Gaglani M, Kharbanda AB, Irving SA, Rao S, Grannis SJ, Dascomb K, Murthy K, Rowley EA, Dalton AF, DeSilva MB, Dixon BE, Natarajan K, Stenehjem E, Naleway AL, Lewis N, Ong TC, Patel P, Konatham D, Embi PJ, Reese SE, Han J, Grisel N, Goddard K, Barron MA, Dickerson M, Liao IC, Fadel WF, Yang DH, Arndorfer J, Fireman B, Griggs EP, Valvi NR, Hallowell C, Zerbo O, Reynolds S, Ferdinands J, Wondimu MH, Williams J, Bozio CH, Link-Gelles R, Azziz-Baumgartner E, Schrag SJ, Thompson MG, Verani JR. Effectiveness of COVID-19 Pfizer-BioNTech BNT162b2 mRNA Vaccination in Preventing COVID-19-Associated Emergency Department and Urgent Care Encounters and Hospitalizations Among Nonimmunocompromised Children and Adolescents Aged 5-17 Years - VISION Network, 10 States, April 2021-January 2022. MMWR Morb Mortal Wkly Rep 2022; 71:352-358. [PMID: 35239634 PMCID: PMC8893336 DOI: 10.15585/mmwr.mm7109e3] [Citation(s) in RCA: 109] [Impact Index Per Article: 54.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
The efficacy of the BNT162b2 (Pfizer-BioNTech) vaccine against laboratory-confirmed COVID-19 exceeded 90% in clinical trials that included children and adolescents aged 5-11, 12-15, and 16-17 years (1-3). Limited real-world data on 2-dose mRNA vaccine effectiveness (VE) in persons aged 12-17 years (referred to as adolescents in this report) have also indicated high levels of protection against SARS-CoV-2 (the virus that causes COVID-19) infection and COVID-19-associated hospitalization (4-6); however, data on VE against the SARS-CoV-2 B.1.1.529 (Omicron) variant and duration of protection are limited. Pfizer-BioNTech VE data are not available for children aged 5-11 years. In partnership with CDC, the VISION Network* examined 39,217 emergency department (ED) and urgent care (UC) encounters and 1,699 hospitalizations† among persons aged 5-17 years with COVID-19-like illness across 10 states during April 9, 2021-January 29, 2022,§ to estimate VE using a case-control test-negative design. Among children aged 5-11 years, VE against laboratory-confirmed COVID-19-associated ED and UC encounters 14-67 days after dose 2 (the longest interval after dose 2 in this age group) was 46%. Among adolescents aged 12-15 and 16-17 years, VE 14-149 days after dose 2 was 83% and 76%, respectively; VE ≥150 days after dose 2 was 38% and 46%, respectively. Among adolescents aged 16-17 years, VE increased to 86% ≥7 days after dose 3 (booster dose). VE against COVID-19-associated ED and UC encounters was substantially lower during the Omicron predominant period than the B.1.617.2 (Delta) predominant period among adolescents aged 12-17 years, with no significant protection ≥150 days after dose 2 during Omicron predominance. However, in adolescents aged 16-17 years, VE during the Omicron predominant period increased to 81% ≥7 days after a third booster dose. During the full study period, including pre-Delta, Delta, and Omicron predominant periods, VE against laboratory-confirmed COVID-19-associated hospitalization among children aged 5-11 years was 74% 14-67 days after dose 2, with wide CIs that included zero. Among adolescents aged 12-15 and 16-17 years, VE 14-149 days after dose 2 was 92% and 94%, respectively; VE ≥150 days after dose 2 was 73% and 88%, respectively. All eligible children and adolescents should remain up to date with recommended COVID-19 vaccinations, including a booster dose for those aged 12-17 years.
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23
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Palomo-Palomo C, Guerra-Estévez D, Parrado-González A, Estaire-Gutiérrez J, Reyes-Malia M, Romero-Alonso MM. Reactogenicity of the BNT162b2 mRNA vaccine (Pfizer-BioNTech) against COVID-19 in workers of a tertiary hospital. Farm Hosp 2022; 46:152-156. [PMID: 36183208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/16/2023] Open
Abstract
OBJECTIVE To analyze the local and systemic reactions that appeared after the first and second dose of the BNT162b2 vaccine against COVID‑19 (Pfizer- BioNTech) in a sample of workers from a tertiary hospital, and to identify the factors related to greater vaccine reactogenicity. METHOD A self-administered questionnaire was used to interview 291 workers from a tertiary hospital who received the BNT162b2 vaccine against COVID-19 between January and March 2021. The questionnaire included questions about the sociodemographic variables of the participants, previous COVID-19 infection, and local and systemic reactions after the first and second dose of the vaccine. RESULTS The most common adverse reaction was soreness at the injection site, which was reported more frequently after the first dose of the vaccine. The systemic reactions evaluated were reported more frequently after the second dose of the vaccine. Women, younger adults, and subjects with a prior COVID-19 infection reported increased reactogenicity. Furthermore, high reactogenicity after the first dose was found to be related to a higher number of adverse reactions after the second dose of the vaccine. CONCLUSIONS The distribution of reactogenicity in the present study is consistent with the data reported in previous studies on the BNT162b2 vaccine, especially in terms of its association with the participants' characteristics. These findings could facilitate the identification of people at a higher risk of developing high reactogenicity to the vaccine, thereby making it possible to anticipate the appearance of adverse reactions and plan for their treatment.
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Affiliation(s)
| | | | - Alberto Parrado-González
- Fundación Andaluza Beturia para la Investigación en Salud, Huelva. Spain. Department of Social, Developmental and Educational Psychology, Universidad de Huelva, Huelva. Spain..
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24
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Terpos E, Gavriatopoulou M, Ntanasis-Stathopoulos I, Briasoulis A, Gumeni S, Malandrakis P, Papanagnou ED, Migkou M, Kanellias N, Kastritis E, Trougakos IP, Dimopoulos MA. Booster BNT162b2 optimizes SARS-CoV-2 humoral response in patients with myeloma: the negative effect of anti-BCMA therapy. Blood 2022; 139:1409-1412. [PMID: 34986251 PMCID: PMC8736278 DOI: 10.1182/blood.2021014989] [Citation(s) in RCA: 26] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Accepted: 12/24/2021] [Indexed: 11/20/2022] Open
Affiliation(s)
| | | | | | | | - Sentiljana Gumeni
- Department of Cell Biology and Biophysics, Faculty of Biology, National and Kapodistrian University of Athens, Athens, Greece
| | | | - Eleni-Dimitra Papanagnou
- Department of Cell Biology and Biophysics, Faculty of Biology, National and Kapodistrian University of Athens, Athens, Greece
| | | | | | | | - Ioannis P Trougakos
- Department of Cell Biology and Biophysics, Faculty of Biology, National and Kapodistrian University of Athens, Athens, Greece
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25
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Tarke A, Coelho CH, Zhang Z, Dan JM, Yu ED, Methot N, Bloom NI, Goodwin B, Phillips E, Mallal S, Sidney J, Filaci G, Weiskopf D, da Silva Antunes R, Crotty S, Grifoni A, Sette A. SARS-CoV-2 vaccination induces immunological T cell memory able to cross-recognize variants from Alpha to Omicron. Cell 2022; 185:847-859.e11. [PMID: 35139340 PMCID: PMC8784649 DOI: 10.1016/j.cell.2022.01.015] [Citation(s) in RCA: 469] [Impact Index Per Article: 234.5] [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] [Subscribe] [Scholar Register] [Received: 12/28/2021] [Revised: 01/11/2022] [Accepted: 01/19/2022] [Indexed: 12/19/2022]
Abstract
We address whether T cell responses induced by different vaccine platforms (mRNA-1273, BNT162b2, Ad26.COV2.S, and NVX-CoV2373) cross-recognize early SARS-CoV-2 variants. T cell responses to early variants were preserved across vaccine platforms. By contrast, significant overall decreases were observed for memory B cells and neutralizing antibodies. In subjects ∼6 months post-vaccination, 90% (CD4+) and 87% (CD8+) of memory T cell responses were preserved against variants on average by AIM assay, and 84% (CD4+) and 85% (CD8+) preserved against Omicron. Omicron RBD memory B cell recognition was substantially reduced to 42% compared with other variants. T cell epitope repertoire analysis revealed a median of 11 and 10 spike epitopes recognized by CD4+ and CD8+ T cells, with average preservation > 80% for Omicron. Functional preservation of the majority of T cell responses may play an important role as a second-level defense against diverse variants.
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Affiliation(s)
- Alison Tarke
- Center for Infectious Disease and Vaccine Research, La Jolla Institute for Immunology (LJI), La Jolla, CA 92037, USA; Department of Internal Medicine and Center of Excellence for Biomedical Research (CEBR), University of Genoa, Genoa 16132, Italy
| | - Camila H Coelho
- Center for Infectious Disease and Vaccine Research, La Jolla Institute for Immunology (LJI), La Jolla, CA 92037, USA
| | - Zeli Zhang
- Center for Infectious Disease and Vaccine Research, La Jolla Institute for Immunology (LJI), La Jolla, CA 92037, USA
| | - Jennifer M Dan
- Center for Infectious Disease and Vaccine Research, La Jolla Institute for Immunology (LJI), La Jolla, CA 92037, USA; Department of Medicine, Division of Infectious Diseases and Global Public Health, University of California, San Diego (UCSD), La Jolla, CA 92037, USA
| | - Esther Dawen Yu
- Center for Infectious Disease and Vaccine Research, La Jolla Institute for Immunology (LJI), La Jolla, CA 92037, USA
| | - Nils Methot
- Center for Infectious Disease and Vaccine Research, La Jolla Institute for Immunology (LJI), La Jolla, CA 92037, USA
| | - Nathaniel I Bloom
- Center for Infectious Disease and Vaccine Research, La Jolla Institute for Immunology (LJI), La Jolla, CA 92037, USA
| | - Benjamin Goodwin
- Center for Infectious Disease and Vaccine Research, La Jolla Institute for Immunology (LJI), La Jolla, CA 92037, USA
| | - Elizabeth Phillips
- Institute for Immunology and Infectious Diseases, Murdoch University, Perth, WA, Australia
| | - Simon Mallal
- Institute for Immunology and Infectious Diseases, Murdoch University, Perth, WA, Australia
| | - John Sidney
- Center for Infectious Disease and Vaccine Research, La Jolla Institute for Immunology (LJI), La Jolla, CA 92037, USA
| | - Gilberto Filaci
- Department of Internal Medicine and Center of Excellence for Biomedical Research (CEBR), University of Genoa, Genoa 16132, Italy; Biotherapy Unit, IRCCS Ospedale Policlinico San Martino, Genoa 16132, Italy
| | - Daniela Weiskopf
- Center for Infectious Disease and Vaccine Research, La Jolla Institute for Immunology (LJI), La Jolla, CA 92037, USA
| | - Ricardo da Silva Antunes
- Center for Infectious Disease and Vaccine Research, La Jolla Institute for Immunology (LJI), La Jolla, CA 92037, USA
| | - Shane Crotty
- Center for Infectious Disease and Vaccine Research, La Jolla Institute for Immunology (LJI), La Jolla, CA 92037, USA; Department of Medicine, Division of Infectious Diseases and Global Public Health, University of California, San Diego (UCSD), La Jolla, CA 92037, USA.
| | - Alba Grifoni
- Center for Infectious Disease and Vaccine Research, La Jolla Institute for Immunology (LJI), La Jolla, CA 92037, USA.
| | - Alessandro Sette
- Center for Infectious Disease and Vaccine Research, La Jolla Institute for Immunology (LJI), La Jolla, CA 92037, USA; Department of Medicine, Division of Infectious Diseases and Global Public Health, University of California, San Diego (UCSD), La Jolla, CA 92037, USA.
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26
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Chatterjee D, Tauzin A, Marchitto L, Gong SY, Boutin M, Bourassa C, Beaudoin-Bussières G, Bo Y, Ding S, Laumaea A, Vézina D, Perreault J, Gokool L, Morrisseau C, Arlotto P, Fournier É, Guilbault A, Delisle B, Levade I, Goyette G, Gendron-Lepage G, Medjahed H, De Serres G, Tremblay C, Martel-Laferrière V, Kaufmann DE, Bazin R, Prévost J, Moreira S, Richard J, Côté M, Finzi A. SARS-CoV-2 Omicron Spike recognition by plasma from individuals receiving BNT162b2 mRNA vaccination with a 16-week interval between doses. Cell Rep 2022; 38:110429. [PMID: 35216664 PMCID: PMC8823958 DOI: 10.1016/j.celrep.2022.110429] [Citation(s) in RCA: 38] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Revised: 01/25/2022] [Accepted: 02/02/2022] [Indexed: 11/22/2022] Open
Abstract
Continuous emergence of SARS-CoV-2 variants of concern (VOCs) is fueling the COVID-19 pandemic. Omicron (B.1.1.529) rapidly spread worldwide. The large number of mutations in its Spike raise concerns about a major antigenic drift that could significantly decrease vaccine efficacy and infection-induced immunity. A long interval between BNT162b2 mRNA doses elicits antibodies that efficiently recognize Spikes from different VOCs. Here, we evaluate the recognition of Omicron Spike by plasma from a cohort of SARS-CoV-2 naive and previously infected individuals who received their BNT162b2 mRNA vaccine 16 weeks apart. Omicron Spike is recognized less efficiently than D614G, Alpha, Beta, Gamma, and Delta Spikes. We compare with plasma activity from participants receiving a short (4 weeks) interval regimen. Plasma from individuals of the long-interval cohort recognize and neutralize better the Omicron Spike compared with those who received a short interval. Whether this difference confers any clinical benefit against Omicron remains unknown.
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MESH Headings
- Adult
- Aged
- Antibodies, Neutralizing/analysis
- Antibodies, Neutralizing/blood
- Antibodies, Neutralizing/immunology
- Antibodies, Viral/analysis
- Antibodies, Viral/blood
- Antibodies, Viral/immunology
- BNT162 Vaccine/administration & dosage
- BNT162 Vaccine/immunology
- Cohort Studies
- Female
- HEK293 Cells
- Humans
- Immunization Schedule
- Immunization, Secondary/methods
- Male
- Middle Aged
- Quebec
- SARS-CoV-2/immunology
- SARS-CoV-2/pathogenicity
- Spike Glycoprotein, Coronavirus/immunology
- Time Factors
- Vaccination/methods
- Vaccine Potency
- Vaccines, Synthetic/administration & dosage
- Vaccines, Synthetic/immunology
- Young Adult
- mRNA Vaccines/administration & dosage
- mRNA Vaccines/immunology
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Affiliation(s)
| | - Alexandra Tauzin
- Centre de Recherche du CHUM, Montreal, QC H2X 0A9, Canada; Département de Microbiologie, Infectiologie et Immunologie, Université de Montréal, Montreal, QC H2X 0A9, Canada
| | - Lorie Marchitto
- Centre de Recherche du CHUM, Montreal, QC H2X 0A9, Canada; Département de Microbiologie, Infectiologie et Immunologie, Université de Montréal, Montreal, QC H2X 0A9, Canada
| | - Shang Yu Gong
- Centre de Recherche du CHUM, Montreal, QC H2X 0A9, Canada; Department of Microbiology and Immunology, McGill University, Montreal, QC H3A 2B4, Canada
| | - Marianne Boutin
- Centre de Recherche du CHUM, Montreal, QC H2X 0A9, Canada; Département de Microbiologie, Infectiologie et Immunologie, Université de Montréal, Montreal, QC H2X 0A9, Canada
| | | | - Guillaume Beaudoin-Bussières
- Centre de Recherche du CHUM, Montreal, QC H2X 0A9, Canada; Département de Microbiologie, Infectiologie et Immunologie, Université de Montréal, Montreal, QC H2X 0A9, Canada
| | - Yuxia Bo
- Department of Biochemistry, Microbiology and Immunology, Center for Infection, Immunity, and Inflammation, University of Ottawa, Ottawa, ON K1H 8M5, Canada
| | - Shilei Ding
- Centre de Recherche du CHUM, Montreal, QC H2X 0A9, Canada
| | - Annemarie Laumaea
- Centre de Recherche du CHUM, Montreal, QC H2X 0A9, Canada; Département de Microbiologie, Infectiologie et Immunologie, Université de Montréal, Montreal, QC H2X 0A9, Canada
| | - Dani Vézina
- Centre de Recherche du CHUM, Montreal, QC H2X 0A9, Canada; Département de Microbiologie, Infectiologie et Immunologie, Université de Montréal, Montreal, QC H2X 0A9, Canada
| | - Josée Perreault
- Héma-Québec, Affaires Médicales et Innovation, Quebec, QC G1V 5C3, Canada
| | - Laurie Gokool
- Centre de Recherche du CHUM, Montreal, QC H2X 0A9, Canada
| | | | | | - Éric Fournier
- Laboratoire de Santé Publique du Québec, Institut Nationale de Santé Publique du Québec, Sainte-Anne-de-Bellevue, QC H9X 3R5, Canada
| | - Aurélie Guilbault
- Laboratoire de Santé Publique du Québec, Institut Nationale de Santé Publique du Québec, Sainte-Anne-de-Bellevue, QC H9X 3R5, Canada
| | - Benjamin Delisle
- Laboratoire de Santé Publique du Québec, Institut Nationale de Santé Publique du Québec, Sainte-Anne-de-Bellevue, QC H9X 3R5, Canada
| | - Inès Levade
- Laboratoire de Santé Publique du Québec, Institut Nationale de Santé Publique du Québec, Sainte-Anne-de-Bellevue, QC H9X 3R5, Canada
| | | | | | | | - Gaston De Serres
- Institut National de Santé Publique du Québec, Quebec, QC H2P 1E2, Canada
| | - Cécile Tremblay
- Centre de Recherche du CHUM, Montreal, QC H2X 0A9, Canada; Département de Microbiologie, Infectiologie et Immunologie, Université de Montréal, Montreal, QC H2X 0A9, Canada
| | - Valérie Martel-Laferrière
- Centre de Recherche du CHUM, Montreal, QC H2X 0A9, Canada; Département de Microbiologie, Infectiologie et Immunologie, Université de Montréal, Montreal, QC H2X 0A9, Canada
| | - Daniel E Kaufmann
- Centre de Recherche du CHUM, Montreal, QC H2X 0A9, Canada; Département de Médecine, Université de Montréal, Montreal, QC H3T 1J4, Canada
| | - Renée Bazin
- Héma-Québec, Affaires Médicales et Innovation, Quebec, QC G1V 5C3, Canada
| | - Jérémie Prévost
- Centre de Recherche du CHUM, Montreal, QC H2X 0A9, Canada; Département de Microbiologie, Infectiologie et Immunologie, Université de Montréal, Montreal, QC H2X 0A9, Canada
| | - Sandrine Moreira
- Laboratoire de Santé Publique du Québec, Institut Nationale de Santé Publique du Québec, Sainte-Anne-de-Bellevue, QC H9X 3R5, Canada
| | - Jonathan Richard
- Centre de Recherche du CHUM, Montreal, QC H2X 0A9, Canada; Département de Microbiologie, Infectiologie et Immunologie, Université de Montréal, Montreal, QC H2X 0A9, Canada.
| | - Marceline Côté
- Department of Biochemistry, Microbiology and Immunology, Center for Infection, Immunity, and Inflammation, University of Ottawa, Ottawa, ON K1H 8M5, Canada.
| | - Andrés Finzi
- Centre de Recherche du CHUM, Montreal, QC H2X 0A9, Canada; Département de Microbiologie, Infectiologie et Immunologie, Université de Montréal, Montreal, QC H2X 0A9, Canada; Department of Microbiology and Immunology, McGill University, Montreal, QC H3A 2B4, Canada.
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Nasreen S, Chung H, He S, Brown KA, Gubbay JB, Buchan SA, Fell DB, Austin PC, Schwartz KL, Sundaram ME, Calzavara A, Chen B, Tadrous M, Wilson K, Wilson SE, Kwong JC. Effectiveness of COVID-19 vaccines against symptomatic SARS-CoV-2 infection and severe outcomes with variants of concern in Ontario. Nat Microbiol 2022; 7:379-385. [PMID: 35132198 DOI: 10.1101/2021.06.28.21259420] [Citation(s) in RCA: 66] [Impact Index Per Article: 33.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Accepted: 12/16/2021] [Indexed: 05/26/2023]
Abstract
SARS-CoV-2 variants of concern (VOC) are more transmissible and may have the potential for increased disease severity and decreased vaccine effectiveness. We estimated the effectiveness of BNT162b2 (Pfizer-BioNTech Comirnaty), mRNA-1273 (Moderna Spikevax) and ChAdOx1 (AstraZeneca Vaxzevria) vaccines against symptomatic SARS-CoV-2 infection and COVID-19 hospitalization or death caused by the Alpha (B.1.1.7), Beta (B.1.351), Gamma (P.1) and Delta (B.1.617.2) VOC in Ontario, Canada, using a test-negative design study. We identified 682,071 symptomatic community-dwelling individuals who were tested for SARS-CoV-2, and 15,269 individuals with a COVID-19 hospitalization or death. Effectiveness against symptomatic infection ≥7 d after two doses was 89-92% against Alpha, 87% against Beta, 88% against Gamma, 82-89% against Beta/Gamma and 87-95% against Delta across vaccine products. The corresponding estimates ≥14 d after one dose were lower. Effectiveness estimates against hospitalization or death were similar to or higher than against symptomatic infection. Effectiveness against symptomatic infection was generally lower for older adults (≥60 years) than for younger adults (<60 years) for most of the VOC-vaccine combinations. Our findings suggest that jurisdictions facing vaccine supply constraints may benefit from delaying the second dose in younger individuals to more rapidly achieve greater overall population protection; however, older adults would likely benefit most from minimizing the delay in receiving the second dose to achieve adequate protection against VOC.
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Affiliation(s)
- Sharifa Nasreen
- ICES, Toronto, Ontario, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | | | - Siyi He
- ICES, Toronto, Ontario, Canada
| | - Kevin A Brown
- ICES, Toronto, Ontario, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
- Public Health Ontario, Toronto, Ontario, Canada
| | | | - Sarah A Buchan
- ICES, Toronto, Ontario, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
- Public Health Ontario, Toronto, Ontario, Canada
- Centre for Vaccine Preventable Diseases, University of Toronto, Toronto, Ontario, Canada
| | - Deshayne B Fell
- ICES, Toronto, Ontario, Canada
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada
- Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, Canada
| | - Peter C Austin
- ICES, Toronto, Ontario, Canada
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada
| | - Kevin L Schwartz
- ICES, Toronto, Ontario, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
- Public Health Ontario, Toronto, Ontario, Canada
| | - Maria E Sundaram
- ICES, Toronto, Ontario, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
- Center for Clinical Epidemiology and Population Health, Marshfield Clinic Research Institute, Marshfield, WI, USA
| | | | | | - Mina Tadrous
- ICES, Toronto, Ontario, Canada
- Women's College Hospital, Toronto, Ontario, Canada
| | - Kumanan Wilson
- Department of Medicine, University of Ottawa, Ottawa, Ontario, Canada
- Bruyere and Ottawa Hospital Research Institutes, Ottawa, Ontario, Canada
| | - Sarah E Wilson
- ICES, Toronto, Ontario, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
- Public Health Ontario, Toronto, Ontario, Canada
- Centre for Vaccine Preventable Diseases, University of Toronto, Toronto, Ontario, Canada
| | - Jeffrey C Kwong
- ICES, Toronto, Ontario, Canada.
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.
- Public Health Ontario, Toronto, Ontario, Canada.
- Centre for Vaccine Preventable Diseases, University of Toronto, Toronto, Ontario, Canada.
- Department of Family and Community Medicine, University of Toronto, Toronto, Ontario, Canada.
- University Health Network, Toronto, Ontario, Canada.
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Oliveira CR, Niccolai LM, Sheikha H, Elmansy L, Kalinich CC, Grubaugh ND, Shapiro ED. Assessment of Clinical Effectiveness of BNT162b2 COVID-19 Vaccine in US Adolescents. JAMA Netw Open 2022; 5:e220935. [PMID: 35238933 PMCID: PMC8895259 DOI: 10.1001/jamanetworkopen.2022.0935] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Accepted: 01/13/2022] [Indexed: 01/12/2023] Open
Abstract
Importance The emergence of the B.1.617.2 (Delta) variant of SARS-CoV-2 has led to increases in both infections and hospitalizations among adolescents. Little is known about the effectiveness of the BNT162b2 vaccine in adolescents in the general population, as opposed to a clinical trial population. Objective To estimate the effectiveness of the BNT162b2 vaccine in adolescents aged 12 to 18 years. Design, Setting, and Participants This was a matched case-control study among adolescents (aged 12-18 years) who had results from a SARS-CoV-2 reverse transcription-polymerase chain reaction (RT-PCR) test. Immunization histories, relevant clinical data, and RT-PCR test results were obtained from the Yale New Haven Health System's medical records between June 1, 2021, and August 15, 2021, when the Delta variant caused 92% of infections in Connecticut. Case participants were defined as adolescents who had a positive test result and an associated medical encounter. Control participants were defined as those who had a negative test result and were matched to a case participant by age, county of residence, and date of testing. Exposures Adolescents were defined as fully immunized if they had received 2 doses of vaccine at least 14 days before focal time. Main Outcomes and Measures The primary outcome measured was SARS-CoV-2 infection confirmed by RT-PCR. The vaccine's effectiveness (VE) was estimated using matched odds ratios from conditional logistic regression models. Secondary measures included estimated VE by clinical symptoms, number of vaccine doses received, and elapsed time from immunization. Results A total of 6901 adolescents were tested for SARS-CoV-2. The final sample comprised 186 case participants and 356 matched control participants. The median age was 14 (IQR, 13-16) years, 262 (48%) identified as female, 81 (15%) as Black, 82 (15%) as Hispanic, and 297 (55%) as White. Overall, 134 (25%) were fully immunized (case participants, 10 [5%]; control participants, 124 [35%]). The median time between immunization and the SARS-CoV-2 test was 62 days (range, 17-129 days). Within 4 months of receiving 2 doses, VE against any infection was estimated to be 91% (95% CI, 80%-96%); against asymptomatic infection, 85% (95% CI, 57%-95%). Effectiveness after a single dose was estimated to be 74% (95% CI, 18%-92%). Conclusions and Relevance In this retrospective case-control study of US adolescents, 2 doses of BNT162b2 vaccine appeared to provide excellent protection for at least 4 months after immunization against both symptomatic and asymptomatic SARS-CoV-2 infections.
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Affiliation(s)
- Carlos R. Oliveira
- Department of Pediatrics, Section of Infectious Diseases and Global Health, Yale School of Medicine, New Haven, Connecticut
- Department of Biostatistics, Section of Health Informatics, Yale School of Public Health, New Haven, Connecticut
| | - Linda M. Niccolai
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, Connecticut
| | - Hassan Sheikha
- Department of Pediatrics, Section of Infectious Diseases and Global Health, Yale School of Medicine, New Haven, Connecticut
| | - Lina Elmansy
- Department of Pediatrics, Section of Infectious Diseases and Global Health, Yale School of Medicine, New Haven, Connecticut
| | - Chaney C. Kalinich
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, Connecticut
| | - Nathan D. Grubaugh
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, Connecticut
- Department of Ecology and Evolutionary Biology, Yale University, New Haven, Connecticut
| | - Eugene D. Shapiro
- Department of Pediatrics, Section of Infectious Diseases and Global Health, Yale School of Medicine, New Haven, Connecticut
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, Connecticut
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29
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Nordström P, Ballin M, Nordström A. Risk of infection, hospitalisation, and death up to 9 months after a second dose of COVID-19 vaccine: a retrospective, total population cohort study in Sweden. Lancet 2022; 399:814-823. [PMID: 35131043 PMCID: PMC8816388 DOI: 10.1016/s0140-6736(22)00089-7] [Citation(s) in RCA: 139] [Impact Index Per Article: 69.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2021] [Revised: 12/31/2021] [Accepted: 01/06/2022] [Indexed: 12/14/2022]
Abstract
BACKGROUND Vaccine effectiveness against COVID-19 beyond 6 months remains incompletely understood. We aimed to investigate the effectiveness of COVID-19 vaccination against the risk of infection, hospitalisation, and death during the first 9 months after vaccination for the total population of Sweden. METHODS This retrospective, total population cohort study was done using data from Swedish nationwide registers. The cohort comprised all individuals vaccinated with two doses of ChAdOx1 nCoV-19, mRNA-1273, or BNT162b2, and matched unvaccinated individuals, with data on vaccinations and infections updated until Oct 4, 2021. Two outcomes were evaluated. The first was SARS-CoV-2 infection of any severity from Jan 12 to Oct 4, 2021. The second was severe COVID-19, defined as hospitalisation for COVID-19 or all-cause 30-day mortality after confirmed infection, from March 15 to Sept 28, 2021. FINDINGS Between Dec 28, 2020, and Oct 4, 2021, 842 974 individuals were fully vaccinated (two doses), and were matched (1:1) to an equal number of unvaccinated individuals (total study cohort n=1 685 948). For the outcome SARS-CoV-2 infection of any severity, the vaccine effectiveness of BNT162b2 waned progressively over time, from 92% (95% CI 92 to 93; p<0·001) at 15-30 days, to 47% (39 to 55; p<0·001) at 121-180 days, and to 23% (-2 to 41; p=0·07) from day 211 onwards. Waning was slightly slower for mRNA-1273, with a vaccine effectiveness of 96% (94 to 97; p<0·001) at 15-30 days and 59% (18 to 79; p=0·012) from day 181 onwards. Waning was also slightly slower for heterologous ChAdOx1 nCoV-19 plus an mRNA vaccine, for which vaccine effectiveness was 89% (79 to 94; p<0·001) at 15-30 days and 66% (41 to 80; p<0·001) from day 121 onwards. By contrast, vaccine effectiveness for homologous ChAdOx1 nCoV-19 vaccine was 68% (52 to 79; p<0·001) at 15-30 days, with no detectable effectiveness from day 121 onwards (-19% [-98 to 28]; p=0·49). For the outcome of severe COVID-19, vaccine effectiveness waned from 89% (82 to 93; p<0·001) at 15-30 days to 64% (44 to 77; p<0·001) from day 121 onwards. Overall, there was some evidence for lower vaccine effectiveness in men than in women and in older individuals than in younger individuals. INTERPRETATION We found progressively waning vaccine effectiveness against SARS-CoV-2 infection of any severity across all subgroups, but the rate of waning differed according to vaccine type. With respect to severe COVID-19, vaccine effectiveness seemed to be better maintained, although some waning became evident after 4 months. The results strengthen the evidence-based rationale for administration of a third vaccine dose as a booster. FUNDING None.
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Affiliation(s)
- Peter Nordström
- Department of Community Medicine and Rehabilitation, Unit of Geriatric Medicine, Umeå University, Umeå, Sweden.
| | - Marcel Ballin
- Department of Community Medicine and Rehabilitation, Unit of Geriatric Medicine, Umeå University, Umeå, Sweden; Department of Public Health and Clinical Medicine, Section of Sustainable Health, Umeå University, Umeå, Sweden
| | - Anna Nordström
- Department of Community Medicine and Rehabilitation, Unit of Geriatric Medicine, Umeå University, Umeå, Sweden; Department of Public Health and Clinical Medicine, Section of Sustainable Health, Umeå University, Umeå, Sweden; School of Sport Sciences, UiT the Arctic University of Norway, Tromsø, Norway
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30
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Accorsi EK, Britton A, Fleming-Dutra KE, Smith ZR, Shang N, Derado G, Miller J, Schrag SJ, Verani JR. Association Between 3 Doses of mRNA COVID-19 Vaccine and Symptomatic Infection Caused by the SARS-CoV-2 Omicron and Delta Variants. JAMA 2022; 327:639-651. [PMID: 35060999 PMCID: PMC8848203 DOI: 10.1001/jama.2022.0470] [Citation(s) in RCA: 424] [Impact Index Per Article: 212.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
IMPORTANCE Assessing COVID-19 vaccine performance against the rapidly spreading SARS-CoV-2 Omicron variant is critical to inform public health guidance. OBJECTIVE To estimate the association between receipt of 3 doses of Pfizer-BioNTech BNT162b2 or Moderna mRNA-1273 vaccine and symptomatic SARS-CoV-2 infection, stratified by variant (Omicron and Delta). DESIGN, SETTING, AND PARTICIPANTS A test-negative case-control analysis among adults 18 years or older with COVID-like illness tested December 10, 2021, through January 1, 2022, by a national pharmacy-based testing program (4666 COVID-19 testing sites across 49 US states). EXPOSURES Three doses of mRNA COVID-19 vaccine (third dose ≥14 days before test and ≥6 months after second dose) vs unvaccinated and vs 2 doses 6 months or more before test (ie, eligible for a booster dose). MAIN OUTCOMES AND MEASURES Association between symptomatic SARS-CoV-2 infection (stratified by Omicron or Delta variants defined using S-gene target failure) and vaccination (3 doses vs unvaccinated and 3 doses vs 2 doses). Associations were measured with multivariable multinomial regression. Among cases, a secondary outcome was median cycle threshold values (inversely proportional to the amount of target nucleic acid present) for 3 viral genes, stratified by variant and vaccination status. RESULTS Overall, 23 391 cases (13 098 Omicron; 10 293 Delta) and 46 764 controls were included (mean age, 40.3 [SD, 15.6] years; 42 050 [60.1%] women). Prior receipt of 3 mRNA vaccine doses was reported for 18.6% (n = 2441) of Omicron cases, 6.6% (n = 679) of Delta cases, and 39.7% (n = 18 587) of controls; prior receipt of 2 mRNA vaccine doses was reported for 55.3% (n = 7245), 44.4% (n = 4570), and 41.6% (n = 19 456), respectively; and being unvaccinated was reported for 26.0% (n = 3412), 49.0% (n = 5044), and 18.6% (n = 8721), respectively. The adjusted odds ratio for 3 doses vs unvaccinated was 0.33 (95% CI, 0.31-0.35) for Omicron and 0.065 (95% CI, 0.059-0.071) for Delta; for 3 vaccine doses vs 2 doses the adjusted odds ratio was 0.34 (95% CI, 0.32-0.36) for Omicron and 0.16 (95% CI, 0.14-0.17) for Delta. Median cycle threshold values were significantly higher in cases with 3 doses vs 2 doses for both Omicron and Delta (Omicron N gene: 19.35 vs 18.52; Omicron ORF1ab gene: 19.25 vs 18.40; Delta N gene: 19.07 vs 17.52; Delta ORF1ab gene: 18.70 vs 17.28; Delta S gene: 23.62 vs 20.24). CONCLUSIONS AND RELEVANCE Among individuals seeking testing for COVID-like illness in the US in December 2021, receipt of 3 doses of mRNA COVID-19 vaccine (compared with unvaccinated and with receipt of 2 doses) was less likely among cases with symptomatic SARS-CoV-2 infection compared with test-negative controls. These findings suggest that receipt of 3 doses of mRNA vaccine, relative to being unvaccinated and to receipt of 2 doses, was associated with protection against both the Omicron and Delta variants, although the higher odds ratios for Omicron suggest less protection for Omicron than for Delta.
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Affiliation(s)
- Emma K. Accorsi
- Centers for Disease Control and Prevention COVID-19 Response, Atlanta, Georgia
- Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Amadea Britton
- Centers for Disease Control and Prevention COVID-19 Response, Atlanta, Georgia
- Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, Georgia
| | | | - Zachary R. Smith
- Centers for Disease Control and Prevention COVID-19 Response, Atlanta, Georgia
| | - Nong Shang
- Centers for Disease Control and Prevention COVID-19 Response, Atlanta, Georgia
| | - Gordana Derado
- Centers for Disease Control and Prevention COVID-19 Response, Atlanta, Georgia
| | - Joseph Miller
- Centers for Disease Control and Prevention COVID-19 Response, Atlanta, Georgia
| | - Stephanie J. Schrag
- Centers for Disease Control and Prevention COVID-19 Response, Atlanta, Georgia
| | - Jennifer R. Verani
- Centers for Disease Control and Prevention COVID-19 Response, Atlanta, Georgia
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Kuhlmann C, Mayer CK, Claassen M, Maponga T, Burgers WA, Keeton R, Riou C, Sutherland AD, Suliman T, Shaw ML, Preiser W. Breakthrough infections with SARS-CoV-2 omicron despite mRNA vaccine booster dose. Lancet 2022; 399:625-626. [PMID: 35063123 PMCID: PMC8765759 DOI: 10.1016/s0140-6736(22)00090-3] [Citation(s) in RCA: 227] [Impact Index Per Article: 113.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Revised: 01/03/2022] [Accepted: 01/10/2022] [Indexed: 12/17/2022]
Affiliation(s)
- Constanze Kuhlmann
- Division of Hand, Plastic and Aesthetic Surgery, University Hospital, LMU Munich, Munich, Germany
| | - Carla Konstanze Mayer
- Division of Medical Virology, Faculty of Medicine and Health Sciences, University of Stellenbosch Tygerberg Campus, Cape Town ZA-7505, South Africa
| | - Mathilda Claassen
- Medical Virology, National Health Laboratory Service Tygerberg, Parow, Cape Town, South Africa
| | - Tongai Maponga
- Division of Medical Virology, Faculty of Medicine and Health Sciences, University of Stellenbosch Tygerberg Campus, Cape Town ZA-7505, South Africa
| | - Wendy A Burgers
- Institute of Infectious Disease and Molecular Medicine, University of Cape Town, Observatory, Cape Town, South Africa
| | - Roanne Keeton
- Institute of Infectious Disease and Molecular Medicine, University of Cape Town, Observatory, Cape Town, South Africa
| | - Catherine Riou
- Institute of Infectious Disease and Molecular Medicine, University of Cape Town, Observatory, Cape Town, South Africa; Wellcome Centre for Infectious Diseases Research in Africa, University of Cape Town, Observatory, Cape Town, South Africa
| | - Andrew D Sutherland
- Division of Medical Virology, Faculty of Medicine and Health Sciences, University of Stellenbosch Tygerberg Campus, Cape Town ZA-7505, South Africa
| | - Tasnim Suliman
- Department of Medical Biosciences, University of the Western Cape, Cape Town, South Africa
| | - Megan L Shaw
- Department of Medical Biosciences, University of the Western Cape, Cape Town, South Africa
| | - Wolfgang Preiser
- Division of Medical Virology, Faculty of Medicine and Health Sciences, University of Stellenbosch Tygerberg Campus, Cape Town ZA-7505, South Africa; Medical Virology, National Health Laboratory Service Tygerberg, Parow, Cape Town, South Africa.
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Fabiani M, Puopolo M, Morciano C, Spuri M, Spila Alegiani S, Filia A, D'Ancona F, Del Manso M, Riccardo F, Tallon M, Proietti V, Sacco C, Massari M, Da Cas R, Mateo-Urdiales A, Siddu A, Battilomo S, Bella A, Palamara AT, Popoli P, Brusaferro S, Rezza G, Menniti Ippolito F, Pezzotti P. Effectiveness of mRNA vaccines and waning of protection against SARS-CoV-2 infection and severe covid-19 during predominant circulation of the delta variant in Italy: retrospective cohort study. BMJ 2022; 376:e069052. [PMID: 35144968 PMCID: PMC8829820 DOI: 10.1136/bmj-2021-069052] [Citation(s) in RCA: 37] [Impact Index Per Article: 18.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
OBJECTIVES To estimate the effectiveness of mRNA vaccines against SARS-CoV-2 infection and severe covid-19 at different time after vaccination. DESIGN Retrospective cohort study. SETTING Italy, 27 December 2020 to 7 November 2021. PARTICIPANTS 33 250 344 people aged ≥16 years who received a first dose of BNT162b2 (Pfizer-BioNTech) or mRNA-1273 (Moderna) vaccine and did not have a previous diagnosis of SARS-CoV-2 infection. MAIN OUTCOME MEASURES SARS-CoV-2 infection and severe covid-19 (admission to hospital or death). Data were divided by weekly time intervals after vaccination. Incidence rate ratios at different time intervals were estimated by multilevel negative binomial models with robust variance estimator. Sex, age group, brand of vaccine, priority risk category, and regional weekly incidence in the general population were included as covariates. Geographic region was included as a random effect. Adjusted vaccine effectiveness was calculated as (1-IRR)×100, where IRR=incidence rate ratio, with the time interval 0-14 days after the first dose of vaccine as the reference. RESULTS During the epidemic phase when the delta variant was the predominant strain of the SARS-CoV-2 virus, vaccine effectiveness against SARS-CoV-2 infection significantly decreased (P<0.001) from 82% (95% confidence interval 80% to 84%) at 3-4 weeks after the second dose of vaccine to 33% (27% to 39%) at 27-30 weeks after the second dose. In the same time intervals, vaccine effectiveness against severe covid-19 also decreased (P<0.001), although to a lesser extent, from 96% (95% to 97%) to 80% (76% to 83%). High risk people (vaccine effectiveness -6%, -28% to 12%), those aged ≥80 years (11%, -15% to 31%), and those aged 60-79 years (2%, -11% to 14%) did not seem to be protected against infection at 27-30 weeks after the second dose of vaccine. CONCLUSIONS The results support the vaccination campaigns targeting high risk people, those aged ≥60 years, and healthcare workers to receive a booster dose of vaccine six months after the primary vaccination cycle. The results also suggest that timing the booster dose earlier than six months after the primary vaccination cycle and extending the offer of the booster dose to the wider eligible population might be warranted.
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Affiliation(s)
| | - Maria Puopolo
- Italian National Institute of Health (ISS), Rome, Italy
| | | | - Matteo Spuri
- Italian National Institute of Health (ISS), Rome, Italy
| | | | | | | | | | | | - Marco Tallon
- Italian National Institute of Health (ISS), Rome, Italy
| | | | - Chiara Sacco
- Italian National Institute of Health (ISS), Rome, Italy
| | - Marco Massari
- Italian National Institute of Health (ISS), Rome, Italy
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Uprichard SL, O’Brien A, Evdokimova M, Rowe CL, Joyce C, Hackbart M, Cruz-Pulido YE, Cohen CA, Rock ML, Dye JM, Kuehnert P, Ricks KM, Casper M, Linhart L, Anderson K, Kirk L, Maggiore JA, Herbert AS, Clark NM, Reid GE, Baker SC. Antibody Response to SARS-CoV-2 Infection and Vaccination in COVID-19-naïve and Experienced Individuals. Viruses 2022; 14:370. [PMID: 35215962 PMCID: PMC8878640 DOI: 10.3390/v14020370] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Revised: 02/01/2022] [Accepted: 02/04/2022] [Indexed: 11/25/2022] Open
Abstract
Understanding the magnitude of responses to vaccination during the ongoing SARS-CoV-2 pandemic is essential for ultimate mitigation of the disease. Here, we describe a cohort of 102 subjects (70 COVID-19-naïve, 32 COVID-19-experienced) who received two doses of one of the mRNA vaccines (BNT162b2 (Pfizer-BioNTech) and mRNA-1273 (Moderna)). We document that a single exposure to antigen via infection or vaccination induces a variable antibody response which is affected by age, gender, race, and co-morbidities. In response to a second antigen dose, both COVID-19-naïve and experienced subjects exhibited elevated levels of anti-spike and SARS-CoV-2 neutralizing activity; however, COVID-19-experienced individuals achieved higher antibody levels and neutralization activity as a group. The COVID-19-experienced subjects exhibited no significant increase in antibody or neutralization titer in response to the second vaccine dose (i.e., third antigen exposure). Finally, we found that COVID-19-naïve individuals who received the Moderna vaccine exhibited a more robust boost response to the second vaccine dose (p = 0.004) as compared to the response to Pfizer-BioNTech. Ongoing studies with this cohort will continue to contribute to our understanding of the range and durability of responses to SARS-CoV-2 mRNA vaccines.
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Affiliation(s)
- Susan L. Uprichard
- Department of Medicine, Stritch School of Medicine, Loyola University Chicago, Maywood, IL 60153, USA; (M.C.); (L.L.); (K.A.); (L.K.); (N.M.C.); (G.E.R.)
- Department of Microbiology and Immunology, Stritch School of Medicine, Loyola University Chicago, Maywood, IL 60153, USA; (A.O.); (M.E.); (C.L.R.); (M.H.); (Y.E.C.-P.); (S.C.B.)
- Infectious Disease and Immunology Research Institute, Stritch School of Medicine, Loyola University Chicago, Maywood, IL 60153, USA
| | - Amornrat O’Brien
- Department of Microbiology and Immunology, Stritch School of Medicine, Loyola University Chicago, Maywood, IL 60153, USA; (A.O.); (M.E.); (C.L.R.); (M.H.); (Y.E.C.-P.); (S.C.B.)
| | - Monika Evdokimova
- Department of Microbiology and Immunology, Stritch School of Medicine, Loyola University Chicago, Maywood, IL 60153, USA; (A.O.); (M.E.); (C.L.R.); (M.H.); (Y.E.C.-P.); (S.C.B.)
| | - Cynthia L. Rowe
- Department of Microbiology and Immunology, Stritch School of Medicine, Loyola University Chicago, Maywood, IL 60153, USA; (A.O.); (M.E.); (C.L.R.); (M.H.); (Y.E.C.-P.); (S.C.B.)
| | - Cara Joyce
- Department of Public Health Sciences, Parkinson School of Health Sciences and Public Health, Loyola University Chicago, Maywood, IL 60153, USA;
| | - Matthew Hackbart
- Department of Microbiology and Immunology, Stritch School of Medicine, Loyola University Chicago, Maywood, IL 60153, USA; (A.O.); (M.E.); (C.L.R.); (M.H.); (Y.E.C.-P.); (S.C.B.)
| | - Yazmin E. Cruz-Pulido
- Department of Microbiology and Immunology, Stritch School of Medicine, Loyola University Chicago, Maywood, IL 60153, USA; (A.O.); (M.E.); (C.L.R.); (M.H.); (Y.E.C.-P.); (S.C.B.)
| | - Courtney A. Cohen
- Viral Immunology Branch, Virology Division, United States Army Medical Research Institute of Infectious Diseases, Fort Detrick, Frederick, MD 21702, USA; (C.A.C.); (M.L.R.); (J.M.D.); (A.S.H.)
- The Geneva Foundation, Tacoma, WA 98042, USA
| | - Michelle L. Rock
- Viral Immunology Branch, Virology Division, United States Army Medical Research Institute of Infectious Diseases, Fort Detrick, Frederick, MD 21702, USA; (C.A.C.); (M.L.R.); (J.M.D.); (A.S.H.)
- The Geneva Foundation, Tacoma, WA 98042, USA
| | - John M. Dye
- Viral Immunology Branch, Virology Division, United States Army Medical Research Institute of Infectious Diseases, Fort Detrick, Frederick, MD 21702, USA; (C.A.C.); (M.L.R.); (J.M.D.); (A.S.H.)
| | - Paul Kuehnert
- Diagnostic Systems Division, United States Army Medical Research Institute of Infectious Diseases (USAMRIID), Frederick, MD 21702, USA; (P.K.); (K.M.R.)
| | - Keersten M. Ricks
- Diagnostic Systems Division, United States Army Medical Research Institute of Infectious Diseases (USAMRIID), Frederick, MD 21702, USA; (P.K.); (K.M.R.)
| | - Marybeth Casper
- Department of Medicine, Stritch School of Medicine, Loyola University Chicago, Maywood, IL 60153, USA; (M.C.); (L.L.); (K.A.); (L.K.); (N.M.C.); (G.E.R.)
| | - Lori Linhart
- Department of Medicine, Stritch School of Medicine, Loyola University Chicago, Maywood, IL 60153, USA; (M.C.); (L.L.); (K.A.); (L.K.); (N.M.C.); (G.E.R.)
| | - Katrina Anderson
- Department of Medicine, Stritch School of Medicine, Loyola University Chicago, Maywood, IL 60153, USA; (M.C.); (L.L.); (K.A.); (L.K.); (N.M.C.); (G.E.R.)
| | - Laura Kirk
- Department of Medicine, Stritch School of Medicine, Loyola University Chicago, Maywood, IL 60153, USA; (M.C.); (L.L.); (K.A.); (L.K.); (N.M.C.); (G.E.R.)
| | - Jack A. Maggiore
- Department of Pathology, Stritch School of Medicine, Loyola University Chicago, Maywood, IL 60153, USA;
| | - Andrew S. Herbert
- Viral Immunology Branch, Virology Division, United States Army Medical Research Institute of Infectious Diseases, Fort Detrick, Frederick, MD 21702, USA; (C.A.C.); (M.L.R.); (J.M.D.); (A.S.H.)
| | - Nina M. Clark
- Department of Medicine, Stritch School of Medicine, Loyola University Chicago, Maywood, IL 60153, USA; (M.C.); (L.L.); (K.A.); (L.K.); (N.M.C.); (G.E.R.)
- Infectious Disease and Immunology Research Institute, Stritch School of Medicine, Loyola University Chicago, Maywood, IL 60153, USA
| | - Gail E. Reid
- Department of Medicine, Stritch School of Medicine, Loyola University Chicago, Maywood, IL 60153, USA; (M.C.); (L.L.); (K.A.); (L.K.); (N.M.C.); (G.E.R.)
- Infectious Disease and Immunology Research Institute, Stritch School of Medicine, Loyola University Chicago, Maywood, IL 60153, USA
| | - Susan C. Baker
- Department of Microbiology and Immunology, Stritch School of Medicine, Loyola University Chicago, Maywood, IL 60153, USA; (A.O.); (M.E.); (C.L.R.); (M.H.); (Y.E.C.-P.); (S.C.B.)
- Infectious Disease and Immunology Research Institute, Stritch School of Medicine, Loyola University Chicago, Maywood, IL 60153, USA
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Abstract
Dermatomyositis (DM) is one of the uncommon multi-organ idiopathic inflammatory myopathies that has been reported following the hepatitis B, Influenza, tetanus toxoid, H1N1, and BCG vaccines. However, an association with the coronavirus disease 2019 (COVID-19) vaccine is yet to be reported. In this case, we present the case of a 43-year-old Asian Indian female who was diagnosed with DM 10 days after receiving the second dosage of BNT162b2 mRNA COVID-19 vaccination, in the absence of any additional triggering factors. The diagnosis was established based on physical examination, serological antibodies, magnetic resonance imaging of the muscles, skin biopsy, and electromyography. She received standard treatment for DM, including oral high doses of prednisolone, hydroxychloroquine, mycophenolate, and physiotherapy. The treatment successfully reversed skin changes and muscle weakness. This is the first reported case of classic DM complicated by interstitial lung disease following COVID-19 vaccination. More clinical and functional studies are needed to elucidate this association. Clinicians should be aware of this unexpected adverse event following COVID-19 vaccination and arrange for appropriate management.
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Affiliation(s)
- Wesam Gouda
- Department of Rheumatology, Faculty of Medicine, Al Azhar University, Assiut, Egypt
- Department of Rheumatology, Al-Sabah Hospital, Kuwait, Kuwait.
| | - Anwar Albasri
- Department of Rheumatology, Al-Sabah Hospital, Kuwait, Kuwait
- Department of Rheumatology, Jaber Al Ahmad Hospital, Kuwait, Kuwait
| | - Faisal Alsaqabi
- Department of Rheumatology, Al-Sabah Hospital, Kuwait, Kuwait
| | | | | | - Hassan Abdelnaby
- Department of Endemic and Infectious Diseases, Faculty of Medicine, Suez Canal University, Ismailia, Egypt
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35
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Basso P, Negro C, Cegolon L, Larese Filon F. Risk of Vaccine Breakthrough SARS-CoV-2 Infection and Associated Factors in Healthcare Workers of Trieste Teaching Hospitals (North-Eastern Italy). Viruses 2022; 14:336. [PMID: 35215930 PMCID: PMC8875653 DOI: 10.3390/v14020336] [Citation(s) in RCA: 28] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2022] [Revised: 01/25/2022] [Accepted: 01/26/2022] [Indexed: 11/17/2022] Open
Abstract
Background: Healthcare workers (HCWs) are particularly exposed to biological risk, including SARS-CoV-2 infection. In order to contrast the current pandemic and alleviate the burden of the disease on the healthcare system, a mass vaccination campaign against COVID-19 has been launched worldwide. Aim To evaluate the impact of COVID-19 vaccination in HCWs exposed to SARS-CoV-2, to describe the clinical presentation of COVID-19 in infected HCWs, and to investigate clinical and occupational risk factors for breakthrough infection. Design: Retrospective cohort study. Methods: The cohort of HCWs of Trieste Hospitals were followed up from 1 March 2020, to 30 November 2021 (21 months). All HCWs were periodically screened for SARS-CoV-2 infection by real-time PCR (RT-PCR) analysis. Clinical data were obtained through routine medical surveillance records. Risk factors for SARS-CoV-2 infection were investigated by univariable as well as multivariable logistic regression analysis. Results: Among 4394 HCWs routinely screened for SARS-CoV-2 by PCR on nasopharyngeal swab, a total of 800 incident cases were identified during the entire study period (1 March 2020 to 30 November 2021). Five hundred and sixty-four cases occurred before, and 236 after the start of the vaccination campaign against COVID-19, of whom 155 received a complete vaccination scheme before SARS-CoV-2 infection. Breakthrough infection was featured by mild or no symptoms and was significantly associated with the male sex, BMI > 25, and diabetes mellitus. Some categories of HCWs (physicians and nurse aids/auxiliary personnel) were at a higher risk of breakthrough infection. Conclusions: Fully vaccinated HCWs were less likely to acquire symptomatic as well as asymptomatic SARS-CoV-2 infection. Risk factors for SARS-CoV-2 infection after a full COVID-19 vaccination scheme included the male gender, diabetes mellitus, and overweight. HCWs with higher exposure to COVID-19 patients were at higher risk of breakthrough infection.
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Affiliation(s)
- Paolo Basso
- Department of Medical, Surgical & Health Sciences, University of Trieste, 34129 Trieste, Italy; (P.B.); (C.N.); (F.L.F.)
| | - Corrado Negro
- Department of Medical, Surgical & Health Sciences, University of Trieste, 34129 Trieste, Italy; (P.B.); (C.N.); (F.L.F.)
- Clinical Unit of Occupational Medicine, University of Trieste, 34129 Trieste, Italy
| | - Luca Cegolon
- Department of Medical, Surgical & Health Sciences, University of Trieste, 34129 Trieste, Italy; (P.B.); (C.N.); (F.L.F.)
- Public Health Department, University Health Agency Giuliano-Isontina (ASUGI), 34128 Trieste, Italy
| | - Francesca Larese Filon
- Department of Medical, Surgical & Health Sciences, University of Trieste, 34129 Trieste, Italy; (P.B.); (C.N.); (F.L.F.)
- Clinical Unit of Occupational Medicine, University of Trieste, 34129 Trieste, Italy
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36
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Nemet I, Kliker L, Lustig Y, Zuckerman N, Erster O, Cohen C, Kreiss Y, Alroy-Preis S, Regev-Yochay G, Mendelson E, Mandelboim M. Third BNT162b2 Vaccination Neutralization of SARS-CoV-2 Omicron Infection. N Engl J Med 2022; 386:492-494. [PMID: 34965337 PMCID: PMC8823651 DOI: 10.1056/nejmc2119358] [Citation(s) in RCA: 286] [Impact Index Per Article: 143.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Affiliation(s)
| | | | | | | | | | - Carmit Cohen
- Sheba Medical Center Tel Hashomer, Ramat Gan, Israel
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37
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Matusali G, Sberna G, Meschi S, Gramigna G, Colavita F, Lapa D, Francalancia M, Bettini A, Capobianchi MR, Puro V, Castilletti C, Vaia F, Bordi L. Differential Dynamics of SARS-CoV-2 Binding and Functional Antibodies upon BNT162b2 Vaccine: A 6-Month Follow-Up. Viruses 2022; 14:v14020312. [PMID: 35215903 PMCID: PMC8878369 DOI: 10.3390/v14020312] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Revised: 01/30/2022] [Accepted: 01/31/2022] [Indexed: 01/14/2023] Open
Abstract
To investigate the dynamic association among binding and functional antibodies in health-care-workers receiving two doses of BNT162b2 mRNA COVID-19-vaccine, SARS-CoV-2 anti-RBD IgG, anti-Trimeric-S IgG, and neutralizing antibodies (Nabs) were measured in serum samples collected at 2 weeks, 3 months, and 6 months from full vaccination. Despite the high correlation, results for anti-RBD and anti-Trimeric S IgG were numerically different even after recalculation to BAU/mL following WHO standards indications. Moreover, after a peak response at 2 weeks, anti-RBD IgG levels showed a 4.5 and 13 fold decrease at 3 and 6 months, respectively, while the anti-Trimeric S IgG presented a less pronounced decay of 2.8 and 4.7 fold. Further different dynamics were observed for Nabs titers, resulting comparable at 3 and 6 months from vaccination. We also demonstrated that at NAbs titers ≥40, the area under the receiver operating characteristic curve and the optimal cutoff point decreased with time from vaccination for both anti-RBD and anti-Trimeric S IgG. The mutating relation among the anti-RBD IgG, anti-Trimeric S IgG, and neutralizing antibodies are indicative of antibody maturation upon vaccination. The lack of standardized laboratory procedures is one factor interfering with the definition of a correlate of protection from COVID-19.
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Affiliation(s)
- Giulia Matusali
- Laboratory of Virology and Biosafety Laboratories, National Institute for Infectious Diseases “Lazzaro Spallanzani” IRCCS, Via Portuense 292, 00149 Rome, Italy; (G.M.); (G.S.); (G.G.); (F.C.); (D.L.); (M.F.); (A.B.); (M.R.C.); (C.C.); (L.B.)
| | - Giuseppe Sberna
- Laboratory of Virology and Biosafety Laboratories, National Institute for Infectious Diseases “Lazzaro Spallanzani” IRCCS, Via Portuense 292, 00149 Rome, Italy; (G.M.); (G.S.); (G.G.); (F.C.); (D.L.); (M.F.); (A.B.); (M.R.C.); (C.C.); (L.B.)
| | - Silvia Meschi
- Laboratory of Virology and Biosafety Laboratories, National Institute for Infectious Diseases “Lazzaro Spallanzani” IRCCS, Via Portuense 292, 00149 Rome, Italy; (G.M.); (G.S.); (G.G.); (F.C.); (D.L.); (M.F.); (A.B.); (M.R.C.); (C.C.); (L.B.)
- Correspondence: ; Tel.: +39-0655170692
| | - Giulia Gramigna
- Laboratory of Virology and Biosafety Laboratories, National Institute for Infectious Diseases “Lazzaro Spallanzani” IRCCS, Via Portuense 292, 00149 Rome, Italy; (G.M.); (G.S.); (G.G.); (F.C.); (D.L.); (M.F.); (A.B.); (M.R.C.); (C.C.); (L.B.)
| | - Francesca Colavita
- Laboratory of Virology and Biosafety Laboratories, National Institute for Infectious Diseases “Lazzaro Spallanzani” IRCCS, Via Portuense 292, 00149 Rome, Italy; (G.M.); (G.S.); (G.G.); (F.C.); (D.L.); (M.F.); (A.B.); (M.R.C.); (C.C.); (L.B.)
| | - Daniele Lapa
- Laboratory of Virology and Biosafety Laboratories, National Institute for Infectious Diseases “Lazzaro Spallanzani” IRCCS, Via Portuense 292, 00149 Rome, Italy; (G.M.); (G.S.); (G.G.); (F.C.); (D.L.); (M.F.); (A.B.); (M.R.C.); (C.C.); (L.B.)
| | - Massimo Francalancia
- Laboratory of Virology and Biosafety Laboratories, National Institute for Infectious Diseases “Lazzaro Spallanzani” IRCCS, Via Portuense 292, 00149 Rome, Italy; (G.M.); (G.S.); (G.G.); (F.C.); (D.L.); (M.F.); (A.B.); (M.R.C.); (C.C.); (L.B.)
| | - Aurora Bettini
- Laboratory of Virology and Biosafety Laboratories, National Institute for Infectious Diseases “Lazzaro Spallanzani” IRCCS, Via Portuense 292, 00149 Rome, Italy; (G.M.); (G.S.); (G.G.); (F.C.); (D.L.); (M.F.); (A.B.); (M.R.C.); (C.C.); (L.B.)
| | - Maria R. Capobianchi
- Laboratory of Virology and Biosafety Laboratories, National Institute for Infectious Diseases “Lazzaro Spallanzani” IRCCS, Via Portuense 292, 00149 Rome, Italy; (G.M.); (G.S.); (G.G.); (F.C.); (D.L.); (M.F.); (A.B.); (M.R.C.); (C.C.); (L.B.)
| | - Vincenzo Puro
- Risk Management Unit, National Institute for Infectious Diseases “Lazzaro Spallanzani” IRCCS, Via Portuense 292, 00149 Rome, Italy;
| | - Concetta Castilletti
- Laboratory of Virology and Biosafety Laboratories, National Institute for Infectious Diseases “Lazzaro Spallanzani” IRCCS, Via Portuense 292, 00149 Rome, Italy; (G.M.); (G.S.); (G.G.); (F.C.); (D.L.); (M.F.); (A.B.); (M.R.C.); (C.C.); (L.B.)
| | - Francesco Vaia
- General Direction, National Institute for Infectious Diseases “Lazzaro Spallanzani” IRCCS, Via Portuense 292, 00149 Rome, Italy;
| | - Licia Bordi
- Laboratory of Virology and Biosafety Laboratories, National Institute for Infectious Diseases “Lazzaro Spallanzani” IRCCS, Via Portuense 292, 00149 Rome, Italy; (G.M.); (G.S.); (G.G.); (F.C.); (D.L.); (M.F.); (A.B.); (M.R.C.); (C.C.); (L.B.)
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Planas D, Saunders N, Maes P, Guivel-Benhassine F, Planchais C, Buchrieser J, Bolland WH, Porrot F, Staropoli I, Lemoine F, Péré H, Veyer D, Puech J, Rodary J, Baele G, Dellicour S, Raymenants J, Gorissen S, Geenen C, Vanmechelen B, Wawina-Bokalanga T, Martí-Carreras J, Cuypers L, Sève A, Hocqueloux L, Prazuck T, Rey FA, Simon-Loriere E, Bruel T, Mouquet H, André E, Schwartz O. Considerable escape of SARS-CoV-2 Omicron to antibody neutralization. Nature 2022; 602:671-675. [PMID: 35016199 DOI: 10.1101/2021.12.14.472630] [Citation(s) in RCA: 38] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Accepted: 12/23/2021] [Indexed: 05/27/2023]
Abstract
The SARS-CoV-2 Omicron variant was first identified in November 2021 in Botswana and South Africa1-3. It has since spread to many countries and is expected to rapidly become dominant worldwide. The lineage is characterized by the presence of around 32 mutations in spike-located mostly in the N-terminal domain and the receptor-binding domain-that may enhance viral fitness and enable antibody evasion. Here we isolated an infectious Omicron virus in Belgium from a traveller returning from Egypt. We examined its sensitivity to nine monoclonal antibodies that have been clinically approved or are in development4, and to antibodies present in 115 serum samples from COVID-19 vaccine recipients or individuals who have recovered from COVID-19. Omicron was completely or partially resistant to neutralization by all monoclonal antibodies tested. Sera from recipients of the Pfizer or AstraZeneca vaccine, sampled five months after complete vaccination, barely inhibited Omicron. Sera from COVID-19-convalescent patients collected 6 or 12 months after symptoms displayed low or no neutralizing activity against Omicron. Administration of a booster Pfizer dose as well as vaccination of previously infected individuals generated an anti-Omicron neutralizing response, with titres 6-fold to 23-fold lower against Omicron compared with those against Delta. Thus, Omicron escapes most therapeutic monoclonal antibodies and, to a large extent, vaccine-elicited antibodies. However, Omicron is neutralized by antibodies generated by a booster vaccine dose.
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Affiliation(s)
- Delphine Planas
- Virus and Immunity Unit, Institut Pasteur, Université de Paris, CNRS UMR3569, Paris, France
- Vaccine Research Institute, Créteil, France
| | - Nell Saunders
- Virus and Immunity Unit, Institut Pasteur, Université de Paris, CNRS UMR3569, Paris, France
- École Doctorale BioSPC 562, Université de Paris, Paris, France
| | - Piet Maes
- Department of Microbiology, Laboratory of Clinical and Epidemiological Virology, Immunology and Transplantation, Rega Institute, KU Leuven, Leuven, Belgium
| | | | - Cyril Planchais
- Humoral Immunology Laboratory, Institut Pasteur, Université de Paris, INSERM U1222, Paris, France
| | - Julian Buchrieser
- Virus and Immunity Unit, Institut Pasteur, Université de Paris, CNRS UMR3569, Paris, France
| | - William-Henry Bolland
- Virus and Immunity Unit, Institut Pasteur, Université de Paris, CNRS UMR3569, Paris, France
- École Doctorale BioSPC 562, Université de Paris, Paris, France
| | - Françoise Porrot
- Virus and Immunity Unit, Institut Pasteur, Université de Paris, CNRS UMR3569, Paris, France
| | - Isabelle Staropoli
- Virus and Immunity Unit, Institut Pasteur, Université de Paris, CNRS UMR3569, Paris, France
| | - Frederic Lemoine
- Hub de Bioinformatique et Biostatistique, Institut Pasteur, Université de Paris, CNRS USR 3756, Paris, France
| | - Hélène Péré
- Laboratoire de Virologie, Service de Microbiologie, Hôpital Européen Georges Pompidou, Paris, France
- Functional Genomics of Solid Tumors (FunGeST), Centre de Recherche des Cordelier, INSERM, Université de Paris, Sorbonne Université, Paris, France
| | - David Veyer
- Laboratoire de Virologie, Service de Microbiologie, Hôpital Européen Georges Pompidou, Paris, France
- Functional Genomics of Solid Tumors (FunGeST), Centre de Recherche des Cordelier, INSERM, Université de Paris, Sorbonne Université, Paris, France
| | - Julien Puech
- Laboratoire de Virologie, Service de Microbiologie, Hôpital Européen Georges Pompidou, Paris, France
| | - Julien Rodary
- Laboratoire de Virologie, Service de Microbiologie, Hôpital Européen Georges Pompidou, Paris, France
| | - Guy Baele
- Department of Microbiology, Laboratory of Clinical and Epidemiological Virology, Immunology and Transplantation, Rega Institute, KU Leuven, Leuven, Belgium
| | - Simon Dellicour
- Department of Microbiology, Laboratory of Clinical and Epidemiological Virology, Immunology and Transplantation, Rega Institute, KU Leuven, Leuven, Belgium
- Spatial Epidemiology Lab (SpELL), Université Libre de Bruxelles, Brussels, Belgium
| | - Joren Raymenants
- Laboratory of Clinical Microbiology, Department of Microbiology, Immunology and Transplantation, KU Leuven, Leuven, Belgium
| | - Sarah Gorissen
- Laboratory of Clinical Microbiology, Department of Microbiology, Immunology and Transplantation, KU Leuven, Leuven, Belgium
| | - Caspar Geenen
- Laboratory of Clinical Microbiology, Department of Microbiology, Immunology and Transplantation, KU Leuven, Leuven, Belgium
| | - Bert Vanmechelen
- Department of Microbiology, Laboratory of Clinical and Epidemiological Virology, Immunology and Transplantation, Rega Institute, KU Leuven, Leuven, Belgium
| | - Tony Wawina-Bokalanga
- Department of Microbiology, Laboratory of Clinical and Epidemiological Virology, Immunology and Transplantation, Rega Institute, KU Leuven, Leuven, Belgium
| | - Joan Martí-Carreras
- Department of Microbiology, Laboratory of Clinical and Epidemiological Virology, Immunology and Transplantation, Rega Institute, KU Leuven, Leuven, Belgium
| | - Lize Cuypers
- Department of Laboratory Medicine, National Reference Centre for Respiratory Pathogens, University Hospitals Leuven, Leuven, Belgium
| | - Aymeric Sève
- Service de Maladies Infectieuses, CHR d'Orléans, Orléans, France
| | | | - Thierry Prazuck
- Service de Maladies Infectieuses, CHR d'Orléans, Orléans, France
| | - Félix A Rey
- Structural Virology Unit, Institut Pasteur, Université de Paris, CNRS UMR3569, Paris, France
| | - Etienne Simon-Loriere
- G5 Evolutionary Genomics of RNA Viruses, Institut Pasteur, Université de Paris, Paris, France
| | - Timothée Bruel
- Virus and Immunity Unit, Institut Pasteur, Université de Paris, CNRS UMR3569, Paris, France.
- Vaccine Research Institute, Créteil, France.
| | - Hugo Mouquet
- Humoral Immunology Laboratory, Institut Pasteur, Université de Paris, INSERM U1222, Paris, France.
| | - Emmanuel André
- Laboratory of Clinical Microbiology, Department of Microbiology, Immunology and Transplantation, KU Leuven, Leuven, Belgium.
- Department of Laboratory Medicine, National Reference Centre for Respiratory Pathogens, University Hospitals Leuven, Leuven, Belgium.
| | - Olivier Schwartz
- Virus and Immunity Unit, Institut Pasteur, Université de Paris, CNRS UMR3569, Paris, France.
- Vaccine Research Institute, Créteil, France.
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Marchesi F, Pimpinelli F, Giannarelli D, Ronchetti L, Papa E, Falcucci P, Pontone M, Di Domenico EG, di Martino S, Laquintana V, Mandoj C, Conti L, Cordone I, La Malfa A, Viggiani C, Renzi D, Palombi F, Romano A, Pisani F, Gumenyuk S, Di Bella O, Vujovic B, Morrone A, Ciliberto G, Ensoli F, Mengarelli A. Impact of anti-CD20 monoclonal antibodies on serologic response to BNT162b2 vaccine in B-cell Non-Hodgkin's lymphomas. Leukemia 2022; 36:588-590. [PMID: 34545184 PMCID: PMC8451738 DOI: 10.1038/s41375-021-01418-8] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Revised: 09/01/2021] [Accepted: 09/07/2021] [Indexed: 11/08/2022]
Affiliation(s)
- Francesco Marchesi
- Hematology Unit, Department of Research and Clinical Oncology, IRCCS Regina Elena National Cancer Institute, Rome, Italy.
| | - Fulvia Pimpinelli
- Microbiology and Virology Unit, Dermatological Clinical and Research Department, IRCCS San Gallicano Institute, Rome, Italy
| | - Diana Giannarelli
- Clinical Trial Center, Biostatistics and Bioinformatics Unit, Scientific Direction, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Livia Ronchetti
- SAFU Unit, Department of Research and Innovative Technologies, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Elena Papa
- Hematology Unit, Department of Research and Clinical Oncology, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Paolo Falcucci
- Hematology Unit, Department of Research and Clinical Oncology, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Martina Pontone
- Microbiology and Virology Unit, Dermatological Clinical and Research Department, IRCCS San Gallicano Institute, Rome, Italy
| | - Enea Gino Di Domenico
- Microbiology and Virology Unit, Dermatological Clinical and Research Department, IRCCS San Gallicano Institute, Rome, Italy
| | - Simona di Martino
- Biological Tissue and Liquid Bank, Scientific Direction, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Valentina Laquintana
- Biological Tissue and Liquid Bank, Scientific Direction, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Chiara Mandoj
- Clinical Pathology and Cancer Biobank, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Laura Conti
- Clinical Pathology and Cancer Biobank, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Iole Cordone
- Clinical Pathology and Cancer Biobank, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Antonia La Malfa
- Pharmacy Unit, Medical Direction, IRCCS Regina Elena National Cancer Institute and San Gallicano Institute, Rome, Italy
| | - Caterina Viggiani
- Hematology Unit, Department of Research and Clinical Oncology, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Daniela Renzi
- Hematology Unit, Department of Research and Clinical Oncology, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Francesca Palombi
- Hematology Unit, Department of Research and Clinical Oncology, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Atelda Romano
- Hematology Unit, Department of Research and Clinical Oncology, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Francesco Pisani
- Hematology Unit, Department of Research and Clinical Oncology, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Svitlana Gumenyuk
- Hematology Unit, Department of Research and Clinical Oncology, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Ornella Di Bella
- Medical Direction, IRCCS Regina Elena National Cancer Institute and San Gallicano Institute, Rome, Italy
| | - Branka Vujovic
- Medical Direction, IRCCS Regina Elena National Cancer Institute and San Gallicano Institute, Rome, Italy
| | - Aldo Morrone
- Scientific Direction, IRCCS San Gallicano Institute, Rome, Italy
| | - Gennaro Ciliberto
- Scientific Direction, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Fabrizio Ensoli
- Microbiology and Virology Unit, Dermatological Clinical and Research Department, IRCCS San Gallicano Institute, Rome, Italy
| | - Andrea Mengarelli
- Hematology Unit, Department of Research and Clinical Oncology, IRCCS Regina Elena National Cancer Institute, Rome, Italy
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Paetzold J, Kimpel J, Bates K, Hummer M, Krammer F, von Laer D, Winner H. Impacts of rapid mass vaccination against SARS-CoV2 in an early variant of concern hotspot. Nat Commun 2022; 13:612. [PMID: 35105889 PMCID: PMC8807735 DOI: 10.1038/s41467-022-28233-8] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Accepted: 01/10/2022] [Indexed: 11/25/2022] Open
Abstract
We study the real-life effect of an unprecedented rapid mass vaccination campaign. Following a large outbreak of the Beta variant in the district of Schwaz/Austria, 100,000 doses of BNT162b2 (Pfizer/BioNTech) were procured to mass vaccinate the entire adult population of the district between the 11th and 16th of March 2021. This made the district the first widely inoculated region in Europe. We examine the effect of this campaign on the number of infections, cases of variants of concern, hospital and ICU admissions. We compare Schwaz with (i) a control group of highly similar districts, and (ii) with populations residing in municipalities along the border of Schwaz which were just excluded from the campaign. We find large and significant decreases for all outcomes after the campaign. Our results suggest that rapid mass vaccination is an effective tool to curb the spread of SARS-CoV-2.
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Affiliation(s)
- Jörg Paetzold
- University of Salzburg, Department of Economics, Residenzplatz 9, A-5010, Salzburg, Austria.
| | - Janine Kimpel
- Institute of Virology, Department of Hygiene, Microbiology and Public Health, Medical University of Innsbruck, Peter-Mayr-Str. 4b, 6020, Innsbruck, Austria
| | - Katie Bates
- Department of Medical Statistics, Informatics and Health Economics, Medical University of Innsbruck, Innsbruck, Austria
| | - Michael Hummer
- The Austrian National Public Health Institute (Gesundheit Österreich GmbH, GÖG), Stubenring 6, 1010, Vienna, Austria
| | - Florian Krammer
- Department of Microbiology, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1124, New York, NY, 10029, USA
| | - Dorothee von Laer
- Institute of Virology, Department of Hygiene, Microbiology and Public Health, Medical University of Innsbruck, Peter-Mayr-Str. 4b, 6020, Innsbruck, Austria
| | - Hannes Winner
- University of Salzburg, Department of Economics, Residenzplatz 9, A-5010, Salzburg, Austria
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41
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Fehr T, Hübel K, de Rougemont O, Abela I, Gaspert A, Güngör T, Hauri M, Helmchen B, Linsenmeier C, Müller T, Nilsson J, Riesterer O, Scandling JD, Schanz U, Cippà PE. Successful Induction of Specific Immunological Tolerance by Combined Kidney and Hematopoietic Stem Cell Transplantation in HLA-Identical Siblings. Front Immunol 2022; 13:796456. [PMID: 35173720 PMCID: PMC8841472 DOI: 10.3389/fimmu.2022.796456] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2021] [Accepted: 01/05/2022] [Indexed: 11/30/2022] Open
Abstract
Induction of immunological tolerance has been the holy grail of transplantation immunology for decades. The only successful approach to achieve it in patients has been a combined kidney and hematopoietic stem cell transplantation from an HLA-matched or -mismatched living donor. Here, we report the first three patients in Europe included in a clinical trial aiming at the induction of tolerance by mixed lymphohematopoietic chimerism after kidney transplantation. Two female and one male patient were transplanted with a kidney and peripherally mobilized hematopoietic stem cells from their HLA-identical sibling donor. The protocol followed previous studies at Stanford University: kidney transplantation was performed on day 0 including induction with anti-thymocyte globulin followed by conditioning with 10x 1.2 Gy total lymphoid irradiation and the transfusion of CD34+ cells together with a body weight-adjusted dose of donor T cells on day 11. Immunosuppression consisted of cyclosporine A and steroids for 10 days, cyclosporine A and mycophenolate mofetil for 1 month, and then cyclosporine A monotherapy with tapering over 9–20 months. The 3 patients have been off immunosuppression for 4 years, 19 months and 8 months, respectively. No rejection or graft-versus-host disease occurred. Hematological donor chimerism was stable in the first, but slowly declining in the other two patients. A molecular microscope analysis in patient 2 revealed the genetic profile of a normal kidney. No relevant infections were observed, and the quality of life in all three patients is excellent. During the SARS-CoV-2 pandemic, all three patients were vaccinated with the mRNA vaccine BNT162b2 (Comirnaty®), and they showed excellent humoral and in 2 out 3 patients also cellular SARS-CoV-2-specific immunity. Thus, combined kidney and hematopoietic stem cell transplantation is a feasible and successful approach to induce specific immunological tolerance in the setting of HLA-matched sibling living kidney donation while maintaining immune responsiveness to an mRNA vaccine (ClinicalTrials.gov: NCT00365846).
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Affiliation(s)
- Thomas Fehr
- Division of Nephrology, University Hospital Zurich, Zurich, Switzerland
- Department of Internal Medicine, Cantonal Hospital Graubuenden, Chur, Switzerland
- *Correspondence: Thomas Fehr,
| | - Kerstin Hübel
- Division of Nephrology, University Hospital Zurich, Zurich, Switzerland
- Department of Surgery and Transplantation, University Hospital Zurich, Zurich, Switzerland
| | - Olivier de Rougemont
- Department of Surgery and Transplantation, University Hospital Zurich, Zurich, Switzerland
| | - Irene Abela
- Institute of Medical Virology, University of Zurich, Zurich, Switzerland
| | - Ariana Gaspert
- Department of Pathology, University Hospital Zurich, Zurich, Switzerland
| | - Tayfun Güngör
- Division of Stem Cell Transplantation, University Children’s Hospital Zurich – Eleonore Foundation & Children`s Research Center (CRC), Zurich, Switzerland
| | - Mathias Hauri
- Division of Stem Cell Transplantation, University Children’s Hospital Zurich – Eleonore Foundation & Children`s Research Center (CRC), Zurich, Switzerland
| | - Birgit Helmchen
- Department of Pathology, University Hospital Zurich, Zurich, Switzerland
| | - Claudia Linsenmeier
- Department of Radiation Oncology, University Hospital Zurich, Zurich, Switzerland
| | - Thomas Müller
- Division of Nephrology, University Hospital Zurich, Zurich, Switzerland
| | - Jakob Nilsson
- Laboratory for Transplantation Immunology, University Hospital Zurich, Zurich, Switzerland
| | - Oliver Riesterer
- Department of Radiation Oncology, University Hospital Zurich, Zurich, Switzerland
| | - John D. Scandling
- Division of Nephrology, Stanford University School of Medicine, Stanford, CA, United States
| | - Urs Schanz
- Department of Medical Oncology and Hematology, University Hospital Zurich, Zurich, Switzerland
| | - Pietro E. Cippà
- Division of Nephrology, University Hospital Zurich, Zurich, Switzerland
- Division of Nephrology, Ente Ospedaliero Cantonale, Lugano, Switzerland
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Tenforde MW, Patel MM, Gaglani M, Ginde AA, Douin DJ, Talbot HK, Casey JD, Mohr NM, Zepeski A, McNeal T, Ghamande S, Gibbs KW, Files DC, Hager DN, Shehu A, Prekker ME, Erickson HL, Gong MN, Mohamed A, Johnson NJ, Srinivasan V, Steingrub JS, Peltan ID, Brown SM, Martin ET, Monto AS, Khan A, Hough CL, Busse LW, Duggal A, Wilson JG, Qadir N, Chang SY, Mallow C, Rivas C, Babcock HM, Kwon JH, Exline MC, Botros M, Lauring AS, Shapiro NI, Halasa N, Chappell JD, Grijalva CG, Rice TW, Jones ID, Stubblefield WB, Baughman A, Womack KN, Rhoads JP, Lindsell CJ, Hart KW, Zhu Y, Naioti EA, Adams K, Lewis NM, Surie D, McMorrow ML, Self WH. Effectiveness of a Third Dose of Pfizer-BioNTech and Moderna Vaccines in Preventing COVID-19 Hospitalization Among Immunocompetent and Immunocompromised Adults - United States, August-December 2021. MMWR Morb Mortal Wkly Rep 2022; 71:118-124. [PMID: 35085218 PMCID: PMC9351530 DOI: 10.15585/mmwr.mm7104a2] [Citation(s) in RCA: 63] [Impact Index Per Article: 31.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
COVID-19 mRNA vaccines (BNT162b2 [Pfizer-BioNTech] and mRNA-1273 [Moderna]) provide protection against infection with SARS-CoV-2, the virus that causes COVID-19, and are highly effective against COVID-19-associated hospitalization among eligible persons who receive 2 doses (1,2). However, vaccine effectiveness (VE) among persons with immunocompromising conditions* is lower than that among immunocompetent persons (2), and VE declines after several months among all persons (3). On August 12, 2021, the Food and Drug Administration (FDA) issued an emergency use authorization (EUA) for a third mRNA vaccine dose as part of a primary series ≥28 days after dose 2 for persons aged ≥12 years with immunocompromising conditions, and, on November 19, 2021, as a booster dose for all adults aged ≥18 years at least 6 months after dose 2, changed to ≥5 months after dose 2 on January 3, 2022 (4,5,6). Among 2,952 adults (including 1,385 COVID-19 case-patients and 1,567 COVID-19-negative controls) hospitalized at 21 U.S. hospitals during August 19-December 15, 2021, effectiveness of mRNA vaccines against COVID-19-associated hospitalization was compared between adults eligible for but who had not received a third vaccine dose (1,251) and vaccine-eligible adults who received a third dose ≥7 days before illness onset (312). Among 1,875 adults without immunocompromising conditions (including 1,065 [57%] unvaccinated, 679 [36%] 2-dose recipients, and 131 [7%] 3-dose [booster] recipients), VE against COVID-19 hospitalization was higher among those who received a booster dose (97%; 95% CI = 95%-99%) compared with that among 2-dose recipients (82%; 95% CI = 77%-86%) (p <0.001). Among 1,077 adults with immunocompromising conditions (including 324 [30%] unvaccinated, 572 [53%] 2-dose recipients, and 181 [17%] 3-dose recipients), VE was higher among those who received a third dose to complete a primary series (88%; 95% CI = 81%-93%) compared with 2-dose recipients (69%; 95% CI = 57%-78%) (p <0.001). Administration of a third COVID-19 mRNA vaccine dose as part of a primary series among immunocompromised adults, or as a booster dose among immunocompetent adults, provides improved protection against COVID-19-associated hospitalization.
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Muhsen K, Maimon N, Mizrahi A, Varticovschi B, Bodenheimer O, Gelbshtein U, Grotto I, Cohen D, Dagan R. Effects of BNT162b2 Covid-19 Vaccine Booster in Long-Term Care Facilities in Israel. N Engl J Med 2022; 386:399-401. [PMID: 34936758 PMCID: PMC8757568 DOI: 10.1056/nejmc2117385] [Citation(s) in RCA: 22] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Affiliation(s)
| | - Nimrod Maimon
- Soroka University Medical Center, Beer-Sheva, Israel
| | - Ami Mizrahi
- Israeli Ministry of Health, Airport City, Israel
| | | | | | | | - Itamar Grotto
- Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | | | - Ron Dagan
- Ben-Gurion University of the Negev, Beer-Sheva, Israel
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Spitzer A, Angel Y, Marudi O, Zeltser D, Saiag E, Goldshmidt H, Goldiner I, Stark M, Halutz O, Gamzu R, Slobodkin M, Amrami N, Feigin E, Elbaz M, Furman M, Bronstein Y, Chikly A, Eshkol A, Furer V, Mayer T, Meijer S, Melloul A, Mizrahi M, Yakubovsky M, Rosenberg D, Safir A, Spitzer L, Taleb E, Elkayam O, Silberman A, Eviatar T, Elalouf O, Levinson T, Pozyuchenko K, Itzhaki-Alfia A, Sprecher E, Ben-Ami R, Henig O. Association of a Third Dose of BNT162b2 Vaccine With Incidence of SARS-CoV-2 Infection Among Health Care Workers in Israel. JAMA 2022; 327:341-349. [PMID: 35006256 PMCID: PMC8749710 DOI: 10.1001/jama.2021.23641] [Citation(s) in RCA: 65] [Impact Index Per Article: 32.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
IMPORTANCE Administration of a BNT162b2 booster dose (Pfizer-BioNTech) to fully vaccinated individuals aged 60 years and older was significantly associated with lower risk of SARS-CoV-2 infection and severe illness. Data are lacking on the effectiveness of booster doses for younger individuals and health care workers. OBJECTIVE To estimate the association of a BNT162b2 booster dose with SARS-CoV-2 infections among health care workers who were previously vaccinated with a 2-dose series of BNT162b2. DESIGN, SETTING, AND PARTICIPANTS This was a prospective cohort study conducted at a tertiary medical center in Tel Aviv, Israel. The study cohort included 1928 immunocompetent health care workers who were previously vaccinated with a 2-dose series of BNT162b2, and had enrolled between August 8 and 19, 2021, with final follow-up reported through September 20, 2021. Screening for SARS-CoV-2 infection was performed every 14 days. Anti-spike protein receptor binding domain IgG titers were determined at baseline and 1 month after enrollment. Cox regression with time-dependent analysis was used to estimate hazard ratios of SARS-CoV-2 infection between booster-immunized status and 2-dose vaccinated (booster-nonimmunized) status. EXPOSURES Vaccination with a booster dose of BNT162b2 vaccine. MAIN OUTCOMES AND MEASURES The primary outcome was SARS-CoV-2 infection, as confirmed by reverse transcriptase-polymerase chain reaction. RESULTS Among 1928 participants, the median age was 44 years (IQR, 36-52 years) and 1381 were women (71.6%). Participants completed the 2-dose vaccination series a median of 210 days (IQR, 205-213 days) before study enrollment. A total of 1650 participants (85.6%) received the booster dose. During a median follow-up of 39 days (IQR, 35-41 days), SARS-CoV-2 infection occurred in 44 participants (incidence rate, 60.2 per 100 000 person-days); 31 (70.5%) were symptomatic. Five SARS-CoV-2 infections occurred in booster-immunized participants and 39 in booster-nonimmunized participants (incidence rate, 12.8 vs 116 per 100 000 person-days, respectively). In a time-dependent Cox regression analysis, the adjusted hazard ratio of SARS-CoV-2 infection for booster-immunized vs booster-nonimmunized participants was 0.07 (95% CI, 0.02-0.20). CONCLUSIONS AND RELEVANCE Among health care workers at a single center in Israel who were previously vaccinated with a 2-dose series of BNT162b2, administration of a booster dose compared with not receiving one was associated with a significantly lower rate of SARS-CoV-2 infection over a median of 39 days of follow-up. Ongoing surveillance is required to assess durability of the findings.
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Affiliation(s)
- Avishay Spitzer
- Department of Oncology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Department of Molecular Cell Biology, Weizmann Institute of Science, Rehovot, Israel
| | - Yoel Angel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Department of Anesthesia, Pain Management and Intensive Care, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
- Department of Physician Affairs, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Or Marudi
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - David Zeltser
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Department of Emergency Medicine, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Esther Saiag
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Department of Information Systems and Operations, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Hanoch Goldshmidt
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Department of Clinical Laboratories, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Ilana Goldiner
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Department of Clinical Laboratories, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Moshe Stark
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Department of Clinical Laboratories, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Ora Halutz
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Department of Clinical Laboratories, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Ronni Gamzu
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Marina Slobodkin
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Department of Internal Medicine “D,” Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Nadav Amrami
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Department of Internal Medicine “D,” Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Eugene Feigin
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Department of Internal Medicine “D,” Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Meital Elbaz
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Department of Infectious Diseases and Infection Control, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Moran Furman
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Department of Dermatology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Yotam Bronstein
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Department of Internal Medicine “D,” Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Amanda Chikly
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Department of Infectious Diseases and Infection Control, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Anna Eshkol
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Department of Dermatology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Victoria Furer
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Department of Rheumatology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Talia Mayer
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Department of Dermatology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Suzy Meijer
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Department of Infectious Diseases and Infection Control, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Ariel Melloul
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Department of Internal Medicine “D,” Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Michal Mizrahi
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Department of Internal Medicine “D,” Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Michal Yakubovsky
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Department of Infectious Diseases and Infection Control, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Dana Rosenberg
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Department of Rheumatology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Ari Safir
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Department of Dermatology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Liron Spitzer
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Department of Dermatology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Eyal Taleb
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Department of Dermatology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Ori Elkayam
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Department of Rheumatology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Adi Silberman
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Department of Rheumatology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Tali Eviatar
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Department of Rheumatology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Ofir Elalouf
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Department of Rheumatology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Tal Levinson
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Department of Infectious Diseases and Infection Control, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Katia Pozyuchenko
- Department of Pathology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Ayelet Itzhaki-Alfia
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Department of Pathology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Eli Sprecher
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Department of Dermatology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
- Department of Research and Development, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Ronen Ben-Ami
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Department of Infectious Diseases and Infection Control, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Oryan Henig
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Department of Infectious Diseases and Infection Control, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
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45
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COVID-19 Updates: Pfizer-BioNTech COVID-19 vaccine. Med Lett Drugs Ther 2022; 64:16. [PMID: 35134045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
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46
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Woldemeskel BA, Dykema AG, Garliss CC, Cherfils S, Smith KN, Blankson JN. CD4+ T-cells from COVID-19 mRNA vaccine recipients recognize a conserved epitope present in diverse coronaviruses. J Clin Invest 2022; 132:156083. [PMID: 35061630 PMCID: PMC8884904 DOI: 10.1172/jci156083] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Accepted: 01/19/2022] [Indexed: 11/28/2022] Open
Abstract
Recent studies have shown that vaccinated individuals harbor T cells that can cross-recognize SARS-CoV-2 and endemic human common cold coronaviruses. However, it is still unknown whether CD4+ T cells from vaccinated individuals recognize peptides from bat coronaviruses that may have the potential of causing future pandemics. In this study, we identified a SARS-CoV-2 spike protein epitope (S815-827) that is conserved in coronaviruses from different genera and subgenera, including SARS-CoV, MERS-CoV, multiple bat coronaviruses, and a feline coronavirus. Our results showed that S815-827 was recognized by 42% of vaccinated participants in our study who received the Pfizer-BioNTech (BNT162b2) or Moderna (mRNA-1273) COVID-19 vaccines. Using T cell expansion and T cell receptor sequencing assays, we demonstrated that S815-827-reactive CD4+ T cells from the majority of responders cross-recognized homologous peptides from at least 6 other diverse coronaviruses. Our results support the hypothesis that the current mRNA vaccines elicit T cell responses that can cross-recognize bat coronaviruses and thus might induce some protection against potential zoonotic outbreaks. Furthermore, our data provide important insights that inform the development of T cell–based pan-coronavirus vaccine strategies.
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Affiliation(s)
| | - Arbor G. Dykema
- Bloomberg-Kimmel Institute for Cancer Immunotherapy, Johns Hopkins Medicine, Baltimore, Maryland, USA
- Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University, Baltimore, Maryland, USA
| | | | | | - Kellie N. Smith
- Bloomberg-Kimmel Institute for Cancer Immunotherapy, Johns Hopkins Medicine, Baltimore, Maryland, USA
- Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University, Baltimore, Maryland, USA
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47
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Abstract
This study investigates the immunogenicity of extended mRNA vaccine dosing intervals.
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Affiliation(s)
- Brian Grunau
- Department of Emergency Medicine, University of British Columbia, Vancouver, Canada
| | - David M. Goldfarb
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, Canada
| | | | - Liam Golding
- Department of Obstetrics and Gynecology, University of British Columbia, Vancouver, Canada
| | - Tracy L. Kirkham
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Paul A. Demers
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Pascal M. Lavoie
- Department of Pediatrics, University of British Columbia, Vancouver, Canada
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48
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van Gils MJ, van Willigen HD, Wynberg E, Han AX, van der Straten K, Burger JA, Poniman M, Oomen M, Tejjani K, Bouhuijs JH, Verveen A, Lebbink R, Dijkstra M, Appelman B, Lavell AA, Caniels TG, Bontjer I, van Vught LA, Vlaar AP, Sikkens JJ, Bomers MK, Russell CA, Kootstra NA, Sanders RW, Prins M, de Bree GJ, de Jong MD. A single mRNA vaccine dose in COVID-19 patients boosts neutralizing antibodies against SARS-CoV-2 and variants of concern. Cell Rep Med 2022; 3:100486. [PMID: 35103254 PMCID: PMC8668345 DOI: 10.1016/j.xcrm.2021.100486] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [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] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Revised: 09/28/2021] [Accepted: 11/26/2021] [Indexed: 12/20/2022]
Abstract
The urgent need for, but limited availability of, SARS-CoV-2 vaccines worldwide has led to widespread consideration of dose-sparing strategies. Here, we evaluate the SARS-CoV-2-specific antibody responses following BNT162b2 vaccination in 150 previously SARS-CoV-2-infected individuals from a population-based cohort. One week after first vaccine dose, spike protein antibody levels are 27-fold higher and neutralizing antibody titers 12-fold higher, exceeding titers of fully vaccinated SARS-CoV-2-naive controls, with minimal additional boosting after the second dose. Neutralizing antibody titers against four variants of concern increase after vaccination; however, overall neutralization breadth does not improve. Pre-vaccination neutralizing antibody titers and time since infection have the largest positive effect on titers following vaccination. COVID-19 severity and the presence of comorbidities have no discernible impact on vaccine response. In conclusion, a single dose of BNT162b2 vaccine up to 15 months after SARS-CoV-2 infection offers higher neutralizing antibody titers than 2 vaccine doses in SARS-CoV-2-naive individuals.
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Affiliation(s)
- Marit J. van Gils
- Department of Medical Microbiology & Infection Prevention, Amsterdam UMC, University of Amsterdam, Amsterdam Institute for Infection and Immunity, Amsterdam, the Netherlands
| | - Hugo D.G. van Willigen
- Department of Medical Microbiology & Infection Prevention, Amsterdam UMC, University of Amsterdam, Amsterdam Institute for Infection and Immunity, Amsterdam, the Netherlands
| | - Elke Wynberg
- Department of Medical Microbiology & Infection Prevention, Amsterdam UMC, University of Amsterdam, Amsterdam Institute for Infection and Immunity, Amsterdam, the Netherlands
- Department of Infectious Diseases, Public Health Service of Amsterdam, GGD, Amsterdam, the Netherlands
| | - Alvin X. Han
- Department of Medical Microbiology & Infection Prevention, Amsterdam UMC, University of Amsterdam, Amsterdam Institute for Infection and Immunity, Amsterdam, the Netherlands
| | - Karlijn van der Straten
- Department of Medical Microbiology & Infection Prevention, Amsterdam UMC, University of Amsterdam, Amsterdam Institute for Infection and Immunity, Amsterdam, the Netherlands
- Department of Internal Medicine, Amsterdam UMC, University of Amsterdam, Amsterdam Institute for Infection and Immunity, Amsterdam, the Netherlands
| | - Judith A. Burger
- Department of Medical Microbiology & Infection Prevention, Amsterdam UMC, University of Amsterdam, Amsterdam Institute for Infection and Immunity, Amsterdam, the Netherlands
| | - Meliawati Poniman
- Department of Medical Microbiology & Infection Prevention, Amsterdam UMC, University of Amsterdam, Amsterdam Institute for Infection and Immunity, Amsterdam, the Netherlands
| | - Melissa Oomen
- Department of Medical Microbiology & Infection Prevention, Amsterdam UMC, University of Amsterdam, Amsterdam Institute for Infection and Immunity, Amsterdam, the Netherlands
| | - Khadija Tejjani
- Department of Medical Microbiology & Infection Prevention, Amsterdam UMC, University of Amsterdam, Amsterdam Institute for Infection and Immunity, Amsterdam, the Netherlands
| | - Joey H. Bouhuijs
- Department of Medical Microbiology & Infection Prevention, Amsterdam UMC, University of Amsterdam, Amsterdam Institute for Infection and Immunity, Amsterdam, the Netherlands
| | - Anouk Verveen
- Department of Medical Psychology, Amsterdam UMC, University of Amsterdam, Amsterdam School of Public Health, Amsterdam, the Netherlands
| | - Romy Lebbink
- Department of Infectious Diseases, Public Health Service of Amsterdam, GGD, Amsterdam, the Netherlands
| | - Maartje Dijkstra
- Department of Infectious Diseases, Public Health Service of Amsterdam, GGD, Amsterdam, the Netherlands
- Department of Internal Medicine, Amsterdam UMC, University of Amsterdam, Amsterdam Institute for Infection and Immunity, Amsterdam, the Netherlands
| | - Brent Appelman
- Center for Experimental and Molecular Medicine, Amsterdam UMC, University of Amsterdam, Amsterdam Institute for Infection and Immunity, Amsterdam, the Netherlands
| | - A.H. Ayesha Lavell
- Department of Internal Medicine, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Institute for Infection and Immunity, Amsterdam, the Netherlands
| | - Tom G. Caniels
- Department of Medical Microbiology & Infection Prevention, Amsterdam UMC, University of Amsterdam, Amsterdam Institute for Infection and Immunity, Amsterdam, the Netherlands
| | - Ilja Bontjer
- Department of Medical Microbiology & Infection Prevention, Amsterdam UMC, University of Amsterdam, Amsterdam Institute for Infection and Immunity, Amsterdam, the Netherlands
| | - Lonneke A. van Vught
- Center for Experimental and Molecular Medicine, Amsterdam UMC, University of Amsterdam, Amsterdam Institute for Infection and Immunity, Amsterdam, the Netherlands
- Department of Intensive Care Medicine, Amsterdam UMC, University of Amsterdam, Amsterdam Institute for Infection and Immunity, Amsterdam, the Netherlands
| | - Alexander P.J. Vlaar
- Department of Intensive Care Medicine, Amsterdam UMC, University of Amsterdam, Amsterdam Institute for Infection and Immunity, Amsterdam, the Netherlands
| | - Jonne J. Sikkens
- Department of Internal Medicine, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Institute for Infection and Immunity, Amsterdam, the Netherlands
| | - Marije K. Bomers
- Department of Internal Medicine, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Institute for Infection and Immunity, Amsterdam, the Netherlands
| | - Colin A. Russell
- Department of Medical Microbiology & Infection Prevention, Amsterdam UMC, University of Amsterdam, Amsterdam Institute for Infection and Immunity, Amsterdam, the Netherlands
| | - Neeltje A. Kootstra
- Department of Experimental Immunology, Amsterdam UMC, University of Amsterdam, Amsterdam Institute for Infection and Immunity, Amsterdam, the Netherlands
| | - Rogier W. Sanders
- Department of Medical Microbiology & Infection Prevention, Amsterdam UMC, University of Amsterdam, Amsterdam Institute for Infection and Immunity, Amsterdam, the Netherlands
- Department of Microbiology and Immunology, Weill Medical College of Cornell University, New York, NY, USA
| | - Maria Prins
- Department of Infectious Diseases, Public Health Service of Amsterdam, GGD, Amsterdam, the Netherlands
- Department of Internal Medicine, Amsterdam UMC, University of Amsterdam, Amsterdam Institute for Infection and Immunity, Amsterdam, the Netherlands
| | - Godelieve J. de Bree
- Department of Internal Medicine, Amsterdam UMC, University of Amsterdam, Amsterdam Institute for Infection and Immunity, Amsterdam, the Netherlands
| | - Menno D. de Jong
- Department of Medical Microbiology & Infection Prevention, Amsterdam UMC, University of Amsterdam, Amsterdam Institute for Infection and Immunity, Amsterdam, the Netherlands
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49
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Reynolds CJ, Gibbons JM, Pade C, Lin KM, Sandoval DM, Pieper F, Butler DK, Liu S, Otter AD, Joy G, Menacho K, Fontana M, Smit A, Kele B, Cutino-Moguel T, Maini MK, Noursadeghi M, Brooks T, Semper A, Manisty C, Treibel TA, Moon JC, McKnight Á, Altmann DM, Boyton RJ. Heterologous infection and vaccination shapes immunity against SARS-CoV-2 variants. Science 2022; 375:183-192. [PMID: 34855510 PMCID: PMC10186585 DOI: 10.1126/science.abm0811] [Citation(s) in RCA: 71] [Impact Index Per Article: 35.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Accepted: 11/25/2021] [Indexed: 12/15/2022]
Abstract
The impact of the initial severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infecting strain on downstream immunity to heterologous variants of concern (VOCs) is unknown. Studying a longitudinal healthcare worker cohort, we found that after three antigen exposures (infection plus two vaccine doses), S1 antibody, memory B cells, and heterologous neutralization of B.1.351, P.1, and B.1.617.2 plateaued, whereas B.1.1.7 neutralization and spike T cell responses increased. Serology using the Wuhan Hu-1 spike receptor binding domain poorly predicted neutralizing immunity against VOCs. Neutralization potency against VOCs changed with heterologous virus encounter and number of antigen exposures. Neutralization potency fell differentially depending on targeted VOCs over the 5 months from the second vaccine dose. Heterologous combinations of spike encountered during infection and vaccination shape subsequent cross-protection against VOC, with implications for future-proof next-generation vaccines.
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Affiliation(s)
| | - Joseph M. Gibbons
- Blizard Institute, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Corinna Pade
- Blizard Institute, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Kai-Min Lin
- Department of Infectious Disease, Imperial College London, London, UK
| | | | - Franziska Pieper
- Department of Infectious Disease, Imperial College London, London, UK
| | - David K. Butler
- Department of Infectious Disease, Imperial College London, London, UK
| | - Siyi Liu
- Department of Infectious Disease, Imperial College London, London, UK
| | | | - George Joy
- St. Bartholomew’s Hospital, Barts Health NHS Trust, London, UK
| | - Katia Menacho
- St. Bartholomew’s Hospital, Barts Health NHS Trust, London, UK
| | | | | | - Beatrix Kele
- St. Bartholomew’s Hospital, Barts Health NHS Trust, London, UK
| | | | - Mala K. Maini
- Division of Infection and Immunity, University College London, London, UK
| | - Mahdad Noursadeghi
- Division of Infection and Immunity, University College London, London, UK
| | - COVIDsortium Immune Correlates Network‡
- Department of Infectious Disease, Imperial College London, London, UK
- Blizard Institute, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, UK
- UK Health Security Agency, Porton Down, UK
- St. Bartholomew’s Hospital, Barts Health NHS Trust, London, UK
- Royal Free London NHS Foundation Trust, London, UK
- Division of Infection and Immunity, University College London, London, UK
- Institute of Cardiovascular Science, University College London, London, UK
- Department of Immunology and Inflammation, Imperial College London, London, UK
- Lung Division, Royal Brompton and Harefield Hospitals, Guy’s and St. Thomas’ NHS Foundation Trust, London, UK
| | - Tim Brooks
- UK Health Security Agency, Porton Down, UK
| | | | - Charlotte Manisty
- St. Bartholomew’s Hospital, Barts Health NHS Trust, London, UK
- Institute of Cardiovascular Science, University College London, London, UK
| | - Thomas A. Treibel
- St. Bartholomew’s Hospital, Barts Health NHS Trust, London, UK
- Institute of Cardiovascular Science, University College London, London, UK
| | - James C. Moon
- St. Bartholomew’s Hospital, Barts Health NHS Trust, London, UK
- Institute of Cardiovascular Science, University College London, London, UK
| | - COVIDsortium Investigators‡
- Department of Infectious Disease, Imperial College London, London, UK
- Blizard Institute, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, UK
- UK Health Security Agency, Porton Down, UK
- St. Bartholomew’s Hospital, Barts Health NHS Trust, London, UK
- Royal Free London NHS Foundation Trust, London, UK
- Division of Infection and Immunity, University College London, London, UK
- Institute of Cardiovascular Science, University College London, London, UK
- Department of Immunology and Inflammation, Imperial College London, London, UK
- Lung Division, Royal Brompton and Harefield Hospitals, Guy’s and St. Thomas’ NHS Foundation Trust, London, UK
| | - Áine McKnight
- Blizard Institute, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Daniel M. Altmann
- Department of Immunology and Inflammation, Imperial College London, London, UK
| | - Rosemary J. Boyton
- Department of Infectious Disease, Imperial College London, London, UK
- Lung Division, Royal Brompton and Harefield Hospitals, Guy’s and St. Thomas’ NHS Foundation Trust, London, UK
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50
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Kian W, Zemel M, Kestenbaum EH, Rouvinov K, Alguayn W, Levitas D, Ievko A, Michlin R, Abod MA, Massalha I, Chernomordikov E, Sharb AA, Shalata W, Levison E, Roisman LC, Lavrenkov K, Peled N, Nesher L, Yakobson A. Safety of the BNT162b2 mRNA COVID-19 vaccine in oncologic patients undergoing numerous cancer treatment options: A retrospective single-center study. Medicine (Baltimore) 2022; 101:e28561. [PMID: 35029223 PMCID: PMC8758044 DOI: 10.1097/md.0000000000028561] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Accepted: 12/18/2021] [Indexed: 01/05/2023] Open
Abstract
The COVID-19 pandemic, caused by the SARS-CoV2 virus, has infected millions worldwide with cancer patients demonstrating a higher prevalence for severe disease and poorer outcomes. Recently, the BNT162b2 mRNA COVID-19 vaccine was released as the primary means to combat COVID-19. The currently reported incidence of local and systemic side effects was 27% in the general public. The safety of the BNT162b2 mRNA COVID-19 vaccine has not been studied in patients with an active cancer diagnosis who are either ongoing or plan to undergo oncologic therapy.This single center study reviewed the charts of 210 patients with active cancer diagnoses that received both doses of the BNT162b2 mRNA COVID-19 vaccine. The development of side effects from the vaccine, hospitalizations or exacerbations from various oncologic treatment were documented. Type of oncologic treatment (immunotherapy, chemotherapy, hormonal, biologic, radiation or mixed) was documented to identify if side effects were related to treatment type. The time at which the vaccine was administered in relation to treatment onset (on long term therapy, within 1 month of therapy or prior to therapy) was also documented to identify any relationships.Sixty five (31%) participants experienced side effects from the BNT162b2 mRNA COVID-19 vaccine, however most were mild to moderate. Treatment protocol was not linked to the development of vaccine related side effects (P = .202), nor was immunotherapy (P = .942). The timing of vaccine administered in relation to treatment onset was also not related to vaccine related side effects (P = .653). Six (2.9%) participants were hospitalized and 4 (2%) died.The incidence of side effects in cancer patients is similar to what has been reported for the general public (31% vs 27%). Therefore, we believe that the BNT162b2 mRNA COVID-19 vaccine is safe in oncologic patients undergoing numerous cancer treatments.
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Affiliation(s)
- Waleed Kian
- The Legacy Heritage Oncology Center & Dr. Larry Norton Institute, Soroka Medical Center & Ben-Gurion University, Beer-Sheva, Israel
| | - Melanie Zemel
- Medical School for International Health, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Emily H. Kestenbaum
- Medical School for International Health, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Keren Rouvinov
- The Legacy Heritage Oncology Center & Dr. Larry Norton Institute, Soroka Medical Center & Ben-Gurion University, Beer-Sheva, Israel
| | - Wafeek Alguayn
- Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Dina Levitas
- The Legacy Heritage Oncology Center & Dr. Larry Norton Institute, Soroka Medical Center & Ben-Gurion University, Beer-Sheva, Israel
| | - Anna Ievko
- The Legacy Heritage Oncology Center & Dr. Larry Norton Institute, Soroka Medical Center & Ben-Gurion University, Beer-Sheva, Israel
| | - Regina Michlin
- The Legacy Heritage Oncology Center & Dr. Larry Norton Institute, Soroka Medical Center & Ben-Gurion University, Beer-Sheva, Israel
| | - Moataz A. Abod
- Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Ismaell Massalha
- The Legacy Heritage Oncology Center & Dr. Larry Norton Institute, Soroka Medical Center & Ben-Gurion University, Beer-Sheva, Israel
| | - Elena Chernomordikov
- The Legacy Heritage Oncology Center & Dr. Larry Norton Institute, Soroka Medical Center & Ben-Gurion University, Beer-Sheva, Israel
| | - Adam A. Sharb
- Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Walid Shalata
- The Legacy Heritage Oncology Center & Dr. Larry Norton Institute, Soroka Medical Center & Ben-Gurion University, Beer-Sheva, Israel
| | - Esther Levison
- Medical School for International Health, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Laila C. Roisman
- The Institute of Oncology, Shaare Zedek Medical Center, Jerusalem, Israel
| | - Konstantin Lavrenkov
- The Legacy Heritage Oncology Center & Dr. Larry Norton Institute, Soroka Medical Center & Ben-Gurion University, Beer-Sheva, Israel
| | - Nir Peled
- The Institute of Oncology, Shaare Zedek Medical Center, Jerusalem, Israel
| | - Lior Nesher
- Infectious Disease Institute, Soroka Medical Center, Ben-Gurion University of the Negev, Beersheba, Israel
| | - Alexander Yakobson
- The Legacy Heritage Oncology Center & Dr. Larry Norton Institute, Soroka Medical Center & Ben-Gurion University, Beer-Sheva, Israel
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