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Soe P, Wong H, Naus M, Muller MP, Vanderkooi OG, Kellner JD, Top KA, Sadarangani M, Isenor JE, Marty K, De Serres G, Valiquette L, McGeer A, Bettinger JA. mRNA COVID-19 vaccine safety among older adults from the Canadian National Vaccine Safety Network. Vaccine 2024:S0264-410X(24)00535-8. [PMID: 38714447 DOI: 10.1016/j.vaccine.2024.04.096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Revised: 03/14/2024] [Accepted: 04/30/2024] [Indexed: 05/09/2024]
Abstract
This study examined short-to-medium term safety of COVID-19 vaccines among adults aged ≥65 years using the Canadian National Vaccine Safety Network active safety surveillance data. Both vaccinated and unvaccinated older adult participants recruited from seven provinces and territories were included in the analysis. Safety was assessed at 7 days after COVID-19 vaccination (dose 1, 2 and 3), and 7 months after dose 1. Multivariable logistic regression was used to examine the association between BNT162b2/mRNA-1273 COVID-19 vaccines and two short-term health events: 1) health event preventing daily activities and/or required medical consultation, 2) serious health events resulting in an emergency department visit and/or hospitalization within 7 days following each dose. We also assessed the rates of serious health events for the period between dose 1 and 2, and 7-months following dose 1. Between December 2020 and February 2022, a total of 173,038, 104,452, and 13,970 older adults completed dose 1, dose 2, and dose 3 surveys, respectively. The control survey was completed by 2,955 unvaccinated older adults. Health events occurred more frequently among recipients after dose 2 homologous mRNA-1273 (adjusted odds ratio [95 % confidence interval]: 2.91 [2.24-3.79]) and dose two heterologous (BNT162b2 followed by mRNA-1273): 1.50 [1.12-2.02] compared to unvaccinated counterparts. There was no difference in event rates after any dose of BNT162b2 and unvaccinated participants. The rates of serious health events following COVID-19 vaccination were very low (≤0.3 %) across all vaccine products and doses, and were not higher compared to unvaccinated controls, and were not associated with an emergency department visit or hospitalization within 7 days following vaccination. Reported symptoms were self-limited and rarely required medical assessment. Our findings further strengthen the current evidence that mRNA COVID-19 vaccines are safe and can be used to inform older adults about expected adverse events following COVID-19 vaccination.
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Affiliation(s)
- Phyumar Soe
- Vaccine Evaluation Center, BC Children's Hospital Research Institute, Vancouver, Canada; School of Population and Public Health, University of British Columbia, Vancouver, Canada
| | - Hubert Wong
- School of Population and Public Health, University of British Columbia, Vancouver, Canada
| | - Monika Naus
- School of Population and Public Health, University of British Columbia, Vancouver, Canada; BC Center for Disease Control, Vancouver, British Columbia, Canada
| | | | - Otto G Vanderkooi
- Department of Pediatrics and Alberta Children's Hospital Research Institute, University of Calgary, Calgary, Canada
| | - James D Kellner
- Department of Pediatrics and Alberta Children's Hospital Research Institute, University of Calgary, Calgary, Canada
| | - Karina A Top
- Canadian Center for Vaccinology, IWK Health and Department of Pediatrics, Dalhousie University, Halifax, Canada
| | - Manish Sadarangani
- Vaccine Evaluation Center, BC Children's Hospital Research Institute, Vancouver, Canada; Department of Pediatrics, University of British Columbia, Vancouver, BC, Canada
| | - Jennifer E Isenor
- Canadian Center for Vaccinology, IWK Health and Department of Pediatrics, Dalhousie University, Halifax, Canada
| | - Kimberly Marty
- Vaccine Evaluation Center, BC Children's Hospital Research Institute, Vancouver, Canada
| | | | - Louis Valiquette
- Department of Microbiology and Infectious Diseases, Université de Sherbrooke, Sherbrooke, Canada
| | - Allison McGeer
- Department of Microbiology, Sinai Health, Toronto, Canada; Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Canada
| | - Julie A Bettinger
- Vaccine Evaluation Center, BC Children's Hospital Research Institute, Vancouver, Canada; Department of Pediatrics, University of British Columbia, Vancouver, BC, Canada.
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Carazo S, Guay CA, Skowronski DM, Amini R, Charest H, De Serres G, Gilca R. Influenza Hospitalization Burden by Subtype, Age, Comorbidity, and Vaccination Status: 2012-2013 to 2018-2019 Seasons, Quebec, Canada. Clin Infect Dis 2024; 78:765-774. [PMID: 37819010 DOI: 10.1093/cid/ciad627] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Revised: 09/26/2023] [Accepted: 10/10/2023] [Indexed: 10/13/2023] Open
Abstract
BACKGROUND Influenza immunization programs aim to reduce the risk and burden of severe outcomes. To inform optimal program strategies, we monitored influenza hospitalizations over 7 seasons, stratified by age, comorbidity, and vaccination status. METHODS We assembled data from 4 hospitals involved in an active surveillance network with systematic collection of nasal samples and polymerase chain reaction testing for influenza virus in all patients admitted through the emergency department with acute respiratory infection during the 2012-2013 to 2018-2019 influenza seasons in Quebec, Canada. We estimated seasonal, population-based incidence of influenza-associated hospitalizations by subtype predominance, age, comorbidity, and vaccine status, and derived the number needed to vaccinate to prevent 1 hospitalization per stratum. RESULTS The average seasonal incidence of influenza-associated hospitalization was 89/100 000 (95% confidence interval, 86-93), lower during A(H1N1) (49-82/100 000) than A(H3N2) seasons (73-143/100 000). Overall risk followed a J-shaped age pattern, highest among infants 0-5 months and adults ≥75 years old. Hospitalization risks were highest for children <5 years old during A(H1N1) but for highest adults aged ≥75 years during A(H3N2) seasons. Age-adjusted hospitalization risks were 7-fold higher among individuals with versus without comorbid conditions (214 vs 30/100 000, respectively). The number needed to vaccinate to prevent hospitalization was 82-fold lower for ≥75-years-olds with comorbid conditions (n = 1995), who comprised 39% of all hospitalizations, than for healthy 18-64-year-olds (n = 163 488), who comprised just 6% of all hospitalizations. CONCLUSIONS In the context of broad-based influenza immunization programs (targeted or universal), severe outcome risks should be simultaneously examined by subtype, age, comorbidity, and vaccine status. Policymakers require such detail to prioritize promotional efforts and expenditures toward the greatest and most efficient program impact.
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Affiliation(s)
- Sara Carazo
- Biological Risks Unit, Institut National de Santé Publique du Québec, Quebec City, Quebec, Canada
- Faculty of Medicine, Laval University, Quebec City, Quebec, Canada
| | - Charles-Antoine Guay
- Biological Risks Unit, Institut National de Santé Publique du Québec, Quebec City, Quebec, Canada
- Faculty of Medicine, Laval University, Quebec City, Quebec, Canada
- Pulmonary Hypertension Research Group, Centre de Recherche de l'Institut Universitaire de Cardiologie et de Pneumologie de Québec, Quebec City, Quebec, Canada
- Département des Sciences de la Santé Communautaire, Faculté de Médecine et des Sciences de la Santé, Université de Sherbrooke, Sherbrooke, Quebec, Canada
| | - Danuta M Skowronski
- Communicable Diseases and Immunization Services, British Columbia Centre for Disease Control, Vancouver, British Columbia, Canada
| | - Rachid Amini
- Biological Risks Unit, Institut National de Santé Publique du Québec, Quebec City, Quebec, Canada
| | - Hugues Charest
- Laboratoire de Santé Publique du Québec, Institut National de Santé Publique du Québec, Sainte-Anne-de-Bellevue, Quebec, Canada
- Faculty of Medicine, Université de Montréal, Montreal, Quebec, Canada
| | - Gaston De Serres
- Biological Risks Unit, Institut National de Santé Publique du Québec, Quebec City, Quebec, Canada
- Faculty of Medicine, Laval University, Quebec City, Quebec, Canada
- Centre Hospitalier Universitaire (CHU) de Québec-Université Laval Research Center, Quebec City, Quebec, Canada
| | - Rodica Gilca
- Biological Risks Unit, Institut National de Santé Publique du Québec, Quebec City, Quebec, Canada
- Faculty of Medicine, Laval University, Quebec City, Quebec, Canada
- Centre Hospitalier Universitaire (CHU) de Québec-Université Laval Research Center, Quebec City, Quebec, Canada
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Dzieciolowska S, Charest H, Roy T, Fafard J, Carazo S, Levade I, Longtin J, Parkes L, Beaulac SN, Villeneuve J, Savard P, Corbeil J, De Serres G, Longtin Y. Timing and Predictors of Loss of Infectivity Among Healthcare Workers With Mild Primary and Recurrent COVID-19: A Prospective Observational Cohort Study. Clin Infect Dis 2024; 78:613-624. [PMID: 37675577 PMCID: PMC10954326 DOI: 10.1093/cid/ciad535] [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: 06/20/2023] [Revised: 08/21/2023] [Accepted: 08/30/2023] [Indexed: 09/08/2023] Open
Abstract
BACKGROUND There is a need to understand the duration of infectivity of primary and recurrent coronavirus disease 2019 (COVID-19) and identify predictors of loss of infectivity. METHODS Prospective observational cohort study with serial viral culture, rapid antigen detection test (RADT) and reverse transcription polymerase chain reaction (RT-PCR) on nasopharyngeal specimens of healthcare workers with COVID-19. The primary outcome was viral culture positivity as indicative of infectivity. Predictors of loss of infectivity were determined using multivariate regression model. The performance of the US Centers for Disease Control and Prevention (CDC) criteria (fever resolution, symptom improvement, and negative RADT) to predict loss of infectivity was also investigated. RESULTS In total, 121 participants (91 female [79.3%]; average age, 40 years) were enrolled. Most (n = 107, 88.4%) had received ≥3 severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccine doses, and 20 (16.5%) had COVID-19 previously. Viral culture positivity decreased from 71.9% (87/121) on day 5 of infection to 18.2% (22/121) on day 10. Participants with recurrent COVID-19 had a lower likelihood of infectivity than those with primary COVID-19 at each follow-up (day 5 odds ratio [OR], 0.14; P < .001]; day 7 OR, 0.04; P = .003]) and were all non-infective by day 10 (P = .02). Independent predictors of infectivity included prior COVID-19 (adjusted OR [aOR] on day 5, 0.005; P = .003), an RT-PCR cycle threshold [Ct] value <23 (aOR on day 5, 22.75; P < .001) but not symptom improvement or RADT result.The CDC criteria would identify 36% (24/67) of all non-infectious individuals on day 7. However, 17% (5/29) of those meeting all the criteria had a positive viral culture. CONCLUSIONS Infectivity of recurrent COVID-19 is shorter than primary infections. Loss of infectivity algorithms could be optimized.
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Affiliation(s)
| | - Hugues Charest
- Faculté de médecine, Université de Montréal, Montréal, Canada
- Laboratoire de Santé Publique du Québec, Sainte-Anne-de-Bellevue, Canada
- Institut National de Santé Publique du Québec, Québec City, Canada
| | - Tonya Roy
- Laboratoire de Santé Publique du Québec, Sainte-Anne-de-Bellevue, Canada
- Institut National de Santé Publique du Québec, Québec City, Canada
| | - Judith Fafard
- Laboratoire de Santé Publique du Québec, Sainte-Anne-de-Bellevue, Canada
- Institut National de Santé Publique du Québec, Québec City, Canada
| | - Sara Carazo
- Institut National de Santé Publique du Québec, Québec City, Canada
- Université Laval, Québec City, Canada
| | - Ines Levade
- Laboratoire de Santé Publique du Québec, Sainte-Anne-de-Bellevue, Canada
- Institut National de Santé Publique du Québec, Québec City, Canada
| | - Jean Longtin
- CHU de Québec—Université Laval, Québec City, Canada
| | - Leighanne Parkes
- McGill University Faculty of Medicine, Montréal, Canada
- Jewish General Hospital Sir Mortimer B. Davis, Montréal, Canada
| | - Sylvie Nancy Beaulac
- Laboratoire de Santé Publique du Québec, Sainte-Anne-de-Bellevue, Canada
- Institut National de Santé Publique du Québec, Québec City, Canada
| | | | - Patrice Savard
- Faculté de médecine, Université de Montréal, Montréal, Canada
- Centre Hospitalier de l’Université de Montréal (CHUM) and CHUM Research Center, Montréal, Canada
| | | | - Gaston De Serres
- Institut National de Santé Publique du Québec, Québec City, Canada
- Université Laval, Québec City, Canada
| | - Yves Longtin
- McGill University Faculty of Medicine, Montréal, Canada
- Jewish General Hospital Sir Mortimer B. Davis, Montréal, Canada
- Lady Davis Research Institute, Montréal, Canada
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Naveed Z, Chu C, Tadrous M, Veroniki AA, Li J, Rouleau I, Febriani Y, Calzavara A, Buchan SA, Nasreen S, Schwartz KL, Wilton J, Seo CY, Thampi N, Wilson SE, Naus M, De Serres G, Janjua NZ, Kwong JC. A multiprovincial retrospective analysis of the incidence of myocarditis or pericarditis after mRNA vaccination compared to the incidence after SARS-CoV-2 infection. Heliyon 2024; 10:e26551. [PMID: 38439866 PMCID: PMC10909657 DOI: 10.1016/j.heliyon.2024.e26551] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2023] [Revised: 02/08/2024] [Accepted: 02/15/2024] [Indexed: 03/06/2024] Open
Abstract
Objective To compare myocarditis/pericarditis risk after COVID-19 mRNA vaccination versus SARS-CoV-2 infection, and to assess if myocarditis/pericarditis risk varies by vaccine dosing interval. Methods In this retrospective cohort study, we used linked databases in Quebec, Ontario, and British Columbia between January 26, 2020, and September 9, 2021. We included individuals aged 12 or above who received an mRNA vaccine as the second dose or were SARS-CoV-2-positive by RT-PCR. The outcome was hospitalization/emergency department visit for myocarditis/pericarditis within 21 days of exposure. We calculated age- and sex-stratified incidence ratios (IRs) of myocarditis/pericarditis following mRNA vaccination versus SARS-CoV-2 infection. We also calculated myocarditis/pericarditis incidence by vaccine type, homologous/heterologous schedule, and dosing interval. We pooled province-specific estimates using meta-analysis. Results Following 18,860,817 mRNA vaccinations and 860,335 SARS-CoV-2 infections, we observed 686 and 160 myocarditis/pericarditis cases, respectively. Myocarditis/pericarditis incidence was lower after vaccination than infection (IR [BNT162b2/SARS-CoV-2], 0.14; 95%CI, 0.07-0.29; IR [mRNA-1273/SARS-CoV-2], 0.28; 95%CI, 0.20-0.39). Within the vaccinated cohort, myocarditis/pericarditis incidence was lower with longer dosing intervals; IR (56 or more days/15-30 days) was 0.28 (95%CI, 0.19-0.41) for BNT162b2 and 0.26 (95%CI, 0.18-0.38) for mRNA-1273. Conclusion Myocarditis/pericarditis risk was lower after mRNA vaccination than SARS-CoV-2 infection, and with longer intervals between primary vaccine doses.
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Affiliation(s)
- Zaeema Naveed
- British Columbia Centre for Disease Control, Vancouver, BC, Canada
- School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada
| | - Cherry Chu
- Women's College Hospital, Toronto, ON, Canada
| | - Mina Tadrous
- Women's College Hospital, Toronto, ON, Canada
- ICES, Toronto, ON, Canada
- Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, ON, Canada
| | - Areti-Angeliki Veroniki
- Knowledge Translation Program, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Unity Health Toronto, Toronto, ON, Canada
- Institute for Health Policy, Management, and Evaluation, University of Toronto, Toronto, ON, Canada
| | - Julia Li
- British Columbia Centre for Disease Control, Vancouver, BC, Canada
- School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada
| | - Isabelle Rouleau
- Institut National de Santé Publique Du Québec, Biological Risks Division, Montreal, QC, Canada
| | - Yossi Febriani
- Centre Hospitalier Universitaire (CHU) de Québec-Université Laval Research Center, Quebec City, QC, Canada
| | | | - Sarah A. Buchan
- ICES, Toronto, ON, Canada
- Public Health Ontario, Toronto, ON, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
- Centre for Vaccine Preventable Diseases, University of Toronto, Toronto, ON, Canada
| | - Sharifa Nasreen
- ICES, Toronto, ON, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Kevin L. Schwartz
- ICES, Toronto, ON, Canada
- Public Health Ontario, Toronto, ON, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - James Wilton
- British Columbia Centre for Disease Control, Vancouver, BC, Canada
| | | | - Nisha Thampi
- Public Health Ontario, Toronto, ON, Canada
- Children's Hospital of Eastern Ontario, Ottawa, ON, Canada
| | - Sarah E. Wilson
- ICES, Toronto, ON, Canada
- Public Health Ontario, Toronto, ON, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
- Centre for Vaccine Preventable Diseases, University of Toronto, Toronto, ON, Canada
| | - Monika Naus
- British Columbia Centre for Disease Control, Vancouver, BC, Canada
| | - Gaston De Serres
- Institut National de Santé Publique Du Québec, Biological Risks Division, Montreal, QC, Canada
- Institut National de Sante Publique Du Québec, Biological and Occupational Risks Division, Quebec City, QC, Canada
- Laval University, Department of Social and Preventive Medicine, Faculty of Medicine, Quebec City, QC, Canada
| | - Naveed Z. Janjua
- British Columbia Centre for Disease Control, Vancouver, BC, Canada
- School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada
- Centre for Health Outcomes and Evaluation, St Paul's Hospital, Vancouver, BC, Canada
| | - Jeffrey C. Kwong
- ICES, Toronto, ON, Canada
- Public Health Ontario, Toronto, ON, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
- Centre for Vaccine Preventable Diseases, University of Toronto, Toronto, ON, Canada
- Department of Family and Community Medicine, University of Toronto, Toronto, ON, Canada
- University Health Network, Toronto, ON, Canada
| | - Canadian Immunization Research Network (CIRN) Provincial Collaborative Network investigators
- British Columbia Centre for Disease Control, Vancouver, BC, Canada
- School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada
- Women's College Hospital, Toronto, ON, Canada
- ICES, Toronto, ON, Canada
- Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, ON, Canada
- Knowledge Translation Program, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Unity Health Toronto, Toronto, ON, Canada
- Institute for Health Policy, Management, and Evaluation, University of Toronto, Toronto, ON, Canada
- Institut National de Santé Publique Du Québec, Biological Risks Division, Montreal, QC, Canada
- Centre Hospitalier Universitaire (CHU) de Québec-Université Laval Research Center, Quebec City, QC, Canada
- Public Health Ontario, Toronto, ON, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
- Centre for Vaccine Preventable Diseases, University of Toronto, Toronto, ON, Canada
- Children's Hospital of Eastern Ontario, Ottawa, ON, Canada
- Institut National de Sante Publique Du Québec, Biological and Occupational Risks Division, Quebec City, QC, Canada
- Laval University, Department of Social and Preventive Medicine, Faculty of Medicine, Quebec City, QC, Canada
- Centre for Health Outcomes and Evaluation, St Paul's Hospital, Vancouver, BC, Canada
- Department of Family and Community Medicine, University of Toronto, Toronto, ON, Canada
- University Health Network, Toronto, ON, Canada
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Brousseau N, Carazo S, Febriani Y, Padet L, Hegg-Deloye S, Cadieux G, Bergeron G, Fafard J, Charest H, Lambert G, Talbot D, Longtin J, Dumont-Blais A, Bastien S, Dalpé V, Minot PH, De Serres G, Skowronski DM. Single-dose Effectiveness of Mpox Vaccine in Quebec, Canada: Test-negative Design With and Without Adjustment for Self-reported Exposure Risk. Clin Infect Dis 2024; 78:461-469. [PMID: 37769158 PMCID: PMC10874272 DOI: 10.1093/cid/ciad584] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2023] [Revised: 09/05/2023] [Accepted: 09/22/2023] [Indexed: 09/30/2023] Open
Abstract
INTRODUCTION During the 2022 mpox outbreak, the province of Quebec, Canada, prioritized first doses for pre-exposure vaccination of people at high mpox risk, delaying second doses due to limited supply. We estimated single-dose mpox vaccine effectiveness (VE) adjusting for virus exposure risk based only on surrogate indicators available within administrative databases (eg, clinical record of sexually transmitted infections) or supplemented by self-reported risk factor information (eg, sexual contacts). METHODS We conducted a test-negative case-control study between 19 June and 24 September 2022. Information from administrative databases was supplemented by questionnaire collection of self-reported risk factors specific to the 3-week period before testing. Two study populations were assessed: all within the administrative databases (All-Admin) and the subset completing the questionnaire (Sub-Quest). Logistic regression models adjusted for age, calendar-time and exposure-risk, the latter based on administrative indicators only (All-Admin and Sub-Quest) or with questionnaire supplementation (Sub-Quest). RESULTS There were 532 All-Admin participants, of which 199 (37%) belonged to Sub-Quest. With exposure-risk adjustment based only on administrative indicators, single-dose VE estimates were similar among All-Admin and Sub-Quest populations at 35% (95% confidence interval [CI]:-2 to 59) and 30% (95% CI:-38 to 64), respectively. With adjustment supplemented by questionnaire information, the Sub-Quest VE estimate increased to 65% (95% CI:1-87), with overlapping confidence intervals. CONCLUSIONS Using only administrative data, we estimate one vaccine dose reduced the mpox risk by about one-third; whereas, additionally adjusting for self-reported risk factor information revealed greater vaccine benefit, with one dose instead estimated to reduce the mpox risk by about two-thirds. Inadequate exposure-risk adjustment may substantially under-estimate mpox VE.
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Affiliation(s)
- Nicholas Brousseau
- Biological Risks Department, Institut national de santé publique du Québec, Quebec, QC, Canada
- Axe Maladies infectieuses et immunitaires, Centre Hospitalier Universitaire (CHU) de Québec–Université Laval Research Center, Quebec, QC, Canada
- Social and Preventive Medicine Department, Faculty of Medicine, Laval University, Quebec, QC, Canada
| | - Sara Carazo
- Biological Risks Department, Institut national de santé publique du Québec, Quebec, QC, Canada
- Social and Preventive Medicine Department, Faculty of Medicine, Laval University, Quebec, QC, Canada
| | - Yossi Febriani
- Axe Maladies infectieuses et immunitaires, Centre Hospitalier Universitaire (CHU) de Québec–Université Laval Research Center, Quebec, QC, Canada
| | - Lauriane Padet
- Biological Risks Department, Institut national de santé publique du Québec, Quebec, QC, Canada
| | - Sandrine Hegg-Deloye
- Axe Maladies infectieuses et immunitaires, Centre Hospitalier Universitaire (CHU) de Québec–Université Laval Research Center, Quebec, QC, Canada
| | - Geneviève Cadieux
- Direction régionale de santé publique de Montréal, Centre intégré universitaire de santé et de services sociaux du Centre-Sud-de-l'Île-de-Montréal, Montreal, QC, Canada
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montréal, QC, Canada
| | - Geneviève Bergeron
- Direction régionale de santé publique de Montréal, Centre intégré universitaire de santé et de services sociaux du Centre-Sud-de-l'Île-de-Montréal, Montreal, QC, Canada
| | - Judith Fafard
- Laboratoire de santé publique du Québec, Institut national de santé publique du Québec, Québec, QC, Canada
| | - Hugues Charest
- Laboratoire de santé publique du Québec, Institut national de santé publique du Québec, Québec, QC, Canada
- Faculty of Medicine, University of Montreal, Montreal, QC, Canada
| | - Gilles Lambert
- Direction régionale de santé publique de Montréal, Centre intégré universitaire de santé et de services sociaux du Centre-Sud-de-l'Île-de-Montréal, Montreal, QC, Canada
| | - Denis Talbot
- Social and Preventive Medicine Department, Faculty of Medicine, Laval University, Quebec, QC, Canada
| | - Jean Longtin
- Axe Maladies infectieuses et immunitaires, Centre Hospitalier Universitaire (CHU) de Québec–Université Laval Research Center, Quebec, QC, Canada
| | | | - Steve Bastien
- Mpox Awareness Team, RÉZO Community Organization, Montreal, QC Canada
| | - Virginie Dalpé
- Biological Risks Department, Institut national de santé publique du Québec, Quebec, QC, Canada
| | - Pierre-Henri Minot
- Biological Risks Department, Institut national de santé publique du Québec, Quebec, QC, Canada
| | - Gaston De Serres
- Biological Risks Department, Institut national de santé publique du Québec, Quebec, QC, Canada
- Axe Maladies infectieuses et immunitaires, Centre Hospitalier Universitaire (CHU) de Québec–Université Laval Research Center, Quebec, QC, Canada
| | - Danuta M Skowronski
- Immunization Programs and Vaccine Preventable Diseases Service, BC Centre for Disease Control, Vancouver, British Columbia, Canada
- School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada
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6
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Mésidor M, Liu Y, Talbot D, Skowronski DM, De Serres G, Merckx J, Koushik A, Tadrous M, Carazo S, Jiang C, Schnitzer ME. Test negative design for vaccine effectiveness estimation in the context of the COVID-19 pandemic: A systematic methodology review. Vaccine 2024; 42:995-1003. [PMID: 38072756 DOI: 10.1016/j.vaccine.2023.12.013] [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: 06/27/2023] [Revised: 11/23/2023] [Accepted: 12/02/2023] [Indexed: 02/25/2024]
Abstract
BACKGROUND During the height of the global COVID-19 pandemic, the test-negative design (TND) was extensively used in many countries to evaluate COVID-19 vaccine effectiveness (VE). Typically, the TND involves the recruitment of care-seeking individuals who meet a common clinical case definition. All participants are then tested for an infection of interest. OBJECTIVES To review and describe the variation in TND methodology, and disclosure of potential biases, as applied to the evaluation of COVID-19 VE during the early vaccination phase of the pandemic. METHODS We conducted a systematic review by searching four biomedical databases using defined keywords to identify peer-reviewed articles published between January 1, 2020, and January 25, 2022. We included only original articles that employed a TND to estimate VE of COVID-19 vaccines in which cases and controls were evaluated based on SARS-CoV-2 laboratory test results. RESULTS We identified 96 studies, 35 of which met the defined criteria. Most studies were from North America (16 studies) and targeted the general population (28 studies). Outcome case definitions were based primarily on COVID-19-like symptoms; however, several papers did not consider or specify symptoms. Cases and controls had the same inclusion criteria in only half of the studies. Most studies relied upon administrative or hospital databases assembled for a different (non-evaluation) clinical purpose. Potential unmeasured confounding (20 studies), misclassification of current SARS-CoV-2 infection (16 studies) and selection bias (10 studies) were disclosed as limitations by some studies. CONCLUSION We observed potentially meaningful deviations from the validated design in the application of the TND during the COVID-19 pandemic.
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Affiliation(s)
- Miceline Mésidor
- Département de médecine sociale et préventive, Université Laval, Québec, Canada; Centre de recherche du CHU de Québec - Université Laval, Québec, Canada
| | - Yan Liu
- Faculty of Pharmacy, Université de Montréal, Québec, Canada
| | - Denis Talbot
- Département de médecine sociale et préventive, Université Laval, Québec, Canada; Centre de recherche du CHU de Québec - Université Laval, Québec, Canada.
| | - Danuta M Skowronski
- British Columbia Centre for Disease Control, Vancouver, Canada; University of British Columbia, Vancouver, Canada
| | - Gaston De Serres
- Département de médecine sociale et préventive, Université Laval, Québec, Canada; Institut national de santé publique du Québec, Québec, Canada
| | - Joanna Merckx
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Quebec, Canada
| | - Anita Koushik
- Département de médecine sociale et préventive, Université de Montréal, Québec, Canada
| | | | - Sara Carazo
- Institut national de santé publique du Québec, Québec, Canada
| | - Cong Jiang
- Faculty of Pharmacy, Université de Montréal, Québec, Canada
| | - Mireille E Schnitzer
- Faculty of Pharmacy, Université de Montréal, Québec, Canada; Département de médecine sociale et préventive, Université de Montréal, Québec, Canada.
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7
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Brillant-Marquis F, Proulx É, Ratnarajah K, Lavoie A, Gauthier A, Gagnon R, Boursiquot JN, Verreault N, Marois L, Bédard MA, Boivin M, Bédard PM, Ouakki M, De Serres G, Drolet JP. Safety of Direct Drug Provocation for the Evaluation of Penicillin Allergy in Low-Risk Adults. J Allergy Clin Immunol Pract 2024; 12:451-457.e2. [PMID: 38572700 DOI: 10.1016/j.jaip.2023.10.035] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Revised: 10/08/2023] [Accepted: 10/17/2023] [Indexed: 04/05/2024]
Abstract
BACKGROUND About 10% of patients have a penicillin allergy label, but less than 5% of them are actually allergic. Unnecessary penicillin avoidance is associated with serious medical consequences. Given the growing number of these labels, it is imperative that our diagnostic strategy for penicillin allergy be as efficient as possible. The validity of traditionally used skin tests (STs) has been questioned, whereas drug provocation testing (DPT), the criterion standard, without previous ST appears very safe in most cases. OBJECTIVE To evaluate the safety of direct DPT without consideration for ST results and the validity of ST in the diagnosis of penicillin allergy. METHODS In this prospective cohort study without a control group, we recruited patients consulting an allergist for penicillin allergy. Patients underwent ST followed by DPT regardless of ST results. Patients with anaphylaxis to penicillin within the past 5 years or a severe delayed reaction were excluded, as were those with significant cardiorespiratory comorbidity. RESULTS None of the 1002 recruited patients had a serious reaction to DPT. Ten (1.0%) had a mild immediate reaction, of whom only 1 (0.1%) was considered likely IgE-mediated. The positive and negative predictive values of ST for an immediate reaction were 3.6% and 99.1%, respectively. CONCLUSIONS In a low-risk adult population reporting penicillin allergy, ST has very poor positive predictive value. Direct DPT without ST is safe and appears to be an ideal diagnostic strategy to remove penicillin allergy labels that could be implemented in first-line practice.
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Affiliation(s)
- Frédéric Brillant-Marquis
- Division of Allergy and Clinical Immunology, Department of Medicine, Centre Hospitalier Universitaire de Québec-Université Laval, Québec City, Québec, Canada
| | - Émilie Proulx
- Division of Allergy and Clinical Immunology, Department of Medicine, Centre Hospitalier Universitaire de Québec-Université Laval, Québec City, Québec, Canada
| | - Kayadri Ratnarajah
- Division of Allergy and Clinical Immunology, Department of Medicine, Centre Hospitalier Universitaire de Québec-Université Laval, Québec City, Québec, Canada
| | - Aubert Lavoie
- Division of Allergy and Clinical Immunology, Department of Medicine, Centre Hospitalier Universitaire de Québec-Université Laval, Québec City, Québec, Canada
| | - Amélie Gauthier
- Division of Allergy and Clinical Immunology, Department of Medicine, Centre Hospitalier Universitaire de Québec-Université Laval, Québec City, Québec, Canada
| | - Rémi Gagnon
- Division of Allergy and Clinical Immunology, Department of Medicine, Centre Hospitalier Universitaire de Québec-Université Laval, Québec City, Québec, Canada
| | - Jean-Nicolas Boursiquot
- Division of Allergy and Clinical Immunology, Department of Medicine, Centre Hospitalier Universitaire de Québec-Université Laval, Québec City, Québec, Canada
| | - Nina Verreault
- Division of Allergy and Clinical Immunology, Department of Medicine, Centre Hospitalier Universitaire de Québec-Université Laval, Québec City, Québec, Canada
| | - Louis Marois
- Division of Allergy and Clinical Immunology, Department of Medicine, Centre Hospitalier Universitaire de Québec-Université Laval, Québec City, Québec, Canada
| | - Marc-Antoine Bédard
- Division of Allergy and Clinical Immunology, Department of Medicine, Centre Hospitalier Universitaire de Québec-Université Laval, Québec City, Québec, Canada
| | - Martine Boivin
- Division of Allergy and Clinical Immunology, Department of Medicine, Centre Hospitalier Universitaire de Québec-Université Laval, Québec City, Québec, Canada
| | - Pierre-Michel Bédard
- Division of Allergy and Clinical Immunology, Department of Medicine, Centre Hospitalier Universitaire de Québec-Université Laval, Québec City, Québec, Canada
| | - Manale Ouakki
- Institut National de Santé Publique du Québec, Québec City, Québec, Canada
| | - Gaston De Serres
- Institut National de Santé Publique du Québec, Québec City, Québec, Canada
| | - Jean-Philippe Drolet
- Division of Allergy and Clinical Immunology, Department of Medicine, Centre Hospitalier Universitaire de Québec-Université Laval, Québec City, Québec, Canada.
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8
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Razafimandimby H, Sauvageau C, Ouakki M, Carazo S, Skowronski DM, De Serres G. Effectiveness of BNT162b2 Vaccine Against Omicron-SARS-CoV-2 Subvariants in Children 5-11 Years of Age in Quebec, Canada, January 2022 to January 2023. Pediatr Infect Dis J 2024; 43:32-39. [PMID: 37922479 DOI: 10.1097/inf.0000000000004145] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2023]
Abstract
BACKGROUND In premarketing clinical trials conducted before Omicron emergence, BNT162b2 vaccine efficacy against COVID-19 was 90% in children. We conducted postmarketing evaluation of 1- and 2-dose vaccine effectiveness (VE) against Omicron BA.1, BA.2 and BA.4/5 subvariants in 5- to 11-year olds. METHODS We estimated VE against SARS-CoV-2 infection using a test-negative design. Specimens collected between January 9, 2022, and January 7, 2023, from children 5-11 years old in Quebec, Canada, and tested by nucleic acid amplification test were eligible. We estimated VE by time since last vaccine dose, interval between doses and by period of Omicron subvariant predominance. RESULTS A total of 48,826 NAATs were included in overall analysis. From 14-55 to 56-385 days postvaccination, 2-dose VE against symptomatic infection decreased from 68% (95% CI, 62-74) to 25% (95% CI, 11-36). Two-dose VE with restriction to specimens collected from acute care hospitals (emergency rooms or wards) did not decline but was stable at ~40%. VE against symptomatic infection remained comparable at any interval between doses but increased with longer interval among children tested in acute care settings, from 18% (95% CI, -17 to 44) with 21- to 55-day interval to 69% (95% CI, 43-86) with ≥84-day interval. Two-dose VE against symptomatic infection dropped from 70% (95% CI, 63-76) during BA.1, to 32% (95% CI, 13-47) with BA.2 and to nonprotective during BA.4/5 dominance. CONCLUSIONS In children 5-11 years of age, VE against symptomatic infection was stable at any interval between doses but decreased with time since the last dose and against more divergent omicron subvariants.
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Affiliation(s)
- Harimahefa Razafimandimby
- From the Centre Hospitalier Universitaire (CHU) de Québec-Université Laval Research Center, Quebec, Quebec, Canada
| | - Chantal Sauvageau
- From the Centre Hospitalier Universitaire (CHU) de Québec-Université Laval Research Center, Quebec, Quebec, Canada
- Biological Risks, Institut National de Santé Publique du Québec, Quebec, Quebec, Canada
- Department of Social and Preventive Medicine, Faculty of Medicine, Laval University, Quebec, Quebec, Canada
| | - Manale Ouakki
- Biological Risks, Institut National de Santé Publique du Québec, Quebec, Quebec, Canada
| | - Sara Carazo
- Biological Risks, Institut National de Santé Publique du Québec, Quebec, Quebec, Canada
| | - Danuta M Skowronski
- Immunization Programs and Vaccine Preventable Diseases Service, BC Centre for Disease Control, Vancouver, British Columbia, Canada
| | - Gaston De Serres
- From the Centre Hospitalier Universitaire (CHU) de Québec-Université Laval Research Center, Quebec, Quebec, Canada
- Biological Risks, Institut National de Santé Publique du Québec, Quebec, Quebec, Canada
- Department of Social and Preventive Medicine, Faculty of Medicine, Laval University, Quebec, Quebec, Canada
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Febriani Y, Mansour T, Sadarangani M, Ulanova M, Amaral K, Halperin SA, De Serres G, Racine É, Brousseau N. Tdap vaccine in pregnancy and immunogenicity of pertussis and pneumococcal vaccines in children: What is the impact of different immunization schedules? Vaccine 2023; 41:6745-6753. [PMID: 37816653 DOI: 10.1016/j.vaccine.2023.09.063] [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: 02/28/2023] [Revised: 09/29/2023] [Accepted: 09/30/2023] [Indexed: 10/12/2023]
Abstract
BACKGROUND In 2019, the 3 + 1 schedule for children's vaccination (2-4-6-18 months old) was changed for a reduced 2 + 1 schedule (2-4-12 months old) in Quebec, Canada. We compared the post-booster anti-pertussis and anti-pneumococcus IgG antibody concentrations among children of Tdap-vaccinated and unvaccinated mothers for different vaccine schedules and vaccine formulations. METHODS We conducted an observational cohort study. An invitation letter to potential participants was provided during a routine vaccination visit. Children's blood samples were analyzed post-booster at 13 (2 + 1 schedule) or 19 (3 + 1 schedule) months of age for antibodies against pertussis antigens (pertussis toxin (PT), filamentous hemagglutinin (FHA) and pertactin (PRN)) and pneumococcal antigens (serotypes 4, 18C, 19A, and 19F). IgG concentrations among children of Tdap-vaccinated and unvaccinated mothers for each vaccination schedule were compared using geometric mean concentrations (GMCs) and GMC ratios (GMRs), adjusting for potentially immune-response-influencing factors (aGMR). Serotype-specific pneumococcal seroprotection rates were also compared. RESULTS A total of 360 children were included for pertussis analysis and 248 for pneumococcal analysis. For the 2 + 1 schedule, 13-month-old children of Tdap-vaccinated mothers had lower GMCs against PT, FHA, and PRN, with aGMR (95 %CI) of 0.77 (0.65-0.90), 0.66 (0.55-0.79), 0.72 (0.52-0.99), respectively. For the 3 + 1 schedule, at 19 months old, the interference appeared to be attenuated (higher aGMR values). GMCs against PT were slightly higher in the 3 + 1 than the 2 + 1 schedule: 126.5 IU/ml vs 91.6 IU/ml; aGMR = 1.27. GMCs against PT, FHA and PRN were slightly higher among children who received Infanrix hexa® compared to those who received Pediacel® at 12 months old. For pneumococcal antibodies, at 13 months old, there was no strong evidence of immune interference in children of Tdap-vaccinated mothers. CONCLUSION Infant vaccination schedule may influence immune interference associated with maternal Tdap vaccination. More studies are needed to assess the clinical impact of this interference on children's protection.
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Affiliation(s)
- Yossi Febriani
- Centre Hospitalier Universitaire (CHU) de Québec-Université Laval Research Center, Quebec City, Quebec, Canada
| | - Thowiba Mansour
- Centre Hospitalier Universitaire (CHU) de Québec-Université Laval Research Center, Quebec City, Quebec, Canada
| | - Manish Sadarangani
- BC Children's Hospital Research Institute, Vaccine Evaluation Center, Vancouver, British Columbia, Canada; University of British Columbia, Department of Pediatrics, Vancouver, British Columbia, Canada
| | | | - Kyle Amaral
- BC Children's Hospital Research Institute, Vaccine Evaluation Center, Vancouver, British Columbia, Canada; University of British Columbia, Department of Medicine, Vancouver, British Columbia, Canada
| | - Scott A Halperin
- Canadian Center for Vaccinology, Departments of Pediatrics and Microbiology and Immunology, Dalhousie University and IWK Health, Halifax, Nova Scotia, Canada
| | - Gaston De Serres
- Centre Hospitalier Universitaire (CHU) de Québec-Université Laval Research Center, Quebec City, Quebec, Canada; Institut national de santé publique du Québec, Biological and Occupational Risks, Quebec City, Quebec, Canada; Laval University, Department of Social and Preventive Medicine, Faculty of Medicine, Quebec City, Quebec, Canada
| | - Étienne Racine
- Institut national de santé publique du Québec, Biological and Occupational Risks, Quebec City, Quebec, Canada
| | - Nicholas Brousseau
- Centre Hospitalier Universitaire (CHU) de Québec-Université Laval Research Center, Quebec City, Quebec, Canada; Institut national de santé publique du Québec, Biological and Occupational Risks, Quebec City, Quebec, Canada; Laval University, Department of Social and Preventive Medicine, Faculty of Medicine, Quebec City, Quebec, Canada.
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10
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Carazo S, Denis G, Padet L, Deshaies P, Villeneuve J, Paquet-Bolduc B, Laliberté D, Talbot D, De Serres G. SARS-CoV-2 infection among healthcare workers: the role of occupational and household exposures during the first three pandemic waves in Quebec, Canada. Antimicrob Steward Healthc Epidemiol 2023; 3:e180. [PMID: 38028905 PMCID: PMC10654992 DOI: 10.1017/ash.2023.442] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Revised: 08/02/2023] [Accepted: 08/07/2023] [Indexed: 12/01/2023]
Abstract
Objective We described the evolution of SARS-CoV-2 source of infection in a cohort of healthcare workers (HCWs) of Quebec, Canada, during the first three pandemic waves. We also estimated their household secondary attack rate (SAR) and its risk factors. Design Cross-sectional surveys. Participants HCWs with a SARS-CoV-2 infection confirmed by polymerasa chain reaction and diagnosed between March 2020 and May 2021. Methods We collected demographic, clinical, vaccination, and employment information, self-reported perceived source of infection, and transmission to household members during the first three pandemic waves. SAR was calculated for households with ≥2 members where the HCW was the index case. A Poisson regression model estimated the association between risk factors and SAR. Results Among the 11,670 HCWs completing the survey, 91%, perceived their workplace as the source of infection during the first wave (March-July 2020), 71% during the second wave (July 2020-March 2021), and 40% during the third wave (March-May 2021). Conversely, HCWs reported an increasing proportion of household-acquired infections with each wave from 4% to 14% and 33%, respectively. The overall household SAR of 7,990 HCWs living with ≥1 person was 30% (95%CI: 29-30). SAR increased with the presence of symptoms, older age, and during Alpha-variant predominant period. Conclusions HCWs and their household members were largely affected during the first pandemic waves of COVID-19, but the relative importance of occupational exposure changed overtime. Pandemic preparedness in healthcare settings is essential to protect HCWs from emerging biological hazard exposures.
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Affiliation(s)
- Sara Carazo
- Biological and Occupational Risks Unit, Institut national de santé publique du Québec, Quebec City, QC, Canada
- Social and Preventive Medicine Department, Faculty of Medicine, Laval University, Quebec City, QC, Canada
| | - Geoffroy Denis
- School of Population and Global Health, Faculty of Medicine, McGill University, Montreal, QC, Canada
- Public Health Department, CIUSSS Centre Sud de Montréal, Montreal, QC, Canada
- General Directorate of Public Health, Quebec Ministry of Health and Social Services, Quebec City, QC, Canada
| | - Lauriane Padet
- Biological and Occupational Risks Unit, Institut national de santé publique du Québec, Quebec City, QC, Canada
| | - Pierre Deshaies
- Public Health Department, CISSS de Chaudière-Appalaches, Levis, QC, Canada
| | - Jasmin Villeneuve
- Biological and Occupational Risks Unit, Institut national de santé publique du Québec, Quebec City, QC, Canada
| | - Bianka Paquet-Bolduc
- Infection Prevention and Control Unit, Institut Universitaire en cardiologie et pneumologie de Québec, Quebec City, QC, Canada
| | - Denis Laliberté
- Public Health Department, CIUSSS de la Capitale-Nationale, Quebec City, QC, Canada
| | - Denis Talbot
- Social and Preventive Medicine Department, Faculty of Medicine, Laval University, Quebec City, QC, Canada
- CHU de Québec-Laval University Research Center, Quebec City, QC, Canada
| | - Gaston De Serres
- Biological and Occupational Risks Unit, Institut national de santé publique du Québec, Quebec City, QC, Canada
- Social and Preventive Medicine Department, Faculty of Medicine, Laval University, Quebec City, QC, Canada
- CHU de Québec-Laval University Research Center, Quebec City, QC, Canada
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11
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Muñoz CE, Pham-Huy A, Pernica JM, Boucher FD, De Serres G, Vaudry W, Constantinescu C, Sadarangani M, Bettinger JA, Tapiéro B, Morris SK, McConnell A, Noya F, Halperin SA, Top KA. Factors associated with intention for revaccination among patients with adverse events following immunization. Vaccine 2023; 41:6239-6247. [PMID: 37666696 DOI: 10.1016/j.vaccine.2023.08.067] [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: 05/19/2023] [Revised: 08/17/2023] [Accepted: 08/24/2023] [Indexed: 09/06/2023]
Abstract
OBJECTIVES Individuals and healthcare providers may be uncertain about the safety of revaccination after an adverse event following immunization (AEFI). We identified factors associated with physician recommendation for revaccination and participant intention to be revaccinated among patients with adverse events following immunization (AEFIs) assessed in the Canadian Special Immunization Clinic (SIC) Network from 2013 to 2019. METHODS This prospective observational study included patients assessed in the Canadian Special Immunization Clinic Network from 2013 to 2019 for an AEFI who required additional doses of the vaccine temporally associated with their AEFI. Participants underwent standardized assessment and data collection. Physician recommendations regarding revaccination and participant intent for revaccination were recorded. AEFI impact on daily activities and need for medical attention was captured as low, moderate, high impact and serious (e.g., requiring hospitalization). Multivariable logistic regression analysis identified factors associated with physician recommendation and participant intention for revaccination, controlling for province of assessment. RESULTS Physician recommendation was significantly associated with the type of AEFI and AEFI impact. Compared to large local reaction, physician recommendation for revaccination was reduced for immediate hypersensitivity (aOR: 0.24 [95% CI: 0.08-0.76]) and new onset autoimmune disease (aOR: 0.16; 95% CI: 0.04-0.69). Compared to low impact AEFIs, physician recommendation was reduced for moderate (aOR: 0.22 [95% CI: 0.07-0.65]), high impact (aOR: 0.08 [95% CI: 0.02-0.30]), and serious AEFIs (aOR: 0.11 [95% CI: 0.03-0.37]). Participant intention for revaccination was significantly associated with AEFI impact, with reduced odds for high versus low impact AEFIs (aOR: 0.12 [95% CI: 0.04-0.42]). CONCLUSION Physicians appear to use AEFI type and impact to guide recommendations while patients use primarily AEFI impact to form intentions for revaccination. The findings may help inform counselling for patients with AEFIs.
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Affiliation(s)
- Caroline E Muñoz
- Department of Community Health and Epidemiology, Dalhousie University, Halifax, Nova Scotia, Canada; Canadian Center for Vaccinology, IWK Health, Nova Scotia Health, and Dalhousie University, Halifax, Nova Scotia, Canada
| | - Anne Pham-Huy
- Children's Hospital of Eastern Ontario, University of Ottawa, Ottawa, Ontario, Canada
| | - Jeffrey M Pernica
- Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada
| | - François D Boucher
- Centre hospitalier universitaire de Québec-Université Laval, Québec, Québec, Canada
| | - Gaston De Serres
- Centre hospitalier universitaire de Québec-Université Laval, Québec, Québec, Canada
| | - Wendy Vaudry
- Stollery Children's Hospital, University of Alberta, Edmonton, Alberta, Canada
| | - Cora Constantinescu
- Alberta Children's Hospital, University of Calgary, Calgary, Alberta, Canada
| | - Manish Sadarangani
- Vaccine Evaluation Center, BC Children's Hospital Research Institute, Vancouver, British Columbia, Canada; Department of Pediatrics, University of British Columbia, Vancouver, British Columbia, Canada
| | - Julie A Bettinger
- Vaccine Evaluation Center, BC Children's Hospital Research Institute, Vancouver, British Columbia, Canada; Department of Pediatrics, University of British Columbia, Vancouver, British Columbia, Canada
| | - Bruce Tapiéro
- Division of Infectious Diseases, CHU Sainte Justine, Université de Montréal, Montréal QC, Canada
| | - Shaun K Morris
- Division of Infectious Diseases, Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada
| | - Athena McConnell
- Jim Pattison Children's Hospital, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Francisco Noya
- Division of Allergy and Immunology and Division of Infectious Diseases, Montreal Children's Hospital-McGill University Health Centre, Montreal, QC, Canada
| | - Scott A Halperin
- Canadian Center for Vaccinology, IWK Health, Nova Scotia Health, and Dalhousie University, Halifax, Nova Scotia, Canada; Department of Pediatrics, Dalhousie University, Canada
| | - Karina A Top
- Department of Community Health and Epidemiology, Dalhousie University, Halifax, Nova Scotia, Canada; Canadian Center for Vaccinology, IWK Health, Nova Scotia Health, and Dalhousie University, Halifax, Nova Scotia, Canada; Department of Pediatrics, Dalhousie University, Canada.
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12
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Zinszer K, Charland K, Pierce L, Saucier A, Hamelin M, Da Torre MB, Carbonneau J, Nguyen CT, De Serres G, Papenburg J, Boivin G, Quach C. Infection-induced seroconversion and seroprevalence of SARS-CoV-2 among a cohort of children and youth in Montreal, Canada. Influenza Other Respir Viruses 2023; 17:e13186. [PMID: 37638094 PMCID: PMC10457549 DOI: 10.1111/irv.13186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Revised: 08/02/2023] [Accepted: 08/07/2023] [Indexed: 08/29/2023] Open
Abstract
The EnCORE study is a prospective serology study of SARS-CoV-2 in a cohort of children from Montreal, Canada. Based on data from our fourth round of data collection (May-October 2022), we estimated SARS-CoV-2 seroprevalence and seroconversion. Using multivariable regression, we identified factors associated with seroconversion. Our results show that previously seronegative children were approximately 9-12 times more likely to seroconvert during the early Omicron-dominant period compared to pre-Omicron rounds. Unlike the pre-Omicron rounds, the adjusted rate of seroconversion among 2- to 4-year-olds was higher than older age groups. As seen previously, higher seroconversion rates were associated with ethnic/racial minority status.
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Affiliation(s)
- Kate Zinszer
- School of Public HealthUniversity of MontrealMontrealQuebecCanada
- Centre for Public Health ResearchMontrealQuebecCanada
| | | | - Laura Pierce
- Centre for Public Health ResearchMontrealQuebecCanada
| | - Adrien Saucier
- School of Public HealthUniversity of MontrealMontrealQuebecCanada
- Centre for Public Health ResearchMontrealQuebecCanada
| | | | - Margot Barbosa Da Torre
- School of Public HealthUniversity of MontrealMontrealQuebecCanada
- Centre for Public Health ResearchMontrealQuebecCanada
| | - Julie Carbonneau
- Research Centre of Quebec‐Université LavalQuebec CityQuebecCanada
| | - Cat Tuong Nguyen
- Ministère de la santé et des services sociauxQuebec CityQuebecCanada
| | - Gaston De Serres
- National Institute of Public Health of QuebecQuebec CityQuebecCanada
| | - Jesse Papenburg
- Montreal Children's Hospital of the McGill University Health CentreMontrealQuebecCanada
| | - Guy Boivin
- Research Centre of Quebec‐Université LavalQuebec CityQuebecCanada
| | - Caroline Quach
- School of Public HealthUniversity of MontrealMontrealQuebecCanada
- Research Centre of the Sainte‐Justine University HospitalMontrealQuebecCanada
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13
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Carazo S, Skowronski DM, Brisson M, Sauvageau C, Brousseau N, Fafard J, Gilca R, Talbot D, Ouakki M, Febriani Y, Deceuninck G, De Wals P, De Serres G. Effectiveness of previous infection-induced and vaccine-induced protection against hospitalisation due to omicron BA subvariants in older adults: a test-negative, case-control study in Quebec, Canada. Lancet Healthy Longev 2023; 4:e409-e420. [PMID: 37459879 DOI: 10.1016/s2666-7568(23)00099-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Revised: 05/23/2023] [Accepted: 05/24/2023] [Indexed: 08/07/2023] Open
Abstract
BACKGROUND Older adults (aged ≥60 years) were prioritised for COVID-19 booster vaccination due to severe outcome risk, but the risk for this group is also affected by previous SARS-CoV-2 infection and vaccination. We estimated vaccine effectiveness against omicron-associated hospitalisation in older adults by previously documented infection, time since last immunological event, and age group. METHODS This was a population-based test-negative case-control study done in Quebec, Canada, during BA.1 dominant (December, 2021, to March, 2022), BA.2 dominant (April to June, 2022), and BA.4/5 dominant (July to November, 2022) periods using provincial laboratory, immunisation, hospitalisation, and chronic disease surveillance databases. We included older adults (aged ≥60 years) with symptoms associated with COVID-19 who were tested for SARS-CoV-2 in acute-care hospitals. Cases were defined as patients who were hospitalised for COVID-19 within 14 days after testing positive; controls were patients who tested negative. Analyses spanned 3-14 months after last vaccine dose or previous infection. Logistic regression models compared COVID-19 hospitalisation risk by mRNA vaccine dose and previous infection versus unvaccinated and infection-naive participants. FINDINGS Between Dec 26, 2021, and Nov 5, 2022, we included 174 819 specimens (82 870 [47·4%] from men and 91 949 [52·6%] from women; from 8455 cases and 166 364 controls), taken from 2951 cases and 48 724 controls in the BA.1 period; 1897 cases and 41 702 controls in the BA.2 period; and 3607 cases and 75 938 controls in the BA.4/5 period. In participants who were infection naive, vaccine effectiveness against hospitalisation improved with dose number, consistent with a shorter median time since last dose, but decreased with more recent omicron subvariants. Four-dose vaccine effectiveness was 96% (95% CI 93-98) during the BA.1 period, 84% (81-87) during the BA.2 period, and 68% (63-72) during the BA.4/5 period. Regardless of dose number (two to five doses) or timing since previous infection, hybrid protection was more than 90%, persisted for at least 6-8 months, and did not decline with age. INTERPRETATION Older adults with both previous SARS-CoV-2 infection and two or more vaccine doses appear to be well protected for a prolonged period against hospitalisation due to omicron subvariants, including BA.4/5. Ensuring that older adults who are infection naive remain up to date with vaccination might reduce COVID-19 hospitalisations most efficiently. FUNDING Ministère de la Santé et des Services Sociaux du Québec. TRANSLATION For the French translation of the abstract see Supplementary Materials section.
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Affiliation(s)
- Sara Carazo
- Biological Risks Unit, Institut National de Santé Publique du Québec, Quebec, QC, Canada; Social and Preventive Medicine Department, Faculty of Medicine, Laval University, Quebec, QC, Canada.
| | - Danuta M Skowronski
- Communicable Diseases and Immunization Services, British Columbia Centre for Disease Control, Vancouver, BC, Canada
| | - Marc Brisson
- Social and Preventive Medicine Department, Faculty of Medicine, Laval University, Quebec, QC, Canada; Centre Hospitalier Universitaire de Québec-Université Laval Research Center, Quebec, QC, Canada
| | - Chantal Sauvageau
- Biological Risks Unit, Institut National de Santé Publique du Québec, Quebec, QC, Canada; Social and Preventive Medicine Department, Faculty of Medicine, Laval University, Quebec, QC, Canada; Centre Hospitalier Universitaire de Québec-Université Laval Research Center, Quebec, QC, Canada
| | - Nicholas Brousseau
- Biological Risks Unit, Institut National de Santé Publique du Québec, Quebec, QC, Canada; Social and Preventive Medicine Department, Faculty of Medicine, Laval University, Quebec, QC, Canada; Centre Hospitalier Universitaire de Québec-Université Laval Research Center, Quebec, QC, Canada
| | - Judith Fafard
- Laboratoire de Santé Publique du Québec, Institut National de Santé Publique du Québec, Sainte-Anne-de-Bellevue, Quebec, QC, Canada
| | - Rodica Gilca
- Biological Risks Unit, Institut National de Santé Publique du Québec, Quebec, QC, Canada; Social and Preventive Medicine Department, Faculty of Medicine, Laval University, Quebec, QC, Canada; Centre Hospitalier Universitaire de Québec-Université Laval Research Center, Quebec, QC, Canada
| | - Denis Talbot
- Social and Preventive Medicine Department, Faculty of Medicine, Laval University, Quebec, QC, Canada; Centre Hospitalier Universitaire de Québec-Université Laval Research Center, Quebec, QC, Canada
| | - Manale Ouakki
- Biological Risks Unit, Institut National de Santé Publique du Québec, Quebec, QC, Canada
| | - Yossi Febriani
- Centre Hospitalier Universitaire de Québec-Université Laval Research Center, Quebec, QC, Canada
| | - Geneviève Deceuninck
- Centre Hospitalier Universitaire de Québec-Université Laval Research Center, Quebec, QC, Canada
| | - Philippe De Wals
- Biological Risks Unit, Institut National de Santé Publique du Québec, Quebec, QC, Canada; Social and Preventive Medicine Department, Faculty of Medicine, Laval University, Quebec, QC, Canada; Centre Hospitalier Universitaire de Québec-Université Laval Research Center, Quebec, QC, Canada
| | - Gaston De Serres
- Biological Risks Unit, Institut National de Santé Publique du Québec, Quebec, QC, Canada; Social and Preventive Medicine Department, Faculty of Medicine, Laval University, Quebec, QC, Canada; Centre Hospitalier Universitaire de Québec-Université Laval Research Center, Quebec, QC, Canada
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14
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Carazo S, Villeneuve J, Laliberté D, Longtin Y, Talbot D, Martin R, Denis G, Ducharme F, Paquet-Bolduc B, Anctil G, Hegg-Deloye S, De Serres G. Risk and protective factors for severe acute respiratory coronavirus virus 2 (SARS-CoV-2) infection among healthcare workers: A test-negative case-control study in Québec, Canada. Infect Control Hosp Epidemiol 2023; 44:1121-1130. [PMID: 36082690 PMCID: PMC9530374 DOI: 10.1017/ice.2022.231] [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] [Received: 06/27/2022] [Revised: 08/23/2022] [Accepted: 08/28/2022] [Indexed: 11/22/2022]
Abstract
OBJECTIVES In Québec, Canada, we evaluated the risk of severe acute respiratory coronavirus virus 2 (SARS-CoV-2) infection associated with (1) the demographic and employment characteristics among healthcare workers (HCWs) and (2) the workplace and household exposures and the infection prevention and control (IPC) measures among patient-facing HCWs. DESIGN Test-negative case-control study. SETTING Provincial health system. PARTICIPANTS HCWs with PCR-confirmed coronavirus disease 2019 (COVID-19) diagnosed between November 15, 2020, and May 29, 2021 (ie, cases), were compared to HCWs with compatible symptoms who tested negative during the same period (ie, controls). METHODS Adjusted odds ratios (aORs) of infection were estimated using regression logistic models evaluating demographic and employment characteristics (all 4,919 cases and 4,803 controls) or household and workplace exposures and IPC measures (2,046 patient-facing cases and 1,362 controls). RESULTS COVID-19 risk was associated with working as housekeeping staff (aOR, 3.6), as a patient-support assistant (aOR, 1.9), and as nursing staff (aOR, 1.4), compared to administrative staff. Other risk factors included being unexperienced (aOR, 1.5) and working in private seniors' homes (aOR, 2.1) or long-term care facilities (aOR, 1.5), compared to acute-care hospitals. Among patient-facing HCWs, exposure to a household contact was reported by 9% of cases and was associated with the highest risk of infection (aOR, 7.8). Most infections were likely attributable to more frequent exposure to infected patients (aOR, 2.7) and coworkers (aOR, 2.2). Wearing an N95 respirator during contacts with COVID-19 patients (aOR, 0.7) and vaccination (aOR, 0.2) were the measures associated with risk reduction. CONCLUSION In the context of the everchanging SARS-CoV-2 virus with increasing transmissibility, measures to ensure HCW protection, including vaccination and respiratory protection, and patient safety will require ongoing evaluation.
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Affiliation(s)
- Sara Carazo
- Institut national de santé Publique du Québec, Québec, Québec, Canada
| | - Jasmin Villeneuve
- Institut national de santé Publique du Québec, Québec, Québec, Canada
| | - Denis Laliberté
- Direction de la santé publique de la Capitale-Nationale, CIUSSS de la Capitale-Nationale, Québec, Québec, Canada
- Faculty of Medicine, Laval University, Québec, Québec, Canada
| | - Yves Longtin
- Infection Prevention and Control Unit, Jewish General Hospital, Montreal, Québec, Canada
- McGill University Faculty of Medicine, Montreal, Québec, Canada
| | - Denis Talbot
- Faculty of Medicine, Laval University, Québec, Québec, Canada
- Centre de recherche du CHU de Québec—Université Laval, Québec, Québec, Canada
| | - Richard Martin
- Institut national de santé Publique du Québec, Québec, Québec, Canada
| | - Geoffroy Denis
- McGill University Faculty of Medicine, Montreal, Québec, Canada
- CIUSSS Centre Sud de Montréal, Montreal, Québec, Canada
| | - Francine Ducharme
- Faculté des sciences infirmières, Université de Montréal, Montreal, Québec, Canada
- Centre de recherche de l’Institut de gériatrie de Montréal, Montreal, Québec, Canada
| | - Bianka Paquet-Bolduc
- Infection Prevention and Control Unit, Institut Universitaire en cardiologie et pneumologie de Québec, Québec, Québec, Canada
| | - Geneviève Anctil
- Institut national de santé Publique du Québec, Québec, Québec, Canada
| | | | - Gaston De Serres
- Institut national de santé Publique du Québec, Québec, Québec, Canada
- Faculty of Medicine, Laval University, Québec, Québec, Canada
- Centre de recherche du CHU de Québec—Université Laval, Québec, Québec, Canada
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15
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Zinszer K, Charland K, Pierce L, Saucier A, McKinnon B, Hamelin MÈ, Cheriet I, Da Torre MB, Carbonneau J, Nguyen CT, De Serres G, Papenburg J, Boivin G, Quach C. Pre-Omicron seroprevalence, seroconversion, and seroreversion of infection-induced SARS-CoV-2 antibodies among a cohort of children and teenagers in Montreal, Canada. Int J Infect Dis 2023; 131:119-126. [PMID: 36963656 PMCID: PMC10033142 DOI: 10.1016/j.ijid.2023.03.036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Revised: 02/22/2023] [Accepted: 03/17/2023] [Indexed: 03/24/2023] Open
Abstract
OBJECTIVE To use serological testing to assess the pre-Omicron seroprevalence, seroconversion, and seroreversion of infection-induced SARS-CoV-2 antibodies in children and adolescents in Montreal, Canada. DESIGN This analysis is from a prospective cohort study of children aged 2 to 17 years (at baseline) that included blood spots (DBS) for antibody detection. The serostatus of participants was determined by enzyme-linked immunosorbent assays (ELISAs) using the receptor-binding domain (RBD) from the spike protein and the nucleocapsid protein (N) as antigens. We estimated seroprevalence, seroconversion rates, and the likelihood of seroreversion at six months and one year. RESULTS The baseline (October 2020 to April 2021) seroprevalence was 5.8% (95% CI 4.8-7.1), which increased to 10.5% (May to September 2021) and 11.0% (November 2021 to March 2022) for the respective follow-ups (95% CI 8.6-12.7; 95% CI 8.8-13.5). The crude rate of seroconversion over the study period was 12.8 per 100 person-years (95% CI 11.0-14.7). Adjusted hazard rates of seroconversion by child characteristics showed higher rates in children who were female, whose parent identified as a racial or ethnic minority, and in households with incomes in the lowest tercile of our study population. The likelihood of remaining seropositive at six months was 68% (95% CI 60%-77%) and dropped to 42% (95% CI 32%-56%) at one year. CONCLUSIONS Serological studies continue to provide valuable contributions for infection prevalence estimates and help us better understand the dynamics of antibody levels following infection.
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Affiliation(s)
- Kate Zinszer
- University of Montreal, Montreal, Quebec, Canada; Centre for Public Health Research, Montreal, Quebec, Canada.
| | - Katia Charland
- Centre for Public Health Research, Montreal, Quebec, Canada
| | - Laura Pierce
- Centre for Public Health Research, Montreal, Quebec, Canada
| | - Adrien Saucier
- University of Montreal, Montreal, Quebec, Canada; Centre for Public Health Research, Montreal, Quebec, Canada
| | - Britt McKinnon
- Centre for Public Health Research, Montreal, Quebec, Canada; Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Marie-Ève Hamelin
- Infectious Disease Research Center, Research Centre of Quebec-Université Laval, Quebec City, Quebec, Canada
| | | | - Margot Barbosa Da Torre
- University of Montreal, Montreal, Quebec, Canada; Centre for Public Health Research, Montreal, Quebec, Canada
| | - Julie Carbonneau
- Infectious Disease Research Center, Research Centre of Quebec-Université Laval, Quebec City, Quebec, Canada
| | - Cat Tuong Nguyen
- Ministère de la santé et des services sociaux, Quebec City, Quebec, Canada
| | - Gaston De Serres
- National Institute of Public Health of Quebec, Quebec City, Quebec, Canada
| | - Jesse Papenburg
- Montreal Children's Hospital of the McGill University Health Centre
| | - Guy Boivin
- Infectious Disease Research Center, Research Centre of Quebec-Université Laval, Quebec City, Quebec, Canada
| | - Caroline Quach
- University of Montreal, Montreal, Quebec, Canada; Research Centre of the Sainte-Justine University Hospital, Montreal, Quebec, Canada
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16
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Bettinger JA, Irvine MA, Shulha HP, Valiquette L, Muller MP, Vanderkooi OG, Kellner JD, Top KA, Sadarangani M, McGeer A, Isenor JE, Marty K, Soe P, De Serres G. Adverse Events Following Immunization With mRNA and Viral Vector Vaccines in Individuals With Previous Severe Acute Respiratory Syndrome Coronavirus 2 Infection From the Canadian National Vaccine Safety Network. Clin Infect Dis 2023; 76:1088-1102. [PMID: 36310514 PMCID: PMC9620384 DOI: 10.1093/cid/ciac852] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Revised: 10/17/2022] [Accepted: 10/26/2022] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND Adults previously infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) develop short-term immunity and may have increased reactogenicity to coronavirus disease 2019 (COVID-19) vaccines. This prospective, multicenter, active-surveillance cohort study examined the short-term safety of COVID-19 vaccines in adults with a prior history of SARS-CoV-2. METHODS Canadian adults vaccinated between 22 December 2020 and 27 November 2021 were sent an electronic questionnaire 7 days post-dose 1, dose 2, and dose 3 vaccination. The main outcome was health events occurring in the first 7 days after each vaccination that prevented daily activities, resulted in work absenteeism, or required a medical consultation, including hospitalization. RESULTS Among 684 998 vaccinated individuals, 2.6% (18 127/684 998) reported a prior history of SARS-CoV-2 infection a median of 4 (interquartile range: 2-6) months previously. After dose 1, individuals with moderate (bedridden) to severe (hospitalized) COVID-19 who received BNT162b2, mRNA-1273, or ChAdox1-S vaccines had higher odds of a health event preventing daily activities, resulting in work absenteeism or requiring medical consultation (adjusted odds ratio [95% confidence interval]: 3.96 [3.67-4.28] for BNT162b2, 5.01 [4.57-5.50] for mRNA-1273, and 1.84 [1.54-2.20] for ChAdox1-S compared with no infection). Following dose 2 and 3, the greater risk associated with previous infection was also present but was attenuated compared with dose 1. For all doses, the association was lower or absent after mild or asymptomatic infection. CONCLUSIONS Adults with moderate or severe previous SARS-CoV-2 infection were more likely to have a health event sufficient to impact routine activities or require medical assessment in the week following each vaccine dose.
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Affiliation(s)
- Julie A Bettinger
- Vaccine Evaluation Center, BC Children's Hospital Research Institute, Vancouver, Canada
- Department of Pediatrics, University of British Columbia, Vancouver, Canada
| | | | - Hennady P Shulha
- Vaccine Evaluation Center, BC Children's Hospital Research Institute, Vancouver, Canada
- Department of Pediatrics, University of British Columbia, Vancouver, Canada
| | - Louis Valiquette
- Department of Microbiology and Infectious Diseases, Université de Sherbrooke, Sherbrooke, Canada
| | | | - Otto G Vanderkooi
- Department of Pediatrics and Alberta Children's Hospital Research Institute, University of Calgary, Calgary, Canada
| | - James D Kellner
- Department of Pediatrics and Alberta Children's Hospital Research Institute, University of Calgary, Calgary, Canada
| | - Karina A Top
- Canadian Center for Vaccinology, IWK Health and Department of Pediatrics, Dalhousie University, Halifax, Canada
| | - Manish Sadarangani
- Vaccine Evaluation Center, BC Children's Hospital Research Institute, Vancouver, Canada
- Department of Pediatrics, University of British Columbia, Vancouver, Canada
| | - Allison McGeer
- Sinai Health System and University of Toronto, Toronto, Canada
| | - Jennifer E Isenor
- College of Pharmacy and Canadian Center for Vaccinology, Dalhousie University, Halifax, Canada
| | - Kimberly Marty
- Vaccine Evaluation Center, BC Children's Hospital Research Institute, Vancouver, Canada
| | - Phyumar Soe
- Vaccine Evaluation Center, BC Children's Hospital Research Institute, Vancouver, Canada
| | - Gaston De Serres
- CHU de Québec-Université Laval, Quebec City, Canada
- Institut National de Santé Publique du Québec, Quebec City, Canada
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17
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Nasreen S, Febriani Y, Velásquez García HA, Zhang G, Tadrous M, Buchan SA, Righolt CH, Mahmud SM, Janjua NZ, Krajden M, De Serres G, Kwong JC. Effectiveness of Coronavirus Disease 2019 Vaccines Against Hospitalization and Death in Canada: A Multiprovincial, Test-Negative Design Study. Clin Infect Dis 2023; 76:640-648. [PMID: 35974428 PMCID: PMC9384799 DOI: 10.1093/cid/ciac634] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Revised: 07/14/2022] [Accepted: 08/01/2022] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND A major goal of coronavirus disease 2019 (COVID-19) vaccination is to prevent severe outcomes (hospitalizations and deaths). We estimated the effectiveness of messenger RNA (mRNA) and ChAdOx1 COVID-19 vaccines against severe outcomes in 4 Canadian provinces between December 2020 and September 2021. METHODS We conducted this multiprovincial, retrospective, test-negative study among community-dwelling adults aged ≥18 years in Ontario, Quebec, British Columbia, and Manitoba using linked provincial databases and a common study protocol. Multivariable logistic regression was used to estimate province-specific vaccine effectiveness against COVID-19 hospitalization and/or death. Estimates were pooled using random-effects models. RESULTS We included 2 508 296 tested participants, with 31 776 COVID-19 hospitalizations and 5842 deaths. Vaccine effectiveness was 83% after a first dose and 98% after a second dose against both hospitalization and death (separately). Against severe outcomes, effectiveness was 87% (95% confidence interval [CI], 71%-94%) ≥84 days after a first dose of mRNA vaccine, increasing to 98% (95% CI, 96%-99%) ≥112 days after a second dose. Vaccine effectiveness against severe outcomes for ChAdOx1 was 88% (95% CI, 75%-94%) ≥56 days after a first dose, increasing to 97% (95% CI, 91%-99%) ≥56 days after a second dose. Lower 1-dose effectiveness was observed for adults aged ≥80 years and those with comorbidities, but effectiveness became comparable after a second dose. Two doses of vaccines provided very high protection for both homologous and heterologous schedules and against Alpha, Gamma, and Delta variants. CONCLUSIONS Two doses of mRNA or ChAdOx1 vaccine provide excellent protection against severe outcomes.
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Affiliation(s)
- Sharifa Nasreen
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.,ICES, Toronto, Ontario, Canada
| | - Yossi Febriani
- Centre Hospitalier Universitaire de Québec-Université Laval Research Center, Quebec City, Quebec, Canada
| | - Héctor Alexander Velásquez García
- British Columbia Centre for Disease Control, Vancouver, British Columbia, Canada.,School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada
| | - Geng Zhang
- Vaccine and Drug Evaluation Centre, Department of Community Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Mina Tadrous
- ICES, Toronto, Ontario, Canada.,Women's College Hospital, Toronto, Ontario, Canada.,Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Ontario, Canada
| | - Sarah A Buchan
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.,ICES, Toronto, Ontario, Canada.,Public Health Ontario, Toronto, Ontario, Canada.,Centre for Vaccine Preventable Diseases, University of Toronto, Toronto, Ontario, Canada
| | - Christiaan H Righolt
- Vaccine and Drug Evaluation Centre, Department of Community Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Salaheddin M Mahmud
- Vaccine and Drug Evaluation Centre, Department of Community Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Naveed Zafar Janjua
- British Columbia Centre for Disease Control, Vancouver, British Columbia, Canada.,School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada.,Centre for Health Evaluation and Outcome Sciences, St Paul's Hospital, Vancouver, British Columbia, Canada
| | - Mel Krajden
- British Columbia Centre for Disease Control, Vancouver, British Columbia, Canada.,Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Gaston De Serres
- Centre Hospitalier Universitaire de Québec-Université Laval Research Center, Quebec City, Quebec, Canada.,Institut national de sante publique du Québec, Biological and Occupational Risks, Quebec City, Quebec, Canada.,Department of Social and Preventive Medicine, Faculty of Medicine, Laval University, Quebec City, Quebec, Canada
| | - Jeffrey C Kwong
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.,ICES, 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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18
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Skowronski DM, Chuang ESY, Sabaiduc S, Kaweski SE, Kim S, Dickinson JA, Olsha R, Gubbay JB, Zelyas N, Charest H, Bastien N, Jassem AN, De Serres G. Vaccine effectiveness estimates from an early-season influenza A(H3N2) epidemic, including unique genetic diversity with reassortment, Canada, 2022/23. Euro Surveill 2023; 28:2300043. [PMID: 36729117 PMCID: PMC9896608 DOI: 10.2807/1560-7917.es.2023.28.5.2300043] [Citation(s) in RCA: 13] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
The Canadian Sentinel Practitioner Surveillance Network estimated vaccine effectiveness (VE) during the unusually early 2022/23 influenza A(H3N2) epidemic. Like vaccine, circulating viruses were clade 3C.2a1b.2a.2, but with genetic diversity affecting haemagglutinin positions 135 and 156, and reassortment such that H156 viruses acquired neuraminidase from clade 3C.2a1b.1a. Vaccine provided substantial protection with A(H3N2) VE of 54% (95% CI: 38 to 66) overall. VE was similar against H156 and vaccine-like S156 viruses, but with potential variation based on diversity at position 135.
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Affiliation(s)
- Danuta M Skowronski
- British Columbia Centre for Disease Control, Vancouver, Canada,University of British Columbia, Vancouver, Canada
| | - Erica SY Chuang
- British Columbia Centre for Disease Control, Vancouver, Canada
| | - Suzana Sabaiduc
- British Columbia Centre for Disease Control, Vancouver, Canada
| | | | - Shinhye Kim
- British Columbia Centre for Disease Control, Vancouver, Canada
| | | | | | - Jonathan B Gubbay
- Public Health Ontario, Toronto, Canada,University of Toronto, Toronto, Canada
| | - Nathan Zelyas
- Public Health Laboratory, Alberta Precision Laboratories, Edmonton, Canada
| | - Hugues Charest
- Institut National de Santé Publique du Québec, Québec, Canada
| | - Nathalie Bastien
- National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, Canada
| | - Agatha N Jassem
- British Columbia Centre for Disease Control, Vancouver, Canada,University of British Columbia, Vancouver, Canada
| | - Gaston De Serres
- Institut National de Santé Publique du Québec, Québec, Canada,Laval University, Quebec, Canada,Centre Hospitalier Universitaire de Québec, Québec, Canada
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19
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Tauzin A, Nicolas A, Ding S, Benlarbi M, Medjahed H, Chatterjee D, Dionne K, Gong SY, Gendron-Lepage G, Bo Y, Perreault J, Goyette G, Gokool L, Arlotto P, Morrisseau C, Tremblay C, Martel-Laferrière V, De Serres G, Levade I, Kaufmann DE, Côté M, Bazin R, Finzi A. Spike recognition and neutralization of SARS-CoV-2 Omicron subvariants elicited after the third dose of mRNA vaccine. Cell Rep 2023; 42:111998. [PMID: 36656710 PMCID: PMC9826988 DOI: 10.1016/j.celrep.2023.111998] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Revised: 11/28/2022] [Accepted: 01/04/2023] [Indexed: 01/11/2023] Open
Abstract
Several severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) Omicron subvariants have recently emerged, becoming the dominant circulating strains in many countries. These variants contain a large number of mutations in their spike glycoprotein, raising concerns about vaccine efficacy. In this study, we evaluate the ability of plasma from a cohort of individuals that received three doses of mRNA vaccine to recognize and neutralize these Omicron subvariant spikes. We observed that BA.4/5 and BQ.1.1 spikes are markedly less recognized and neutralized compared with the D614G and other Omicron subvariant spikes tested. Also, individuals who have been infected before or after vaccination present better humoral responses than SARS-CoV-2-naive vaccinated individuals, thus indicating that hybrid immunity generates better humoral responses against these subvariants.
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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
| | - Alexandre Nicolas
- Centre de Recherche du CHUM, Montreal, QC H2X 0A9, Canada,Département de Microbiologie, Infectiologie et Immunologie, Université de Montréal, Montreal, QC H2X 0A9, Canada
| | - Shilei Ding
- Centre de Recherche du CHUM, Montreal, QC H2X 0A9, Canada
| | - Mehdi Benlarbi
- Centre de Recherche du CHUM, Montreal, QC H2X 0A9, Canada,Département de Microbiologie, Infectiologie et Immunologie, Université de Montréal, Montreal, QC H2X 0A9, Canada
| | | | | | - Katrina Dionne
- 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
| | | | - Yuxia Bo
- Department of Biochemistry, Microbiology and Immunology, and Centre for Infection, Immunity, and Inflammation, University of Ottawa, Ottawa, ON K1H 8M5, 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
| | | | | | - 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
| | - Gaston De Serres
- Institut National de Santé Publique du Québec, Quebec, QC H2P 1E2, Canada
| | - Inès Levade
- Laboratoire de Santé Publique du Québec, Institut National de Santé Publique du Québec, Sainte-Anne-de-Bellevue, QC H9X 3R5, 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,Division of Infectious Diseases, Department of Medicine, University Hospital of Lausanne and University of Lausanne, 1011 Lausanne, Switzerland
| | - Marceline Côté
- Department of Biochemistry, Microbiology and Immunology, and Centre for Infection, Immunity, and Inflammation, University of Ottawa, Ottawa, ON K1H 8M5, Canada
| | - Renée Bazin
- Héma-Québec, Affaires Médicales et Innovation, Quebec, QC G1V 5C3, 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,Corresponding author
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20
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Ionescu IG, Skowronski DM, Sauvageau C, Chuang E, Ouakki M, Kim S, De Serres G. BNT162b2 effectiveness against Delta and Omicron variants of SARS-CoV-2 in adolescents aged 12-17 years, by dosing interval and duration. J Infect Dis 2023; 227:1073-1083. [PMID: 36645782 PMCID: PMC10132765 DOI: 10.1093/infdis/jiad006] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Revised: 12/31/2022] [Accepted: 01/13/2023] [Indexed: 01/17/2023] Open
Abstract
BACKGROUND Two- and three-dose BNT162b2 vaccine effectiveness (VE) against SARS-CoV-2 infection, including Delta and Omicron variants, was assessed among adolescents in Canada where first and second doses were spaced longer than the manufacturer-specified 3-week interval. METHODS Test-negative design estimated VE against laboratory-confirmed SARS-CoV-2 infection ≥14 days post-vaccination among 12-17-year-olds in Quebec and British Columbia, Canada between September 5, 2021-April 30, 2022 (epi-week 36-17). Delta-dominant and Omicron-dominant periods spanned epi-weeks 36-47 and 51-17, respectively. VE was explored by interval between first and second doses, time since second dose, and with a third dose. RESULTS VE against Delta was ≥90% to at least 5 months post-second dose. VE against Omicron decreased from ∼65-75% at 2-3 weeks to ≤50% by the 3rd month post-vaccination, restored to ∼65% by a third dose. Although confidence intervals overlapped, VE against Omicron was ∼5-7% higher (absolute) when first and second doses were spaced ≥8 vs. 3-4 weeks apart. CONCLUSIONS In adolescents, two BNT162b2 doses provided strong and sustained protection against Delta but reduced and rapidly-waning VE against Omicron. Longer interval between first and second doses and a third dose marginally improved Omicron protection. Updated vaccine antigens, increased doses and/or dosing-intervals may improve adolescent VE against immunological-escape variants.
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Affiliation(s)
- Iulia G Ionescu
- Department of Social and Preventive Medicine, Laval University, Faculty of Medicine, Quebec City, Quebec, Canada
| | - Danuta M Skowronski
- Immunization Programs and Vaccine Preventable Diseases Service, BC Centre for Disease Control, Vancouver, British Columbia, Canada.,School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada
| | - Chantal Sauvageau
- Department of Social and Preventive Medicine, Laval University, Faculty of Medicine, Quebec City, Quebec, Canada.,Biological and Occupational Risks, Institut national de santé publique du Québec, Quebec City, Quebec, Canada.,Axe Maladies Infectieuses et Immunitaires, Centre Hospitalier Universitaire (CHU) de Québec-Université Laval Research Center, Quebec City, Quebec, Canada
| | - Erica Chuang
- Immunization Programs and Vaccine Preventable Diseases Service, BC Centre for Disease Control, Vancouver, British Columbia, Canada
| | - Manale Ouakki
- Biological and Occupational Risks, Institut national de santé publique du Québec, Quebec City, Quebec, Canada
| | - Shinhye Kim
- Immunization Programs and Vaccine Preventable Diseases Service, BC Centre for Disease Control, Vancouver, British Columbia, Canada
| | - Gaston De Serres
- Department of Social and Preventive Medicine, Laval University, Faculty of Medicine, Quebec City, Quebec, Canada.,Biological and Occupational Risks, Institut national de santé publique du Québec, Quebec City, Quebec, Canada.,Axe Maladies Infectieuses et Immunitaires, Centre Hospitalier Universitaire (CHU) de Québec-Université Laval Research Center, Quebec City, Quebec, Canada
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21
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Carazo S, Skowronski DM, Brisson M, Barkati S, Sauvageau C, Brousseau N, Gilca R, Fafard J, Talbot D, Ouakki M, Gilca V, Carignan A, Deceuninck G, De Wals P, De Serres G. Protection against omicron (B.1.1.529) BA.2 reinfection conferred by primary omicron BA.1 or pre-omicron SARS-CoV-2 infection among health-care workers with and without mRNA vaccination: a test-negative case-control study. Lancet Infect Dis 2023; 23:45-55. [PMID: 36152671 PMCID: PMC9491856 DOI: 10.1016/s1473-3099(22)00578-3] [Citation(s) in RCA: 34] [Impact Index Per Article: 34.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Revised: 08/11/2022] [Accepted: 08/17/2022] [Indexed: 12/26/2022]
Abstract
BACKGROUND There is a paucity of data on vaccine-induced or infection-induced (hybrid or natural) immunity against omicron (B.1.1.529) subvariant BA.2, particularly in comparing the effects of previous SARS-CoV-2 infection with the same or different genetic lineage. We aimed to estimate the protection against omicron BA.2 associated with previous primary infection with omicron BA.1 or pre-omicron SARS-CoV-2, among health-care workers with and without mRNA vaccination. METHODS We conducted a test-negative case-control study among health-care workers aged 18 years or older who were tested for SARS-CoV-2 in Quebec, Canada, between March 27 and June 4, 2022, when BA.2 was the predominant variant and was presumptively diagnosed with a positive test result. We identified cases (positive test during study period) and controls (negative test during study period) using the provincial laboratory database that records all nucleic acid amplification testing for SARS-CoV-2 in Quebec, and used the provincial immunisation registry to determine vaccination status. Logistic regression models compared the likelihood of BA.2 infection or reinfection (second positive test ≥30 days after primary infection) among health-care workers who had previous primary infection and none to three mRNA vaccine doses versus unvaccinated health-care workers with no primary infection. FINDINGS 258 007 SARS-CoV-2 tests were done during the study period. Among those with a valid result and that met the inclusion criteria, there were 37 732 presumed BA.2 cases (2521 [6·7%] reinfections following pre-omicron primary infection and 659 [1·7%] reinfections following BA.1 primary infection) and 73 507 controls (7360 [10·0%] had pre-omicron primary infection and 12 315 [16·8%] had BA.1 primary infection). Pre-omicron primary infection was associated with a 38% (95% CI 19-53) reduction in BA.2 infection risk, with higher BA.2 protection among those who had also received one (56%, 95% CI 47-63), two (69%, 64-73), or three (70%, 66-74) mRNA vaccine doses. Omicron BA.1 primary infection was associated with greater protection against BA.2 infection (risk reduction of 72%, 95% CI 65-78), and protection was increased further among those who had received two doses of mRNA vaccine (96%, 95-96), but was not improved with a third dose (96%, 95-97). INTERPRETATION Health-care workers who had received two doses of mRNA vaccine and had previous BA.1 infection were subsequently well protected for a prolonged period against BA.2 reinfection, with a third vaccine dose conferring no improvement to that hybrid protection. If this protection also pertains to future variants, there might be limited benefit from additional vaccine doses for people with hybrid immunity, depending on timing and variant. FUNDING Ministère de la Santé et des Services Sociaux du Québec.
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Affiliation(s)
- Sara Carazo
- Biological Risks Unit, Institut National de Santé Publique du Québec, Quebec, QC, Canada; Social and Preventive Medicine Department, Faculty of Medicine, Laval University, Quebec, QC, Canada.
| | - Danuta M Skowronski
- Communicable Diseases and Immunization Services, BC Centre for Disease Control, Vancouver, BC, Canada
| | - Marc Brisson
- Social and Preventive Medicine Department, Faculty of Medicine, Laval University, Quebec, QC, Canada; Centre Hospitalier Universitaire (CHU) de Québec-Université Laval Research Center, Quebec, QC, Canada
| | - Sapha Barkati
- Department of Medicine, Division of Infectious Diseases, McGill University Health Center, McGill University, Montreal, QC, Canada
| | - Chantal Sauvageau
- Biological Risks Unit, Institut National de Santé Publique du Québec, Quebec, QC, Canada; Social and Preventive Medicine Department, Faculty of Medicine, Laval University, Quebec, QC, Canada; Centre Hospitalier Universitaire (CHU) de Québec-Université Laval Research Center, Quebec, QC, Canada
| | - Nicholas Brousseau
- Biological Risks Unit, Institut National de Santé Publique du Québec, Quebec, QC, Canada; Social and Preventive Medicine Department, Faculty of Medicine, Laval University, Quebec, QC, Canada; Centre Hospitalier Universitaire (CHU) de Québec-Université Laval Research Center, Quebec, QC, Canada
| | - Rodica Gilca
- Biological Risks Unit, Institut National de Santé Publique du Québec, Quebec, QC, Canada; Social and Preventive Medicine Department, Faculty of Medicine, Laval University, Quebec, QC, Canada; Centre Hospitalier Universitaire (CHU) de Québec-Université Laval Research Center, Quebec, QC, Canada
| | - Judith Fafard
- Laboratoire de Santé Publique du Québec, Institut National de Santé Publique du Québec, Quebec, QC, Canada; Department of Microbiology, Infectiology and Immunology, Faculty of Medicine, University of Montreal, Montreal, QC, Canada
| | - Denis Talbot
- Social and Preventive Medicine Department, Faculty of Medicine, Laval University, Quebec, QC, Canada; Centre Hospitalier Universitaire (CHU) de Québec-Université Laval Research Center, Quebec, QC, Canada
| | - Manale Ouakki
- Biological Risks Unit, Institut National de Santé Publique du Québec, Quebec, QC, Canada
| | - Vladimir Gilca
- Biological Risks Unit, Institut National de Santé Publique du Québec, Quebec, QC, Canada
| | - Alex Carignan
- Department of Microbiology and Infectious Diseases, Sherbrook University, Sherbrook, QC, Canada
| | - Geneviève Deceuninck
- Centre Hospitalier Universitaire (CHU) de Québec-Université Laval Research Center, Quebec, QC, Canada
| | - Philippe De Wals
- Biological Risks Unit, Institut National de Santé Publique du Québec, Quebec, QC, Canada; Social and Preventive Medicine Department, Faculty of Medicine, Laval University, Quebec, QC, Canada; Centre Hospitalier Universitaire (CHU) de Québec-Université Laval Research Center, Quebec, QC, Canada
| | - Gaston De Serres
- Biological Risks Unit, Institut National de Santé Publique du Québec, Quebec, QC, Canada; Social and Preventive Medicine Department, Faculty of Medicine, Laval University, Quebec, QC, Canada; Centre Hospitalier Universitaire (CHU) de Québec-Université Laval Research Center, Quebec, QC, Canada
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22
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Muñoz CE, MacDonald B, Pham-Huy A, Vaudry W, Pernica JM, Boucher FD, Constantinescu C, Sadarangani M, Bettinger JA, Tapiéro B, Morris SK, McConnell A, Cowan J, Zafack J, Upton J, Abdurrahman Z, McHenry M, Hildebrand KJ, Noya F, De Serres G, Halperin SA, Top KA. Revaccination and Adverse Event Recurrence in Patients with Adverse Events following Immunization. J Pediatr 2022; 250:45-53.e3. [PMID: 35948192 DOI: 10.1016/j.jpeds.2022.07.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2022] [Revised: 07/11/2022] [Accepted: 07/20/2022] [Indexed: 10/15/2022]
Abstract
OBJECTIVES To estimate the risk of recurrence of adverse events following immunization (AEFIs) upon revaccination and to determine among patients with suspected vaccine allergy whether allergy skin test positivity was associated with AEFI recurrence. STUDY DESIGN This prospective observational study included patients assessed in the Canadian Special Immunization Clinic Network from 2013 to 2019 with AEFIs who required revaccination with the vaccine temporally associated with their AEFI. Participants underwent standardized assessment and data collection. Special Immunization Clinic physicians used guidelines to inform their recommendations. Participants were followed up after revaccination to capture AEFI recurrences. Data were transferred to a central database for descriptive analysis. RESULTS Overall, 588 participants were assessed for 627 AEFIs; 570 (91%) AEFIs occurred in children <18 years of age. AEFIs included immediate hypersensitivity (130/627; 21%), large local reactions (110/627; 18%), nonurticarial rash (51/627; 8%), seizures (26/627; 4%), and thrombocytopenia (11/627; 2%). Revaccination was recommended to 513 of 588 (87%) participants. Among participants recommended and due for revaccination during the study period, 63% (299/477) were revaccinated. AEFI recurrence was 10% (31/299) overall, 31% (15/49) for large local reactions, and 7% (5/66) for immediate hypersensitivity. No recurrence was serious. Among 92 participants with suspected vaccine allergy who underwent skin testing and were revaccinated, the negative predictive value of skin testing for AEFI recurrence was 96% (95% CI 92.5%-99.5%). CONCLUSIONS Most individuals with AEFIs were safely revaccinated. Among those with suspected vaccine allergy, skin testing may help determine the safety of revaccination.
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Affiliation(s)
- Caroline E Muñoz
- Department of Community Health and Epidemiology, Dalhousie University, Halifax, Nova Scotia, Canada; Canadian Center for Vaccinology, IWK Health, Nova Scotia Health, and Dalhousie University, Halifax, Nova Scotia, Canada
| | - Beth MacDonald
- Canadian Center for Vaccinology, IWK Health, Nova Scotia Health, and Dalhousie University, Halifax, Nova Scotia, Canada; Faculty of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Anne Pham-Huy
- Division of Infectious Diseases, Immunology and Allergy, Children's Hospital of Eastern Ontario, University of Ottawa, Ottawa, Ontario, Canada
| | - Wendy Vaudry
- Stollery Children's Hospital, University of Alberta, Edmonton, Alberta, Canada
| | - Jeffrey M Pernica
- Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada
| | - François D Boucher
- Centre hospitalier universitaire de Québec-Université Laval, Québec, Canada
| | - Cora Constantinescu
- Alberta Children's Hospital, University of Calgary, Calgary, Alberta, Canada
| | - Manish Sadarangani
- Vaccine Evaluation Center, BC Children's Hospital Research Institute, Vancouver, British Columbia, Canada; Department of Pediatrics, Faculty of Medicine, University of British Columbia and BC Children's Hospital Research Institute, Vancouver, British Columbia, Canada
| | - Julie A Bettinger
- Vaccine Evaluation Center, BC Children's Hospital Research Institute, Vancouver, British Columbia, Canada; Department of Pediatrics, Faculty of Medicine, University of British Columbia and BC Children's Hospital Research Institute, Vancouver, British Columbia, Canada
| | - Bruce Tapiéro
- Division of Infectious Diseases, CHU Sainte Justine, Université de Montréal, Montréal, Québec, Canada
| | - Shaun K Morris
- Division of Infectious Diseases, Hospital for Sick Children & Department of Pediatrics, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Athena McConnell
- Jim Pattison Children's Hospital, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Juthaporn Cowan
- The Ottawa Hospital Research Institute, University of Ottawa, Ottawa, Ontario, Canada
| | | | - Julia Upton
- Division of Infectious Diseases, Hospital for Sick Children & Department of Pediatrics, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Zainab Abdurrahman
- Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada
| | - Mary McHenry
- Department of Pediatrics, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Kyla J Hildebrand
- Department of Pediatrics, Faculty of Medicine, University of British Columbia and BC Children's Hospital Research Institute, Vancouver, British Columbia, Canada
| | - Francisco Noya
- Division of Allergy and Immunology and Division of Infectious Diseases, Montreal Children's Hospital-McGill University Health Centre, Montreal, Quebec, Canada
| | - Gaston De Serres
- Centre hospitalier universitaire de Québec-Université Laval, Québec, Canada
| | - Scott A Halperin
- Canadian Center for Vaccinology, IWK Health, Nova Scotia Health, and Dalhousie University, Halifax, Nova Scotia, Canada; Department of Pediatrics, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Karina A Top
- Department of Community Health and Epidemiology, Dalhousie University, Halifax, Nova Scotia, Canada; Canadian Center for Vaccinology, IWK Health, Nova Scotia Health, and Dalhousie University, Halifax, Nova Scotia, Canada; Department of Pediatrics, Dalhousie University, Halifax, Nova Scotia, Canada.
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23
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Tauzin A, Gong SY, Chatterjee D, Ding S, Painter MM, Goel RR, Beaudoin-Bussières G, Marchitto L, Boutin M, Laumaea A, Okeny J, Gendron-Lepage G, Bourassa C, Medjahed H, Goyette G, Williams JC, Bo Y, Gokool L, Morrisseau C, Arlotto P, Bazin R, Fafard J, Tremblay C, Kaufmann DE, De Serres G, Richard J, Côté M, Duerr R, Martel-Laferrière V, Greenplate AR, Wherry EJ, Finzi A. A boost with SARS-CoV-2 BNT162b2 mRNA vaccine elicits strong humoral responses independently of the interval between the first two doses. Cell Rep 2022; 41:111554. [PMID: 36244343 PMCID: PMC9533674 DOI: 10.1016/j.celrep.2022.111554] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2022] [Revised: 07/27/2022] [Accepted: 10/03/2022] [Indexed: 11/23/2022] Open
Abstract
Due to the recrudescence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections worldwide, mainly caused by the Omicron variant of concern (VOC) and its sub-lineages, several jurisdictions are administering an mRNA vaccine boost. Here, we analyze humoral responses induced after the second and third doses of an mRNA vaccine in naive and previously infected donors who received their second dose with an extended 16-week interval. We observe that the extended interval elicits robust humoral responses against VOCs, but this response is significantly diminished 4 months after the second dose. Administering a boost to these individuals brings back the humoral responses to the same levels obtained after the extended second dose. Interestingly, we observe that administering a boost to individuals that initially received a short 3- to 4-week regimen elicits humoral responses similar to those observed in the long interval regimen. Nevertheless, humoral responses elicited by the boost in naive individuals do not reach those present in previously infected vaccinated individuals.
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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
| | - 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
| | | | - Shilei Ding
- Centre de Recherche du CHUM, Montreal, QC H2X 0A9, Canada
| | - Mark M. Painter
- Institute for Immunology, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA 19104, USA,Immune Health, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA 19104, USA,Department of Systems Pharmacology and Translational Therapeutics, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA 19104, USA
| | - Rishi R. Goel
- Institute for Immunology, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA 19104, USA,Immune Health, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA 19104, USA
| | - 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
| | - 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
| | - 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
| | - 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
| | - James Okeny
- Department of Biochemistry, Microbiology and Immunology, and Center for Infection, Immunity, and Inflammation, University of Ottawa, Ottawa, ON K1H 8M5, Canada
| | | | | | | | | | - Justine C. Williams
- Immune Health, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA 19104, USA
| | - Yuxia Bo
- Department of Biochemistry, Microbiology and Immunology, and Center for Infection, Immunity, and Inflammation, University of Ottawa, Ottawa, ON K1H 8M5, Canada
| | - Laurie Gokool
- Centre de Recherche du CHUM, Montreal, QC H2X 0A9, Canada
| | | | | | - Renée Bazin
- Héma-Québec, Affaires Médicales et Innovation, Quebec, QC G1V 5C3, Canada
| | - Judith Fafard
- Laboratoire de Santé Publique du Québec, Institut National de Santé Publique du Québec, Sainte-Anne-de-Bellevue, QC H9X 3R5, 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
| | - Daniel E. Kaufmann
- Centre de Recherche du CHUM, Montreal, QC H2X 0A9, Canada,Département de Médecine, Université de Montréal, Montreal, QC H3T 1J4, Canada
| | - Gaston De Serres
- Institut National de Santé Publique du Québec, Quebec, QC H2P 1E2, 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, and Center for Infection, Immunity, and Inflammation, University of Ottawa, Ottawa, ON K1H 8M5, Canada
| | - Ralf Duerr
- Department of Microbiology, New York University School of Medicine, New York, NY 10016, USA
| | - 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
| | - Allison R. Greenplate
- Institute for Immunology, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA 19104, USA,Immune Health, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA 19104, USA
| | - E. John Wherry
- Institute for Immunology, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA 19104, USA,Immune Health, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA 19104, USA,Department of Systems Pharmacology and Translational Therapeutics, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA 19104, USA
| | - 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,Corresponding author
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24
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Nantel S, Bourdin B, Adams K, Carbonneau J, Rabezanahary H, Hamelin MÈ, McCormack D, Savard P, Longtin Y, Cheng MP, De Serres G, Corbeil J, Gilca V, Baz M, Boivin G, Quach C, Decaluwe H. Symptomatology during previous SARS-CoV-2 infection and serostatus before vaccination influence the immunogenicity of BNT162b2 COVID-19 mRNA vaccine. Front Immunol 2022; 13:930252. [PMID: 36311736 PMCID: PMC9614167 DOI: 10.3389/fimmu.2022.930252] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Accepted: 09/20/2022] [Indexed: 11/07/2023] Open
Abstract
Public health vaccination recommendations for COVID-19 primary series and boosters in previously infected individuals differ worldwide. As infection with SARS-CoV-2 is often asymptomatic, it remains to be determined if vaccine immunogenicity is comparable in all previously infected subjects. This study presents detailed immunological evidence to clarify the requirements for one- or two-dose primary vaccination series for naturally primed individuals. The main objective was to evaluate the immune response to COVID-19 mRNA vaccination to establish the most appropriate vaccination regimen to induce robust immune responses in individuals with prior SARS-CoV-2 infection. The main outcome measure was a functional immunity score (zero to three) before and after vaccination, based on anti-RBD IgG levels, serum capacity to neutralize live virus and IFN-γ secretion capacity in response to SARS-CoV-2 peptide pools. One point was attributed for each of these three functional assays with response above the positivity threshold. The immunity score was compared based on subjects' symptoms at diagnosis and/or serostatus prior to vaccination. None of the naïve participants (n=14) showed a maximal immunity score of three following one dose of vaccine compared to 84% of the previously infected participants (n=55). All recovered individuals who did not have an immunity score of three were seronegative prior to vaccination, and 67% had not reported symptoms resulting from their initial infection. Following one dose of vaccine, their immune responses were comparable to naïve individuals, with significantly weaker responses than individuals who were symptomatic during infection. These results indicate that the absence of symptoms during initial infection and negative serostatus prior to vaccination predict the strength of immune responses to COVID-19 mRNA vaccine. Altogether, these findings highlight the importance of administering the complete two-dose primary regimen and following boosters of mRNA vaccines to individuals who experienced asymptomatic SARS-CoV-2 infection.
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Affiliation(s)
- Sabryna Nantel
- Cytokines and Adaptive Immunity Lab, Sainte-Justine University Hospital and Research Center, Montréal, QC, Canada
- Microbiology, Infectiology and Immunology Department, Faculty of Medicine, University of Montréal, Montréal, QC, Canada
| | - Benoîte Bourdin
- Cytokines and Adaptive Immunity Lab, Sainte-Justine University Hospital and Research Center, Montréal, QC, Canada
| | - Kelsey Adams
- Clinical Department of Laboratory Medicine, Infection Prevention and Control, Sainte-Justine University Hospital and Research Center, Montréal, QC, Canada
| | - Julie Carbonneau
- Infectious Disease Research Center, Université Laval, Québec City, QC, Canada
- Centre Hospitalier Universitaire de Québec - Université Laval Research Center, Québec City, QC, Canada
| | - Henintsoa Rabezanahary
- Infectious Disease Research Center, Université Laval, Québec City, QC, Canada
- Centre Hospitalier Universitaire de Québec - Université Laval Research Center, Québec City, QC, Canada
- Microbiology, Infectiology and Immunology Department, Université Laval, Québec City, QC, Canada
| | - Marie-Ève Hamelin
- Infectious Disease Research Center, Université Laval, Québec City, QC, Canada
- Centre Hospitalier Universitaire de Québec - Université Laval Research Center, Québec City, QC, Canada
| | - Deirdre McCormack
- Clinical Department of Laboratory Medicine, Infection Prevention and Control, Sainte-Justine University Hospital and Research Center, Montréal, QC, Canada
| | - Patrice Savard
- Microbiology, Infectiology and Immunology Department, Faculty of Medicine, University of Montréal, Montréal, QC, Canada
- Immunopathology Department, Montreal University Hospital and Research Center, Montréal, QC, Canada
| | - Yves Longtin
- Infectious Diseases Service, Department of Medicine, Jewish General Hospital, Montréal, QC, Canada
| | - Matthew P. Cheng
- Biological and Occupational Risk, Divisions of Infectious Diseases and Medical Microbiology, Departments of Medicine and Laboratory Medicine, McGill University Health Center, Montréal, QC, Canada
| | - Gaston De Serres
- Centre Hospitalier Universitaire de Québec - Université Laval Research Center, Québec City, QC, Canada
- Biological and Occupational Risk, Institut National de Santé Publique du Québec, Québec City, QC, Canada
- Preventive and Social Medicine Department, Université Laval, Québec City, QC, Canada
| | - Jacques Corbeil
- Centre Hospitalier Universitaire de Québec - Université Laval Research Center, Québec City, QC, Canada
- Molecular Medicine Department, Université Laval, Québec City, QC, Canada
| | - Vladimir Gilca
- Centre Hospitalier Universitaire de Québec - Université Laval Research Center, Québec City, QC, Canada
- Biological and Occupational Risk, Institut National de Santé Publique du Québec, Québec City, QC, Canada
- Preventive and Social Medicine Department, Université Laval, Québec City, QC, Canada
| | - Mariana Baz
- Infectious Disease Research Center, Université Laval, Québec City, QC, Canada
- Centre Hospitalier Universitaire de Québec - Université Laval Research Center, Québec City, QC, Canada
- Microbiology, Infectiology and Immunology Department, Université Laval, Québec City, QC, Canada
| | - Guy Boivin
- Infectious Disease Research Center, Université Laval, Québec City, QC, Canada
- Centre Hospitalier Universitaire de Québec - Université Laval Research Center, Québec City, QC, Canada
| | - Caroline Quach
- Microbiology, Infectiology and Immunology Department, Faculty of Medicine, University of Montréal, Montréal, QC, Canada
- Clinical Department of Laboratory Medicine, Infection Prevention and Control, Sainte-Justine University Hospital and Research Center, Montréal, QC, Canada
| | - Hélène Decaluwe
- Cytokines and Adaptive Immunity Lab, Sainte-Justine University Hospital and Research Center, Montréal, QC, Canada
- Microbiology, Infectiology and Immunology Department, Faculty of Medicine, University of Montréal, Montréal, QC, Canada
- Pediatric Immunology and Rheumatology Division, Department of Pediatrics, University of Montréal, Montréal, QC, Canada
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25
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Carazo S, Skowronski DM, Brisson M, Sauvageau C, Brousseau N, Gilca R, Ouakki M, Barkati S, Fafard J, Talbot D, Gilca V, Deceuninck G, Garenc C, Carignan A, De Wals P, De Serres G. Estimated Protection of Prior SARS-CoV-2 Infection Against Reinfection With the Omicron Variant Among Messenger RNA-Vaccinated and Nonvaccinated Individuals in Quebec, Canada. JAMA Netw Open 2022; 5:e2236670. [PMID: 36239934 PMCID: PMC9568797 DOI: 10.1001/jamanetworkopen.2022.36670] [Citation(s) in RCA: 24] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
IMPORTANCE The Omicron variant is phylogenetically and antigenically distinct from earlier SARS-CoV-2 variants and the original vaccine strain. Protection conferred by prior SARS-CoV-2 infection against Omicron reinfection, with and without vaccination, requires quantification. OBJECTIVE To estimate the protection against Omicron reinfection and hospitalization conferred by prior heterologous non-Omicron SARS-CoV-2 infection and/or up to 3 doses of an ancestral, Wuhan-like messenger RNA (mRNA) vaccine. DESIGN, SETTING, AND PARTICIPANTS This test-negative, population-based case-control study was conducted between December 26, 2021, and March 12, 2022, and included community-dwelling individuals aged 12 years or older who were tested for SARS-CoV-2 infection in the province of Quebec, Canada. EXPOSURES Prior laboratory-confirmed SARS-CoV-2 infection with or without mRNA vaccination. MAIN OUTCOMES AND MEASURES The main outcome was laboratory-confirmed SARS-CoV-2 reinfection and associated hospitalization, presumed to be associated with the Omicron variant according to genomic surveillance. The odds of prior infection with or without vaccination were compared for case participants with Omicron infection and associated hospitalizations vs test-negative control participants. Estimated protection was derived as 1 - the odds ratio, adjusted for age, sex, testing indication, and epidemiologic week. Analyses were stratified by severity and time since last non-Omicron infection or vaccine dose. RESULTS This study included 696 439 individuals (224 007 case participants and 472 432 control participants); 62.2% and 63.9% were female and 87.4% and 75.5% were aged 18 to 69 years, respectively. Prior non-Omicron SARS-CoV-2 infection was detected for 9505 case participants (4.2%) and 29 712 control participants (6.3%). Among nonvaccinated individuals, prior non-Omicron infection was associated with a 44% reduction (95% CI, 38%-48%) in Omicron reinfection risk, which decreased from 66% (95% CI, 57%-73%) at 3 to 5 months to 35% (95% CI, 21%-47%) at 9 to 11 months postinfection and was below 30% thereafter. The more severe the prior infection, the greater the risk reduction. Estimated protection (95% CI) against Omicron infection was consistently significantly higher among vaccinated individuals with prior infection compared with vaccinated infection-naive individuals, with 65% (63%-67%) vs 20% (16%-24%) for 1 dose, 68% (67%-70%) vs 42% (41%-44%) for 2 doses, and 83% (81%-84%) vs 73% (72%-73%) for 3 doses. For individuals with prior infection, estimated protection (95% CI) against Omicron-associated hospitalization was 81% (66%-89%) and increased to 86% (77%-99%) with 1, 94% (91%-96%) with 2, and 97% (94%-99%) with 3 mRNA vaccine doses, without signs of waning. CONCLUSIONS AND RELEVANCE The findings of this study suggest that vaccination with 2 or 3 mRNA vaccine doses among individuals with prior heterologous SARS-CoV-2 infection provided the greatest protection against Omicron-associated hospitalization. In the context of program goals to prevent severe outcomes and preserve health care system capacity, a third mRNA vaccine dose may add limited protection in twice-vaccinated individuals with prior SARS-CoV-2 infection.
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Affiliation(s)
- Sara Carazo
- Biological Risks Unit, Institut National de Santé Publique du Québec, Quebec City, Quebec, Canada
| | - Danuta M. Skowronski
- Communicable Diseases and Immunization Services, British Columbia Centre for Disease Control, Vancouver, British Columbia, Canada
| | - Marc Brisson
- Centre Hospitalier Universitaire de Québec-Université Laval Research Center, Quebec City, Quebec, Canada
- Social and Preventive Medicine Department, Faculty of Medicine, Laval University, Quebec City, Quebec, Canada
| | - Chantal Sauvageau
- Biological Risks Unit, Institut National de Santé Publique du Québec, Quebec City, Quebec, Canada
- Centre Hospitalier Universitaire de Québec-Université Laval Research Center, Quebec City, Quebec, Canada
- Social and Preventive Medicine Department, Faculty of Medicine, Laval University, Quebec City, Quebec, Canada
| | - Nicholas Brousseau
- Biological Risks Unit, Institut National de Santé Publique du Québec, Quebec City, Quebec, Canada
- Centre Hospitalier Universitaire de Québec-Université Laval Research Center, Quebec City, Quebec, Canada
- Social and Preventive Medicine Department, Faculty of Medicine, Laval University, Quebec City, Quebec, Canada
| | - Rodica Gilca
- Biological Risks Unit, Institut National de Santé Publique du Québec, Quebec City, Quebec, Canada
- Centre Hospitalier Universitaire de Québec-Université Laval Research Center, Quebec City, Quebec, Canada
- Social and Preventive Medicine Department, Faculty of Medicine, Laval University, Quebec City, Quebec, Canada
| | - Manale Ouakki
- Biological Risks Unit, Institut National de Santé Publique du Québec, Quebec City, Quebec, Canada
| | - Sapha Barkati
- Division of Infectious Diseases, Department of Medicine, McGill University Health Center, McGill University, Montreal, Quebec, Canada
| | - Judith Fafard
- Laboratoire de Santé Publique du Québec, Institut National de Santé Publique du Québec, Sainte-Anne-de-Bellevue, Quebec, Canada
| | - Denis Talbot
- Centre Hospitalier Universitaire de Québec-Université Laval Research Center, Quebec City, Quebec, Canada
- Social and Preventive Medicine Department, Faculty of Medicine, Laval University, Quebec City, Quebec, Canada
| | - Vladimir Gilca
- Biological Risks Unit, Institut National de Santé Publique du Québec, Quebec City, Quebec, Canada
| | - Geneviève Deceuninck
- Centre Hospitalier Universitaire de Québec-Université Laval Research Center, Quebec City, Quebec, Canada
| | - Christophe Garenc
- Biological Risks Unit, Institut National de Santé Publique du Québec, Quebec City, Quebec, Canada
- Centre Hospitalier Universitaire de Québec-Université Laval Research Center, Quebec City, Quebec, Canada
| | - Alex Carignan
- Department of Microbiology and Infectious Diseases, Sherbrook University, Sherbrook, Quebec, Canada
| | - Philippe De Wals
- Biological Risks Unit, Institut National de Santé Publique du Québec, Quebec City, Quebec, Canada
- Centre Hospitalier Universitaire de Québec-Université Laval Research Center, Quebec City, Quebec, Canada
- Social and Preventive Medicine Department, Faculty of Medicine, Laval University, Quebec City, Quebec, Canada
| | - Gaston De Serres
- Biological Risks Unit, Institut National de Santé Publique du Québec, Quebec City, Quebec, Canada
- Centre Hospitalier Universitaire de Québec-Université Laval Research Center, Quebec City, Quebec, Canada
- Social and Preventive Medicine Department, Faculty of Medicine, Laval University, Quebec City, Quebec, Canada
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26
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Kim S, Chuang ES, Sabaiduc S, Olsha R, Kaweski SE, Zelyas N, Gubbay JB, Jassem AN, Charest H, De Serres G, Dickinson JA, Skowronski DM. Influenza vaccine effectiveness against A(H3N2) during the delayed 2021/22 epidemic in Canada. Euro Surveill 2022; 27. [PMID: 36148674 PMCID: PMC9511683 DOI: 10.2807/1560-7917.es.2022.27.38.2200720] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Influenza virus circulation virtually ceased in Canada during the COVID-19 pandemic, re-emerging with the relaxation of restrictions in spring 2022. Using a test-negative design, the Canadian Sentinel Practitioner Surveillance Network reports 2021/22 vaccine effectiveness of 36% (95% CI: −38 to 71) against late-season illness due to influenza A(H3N2) clade 3C.2a1b.2a.2 viruses, considered antigenically distinct from the 3C.2a1b.2a.1 vaccine strain. Findings reinforce the World Health Organization’s decision to update the 2022/23 northern hemisphere vaccine to a more representative A(H3N2) clade 3C.2a1b.2a.2 strain.
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Affiliation(s)
- Shinhye Kim
- British Columbia Centre for Disease Control, Vancouver, Canada
| | - Erica Sy Chuang
- British Columbia Centre for Disease Control, Vancouver, Canada
| | - Suzana Sabaiduc
- British Columbia Centre for Disease Control, Vancouver, Canada
| | | | | | - Nathan Zelyas
- Public Health Laboratory, Alberta Precision Laboratories, Edmonton, Canada
| | - Jonathan B Gubbay
- University of Toronto, Toronto, Canada.,Public Health Ontario, Toronto, Canada
| | - Agatha N Jassem
- University of British Columbia, Vancouver, Canada.,British Columbia Centre for Disease Control, Vancouver, Canada
| | - Hugues Charest
- Institut national de santé publique du Québec, Québec, Canada
| | - Gaston De Serres
- Centre Hospitalier Universitaire de Québec, Québec, Canada.,Laval University, Quebec, Canada.,Institut national de santé publique du Québec, Québec, Canada
| | | | - Danuta M Skowronski
- University of British Columbia, Vancouver, Canada.,British Columbia Centre for Disease Control, Vancouver, Canada
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27
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Carazo S, Talbot D, Boulianne N, Brisson M, Gilca R, Deceuninck G, Brousseau N, Drolet M, Ouakki M, Sauvageau C, Barkati S, Fortin É, Carignan A, De Wals P, Skowronski DM, De Serres G. Single-Dose Messenger RNA Vaccine Effectiveness Against Severe Acute Respiratory Syndrome Coronavirus 2 in Healthcare Workers Extending 16 Weeks Postvaccination: A Test-Negative Design From Québec, Canada. Clin Infect Dis 2022; 75:e805-e813. [PMID: 34460902 PMCID: PMC8522396 DOI: 10.1093/cid/ciab739] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [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: 07/12/2021] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND In Canada, first and second doses of messenger RNA (mRNA) vaccines against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) were uniquely spaced 16 weeks apart. We estimated 1- and 2-dose mRNA vaccine effectiveness (VE) among healthcare workers (HCWs) in Québec, Canada, including protection against varying outcome severity, variants of concern (VOCs), and the stability of single-dose protection up to 16 weeks postvaccination. METHODS A test-negative design compared vaccination among SARS-CoV-2 test-positive and weekly matched (10:1), randomly sampled, test-negative HCWs using linked surveillance and immunization databases. Vaccine status was defined by 1 dose ≥14 days or 2 doses ≥7 days before illness onset or specimen collection. Adjusted VE was estimated by conditional logistic regression. RESULTS Primary analysis included 5316 cases and 53 160 controls. Single-dose VE was 70% (95% confidence interval [CI], 68%-73%) against SARS-CoV-2 infection; 73% (95% CI, 71%-75%) against illness; and 97% (95% CI, 92%-99%) against hospitalization. Two-dose VE was 86% (95% CI, 81%-90%) and 93% (95% CI, 89%-95%), respectively, with no hospitalizations. VE was higher for non-VOCs than VOCs (73% Alpha) among single-dose recipients but not 2-dose recipients. Across 16 weeks, no decline in single-dose VE was observed, with appropriate stratification based upon prioritized vaccination determined by higher vs lower likelihood of direct patient contact. CONCLUSIONS One mRNA vaccine dose provided substantial and sustained protection to HCWs extending at least 4 months postvaccination. In circumstances of vaccine shortage, delaying the second dose may be a pertinent public health strategy.
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Affiliation(s)
- Sara Carazo
- Centre de Recherche du CHU de Quebec-Universite Laval, Quebec City, Quebec, Canada
| | - Denis Talbot
- Centre de Recherche du CHU de Quebec-Universite Laval, Quebec City, Quebec, Canada
- Social and preventive medicine department, Faculty of medicine, Laval University, Quebec city, Quebec, Canada
| | - Nicole Boulianne
- Biological and occupational risks. Institut national de sante publique du Quebec, Quebec City, Quebec, Canada
| | - Marc Brisson
- Centre de Recherche du CHU de Quebec-Universite Laval, Quebec City, Quebec, Canada
- Social and preventive medicine department, Faculty of medicine, Laval University, Quebec city, Quebec, Canada
- Department of Infectious Disease Epidemiology, Imperial College London, UK
| | - Rodica Gilca
- Centre de Recherche du CHU de Quebec-Universite Laval, Quebec City, Quebec, Canada
- Social and preventive medicine department, Faculty of medicine, Laval University, Quebec city, Quebec, Canada
- Biological and occupational risks. Institut national de sante publique du Quebec, Quebec City, Quebec, Canada
| | - Geneviève Deceuninck
- Centre de Recherche du CHU de Quebec-Universite Laval, Quebec City, Quebec, Canada
| | - Nicholas Brousseau
- Centre de Recherche du CHU de Quebec-Universite Laval, Quebec City, Quebec, Canada
- Social and preventive medicine department, Faculty of medicine, Laval University, Quebec city, Quebec, Canada
- Biological and occupational risks. Institut national de sante publique du Quebec, Quebec City, Quebec, Canada
| | - Mélanie Drolet
- Centre de Recherche du CHU de Quebec-Universite Laval, Quebec City, Quebec, Canada
| | - Manale Ouakki
- Biological and occupational risks. Institut national de sante publique du Quebec, Quebec City, Quebec, Canada
| | - Chantal Sauvageau
- Centre de Recherche du CHU de Quebec-Universite Laval, Quebec City, Quebec, Canada
- Social and preventive medicine department, Faculty of medicine, Laval University, Quebec city, Quebec, Canada
- Biological and occupational risks. Institut national de sante publique du Quebec, Quebec City, Quebec, Canada
| | - Sapha Barkati
- JD MacLean Centre for Tropical Diseases, McGill University Health Centre, McGill University, Montreal, Canada
- Department of Medicine, Division of Infectious Diseases, McGill University Health Center, McGill University, Montreal, Quebec, Canada
| | - Élise Fortin
- Biological and occupational risks. Institut national de sante publique du Quebec, Quebec City, Quebec, Canada
| | - Alex Carignan
- Department of Microbiology and Infectious Diseases, Sherbrooke University, Sherbrooke, Quebec, Canada
| | - Philippe De Wals
- Social and preventive medicine department, Faculty of medicine, Laval University, Quebec city, Quebec, Canada
- Biological and occupational risks. Institut national de sante publique du Quebec, Quebec City, Quebec, Canada
| | - Danuta M Skowronski
- Communicable Diseases and Immunization Services, BC Centre for Disease Control, Vancouver, British Columbia, Canada
| | - Gaston De Serres
- Centre de Recherche du CHU de Quebec-Universite Laval, Quebec City, Quebec, Canada
- Social and preventive medicine department, Faculty of medicine, Laval University, Quebec city, Quebec, Canada
- Biological and occupational risks. Institut national de sante publique du Quebec, Quebec City, Quebec, Canada
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28
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Carazo S, Skowronski DM, Laforce R, Talbot D, Falcone EL, Laliberté D, Denis G, Deshaies P, Hegg-Deloye S, De Serres G. Physical, psychological and cognitive profile of post-COVID conditions in healthcare workers, Quebec, Canada. Open Forum Infect Dis 2022; 9:ofac386. [PMID: 35983264 PMCID: PMC9379818 DOI: 10.1093/ofid/ofac386] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Accepted: 07/29/2022] [Indexed: 11/14/2022] Open
Abstract
ABSTRACT
Background
The prevalence of post-COVID conditions (PCC) and associated physical, psychological and cognitive symptoms was assessed among Quebec healthcare workers (HCWs) with COVID-19.
Methods
This case-control study compared 6061 symptomatic HCWs with PCR-confirmed COVID-19 between July 2020 and May 2021 with a random sample of 4390 symptomatic HCWs who were test-negative controls. The prevalence of physical symptoms lasting ≥4 weeks (PCC4w) or ≥12 weeks (PCC12w) was estimated among hospitalized and non-hospitalized cases. In multivariate models, sociodemographic and clinical characteristics, as well as vaccine history, were evaluated as potential risk factors. Prevalence ratios compared four aspects of self-reported cognitive dysfunction among PCC cases to controls, adjusting for psychological distress and fatigue.
Results
PCC4w and PCC12w prevalences of 46% (2,746/5,943) and 40% (653/1,746), respectively, were observed among non-hospitalized cases and 76% (90/118) and 68% (27/37), respectively, among hospitalized cases. Hospitalization, female sex and age were associated with higher PCC risk.
A substantial proportion of non-hospitalized PCC4w cases often or very often reported cognitive dysfunction, including concentration (33%) or organizing (23%) difficulties, forgetfulness (20%) and loss of necessary items (10%). All four aspects of cognitive dysfunction were associated with PCC4w symptoms, psychological distress and fatigue.
Conclusion
PCC may be a frequent sequela of ambulatory COVID-19 in working-age adults, with important effects on cognition. With so many HCWs infected, the implications for quality healthcare delivery could be profound if cognitive dysfunction and other severe PCC symptoms persist in a professionally-disabling way. Further evaluation of PCC prevalence and prognosis is warranted.
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Affiliation(s)
- Sara Carazo
- CHU de Québec-Laval University Research Center , Quebec City, Quebec , Canada
- Biological and occupational risks unit. Institut national de santé publique du Québec , Quebec City, Quebec , Canada
| | - Danuta M Skowronski
- Communicable Diseases and Immunization Services, BC Centre for Disease Control , Vancouver, British Columbia , Canada
| | - Robert Laforce
- Interdisciplinary Memory Clinic, Department of Neurological Sciences, CHU de Quebec, and Faculty of Medicine, Laval University , Quebec City, Quebec , Canada
| | - Denis Talbot
- CHU de Québec-Laval University Research Center , Quebec City, Quebec , Canada
- Social and preventive medicine department, Faculty of Medicine, Laval University , Quebec City, Quebec, Canada
| | - Emilia L Falcone
- Department of Medicine, Faculty of Medicine, University of Montreal , Montreal, Quebec , Canada
- Center for Inflammation, Immunity and Infectious Diseases, Montreal Clinical Research Institute (IRCM) , Montreal, Quebec , Canada
| | - Denis Laliberté
- Social and preventive medicine department, Faculty of Medicine, Laval University , Quebec City, Quebec, Canada
- CIUSSS de la Capitale-Nationale , Quebec City, Quebec , Canada
| | - Geoffroy Denis
- CIUSSS Centre Sud de Montréal , Montreal, Quebec , Canada
- McGill University , Montreal, Quebec , Canada
| | | | | | - Gaston De Serres
- CHU de Québec-Laval University Research Center , Quebec City, Quebec , Canada
- Biological and occupational risks unit. Institut national de santé publique du Québec , Quebec City, Quebec , Canada
- Social and preventive medicine department, Faculty of Medicine, Laval University , Quebec City, Quebec, Canada
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29
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Lewin A, De Serres G, Grégoire Y, Perreault J, Drouin M, Fournier MJ, Tremblay T, Beaudoin J, Boivin A, Goyette G, Finzi A, Bazin R, Germain M, Delage G, Renaud C. Seroprevalence of SARS-CoV-2 antibodies among blood donors in Québec: an update from a serial cross-sectional study. Can J Public Health 2022; 113:385-393. [PMID: 35380364 PMCID: PMC8982303 DOI: 10.17269/s41997-022-00622-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Accepted: 02/24/2022] [Indexed: 12/14/2022]
Abstract
Objectives We previously estimated the seroprevalence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) antibodies following the first pandemic wave at 2.23% in Québec, Canada. Following the much bigger second wave in fall 2020 and early 2021, we estimated the seroprevalence of anti-SARS-CoV-2 in Québec during the first months of 2021. Methods Blood samples from regular, asymptomatic (for ≥ 14 days) donors were collected between January 25, 2021 and March 11, 2021. Anti-SARS-CoV-2 seropositivity was assessed using an enzyme-linked immunosorbent assay that captures antibodies directed against the receptor binding domain of the SARS-CoV-2 spike (and hence cannot discriminate between infection- and vaccine-induced seropositivity). Seroprevalence estimates were adjusted for regional distribution, age, and sex. Results Samples from 7924 eligible donors were analyzed, including 620 (7.8%) vaccinated donors and 7046 (88.9%) unvaccinated donors (vaccination status unknown for 258 (3.3%) donors). Overall, median age was 51 years; 46.4% of donors were female. The adjusted seroprevalence was 10.5% (95% CI = 9.7–11.3) in the unvaccinated population and 14.7% (95% CI = 13.8–15.6) in the overall population. Seroprevalence gradually decreased with age and was higher among donors who self-identified as having a racial/ethnic background other than white, both in the overall and in the unvaccinated populations. Conclusion The seroprevalence of SARS-CoV-2 antibodies significantly increased in Québec since spring 2020, with younger persons and ethnic minorities being disproportionately affected. When compared with the cumulative incidence rate reported by public health authorities (i.e., 3.3% as of March 11, 2021), these results suggest that a substantial proportion of infections remain undetected despite improvements in access to COVID-19 testing. Supplementary Information The online version contains supplementary material available at 10.17269/s41997-022-00622-y.
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Affiliation(s)
- Antoine Lewin
- Affaires Médicales et Innovation, Héma-Québec, Montréal, QC, Canada.,Faculté de médecine et des sciences de la santé, Université de Sherbrooke, Sherbrooke, QC, Canada
| | - Gaston De Serres
- Institut National de Santé Publique du Québec, Québec, QC, Canada.,Centre de recherche du CHU de Québec-Université Laval, Québec, QC, Canada
| | - Yves Grégoire
- Affaires Médicales et Innovation, Héma-Québec, Québec, QC, Canada
| | - Josée Perreault
- Affaires Médicales et Innovation, Héma-Québec, Québec, QC, Canada
| | - Mathieu Drouin
- Affaires Médicales et Innovation, Héma-Québec, Québec, QC, Canada
| | | | - Tony Tremblay
- Affaires Médicales et Innovation, Héma-Québec, Québec, QC, Canada
| | - Julie Beaudoin
- Qualité et développement, Héma-Québec, Montréal, QC, Canada
| | - Amélie Boivin
- Affaires Médicales et Innovation, Héma-Québec, Montréal, QC, Canada
| | - Guillaume Goyette
- Centre de Recherche du CHUM, Montréal, QC, Canada.,Département de Microbiologie, Infectiologie et Immunologie, Université de Montréal, Montréal, QC, Canada
| | - Andrés Finzi
- Centre de Recherche du CHUM, Montréal, QC, Canada.,Département de Microbiologie, Infectiologie et Immunologie, Université de Montréal, Montréal, QC, Canada
| | - Renée Bazin
- Affaires Médicales et Innovation, Héma-Québec, Québec, QC, Canada
| | - Marc Germain
- Affaires Médicales et Innovation, Héma-Québec, Québec, QC, Canada
| | - Gilles Delage
- Affaires Médicales et Innovation, Héma-Québec, Montréal, QC, Canada
| | - Christian Renaud
- Affaires Médicales et Innovation, Héma-Québec, Montréal, QC, Canada.
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30
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Carazo S, Pelletier M, Talbot D, Jauvin N, De Serres G, Vézina M. Psychological Distress of Healthcare Workers in Québec (Canada) During the Second and the Third Pandemic Waves. J Occup Environ Med 2022; 64:495-503. [PMID: 35051960 PMCID: PMC9275796 DOI: 10.1097/jom.0000000000002487] [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] [Indexed: 12/20/2022]
Abstract
OBJECTIVE We aimed to measure the prevalence of psychological distress among Quebec healthcare workers (HCWs) during the second and third pandemic waves and to assess the effect of psychosocial risk factors (PSRs) on work-related psychological distress among severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infected (cases) and non-infected (controls) HCWs. METHODS A self-administered survey was used to measure validated indicators of psychological distress (K6 scale) and PSR (questions based on Karasek and Siegrist models, value conflicts, and work-life balance). Adjusted robust Poisson models were used to estimate prevalence ratios. RESULTS Four thousand sixty eight cases and 4152 controls completed the survey. Prevalence of high work-related psychological distress was 42%; it was associated with PSRs (mainly work-life balance, value conflicts, and high psychological demands) but not with SARS-CoV-2 infection. CONCLUSION Primary prevention measures targeting PSRs are needed to reduce mental health risks of HCWs.
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Affiliation(s)
- Sara Carazo
- From the Centre Hospitalier Universitaire de Québec-Laval University Research Center (Dr Carazo, Dr Talbot, Dr Serres); Biological and Occupational Risks Unit, Quebec National Institute of Public Health (Dr Carazo, Dr Pelletier, Dr Jauvin, Dr Serres, Dr Vézina); Social and Preventive Medicine Department, Faculty of Medicine, Laval University (Dr Talbot, Dr Serres, Dr Vézina), Québec, Québec, Canada
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31
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Godbout A, Drolet M, Mondor M, Simard M, Sauvageau C, De Serres G, Brisson M. Time trends in social contacts of individuals according to comorbidity and vaccination status, before and during the COVID-19 pandemic. BMC Med 2022; 20:199. [PMID: 35606803 PMCID: PMC9126104 DOI: 10.1186/s12916-022-02398-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Accepted: 05/09/2022] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND As we are confronted with more transmissible/severe variants with immune escape and the waning of vaccine efficacy, it is particularly relevant to understand how the social contacts of individuals at greater risk of COVID-19 complications evolved over time. We described time trends in social contacts of individuals according to comorbidity and vaccination status before and during the first three waves of the COVID-19 pandemic in Quebec, Canada. METHODS We used data from CONNECT, a repeated cross-sectional population-based survey of social contacts conducted before (2018/2019) and during the pandemic (April 2020 to July 2021). We recruited non-institutionalized adults from Quebec, Canada, by random digit dialling. We used a self-administered web-based questionnaire to measure the number of social contacts of participants (two-way conversation at a distance ≤2 m or a physical contact, irrespective of masking). We compared the mean number of contacts/day according to the comorbidity status of participants (pre-existing medical conditions with symptoms/medication in the past 12 months) and 1-dose vaccination status during the third wave. All analyses were performed using weighted generalized linear models with a Poisson distribution and robust variance. RESULTS A total of 1441 and 5185 participants with and without comorbidities, respectively, were included in the analyses. Contacts significantly decreased from a mean of 6.1 (95%CI 4.9-7.3) before the pandemic to 3.2 (95%CI 2.5-3.9) during the first wave among individuals with comorbidities and from 8.1 (95%CI 7.3-9.0) to 2.7 (95%CI 2.2-3.2) among individuals without comorbidities. Individuals with comorbidities maintained fewer contacts than those without comorbidities in the second wave, with a significant difference before the Christmas 2020/2021 holidays (2.9 (95%CI 2.5-3.2) vs 3.9 (95%CI 3.5-4.3); P<0.001). During the third wave, contacts were similar for individuals with (4.1, 95%CI 3.4-4.7) and without comorbidities (4.5, 95%CI 4.1-4.9; P=0.27). This could be partly explained by individuals with comorbidities vaccinated with their first dose who increased their contacts to the level of those without comorbidities. CONCLUSIONS It will be important to closely monitor COVID-19-related outcomes and social contacts by comorbidity and vaccination status to inform targeted or population-based interventions (e.g., booster doses of the vaccine).
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Affiliation(s)
- Aurélie Godbout
- Centre de recherche du CHU de Québec-Université Laval, 1050 Chemin Sainte-Foy, Québec, G1S 4L8, Canada.,Laval University, Québec, Canada
| | - Mélanie Drolet
- Centre de recherche du CHU de Québec-Université Laval, 1050 Chemin Sainte-Foy, Québec, G1S 4L8, Canada
| | - Myrto Mondor
- Centre de recherche du CHU de Québec-Université Laval, 1050 Chemin Sainte-Foy, Québec, G1S 4L8, Canada
| | - Marc Simard
- Institut National de Santé Publique du Québec, Québec, Canada
| | - Chantal Sauvageau
- Centre de recherche du CHU de Québec-Université Laval, 1050 Chemin Sainte-Foy, Québec, G1S 4L8, Canada.,Laval University, Québec, Canada.,Institut National de Santé Publique du Québec, Québec, Canada
| | - Gaston De Serres
- Centre de recherche du CHU de Québec-Université Laval, 1050 Chemin Sainte-Foy, Québec, G1S 4L8, Canada.,Laval University, Québec, Canada.,Institut National de Santé Publique du Québec, Québec, Canada
| | - Marc Brisson
- Centre de recherche du CHU de Québec-Université Laval, 1050 Chemin Sainte-Foy, Québec, G1S 4L8, Canada. .,Laval University, Québec, Canada. .,MRC Centre for Global Infectious Disease Analysis, School of Public Health, Imperial College London, London, UK.
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Drolet M, Godbout A, Mondor M, Béraud G, Drolet-Roy L, Lemieux-Mellouki P, Bureau A, Demers É, Boily MC, Sauvageau C, De Serres G, Hens N, Beutels P, Dervaux B, Brisson M. Time trends in social contacts before and during the COVID-19 pandemic: the CONNECT study. BMC Public Health 2022; 22:1032. [PMID: 35606703 PMCID: PMC9125550 DOI: 10.1186/s12889-022-13402-7] [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] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Accepted: 05/04/2022] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Since the beginning of the COVID-19 pandemic, many countries, including Canada, have adopted unprecedented physical distancing measures such as closure of schools and non-essential businesses, and restrictions on gatherings and household visits. We described time trends in social contacts for the pre-pandemic and pandemic periods in Quebec, Canada. METHODS CONNECT is a population-based study of social contacts conducted shortly before (2018/2019) and during the COVID-19 pandemic (April 2020 - February 2021), using the same methodology for both periods. We recruited participants by random digit dialing and collected data by self-administered web-based questionnaires. Questionnaires documented socio-demographic characteristics and social contacts for two assigned days. A contact was defined as a two-way conversation at a distance ≤ 2 m or as a physical contact, irrespective of masking. We used weighted generalized linear models with a Poisson distribution and robust variance (taking possible overdispersion into account) to compare the mean number of social contacts over time and by socio-demographic characteristics. RESULTS A total of 1291 and 5516 Quebecers completed the study before and during the pandemic, respectively. Contacts significantly decreased from a mean of 8 contacts/day prior to the pandemic to 3 contacts/day during the spring 2020 lockdown. Contacts remained lower than the pre-COVID period thereafter (lowest = 3 contacts/day during the Christmas 2020/2021 holidays, highest = 5 in September 2020). Contacts at work, during leisure activities/in other locations, and at home with visitors showed the greatest decreases since the beginning of the pandemic. All sociodemographic subgroups showed significant decreases of contacts since the beginning of the pandemic. The mixing matrices illustrated the impact of public health measures (e.g. school closure, gathering restrictions) with fewer contacts between children/teenagers and fewer contacts outside of the three main diagonals of contacts between same-age partners/siblings and between children and their parents. CONCLUSION Physical distancing measures in Quebec significantly decreased social contacts, which most likely mitigated the spread of COVID-19.
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Affiliation(s)
- Mélanie Drolet
- Centre de Recherche du CHU de Québec - Université Laval, Québec, Québec, Canada
| | - Aurélie Godbout
- Centre de Recherche du CHU de Québec - Université Laval, Québec, Québec, Canada
- Laval University, Québec, Québec, Canada
| | - Myrto Mondor
- Centre de Recherche du CHU de Québec - Université Laval, Québec, Québec, Canada
| | - Guillaume Béraud
- Department of Infectious Diseases, Centre Hospitalier Universitaire de Poitiers, 86021, Poitiers, France
| | - Léa Drolet-Roy
- Centre de Recherche du CHU de Québec - Université Laval, Québec, Québec, Canada
| | - Philippe Lemieux-Mellouki
- Centre de Recherche du CHU de Québec - Université Laval, Québec, Québec, Canada
- Laval University, Québec, Québec, Canada
| | - Alexandre Bureau
- Laval University, Québec, Québec, Canada
- CERVO Brain Research Center, Centre Intégré Universitaire de Santé Et de Services Sociaux de La Capitale-Nationale, Québec, QC, Canada
| | - Éric Demers
- Centre de Recherche du CHU de Québec - Université Laval, Québec, Québec, Canada
| | - Marie-Claude Boily
- MRC Centre for Global Infectious Disease Analysis, School of Public Health, Imperial College London, London, UK
| | - Chantal Sauvageau
- Centre de Recherche du CHU de Québec - Université Laval, Québec, Québec, Canada
- Laval University, Québec, Québec, Canada
- Institut National de Santé Publique du Québec, Québec, Québec, Canada
| | - Gaston De Serres
- Centre de Recherche du CHU de Québec - Université Laval, Québec, Québec, Canada
- Laval University, Québec, Québec, Canada
- Institut National de Santé Publique du Québec, Québec, Québec, Canada
| | - Niel Hens
- I-BioStat, Data Science Institute, Hasselt University, Hasselt, Belgium
- Centre for Health Economic Research and Modelling Infectious Diseases, Vaccine and Infectious Disease Institute, University of Antwerp, Antwerp, Belgium
| | - Philippe Beutels
- Centre for Health Economic Research and Modelling Infectious Diseases, Vaccine and Infectious Disease Institute, University of Antwerp, Antwerp, Belgium
- School of Public Health, University of New South Wales, Sydney, Australia
| | - Benoit Dervaux
- Institut Pasteur U1167 - RID-AGE - Facteurs de risque et déterminants moléculaires des maladies liées au vieillissement, Univ Lille, Inserm, CHU Lille, 59000, Lille, France
| | - Marc Brisson
- Centre de Recherche du CHU de Québec - Université Laval, Québec, Québec, Canada.
- Laval University, Québec, Québec, Canada.
- MRC Centre for Global Infectious Disease Analysis, School of Public Health, Imperial College London, London, UK.
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Racine É, Boivin G, Longtin Y, McCormack D, Decaluwe H, Savard P, Cheng MP, Hamelin MÈ, Carbonneau J, Tadount F, Adams K, Bourdin B, Nantel S, Gilca V, Corbeil J, De Serres G, Quach-Thanh C. The REinfection in COVID-19 Estimation of Risk (RECOVER) study: Reinfection and serology dynamics in a cohort of Canadian healthcare workers. Influenza Other Respir Viruses 2022; 16:916-925. [PMID: 35510653 PMCID: PMC9343327 DOI: 10.1111/irv.12997] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2022] [Revised: 04/22/2022] [Accepted: 04/25/2022] [Indexed: 11/30/2022] Open
Abstract
Background Understanding the immune response to natural infection by SARS‐CoV‐2 is key to pandemic management, especially in the current context of emerging variants. Uncertainty remains regarding the efficacy and duration of natural immunity against reinfection. Methods We conducted an observational prospective cohort study in Canadian healthcare workers (HCWs) with a history of PCR‐confirmed SARS‐CoV‐2 infection to (i) measure the average incidence rate of reinfection and (ii) describe the serological immune response to the primary infection. Results Our cohort comprised 569 HCWs; median duration of individual follow‐up was 371 days. We detected six cases of reinfection in absence of vaccination between August 21, 2020, and March 1, 2022, for a reinfection incidence rate of 4.0 per 100 person‐years. Median duration of seropositivity was 415 days in symptomatics at primary infection compared with 213 days in asymptomatics (p < 0.0001). Other characteristics associated with prolonged seropositivity for IgG against the spike protein included age over 55 years, obesity, and non‐Caucasian ethnicity. Conclusions Among unvaccinated healthcare workers, reinfection with SARS‐CoV‐2 following a primary infection remained rare. SARS‐CoV‐2 reinfections remained rare events among unvaccinated healthcare workers. Prior natural infection confers some protection against reinfection and clinical disease, but waning of serum antibodies suggests this protection may not last in the long term.
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Affiliation(s)
- Étienne Racine
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Quebec, Canada.,Sainte-Justine Hospital Health and Research Center, Montreal, Quebec, Canada
| | - Guy Boivin
- Department of Microbiology-Immunology and Infectious Diseases, Laval University, Quebec City, Quebec, Canada.,Infectious and Immune Diseases Axis, Research Center of the Centre Hospitalier de l'Université Laval, Quebec City, Quebec, Canada
| | - Yves Longtin
- Jewish General Hospital and Lady Davis Research Institute, Montreal, Quebec, Canada
| | | | - Hélène Decaluwe
- Immune Diseases and Cancer Axis, Sainte-Justine Hospital University Health and Research Center, Montreal, Quebec, Canada.,Department of Pediatrics, University of Montreal, Montreal, Quebec, Canada
| | - Patrice Savard
- Department of Microbiology, Infectious Diseases and Immunology, University of Montreal, Montreal, Quebec, Canada.,Immunopathology Axis, Research Center of the Centre Hospitalier de l'Université de Montréal, Montreal, Quebec, Canada.,Infectious Disease Service, Centre Hospitalier de l'Université de Montréal, Montreal, Quebec, Canada
| | - Matthew P Cheng
- Divisions of Infectious Diseases and Medical Microbiology, McGill University Health Center, McGill University, Montreal, Quebec, Canada.,McGill Interdisciplinary Initiative in Infection and Immunity, Montreal, Quebec, Canada
| | - Marie-Ève Hamelin
- Infectious and Immune Diseases Axis, Research Center of the Centre Hospitalier de l'Université Laval, Quebec City, Quebec, Canada
| | - Julie Carbonneau
- Infectious and Immune Diseases Axis, Research Center of the Centre Hospitalier de l'Université Laval, Quebec City, Quebec, Canada
| | - Fazia Tadount
- Sainte-Justine Hospital Health and Research Center, Montreal, Quebec, Canada
| | - Kelsey Adams
- Sainte-Justine Hospital Health and Research Center, Montreal, Quebec, Canada
| | - Benoîte Bourdin
- Immune Diseases and Cancer Axis, Sainte-Justine Hospital University Health and Research Center, Montreal, Quebec, Canada
| | - Sabryna Nantel
- Immune Diseases and Cancer Axis, Sainte-Justine Hospital University Health and Research Center, Montreal, Quebec, Canada.,Department of Microbiology, Infectiology and Immunology, University of Montreal, Montreal, Quebec, Canada
| | - Vladimir Gilca
- Quebec National Public Health Institute, Quebec City, Quebec, Canada
| | - Jacques Corbeil
- Department of Molecular Medicine, Big Data Research Center, Institute Intelligence and Data, Laval University, Quebec City, QC, Canada.,Infectiology Research Center of the Centre Hospitalier Universitaire de Québec, Quebec City, QC, Canada
| | - Gaston De Serres
- Quebec National Public Health Institute, Quebec City, Quebec, Canada.,Department of Social and Preventive Medicine, Laval University, Quebec City, Quebec, Canada
| | - Caroline Quach-Thanh
- Department of Microbiology, Infectious Diseases, and Immunology, University of Montreal, Montreal, Quebec, Canada.,Sainte-Justine Hospital University Health and Research Center, Montreal, Quebec, Canada
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34
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Bensaidane MR, Picher-Martel V, Émond F, De Serres G, Dupré N, Beauchemin P. Case Report: Acute Necrotizing Encephalopathy Following COVID-19 Vaccine. Front Neurol 2022; 13:872734. [PMID: 35572945 PMCID: PMC9099242 DOI: 10.3389/fneur.2022.872734] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Accepted: 03/28/2022] [Indexed: 11/29/2022] Open
Abstract
Objectives Acute necrotizing encephalopathy (ANE) is a rare neurological disorder arising from a para- or post-infectious "cytokine storm. "It has recently been reported in association with coronavirus disease 2019 (COVID-19) infection. Methods A 56-year-old male with a diagnosis of ANE 48 h following the first dose of ChAdOx1 nCoV-19 vaccination was investigated. Cytokine analyses on serum and cerebrospinal fluid (CSF) were performed. The patient was treated with high-dose corticosteroids and followed clinically and radiologically. Results Favorable clinical and radiological outcomes were noted. There was an upregulation in serum levels of CXCL5, CXCL1, Il-8, IL-15, CCL2, TGF-B, and EGF, and up-regulation in CSF levels of CXCL5, IL-2, IL-3, and IL-8. Discussion As COVID-19 infection has been previously reported as a possible rare cause of ANE, we speculate on an aberrant immune response mechanism that was brought about by the vaccine. To increase our understanding of the pathogenesis of ANE in the context of COVID-19 vaccination and to better define its clinical features and outcomes, clinicians and scientists should continue reporting convincing cases of such entities.
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Affiliation(s)
- Mohamed Reda Bensaidane
- Department of Medicine, Faculty of Medicine, Centre Hospitalier Universitaire de Québec—Université Laval, Quebec, QC, Canada
| | - Vincent Picher-Martel
- Department of Medicine, Faculty of Medicine, Centre Hospitalier Universitaire de Québec—Université Laval, Quebec, QC, Canada
- Department of Psychiatry and Neuroscience, Faculty of Medicine, CERVO Brain Research Centre, Quebec, QC, Canada
| | - François Émond
- Department of Medicine, Faculty of Medicine, Centre Hospitalier Universitaire de Québec—Université Laval, Quebec, QC, Canada
| | - Gaston De Serres
- Institut National de Santé Publique du Québec, Quebec, QC, Canada
| | - Nicolas Dupré
- Department of Medicine, Faculty of Medicine, Centre Hospitalier Universitaire de Québec—Université Laval, Quebec, QC, Canada
| | - Philippe Beauchemin
- Department of Medicine, Faculty of Medicine, Centre Hospitalier Universitaire de Québec—Université Laval, Quebec, QC, Canada
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35
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Skowronski DM, Febriani Y, Ouakki M, Setayeshgar S, El Adam S, Zou M, Talbot D, Prystajecky N, Tyson JR, Gilca R, Brousseau N, Deceuninck G, Galanis E, Fjell CD, Sbihi H, Fortin E, Barkati S, Sauvageau C, Naus M, Patrick DM, Henry B, Hoang LMN, De Wals P, Garenc C, Carignan A, Drolet M, Jassem AN, Sadarangani M, Brisson M, Krajden M, De Serres G. Two-Dose Severe Acute Respiratory Syndrome Coronavirus 2 Vaccine Effectiveness With Mixed Schedules and Extended Dosing Intervals: Test-Negative Design Studies From British Columbia and Quebec, Canada. Clin Infect Dis 2022; 75:1980-1992. [PMID: 35438175 PMCID: PMC9047203 DOI: 10.1093/cid/ciac290] [Citation(s) in RCA: 54] [Impact Index Per Article: 27.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Indexed: 01/17/2023] Open
Abstract
BACKGROUND The Canadian coronavirus disease 2019 (COVID-19) immunization strategy deferred second doses and allowed mixed schedules. We compared 2-dose vaccine effectiveness (VE) by vaccine type (mRNA and/or ChAdOx1), interval between doses, and time since second dose in 2 of Canada's larger provinces. METHODS Two-dose VE against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection or hospitalization among adults ≥18 years, including due to Alpha, Gamma, and Delta variants of concern (VOCs), was assessed ≥14 days postvaccination by test-negative design studies separately conducted in British Columbia and Quebec, Canada, between 30 May and 27 November (epi-weeks 22-47) 2021. RESULTS In both provinces, all homologous or heterologous mRNA and/or ChAdOx1 2-dose schedules were associated with ≥90% reduction in SARS-CoV-2 hospitalization risk for ≥7 months. With slight decline from a peak of >90%, VE against infection was ≥80% for ≥6 months following homologous mRNA vaccination, lower by ∼10% when both doses were ChAdOx1 but comparably high following heterologous ChAdOx1 + mRNA receipt. Findings were similar by age group, sex, and VOC. VE was significantly higher with longer 7-8-week versus manufacturer-specified 3-4-week intervals between mRNA doses. CONCLUSIONS Two doses of any mRNA and/or ChAdOx1 combination gave substantial and sustained protection against SARS-CoV-2 hospitalization, spanning Delta-dominant circulation. ChAdOx1 VE against infection was improved by heterologous mRNA series completion. A 7-8-week interval between first and second doses improved mRNA VE and may be the optimal schedule outside periods of intense epidemic surge. Findings support interchangeability and extended intervals between SARS-CoV-2 vaccine doses, with potential global implications for low-coverage areas and, going forward, for children.
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Affiliation(s)
- Danuta M Skowronski
- Correspondence: D. M. Skowronski, BC Centre for Disease Control, 655 West 12th Avenue, Vancouver, BC, Canada V5Z 4R4 ()
| | - Yossi Febriani
- Centre Hospitalier Universitaire (CHU) de Québec-Université Laval Research Center, Quebec City, Quebec, Canada
| | - Manale Ouakki
- Institut National de Sante Publique du Québec, Biological and Occupational Risks, Quebec City, Quebec, Canada
| | - Solmaz Setayeshgar
- BC Centre for Disease Control, Communicable Diseases and Immunization Services, Vancouver, British Columbia, Canada
| | - Shiraz El Adam
- BC Centre for Disease Control, Communicable Diseases and Immunization Services, Vancouver, British Columbia, Canada
| | - Macy Zou
- BC Centre for Disease Control, Data and Analytics Services, Vancouver, British Columbia, Canada
| | - Denis Talbot
- Centre Hospitalier Universitaire (CHU) de Québec-Université Laval Research Center, Quebec City, Quebec, Canada,Laval University, Department of Social and Preventive Medicine, Faculty of Medicine, Quebec City, Quebec, Canada
| | - Natalie Prystajecky
- BC Centre for Disease Control, Public Health Laboratory, Vancouver, British Columbia, Canada,University of British Columbia, Department of Pathology and Laboratory Medicine, Vancouver, British Columbia, Canada
| | - John R Tyson
- BC Centre for Disease Control, Public Health Laboratory, Vancouver, British Columbia, Canada
| | - Rodica Gilca
- Centre Hospitalier Universitaire (CHU) de Québec-Université Laval Research Center, Quebec City, Quebec, Canada,Institut National de Sante Publique du Québec, Biological and Occupational Risks, Quebec City, Quebec, Canada,Laval University, Department of Social and Preventive Medicine, Faculty of Medicine, Quebec City, Quebec, Canada
| | - Nicholas Brousseau
- Centre Hospitalier Universitaire (CHU) de Québec-Université Laval Research Center, Quebec City, Quebec, Canada,Institut National de Sante Publique du Québec, Biological and Occupational Risks, Quebec City, Quebec, Canada,Laval University, Department of Social and Preventive Medicine, Faculty of Medicine, Quebec City, Quebec, Canada
| | - Geneviève Deceuninck
- Centre Hospitalier Universitaire (CHU) de Québec-Université Laval Research Center, Quebec City, Quebec, Canada
| | - Eleni Galanis
- BC Centre for Disease Control, Communicable Diseases and Immunization Services, Vancouver, British Columbia, Canada,University of British Columbia, School of Population and Public Health, Vancouver, British Columbia, Canada
| | - Chris D Fjell
- BC Centre for Disease Control, Public Health Laboratory, Vancouver, British Columbia, Canada
| | - Hind Sbihi
- University of British Columbia, School of Population and Public Health, Vancouver, British Columbia, Canada,BC Centre for Disease Control, Data and Analytics Services, Vancouver, British Columbia, Canada
| | - Elise Fortin
- Institut National de Sante Publique du Québec, Biological and Occupational Risks, Quebec City, Quebec, Canada,Laval University, Department of Social and Preventive Medicine, Faculty of Medicine, Quebec City, Quebec, Canada,Université de Montréal, Département de Microbiologie, Infectiologie et Immunologie, Montreal, Quebec, Canada
| | - Sapha Barkati
- McGill University, Department of Medicine, Division of Infectious Diseases, McGill University Health Center, Montreal, Quebec, Canada
| | - Chantal Sauvageau
- Centre Hospitalier Universitaire (CHU) de Québec-Université Laval Research Center, Quebec City, Quebec, Canada,Institut National de Sante Publique du Québec, Biological and Occupational Risks, Quebec City, Quebec, Canada,Laval University, Department of Social and Preventive Medicine, Faculty of Medicine, Quebec City, Quebec, Canada
| | - Monika Naus
- BC Centre for Disease Control, Communicable Diseases and Immunization Services, Vancouver, British Columbia, Canada,University of British Columbia, School of Population and Public Health, Vancouver, British Columbia, Canada
| | - David M Patrick
- BC Centre for Disease Control, Communicable Diseases and Immunization Services, Vancouver, British Columbia, Canada,University of British Columbia, School of Population and Public Health, Vancouver, British Columbia, Canada
| | - Bonnie Henry
- University of British Columbia, School of Population and Public Health, Vancouver, British Columbia, Canada,Office of the Provincial Health Officer, Ministry of Health, Victoria, British Columbia, Canada
| | - Linda M N Hoang
- BC Centre for Disease Control, Public Health Laboratory, Vancouver, British Columbia, Canada,University of British Columbia, Department of Pathology and Laboratory Medicine, Vancouver, British Columbia, Canada
| | - Philippe De Wals
- Centre Hospitalier Universitaire (CHU) de Québec-Université Laval Research Center, Quebec City, Quebec, Canada,Institut National de Sante Publique du Québec, Biological and Occupational Risks, Quebec City, Quebec, Canada,Laval University, Department of Social and Preventive Medicine, Faculty of Medicine, Quebec City, Quebec, Canada
| | - Christophe Garenc
- Centre Hospitalier Universitaire (CHU) de Québec-Université Laval Research Center, Quebec City, Quebec, Canada,Institut National de Sante Publique du Québec, Biological and Occupational Risks, Quebec City, Quebec, Canada
| | - Alex Carignan
- Sherbrooke University, Department of Microbiology and Infectious Diseases, Sherbrooke, Quebec, Canada
| | - Mélanie Drolet
- Centre Hospitalier Universitaire (CHU) de Québec-Université Laval Research Center, Quebec City, Quebec, Canada,Laval University, Department of Social and Preventive Medicine, Faculty of Medicine, Quebec City, Quebec, Canada
| | - Agatha N Jassem
- BC Centre for Disease Control, Public Health Laboratory, Vancouver, British Columbia, Canada,University of British Columbia, Department of Pathology and Laboratory Medicine, Vancouver, British Columbia, Canada
| | - Manish Sadarangani
- BC Children’s Hospital Research Institute, Vaccine Evaluation Center, Vancouver, British Columbia, Canada,University of British Columbia, Department of Pediatrics, Vancouver, British Columbia, Canada
| | - Marc Brisson
- Centre Hospitalier Universitaire (CHU) de Québec-Université Laval Research Center, Quebec City, Quebec, Canada,Laval University, Department of Social and Preventive Medicine, Faculty of Medicine, Quebec City, Quebec, Canada
| | - Mel Krajden
- BC Centre for Disease Control, Public Health Laboratory, Vancouver, British Columbia, Canada,University of British Columbia, Department of Pathology and Laboratory Medicine, Vancouver, British Columbia, Canada
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Suresh S, Zafack J, Pham-Huy A, Derfalvi B, Sadarangani M, McConnell A, Tapiéro B, Halperin SA, De Serres G, M Pernica J, Top KA. Physician vaccination practices in mild to moderate inborn errors of immunity and retrospective review of vaccine completeness in IEI: results from the Canadian Immunization Research Network. Allergy Asthma Clin Immunol 2022; 18:32. [PMID: 35397595 PMCID: PMC8994318 DOI: 10.1186/s13223-022-00667-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Accepted: 03/08/2022] [Indexed: 11/26/2022]
Abstract
Background and objectives Safety and effectiveness concerns may preclude physicians from recommending vaccination in mild/moderate inborn errors of immunity (IEI). This study describes attitudes and practices regarding vaccination among physicians who care for patients with mild/moderate B cell or mild/moderate combined immunodeficiencies (CID) and vaccination completeness among patients diagnosed with IEIs. Methods Canadian physicians caring for children with IEI were surveyed about attitudes and practices regarding vaccination in mild/moderate IEI. Following informed consent, immunization records of pediatric patients with IEI evaluated before 7 years of age were reviewed. Vaccine completeness was defined at age 2 years as 4 doses of diphtheria-tetanus-pertussis (DTaP), 3 doses pneumococcal conjugate (PCV), and 1 dose measles-mumps-rubella (MMR) vaccines. At 7 years 5 doses of DTP and 2 doses MMR were required. Results Forty-five physicians from 8 provinces completed the survey. Most recommended inactivated vaccines for B cell deficiency: (84% (38/45) and CID (73% (33/45). Fewer recommended live attenuated vaccines (B cell: 53% (24/45), CID 31% (14/45)). Of 96 patients with IEI recruited across 7 centers, vaccination completeness at age 2 was 25/43 (58%) for predominantly antibody, 3/13 (23%) for CID, 7/35 (20%) for CID with syndromic features, and 4/4 (100%) for innate/phagocyte defects. Completeness at age 7 was 15%, 17%, 5%, and 33%, respectively. Conclusion Most physicians surveyed recommended inactivated vaccines in children with mild to moderate IEI. Vaccine completeness for all IEI was low, particularly at age 7. Further studies should address the reasons for low vaccine uptake among children with IEI and whether those with mild-moderate IEI, where vaccination is recommended, eventually receive all indicated vaccines. Supplementary Information The online version contains supplementary material available at 10.1186/s13223-022-00667-1.
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Affiliation(s)
- Sneha Suresh
- Division of Immunology, Department of Pediatrics, Edmonton Clinic Health Academy, 3-529, 11405 87 Ave, Edmonton, AB, T6G 1C9, Canada. .,Division of Infectious Disease and IHOPE, Department of Paediatrics, Stollery Children's Hospital, University of Alberta, Edmonton, Canada.
| | | | - Anne Pham-Huy
- Division of Infectious Diseases, Immunology and Allergy, Department of Paediatrics, Children's Hospital of Eastern Ontario, University of Ottawa, Ottawa, Canada
| | - Beata Derfalvi
- Division of Immunology, Departments of Paediatrics and Microbiology and Immunology, IWK Health Centre, Dalhousie University, Halifax, Canada
| | - Manish Sadarangani
- Vaccine Evaluation Center, BC Children's Hospital Research Institute, Department of Pediatrics, University of British Columbia, Vancouver, Canada
| | - Athena McConnell
- Division of Infectious Diseases, Department of Pediatrics, Jim Pattison Children's Hospital, University of Saskatchewan, Saskatoon, Canada
| | - Bruce Tapiéro
- Division of Infectious Diseases, Department of Pediatrics, CHU Sainte Justine, Université de Montreal, Montreal, Canada
| | - Scott A Halperin
- Departments of Paediatrics and Microbiology and Immunology, Canadian Center for Vaccinology IWK Health Centre, Dalhousie University, Halifax, Canada
| | - Gaston De Serres
- Department of Social and Preventive Medicine, Institut Nationale de Santé Publique du Québec, Université Laval, Québec, Canada
| | - Jeffrey M Pernica
- Division of Infectious Diseases, Department of Pediatrics, McMaster University, Hamilton, Canada
| | - Karina A Top
- Departments of Pediatrics and Community Health and Epidemiology, Canadian Center for Vaccinology, IWK Health Centre, Dalhousie University, Halifax, Canada.
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Carazo S, Laliberté D, Villeneuve J, Martin R, Deshaies P, Denis G, Adib G, Tissot F, Dionne M, De Serres G. Characterization and evolution of infection control practices among severe acute respiratory coronavirus virus 2 (SARS-CoV-2)-infected healthcare workers in acute-care hospitals and long-term care facilities in Québec, Canada, Spring 2020. Infect Control Hosp Epidemiol 2022; 43:481-489. [PMID: 33853702 PMCID: PMC8111200 DOI: 10.1017/ice.2021.160] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Revised: 02/18/2021] [Accepted: 03/12/2021] [Indexed: 12/16/2022]
Abstract
OBJECTIVES In this study, we aimed to (1) estimate the severe acute respiratory coronavirus 2 (SARS-CoV-2) infection rate and the secondary attack rate among healthcare workers (HCWs) in Québec, the most affected province of Canada during the first wave; (2) describe the evolution of work-related exposures and infection prevention and control (IPC) practices in infected HCWs; and (3) compare the exposures and practices between acute-care hospitals (ACHs) and long-term care facilities (LTCFs). DESIGN Survey of cases. PARTICIPANTS The study included Québec HCWs from private and public institutions with laboratory-confirmed coronavirus disease 2019 (COVID-19) diagnosed between March 1 and June 14, 2020. HCWs aged ≥18 years who worked during the exposure period and survived their illness were eligible for the survey. METHODS After obtaining consent, 4,542 HCWs completed a standardized questionnaire. COVID-19 rates and proportions of exposures and practices were estimated and compared between ACHs and LTCFs. RESULTS HCWs represented 13,726 (25%) of 54,005 reported COVID-19 cases in Québec and had an 11-times greater rate of COVID-19 than non-HCWs. Their secondary household attack rate was 30%. Most affected occupations were healthcare support workers, nurses and nurse assistants working in LTCFs (45%) and ACHs (30%). Compared to ACHs, HCWs in LTCFs had less training, higher staff mobility between working sites, similar PPE use, and better self-reported compliance with at-work physical distancing. Suboptimal IPC practices declined over time but were still present at the end of the first wave. CONCLUSION Québec HCWs and their families were severely affected during the first wave of COVID-19. Insufficient pandemic preparedness and suboptimal IPC practices likely contributed to high transmission in both LTCFs and ACHs.
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Affiliation(s)
- Sara Carazo
- CHU de Québec-Université Laval Research Center, Québec, Québec, Canada
| | - Denis Laliberté
- Department of Social and Preventive Medicine, Laval University, Québec, Québec, Canada
- CIUSSS de la Capitale-Nationale, Québec, Québec, Canada
| | - Jasmin Villeneuve
- Institut National de Santé Publique du Québec, Québec, Québec, Canada
| | - Richard Martin
- Institut National de Santé Publique du Québec, Québec, Québec, Canada
| | | | - Geoffroy Denis
- CIUSSS Centre Sud de Montréal, Montreal, Québec, Canada
- McGill University, Montreal, Québec, Canada
| | - Georges Adib
- Institut National de Santé Publique du Québec, Québec, Québec, Canada
| | - France Tissot
- Institut National de Santé Publique du Québec, Québec, Québec, Canada
| | - Marc Dionne
- CHU de Québec-Université Laval Research Center, Québec, Québec, Canada
| | - Gaston De Serres
- CHU de Québec-Université Laval Research Center, Québec, Québec, Canada
- Department of Social and Preventive Medicine, Laval University, Québec, Québec, Canada
- Institut National de Santé Publique du Québec, Québec, Québec, Canada
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38
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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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39
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Bettinger JA, Sadarangani M, De Serres G, Valiquette L, Vanderkooi OG, Kellner JD, Muller MP, Top KA, Isenor JE, McGeer A, Marty K. The Canadian National Vaccine Safety Network: surveillance of adverse events following immunisation among individuals immunised with the COVID-19 vaccine, a cohort study in Canada. BMJ Open 2022; 12:e051254. [PMID: 35058258 PMCID: PMC8783966 DOI: 10.1136/bmjopen-2021-051254] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [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] [Indexed: 11/05/2022] Open
Abstract
INTRODUCTION COVID-19 vaccines require enhanced safety monitoring after emergency approval. The Canadian National Vaccine Safety Network monitors the safety of COVID-19 vaccines and provides enhanced monitoring for healthy, auto-immune, immunocompromised, pregnant and breastfeeding populations and allows for the detection of safety signals. METHODS AND ANALYSIS Online participant reporting of health events in vaccinated and unvaccinated individuals 12 years of age and older is captured in three surveys: 1 week after dose 1, 1 week after dose 2 and 7 months after dose 1. Medically attended events are followed up by telephone. The number, percentage, rate per 10 000 and incident rate ratios with 95% CIs are calculated by health event, vaccine type, sex and in 10-year age groups. ETHICS AND DISSEMINATION Each study site has Research Ethics Board approvals for the project (UBC Children's & Women's, CIUSSS de l'Estrie-CHUS, Health PEI, Conjoint Health Research Ethics Board, University of Calgary and Alberta Health Services, IWK Health, Unity Health Toronto and CHU de Québec-Université Laval Research Ethics Boards). Individuals are invited to participate in this active surveillance and electronic consent is given before proceeding to each survey. Weekly reports are shared with public health and posted on the study website. At least one peer-reviewed manuscript is produced.
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Affiliation(s)
- Julie A Bettinger
- Vaccine Evaluation Center, BC Children's Hospital Research Institute, Vancouver, British Columbia, Canada
- Pediatrics, University of British Columbia, Vancouver, British Columbia, Canada
| | - Manish Sadarangani
- Vaccine Evaluation Center, BC Children's Hospital Research Institute, Vancouver, British Columbia, Canada
- Pediatrics, University of British Columbia, Vancouver, British Columbia, Canada
| | | | - Louis Valiquette
- Centre Intégré Universitaire de Santé et de Services Sociaux de l'Estrie-Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke, Quebec, Canada
| | - Otto G Vanderkooi
- Alberta Children's Hospital Research Institute, Calgary, Alberta, Canada
- Pediatrics, University of Calgary, Calgary, Alberta, Canada
| | - James D Kellner
- Alberta Children's Hospital Research Institute, Calgary, Alberta, Canada
- Pediatrics, University of Calgary, Calgary, Alberta, Canada
| | - Matthew P Muller
- Medicine, Unity Health Toronto, Toronto, Ontario, Canada
- University of Toronto, Toronto, Ontario, Canada
| | - Karina A Top
- Canadian Center for Vaccinology, Dalhousie University, Halifax, Nova Scotia, Canada
- Pediatrics, IWK Health Centre, Halifax, Nova Scotia, Canada
| | - Jennifer E Isenor
- Canadian Center for Vaccinology, Dalhousie University, Halifax, Nova Scotia, Canada
- College of Pharmacy, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Allison McGeer
- University of Toronto, Toronto, Ontario, Canada
- Sinai Health System, Toronto, Ontario, Canada
| | - Kimberly Marty
- Vaccine Evaluation Center, BC Children's Hospital Research Institute, Vancouver, British Columbia, Canada
- Pediatrics, University of British Columbia, Vancouver, British Columbia, Canada
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40
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Tauzin A, Gong SY, Beaudoin-Bussières G, Vézina D, Gasser R, Nault L, Marchitto L, Benlarbi M, Chatterjee D, Nayrac M, Laumaea A, Prévost J, Boutin M, Sannier G, Nicolas A, Bourassa C, Gendron-Lepage G, Medjahed H, Goyette G, Bo Y, Perreault J, Gokool L, Morrisseau C, Arlotto P, Bazin R, Dubé M, De Serres G, Brousseau N, Richard J, Rovito R, Côté M, Tremblay C, Marchetti GC, Duerr R, Martel-Laferrière V, Kaufmann DE, Finzi A. Strong humoral immune responses against SARS-CoV-2 Spike after BNT162b2 mRNA vaccination with a 16-week interval between doses. Cell Host Microbe 2022; 30:97-109.e5. [PMID: 34953513 PMCID: PMC8639412 DOI: 10.1016/j.chom.2021.12.004] [Citation(s) in RCA: 54] [Impact Index Per Article: 27.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Revised: 11/08/2021] [Accepted: 11/29/2021] [Indexed: 12/21/2022]
Abstract
The standard regimen of the BNT162b2 mRNA vaccine for SARS-CoV-2 includes two doses administered three weeks apart. However, some public health authorities spaced these doses, raising questions about efficacy. We analyzed longitudinal humoral responses against the D614G strain and variants of concern for SARS-CoV-2 in a cohort of SARS-CoV-2-naive and previously infected individuals who received the BNT162b2 mRNA vaccine with sixteen weeks between doses. While administering a second dose to previously infected individuals did not significantly improve humoral responses, these responses significantly increased in naive individuals after a 16-week spaced second dose, achieving similar levels as in previously infected individuals. Comparing these responses to those elicited in individuals receiving a short (4-week) dose interval showed that a 16-week interval induced more robust responses among naive vaccinees. These findings suggest that a longer interval between vaccine doses does not compromise efficacy and may allow greater flexibility in vaccine administration.
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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
| | - 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
| | - 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
| | - Dani Vézina
- Centre de Recherche du CHUM, Montreal, QC H2X 0A9, Canada
| | - Romain Gasser
- Centre de Recherche du CHUM, Montreal, QC H2X 0A9, Canada; Département de Microbiologie, Infectiologie et Immunologie, Université de Montréal, Montreal, QC H2X 0A9, Canada
| | - Lauriane Nault
- 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
| | - Mehdi Benlarbi
- Centre de Recherche du CHUM, Montreal, QC H2X 0A9, Canada
| | | | - Manon Nayrac
- Centre de Recherche du CHUM, Montreal, QC H2X 0A9, Canada; Département de Microbiologie, Infectiologie et Immunologie, Université de Montréal, 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
| | - 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
| | - 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
| | - Gérémy Sannier
- Centre de Recherche du CHUM, Montreal, QC H2X 0A9, Canada; Département de Microbiologie, Infectiologie et Immunologie, Université de Montréal, Montreal, QC H2X 0A9, Canada
| | - Alexandre Nicolas
- 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, and Center for Infection, Immunity, and Inflammation, University of Ottawa, Ottawa ON K1H 8M5, 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
| | | | | | - Renée Bazin
- Héma-Québec, Affaires Médicales et Innovation, Quebec QC G1V 5C3, Canada
| | - Mathieu Dubé
- Centre de Recherche du CHUM, Montreal, QC H2X 0A9, Canada
| | - Gaston De Serres
- Institut National de Santé Publique du Québec, Quebec QC H2P 1E2, Canada
| | - Nicholas Brousseau
- Institut National de Santé Publique du Québec, Quebec QC H2P 1E2, 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
| | - Roberta Rovito
- Clinic of Infectious Diseases, Department of Health Sciences, ASST Santi Paolo e Carlo, University of Milan, Milan, Italy
| | - Marceline Côté
- Department of Biochemistry, Microbiology and Immunology, and Center for Infection, Immunity, and Inflammation, University of Ottawa, Ottawa ON K1H 8M5, 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
| | - Giulia C Marchetti
- Clinic of Infectious Diseases, Department of Health Sciences, ASST Santi Paolo e Carlo, University of Milan, Milan, Italy
| | - Ralf Duerr
- Department of Microbiology, New York University School of Medicine, New York, NY 10016, USA
| | - 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.
| | - 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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41
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Longtin Y, Charest H, Quach C, Savard P, Baz M, Boivin G, Farfard J, Villeneuve J, Roger M, De Serres G. Infectivity of healthcare workers diagnosed with coronavirus disease 2019 (COVID-19) approximately 2 weeks after onset of symptoms: A cross-sectional study. Infect Control Hosp Epidemiol 2022; 43:102-104. [PMID: 33427133 PMCID: PMC7853751 DOI: 10.1017/ice.2020.1420] [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] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2020] [Revised: 12/15/2020] [Accepted: 12/22/2020] [Indexed: 11/10/2022]
Abstract
We performed viral culture of respiratory specimens in 118 severe acute respiratory coronavirus virus 2 (SARS-CoV-2)-infected healthcare workers (HCWs), ∼2 weeks after symptom onset. Only 1 HCW (0.8%) had a positive culture. No factors for prolonged viral shedding were identified. Infectivity is resolved in nearly all HCWs ∼2 weeks after symptom onset.
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Affiliation(s)
- Yves Longtin
- Jewish General Hospital Sir Mortimer B. Davis, Montreal, Quebec, Canada
- Lady Davis Research Institute, Montreal, Quebec, Canada
| | - Hugues Charest
- Laboratoire de Santé Publique du Québec, Sainte-Anne-de-Bellevue, Quebec, Canada
- Université de Montréal Facultée de Médecine, Montreal, Quebec, Canada
- Institut National de Santé Publique du Québec, Quebec City, Quebec, Canada
| | - Caroline Quach
- Université de Montréal Facultée de Médecine, Montreal, Quebec, Canada
- Centre Hospitalier Universitaire Sainte-Justine, Montreal, Quebec, Canada
| | - Patrice Savard
- Université de Montréal Facultée de Médecine, Montreal, Quebec, Canada
- Centre Hospitalier de l’Université de Montréal, Montreal, Quebec, Canada
| | - Mariana Baz
- Centre de Recherche en Infectiologie de l’Université Laval, Quebec City, Quebec, Canada
| | - Guy Boivin
- Centre de Recherche en Infectiologie de l’Université Laval, Quebec City, Quebec, Canada
| | - Judith Farfard
- Laboratoire de Santé Publique du Québec, Sainte-Anne-de-Bellevue, Quebec, Canada
- Institut National de Santé Publique du Québec, Quebec City, Quebec, Canada
| | - Jasmin Villeneuve
- Institut National de Santé Publique du Québec, Quebec City, Quebec, Canada
| | - Michel Roger
- Laboratoire de Santé Publique du Québec, Sainte-Anne-de-Bellevue, Quebec, Canada
- Université de Montréal Facultée de Médecine, Montreal, Quebec, Canada
- Institut National de Santé Publique du Québec, Quebec City, Quebec, Canada
| | - Gaston De Serres
- Institut National de Santé Publique du Québec, Quebec City, Quebec, Canada
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42
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Brousseau N, Morin L, Ouakki M, Savard P, Quach C, Longtin Y, Cheng MP, Carignan A, Dufresne SF, Leduc JM, Lavallée C, Gauthier N, Bestman-Smith J, Arrieta MJ, Ishak M, Lévesque S, Martin P, De Serres G. SARS-CoV-2 seroprevalence in health care workers from 10 hospitals in Quebec, Canada: a cross-sectional study. CMAJ 2021; 193:E1868-E1877. [PMID: 34903591 PMCID: PMC8677578 DOI: 10.1503/cmaj.202783] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/04/2021] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND The COVID-19 pandemic has disproportionately affected health care workers. We sought to estimate SARS-CoV-2 seroprevalence among hospital health care workers in Quebec, Canada, after the first wave of the pandemic and to explore factors associated with SARS-CoV-2 seropositivity. METHODS Between July 6 and Sept. 24, 2020, we enrolled health care workers from 10 hospitals, including 8 from a region with a high incidence of COVID-19 (the Montréal area) and 2 from low-incidence regions of Quebec. Eligible health care workers were physicians, nurses, orderlies and cleaning staff working in 4 types of care units (emergency department, intensive care unit, COVID-19 inpatient unit and non-COVID-19 inpatient unit). Participants completed a questionnaire and underwent SARS-CoV-2 serology testing. We identified factors independently associated with higher seroprevalence. RESULTS Among 2056 enrolled health care workers, 241 (11.7%) had positive SARS-CoV-2 serology. Of these, 171 (71.0%) had been previously diagnosed with COVID-19. Seroprevalence varied among hospitals, from 2.4% to 3.7% in low-incidence regions to 17.9% to 32.0% in hospitals with outbreaks involving 5 or more health care workers. Higher seroprevalence was associated with working in a hospital where outbreaks occurred (adjusted prevalence ratio 4.16, 95% confidence interval [CI] 2.63-6.57), being a nurse or nursing assistant (adjusted prevalence ratio 1.34, 95% CI 1.03-1.74) or an orderly (adjusted prevalence ratio 1.49, 95% CI 1.12-1.97), and Black or Hispanic ethnicity (adjusted prevalence ratio 1.41, 95% CI 1.13-1.76). Lower seroprevalence was associated with working in the intensive care unit (adjusted prevalence ratio 0.47, 95% CI 0.30-0.71) or the emergency department (adjusted prevalence ratio 0.61, 95% CI 0.39-0.98). INTERPRETATION Health care workers in Quebec hospitals were at high risk of SARS-CoV-2 infection, particularly in outbreak settings. More work is needed to better understand SARS-CoV-2 transmission dynamics in health care settings.
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Affiliation(s)
- Nicholas Brousseau
- Institut national de santé publique du Québec (Brousseau, Ouakki, De Serres), Montréal, Que.; Centre de recherche du CHU de Québec-Université Laval (Brousseau, Morin, De Serres), Québec, Que.; Départements de médecine et de médecine des laboratoires (Savard), Centre Hospitalier de l'Université de Montréal; Centre de recherche du Centre Hospitalier de l'Université de Montréal (Savard); Department of Microbiology, Infectious Diseases & Immunology (Quach), CHU Sainte-Justine, Université de Montréal; Jewish General Hospital (Longtin); Divisions of Infectious Disease and Medical Microbiology (Cheng), McGill University Health Center, Montréal, Que.; CIUSSS de l'Estrie - CHUS (Carignan, Lévesque, Martin); Département de microbiologie et infectiologie (Carignan, Lévesque, Martin), Faculté de médecine et des sciences de la santé, Université de Sherbrooke, Sherbrooke, Que.; Département de médecine (Dufresne, Lavallée), CIUSSS-de-l'Est-de-l'Île-de-Montréal; CIUSSS du Nord-de-l'Île-de-Montréal (Leduc, Gauthier), Montréal, Que.; Hôpital de l'Enfant-Jésus du CHU de Québec (Bestman-Smith), Québec, Que.; CIUSSS de l'Ouest-de-l'Île-de-Montréal (Arrieta); CIUSSS du Centre-Sud-de-l'île-de-Montréal (Ishak), Montréal, Que.
| | - Laurianne Morin
- Institut national de santé publique du Québec (Brousseau, Ouakki, De Serres), Montréal, Que.; Centre de recherche du CHU de Québec-Université Laval (Brousseau, Morin, De Serres), Québec, Que.; Départements de médecine et de médecine des laboratoires (Savard), Centre Hospitalier de l'Université de Montréal; Centre de recherche du Centre Hospitalier de l'Université de Montréal (Savard); Department of Microbiology, Infectious Diseases & Immunology (Quach), CHU Sainte-Justine, Université de Montréal; Jewish General Hospital (Longtin); Divisions of Infectious Disease and Medical Microbiology (Cheng), McGill University Health Center, Montréal, Que.; CIUSSS de l'Estrie - CHUS (Carignan, Lévesque, Martin); Département de microbiologie et infectiologie (Carignan, Lévesque, Martin), Faculté de médecine et des sciences de la santé, Université de Sherbrooke, Sherbrooke, Que.; Département de médecine (Dufresne, Lavallée), CIUSSS-de-l'Est-de-l'Île-de-Montréal; CIUSSS du Nord-de-l'Île-de-Montréal (Leduc, Gauthier), Montréal, Que.; Hôpital de l'Enfant-Jésus du CHU de Québec (Bestman-Smith), Québec, Que.; CIUSSS de l'Ouest-de-l'Île-de-Montréal (Arrieta); CIUSSS du Centre-Sud-de-l'île-de-Montréal (Ishak), Montréal, Que
| | - Manale Ouakki
- Institut national de santé publique du Québec (Brousseau, Ouakki, De Serres), Montréal, Que.; Centre de recherche du CHU de Québec-Université Laval (Brousseau, Morin, De Serres), Québec, Que.; Départements de médecine et de médecine des laboratoires (Savard), Centre Hospitalier de l'Université de Montréal; Centre de recherche du Centre Hospitalier de l'Université de Montréal (Savard); Department of Microbiology, Infectious Diseases & Immunology (Quach), CHU Sainte-Justine, Université de Montréal; Jewish General Hospital (Longtin); Divisions of Infectious Disease and Medical Microbiology (Cheng), McGill University Health Center, Montréal, Que.; CIUSSS de l'Estrie - CHUS (Carignan, Lévesque, Martin); Département de microbiologie et infectiologie (Carignan, Lévesque, Martin), Faculté de médecine et des sciences de la santé, Université de Sherbrooke, Sherbrooke, Que.; Département de médecine (Dufresne, Lavallée), CIUSSS-de-l'Est-de-l'Île-de-Montréal; CIUSSS du Nord-de-l'Île-de-Montréal (Leduc, Gauthier), Montréal, Que.; Hôpital de l'Enfant-Jésus du CHU de Québec (Bestman-Smith), Québec, Que.; CIUSSS de l'Ouest-de-l'Île-de-Montréal (Arrieta); CIUSSS du Centre-Sud-de-l'île-de-Montréal (Ishak), Montréal, Que
| | - Patrice Savard
- Institut national de santé publique du Québec (Brousseau, Ouakki, De Serres), Montréal, Que.; Centre de recherche du CHU de Québec-Université Laval (Brousseau, Morin, De Serres), Québec, Que.; Départements de médecine et de médecine des laboratoires (Savard), Centre Hospitalier de l'Université de Montréal; Centre de recherche du Centre Hospitalier de l'Université de Montréal (Savard); Department of Microbiology, Infectious Diseases & Immunology (Quach), CHU Sainte-Justine, Université de Montréal; Jewish General Hospital (Longtin); Divisions of Infectious Disease and Medical Microbiology (Cheng), McGill University Health Center, Montréal, Que.; CIUSSS de l'Estrie - CHUS (Carignan, Lévesque, Martin); Département de microbiologie et infectiologie (Carignan, Lévesque, Martin), Faculté de médecine et des sciences de la santé, Université de Sherbrooke, Sherbrooke, Que.; Département de médecine (Dufresne, Lavallée), CIUSSS-de-l'Est-de-l'Île-de-Montréal; CIUSSS du Nord-de-l'Île-de-Montréal (Leduc, Gauthier), Montréal, Que.; Hôpital de l'Enfant-Jésus du CHU de Québec (Bestman-Smith), Québec, Que.; CIUSSS de l'Ouest-de-l'Île-de-Montréal (Arrieta); CIUSSS du Centre-Sud-de-l'île-de-Montréal (Ishak), Montréal, Que
| | - Caroline Quach
- Institut national de santé publique du Québec (Brousseau, Ouakki, De Serres), Montréal, Que.; Centre de recherche du CHU de Québec-Université Laval (Brousseau, Morin, De Serres), Québec, Que.; Départements de médecine et de médecine des laboratoires (Savard), Centre Hospitalier de l'Université de Montréal; Centre de recherche du Centre Hospitalier de l'Université de Montréal (Savard); Department of Microbiology, Infectious Diseases & Immunology (Quach), CHU Sainte-Justine, Université de Montréal; Jewish General Hospital (Longtin); Divisions of Infectious Disease and Medical Microbiology (Cheng), McGill University Health Center, Montréal, Que.; CIUSSS de l'Estrie - CHUS (Carignan, Lévesque, Martin); Département de microbiologie et infectiologie (Carignan, Lévesque, Martin), Faculté de médecine et des sciences de la santé, Université de Sherbrooke, Sherbrooke, Que.; Département de médecine (Dufresne, Lavallée), CIUSSS-de-l'Est-de-l'Île-de-Montréal; CIUSSS du Nord-de-l'Île-de-Montréal (Leduc, Gauthier), Montréal, Que.; Hôpital de l'Enfant-Jésus du CHU de Québec (Bestman-Smith), Québec, Que.; CIUSSS de l'Ouest-de-l'Île-de-Montréal (Arrieta); CIUSSS du Centre-Sud-de-l'île-de-Montréal (Ishak), Montréal, Que
| | - Yves Longtin
- Institut national de santé publique du Québec (Brousseau, Ouakki, De Serres), Montréal, Que.; Centre de recherche du CHU de Québec-Université Laval (Brousseau, Morin, De Serres), Québec, Que.; Départements de médecine et de médecine des laboratoires (Savard), Centre Hospitalier de l'Université de Montréal; Centre de recherche du Centre Hospitalier de l'Université de Montréal (Savard); Department of Microbiology, Infectious Diseases & Immunology (Quach), CHU Sainte-Justine, Université de Montréal; Jewish General Hospital (Longtin); Divisions of Infectious Disease and Medical Microbiology (Cheng), McGill University Health Center, Montréal, Que.; CIUSSS de l'Estrie - CHUS (Carignan, Lévesque, Martin); Département de microbiologie et infectiologie (Carignan, Lévesque, Martin), Faculté de médecine et des sciences de la santé, Université de Sherbrooke, Sherbrooke, Que.; Département de médecine (Dufresne, Lavallée), CIUSSS-de-l'Est-de-l'Île-de-Montréal; CIUSSS du Nord-de-l'Île-de-Montréal (Leduc, Gauthier), Montréal, Que.; Hôpital de l'Enfant-Jésus du CHU de Québec (Bestman-Smith), Québec, Que.; CIUSSS de l'Ouest-de-l'Île-de-Montréal (Arrieta); CIUSSS du Centre-Sud-de-l'île-de-Montréal (Ishak), Montréal, Que
| | - Matthew P Cheng
- Institut national de santé publique du Québec (Brousseau, Ouakki, De Serres), Montréal, Que.; Centre de recherche du CHU de Québec-Université Laval (Brousseau, Morin, De Serres), Québec, Que.; Départements de médecine et de médecine des laboratoires (Savard), Centre Hospitalier de l'Université de Montréal; Centre de recherche du Centre Hospitalier de l'Université de Montréal (Savard); Department of Microbiology, Infectious Diseases & Immunology (Quach), CHU Sainte-Justine, Université de Montréal; Jewish General Hospital (Longtin); Divisions of Infectious Disease and Medical Microbiology (Cheng), McGill University Health Center, Montréal, Que.; CIUSSS de l'Estrie - CHUS (Carignan, Lévesque, Martin); Département de microbiologie et infectiologie (Carignan, Lévesque, Martin), Faculté de médecine et des sciences de la santé, Université de Sherbrooke, Sherbrooke, Que.; Département de médecine (Dufresne, Lavallée), CIUSSS-de-l'Est-de-l'Île-de-Montréal; CIUSSS du Nord-de-l'Île-de-Montréal (Leduc, Gauthier), Montréal, Que.; Hôpital de l'Enfant-Jésus du CHU de Québec (Bestman-Smith), Québec, Que.; CIUSSS de l'Ouest-de-l'Île-de-Montréal (Arrieta); CIUSSS du Centre-Sud-de-l'île-de-Montréal (Ishak), Montréal, Que
| | - Alex Carignan
- Institut national de santé publique du Québec (Brousseau, Ouakki, De Serres), Montréal, Que.; Centre de recherche du CHU de Québec-Université Laval (Brousseau, Morin, De Serres), Québec, Que.; Départements de médecine et de médecine des laboratoires (Savard), Centre Hospitalier de l'Université de Montréal; Centre de recherche du Centre Hospitalier de l'Université de Montréal (Savard); Department of Microbiology, Infectious Diseases & Immunology (Quach), CHU Sainte-Justine, Université de Montréal; Jewish General Hospital (Longtin); Divisions of Infectious Disease and Medical Microbiology (Cheng), McGill University Health Center, Montréal, Que.; CIUSSS de l'Estrie - CHUS (Carignan, Lévesque, Martin); Département de microbiologie et infectiologie (Carignan, Lévesque, Martin), Faculté de médecine et des sciences de la santé, Université de Sherbrooke, Sherbrooke, Que.; Département de médecine (Dufresne, Lavallée), CIUSSS-de-l'Est-de-l'Île-de-Montréal; CIUSSS du Nord-de-l'Île-de-Montréal (Leduc, Gauthier), Montréal, Que.; Hôpital de l'Enfant-Jésus du CHU de Québec (Bestman-Smith), Québec, Que.; CIUSSS de l'Ouest-de-l'Île-de-Montréal (Arrieta); CIUSSS du Centre-Sud-de-l'île-de-Montréal (Ishak), Montréal, Que
| | - Simon F Dufresne
- Institut national de santé publique du Québec (Brousseau, Ouakki, De Serres), Montréal, Que.; Centre de recherche du CHU de Québec-Université Laval (Brousseau, Morin, De Serres), Québec, Que.; Départements de médecine et de médecine des laboratoires (Savard), Centre Hospitalier de l'Université de Montréal; Centre de recherche du Centre Hospitalier de l'Université de Montréal (Savard); Department of Microbiology, Infectious Diseases & Immunology (Quach), CHU Sainte-Justine, Université de Montréal; Jewish General Hospital (Longtin); Divisions of Infectious Disease and Medical Microbiology (Cheng), McGill University Health Center, Montréal, Que.; CIUSSS de l'Estrie - CHUS (Carignan, Lévesque, Martin); Département de microbiologie et infectiologie (Carignan, Lévesque, Martin), Faculté de médecine et des sciences de la santé, Université de Sherbrooke, Sherbrooke, Que.; Département de médecine (Dufresne, Lavallée), CIUSSS-de-l'Est-de-l'Île-de-Montréal; CIUSSS du Nord-de-l'Île-de-Montréal (Leduc, Gauthier), Montréal, Que.; Hôpital de l'Enfant-Jésus du CHU de Québec (Bestman-Smith), Québec, Que.; CIUSSS de l'Ouest-de-l'Île-de-Montréal (Arrieta); CIUSSS du Centre-Sud-de-l'île-de-Montréal (Ishak), Montréal, Que
| | - Jean-Michel Leduc
- Institut national de santé publique du Québec (Brousseau, Ouakki, De Serres), Montréal, Que.; Centre de recherche du CHU de Québec-Université Laval (Brousseau, Morin, De Serres), Québec, Que.; Départements de médecine et de médecine des laboratoires (Savard), Centre Hospitalier de l'Université de Montréal; Centre de recherche du Centre Hospitalier de l'Université de Montréal (Savard); Department of Microbiology, Infectious Diseases & Immunology (Quach), CHU Sainte-Justine, Université de Montréal; Jewish General Hospital (Longtin); Divisions of Infectious Disease and Medical Microbiology (Cheng), McGill University Health Center, Montréal, Que.; CIUSSS de l'Estrie - CHUS (Carignan, Lévesque, Martin); Département de microbiologie et infectiologie (Carignan, Lévesque, Martin), Faculté de médecine et des sciences de la santé, Université de Sherbrooke, Sherbrooke, Que.; Département de médecine (Dufresne, Lavallée), CIUSSS-de-l'Est-de-l'Île-de-Montréal; CIUSSS du Nord-de-l'Île-de-Montréal (Leduc, Gauthier), Montréal, Que.; Hôpital de l'Enfant-Jésus du CHU de Québec (Bestman-Smith), Québec, Que.; CIUSSS de l'Ouest-de-l'Île-de-Montréal (Arrieta); CIUSSS du Centre-Sud-de-l'île-de-Montréal (Ishak), Montréal, Que
| | - Christian Lavallée
- Institut national de santé publique du Québec (Brousseau, Ouakki, De Serres), Montréal, Que.; Centre de recherche du CHU de Québec-Université Laval (Brousseau, Morin, De Serres), Québec, Que.; Départements de médecine et de médecine des laboratoires (Savard), Centre Hospitalier de l'Université de Montréal; Centre de recherche du Centre Hospitalier de l'Université de Montréal (Savard); Department of Microbiology, Infectious Diseases & Immunology (Quach), CHU Sainte-Justine, Université de Montréal; Jewish General Hospital (Longtin); Divisions of Infectious Disease and Medical Microbiology (Cheng), McGill University Health Center, Montréal, Que.; CIUSSS de l'Estrie - CHUS (Carignan, Lévesque, Martin); Département de microbiologie et infectiologie (Carignan, Lévesque, Martin), Faculté de médecine et des sciences de la santé, Université de Sherbrooke, Sherbrooke, Que.; Département de médecine (Dufresne, Lavallée), CIUSSS-de-l'Est-de-l'Île-de-Montréal; CIUSSS du Nord-de-l'Île-de-Montréal (Leduc, Gauthier), Montréal, Que.; Hôpital de l'Enfant-Jésus du CHU de Québec (Bestman-Smith), Québec, Que.; CIUSSS de l'Ouest-de-l'Île-de-Montréal (Arrieta); CIUSSS du Centre-Sud-de-l'île-de-Montréal (Ishak), Montréal, Que
| | - Nicolas Gauthier
- Institut national de santé publique du Québec (Brousseau, Ouakki, De Serres), Montréal, Que.; Centre de recherche du CHU de Québec-Université Laval (Brousseau, Morin, De Serres), Québec, Que.; Départements de médecine et de médecine des laboratoires (Savard), Centre Hospitalier de l'Université de Montréal; Centre de recherche du Centre Hospitalier de l'Université de Montréal (Savard); Department of Microbiology, Infectious Diseases & Immunology (Quach), CHU Sainte-Justine, Université de Montréal; Jewish General Hospital (Longtin); Divisions of Infectious Disease and Medical Microbiology (Cheng), McGill University Health Center, Montréal, Que.; CIUSSS de l'Estrie - CHUS (Carignan, Lévesque, Martin); Département de microbiologie et infectiologie (Carignan, Lévesque, Martin), Faculté de médecine et des sciences de la santé, Université de Sherbrooke, Sherbrooke, Que.; Département de médecine (Dufresne, Lavallée), CIUSSS-de-l'Est-de-l'Île-de-Montréal; CIUSSS du Nord-de-l'Île-de-Montréal (Leduc, Gauthier), Montréal, Que.; Hôpital de l'Enfant-Jésus du CHU de Québec (Bestman-Smith), Québec, Que.; CIUSSS de l'Ouest-de-l'Île-de-Montréal (Arrieta); CIUSSS du Centre-Sud-de-l'île-de-Montréal (Ishak), Montréal, Que
| | - Julie Bestman-Smith
- Institut national de santé publique du Québec (Brousseau, Ouakki, De Serres), Montréal, Que.; Centre de recherche du CHU de Québec-Université Laval (Brousseau, Morin, De Serres), Québec, Que.; Départements de médecine et de médecine des laboratoires (Savard), Centre Hospitalier de l'Université de Montréal; Centre de recherche du Centre Hospitalier de l'Université de Montréal (Savard); Department of Microbiology, Infectious Diseases & Immunology (Quach), CHU Sainte-Justine, Université de Montréal; Jewish General Hospital (Longtin); Divisions of Infectious Disease and Medical Microbiology (Cheng), McGill University Health Center, Montréal, Que.; CIUSSS de l'Estrie - CHUS (Carignan, Lévesque, Martin); Département de microbiologie et infectiologie (Carignan, Lévesque, Martin), Faculté de médecine et des sciences de la santé, Université de Sherbrooke, Sherbrooke, Que.; Département de médecine (Dufresne, Lavallée), CIUSSS-de-l'Est-de-l'Île-de-Montréal; CIUSSS du Nord-de-l'Île-de-Montréal (Leduc, Gauthier), Montréal, Que.; Hôpital de l'Enfant-Jésus du CHU de Québec (Bestman-Smith), Québec, Que.; CIUSSS de l'Ouest-de-l'Île-de-Montréal (Arrieta); CIUSSS du Centre-Sud-de-l'île-de-Montréal (Ishak), Montréal, Que
| | - Maria-Jesus Arrieta
- Institut national de santé publique du Québec (Brousseau, Ouakki, De Serres), Montréal, Que.; Centre de recherche du CHU de Québec-Université Laval (Brousseau, Morin, De Serres), Québec, Que.; Départements de médecine et de médecine des laboratoires (Savard), Centre Hospitalier de l'Université de Montréal; Centre de recherche du Centre Hospitalier de l'Université de Montréal (Savard); Department of Microbiology, Infectious Diseases & Immunology (Quach), CHU Sainte-Justine, Université de Montréal; Jewish General Hospital (Longtin); Divisions of Infectious Disease and Medical Microbiology (Cheng), McGill University Health Center, Montréal, Que.; CIUSSS de l'Estrie - CHUS (Carignan, Lévesque, Martin); Département de microbiologie et infectiologie (Carignan, Lévesque, Martin), Faculté de médecine et des sciences de la santé, Université de Sherbrooke, Sherbrooke, Que.; Département de médecine (Dufresne, Lavallée), CIUSSS-de-l'Est-de-l'Île-de-Montréal; CIUSSS du Nord-de-l'Île-de-Montréal (Leduc, Gauthier), Montréal, Que.; Hôpital de l'Enfant-Jésus du CHU de Québec (Bestman-Smith), Québec, Que.; CIUSSS de l'Ouest-de-l'Île-de-Montréal (Arrieta); CIUSSS du Centre-Sud-de-l'île-de-Montréal (Ishak), Montréal, Que
| | - Magued Ishak
- Institut national de santé publique du Québec (Brousseau, Ouakki, De Serres), Montréal, Que.; Centre de recherche du CHU de Québec-Université Laval (Brousseau, Morin, De Serres), Québec, Que.; Départements de médecine et de médecine des laboratoires (Savard), Centre Hospitalier de l'Université de Montréal; Centre de recherche du Centre Hospitalier de l'Université de Montréal (Savard); Department of Microbiology, Infectious Diseases & Immunology (Quach), CHU Sainte-Justine, Université de Montréal; Jewish General Hospital (Longtin); Divisions of Infectious Disease and Medical Microbiology (Cheng), McGill University Health Center, Montréal, Que.; CIUSSS de l'Estrie - CHUS (Carignan, Lévesque, Martin); Département de microbiologie et infectiologie (Carignan, Lévesque, Martin), Faculté de médecine et des sciences de la santé, Université de Sherbrooke, Sherbrooke, Que.; Département de médecine (Dufresne, Lavallée), CIUSSS-de-l'Est-de-l'Île-de-Montréal; CIUSSS du Nord-de-l'Île-de-Montréal (Leduc, Gauthier), Montréal, Que.; Hôpital de l'Enfant-Jésus du CHU de Québec (Bestman-Smith), Québec, Que.; CIUSSS de l'Ouest-de-l'Île-de-Montréal (Arrieta); CIUSSS du Centre-Sud-de-l'île-de-Montréal (Ishak), Montréal, Que
| | - Simon Lévesque
- Institut national de santé publique du Québec (Brousseau, Ouakki, De Serres), Montréal, Que.; Centre de recherche du CHU de Québec-Université Laval (Brousseau, Morin, De Serres), Québec, Que.; Départements de médecine et de médecine des laboratoires (Savard), Centre Hospitalier de l'Université de Montréal; Centre de recherche du Centre Hospitalier de l'Université de Montréal (Savard); Department of Microbiology, Infectious Diseases & Immunology (Quach), CHU Sainte-Justine, Université de Montréal; Jewish General Hospital (Longtin); Divisions of Infectious Disease and Medical Microbiology (Cheng), McGill University Health Center, Montréal, Que.; CIUSSS de l'Estrie - CHUS (Carignan, Lévesque, Martin); Département de microbiologie et infectiologie (Carignan, Lévesque, Martin), Faculté de médecine et des sciences de la santé, Université de Sherbrooke, Sherbrooke, Que.; Département de médecine (Dufresne, Lavallée), CIUSSS-de-l'Est-de-l'Île-de-Montréal; CIUSSS du Nord-de-l'Île-de-Montréal (Leduc, Gauthier), Montréal, Que.; Hôpital de l'Enfant-Jésus du CHU de Québec (Bestman-Smith), Québec, Que.; CIUSSS de l'Ouest-de-l'Île-de-Montréal (Arrieta); CIUSSS du Centre-Sud-de-l'île-de-Montréal (Ishak), Montréal, Que
| | - Philippe Martin
- Institut national de santé publique du Québec (Brousseau, Ouakki, De Serres), Montréal, Que.; Centre de recherche du CHU de Québec-Université Laval (Brousseau, Morin, De Serres), Québec, Que.; Départements de médecine et de médecine des laboratoires (Savard), Centre Hospitalier de l'Université de Montréal; Centre de recherche du Centre Hospitalier de l'Université de Montréal (Savard); Department of Microbiology, Infectious Diseases & Immunology (Quach), CHU Sainte-Justine, Université de Montréal; Jewish General Hospital (Longtin); Divisions of Infectious Disease and Medical Microbiology (Cheng), McGill University Health Center, Montréal, Que.; CIUSSS de l'Estrie - CHUS (Carignan, Lévesque, Martin); Département de microbiologie et infectiologie (Carignan, Lévesque, Martin), Faculté de médecine et des sciences de la santé, Université de Sherbrooke, Sherbrooke, Que.; Département de médecine (Dufresne, Lavallée), CIUSSS-de-l'Est-de-l'Île-de-Montréal; CIUSSS du Nord-de-l'Île-de-Montréal (Leduc, Gauthier), Montréal, Que.; Hôpital de l'Enfant-Jésus du CHU de Québec (Bestman-Smith), Québec, Que.; CIUSSS de l'Ouest-de-l'Île-de-Montréal (Arrieta); CIUSSS du Centre-Sud-de-l'île-de-Montréal (Ishak), Montréal, Que
| | - Gaston De Serres
- Institut national de santé publique du Québec (Brousseau, Ouakki, De Serres), Montréal, Que.; Centre de recherche du CHU de Québec-Université Laval (Brousseau, Morin, De Serres), Québec, Que.; Départements de médecine et de médecine des laboratoires (Savard), Centre Hospitalier de l'Université de Montréal; Centre de recherche du Centre Hospitalier de l'Université de Montréal (Savard); Department of Microbiology, Infectious Diseases & Immunology (Quach), CHU Sainte-Justine, Université de Montréal; Jewish General Hospital (Longtin); Divisions of Infectious Disease and Medical Microbiology (Cheng), McGill University Health Center, Montréal, Que.; CIUSSS de l'Estrie - CHUS (Carignan, Lévesque, Martin); Département de microbiologie et infectiologie (Carignan, Lévesque, Martin), Faculté de médecine et des sciences de la santé, Université de Sherbrooke, Sherbrooke, Que.; Département de médecine (Dufresne, Lavallée), CIUSSS-de-l'Est-de-l'Île-de-Montréal; CIUSSS du Nord-de-l'Île-de-Montréal (Leduc, Gauthier), Montréal, Que.; Hôpital de l'Enfant-Jésus du CHU de Québec (Bestman-Smith), Québec, Que.; CIUSSS de l'Ouest-de-l'Île-de-Montréal (Arrieta); CIUSSS du Centre-Sud-de-l'île-de-Montréal (Ishak), Montréal, Que
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Brousseau N, Morin L, Ouakki M, Savard P, Quach C, Longtin Y, Cheng MP, Carignan A, Dufresne SF, Leduc JM, Lavallée C, Gauthier N, Bestman-Smith J, Arrieta MJ, Ishak M, Lévesque S, Martin P, De Serres G. SARS-CoV-2 seroprevalence in health care workers from 10 hospitals in Quebec, Canada: a cross-sectional study. CMAJ 2021. [PMID: 34903591 DOI: 10.1503/cmaj.202783/tab-related-content] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/19/2023] Open
Abstract
BACKGROUND The COVID-19 pandemic has disproportionately affected health care workers. We sought to estimate SARS-CoV-2 seroprevalence among hospital health care workers in Quebec, Canada, after the first wave of the pandemic and to explore factors associated with SARS-CoV-2 seropositivity. METHODS Between July 6 and Sept. 24, 2020, we enrolled health care workers from 10 hospitals, including 8 from a region with a high incidence of COVID-19 (the Montréal area) and 2 from low-incidence regions of Quebec. Eligible health care workers were physicians, nurses, orderlies and cleaning staff working in 4 types of care units (emergency department, intensive care unit, COVID-19 inpatient unit and non-COVID-19 inpatient unit). Participants completed a questionnaire and underwent SARS-CoV-2 serology testing. We identified factors independently associated with higher seroprevalence. RESULTS Among 2056 enrolled health care workers, 241 (11.7%) had positive SARS-CoV-2 serology. Of these, 171 (71.0%) had been previously diagnosed with COVID-19. Seroprevalence varied among hospitals, from 2.4% to 3.7% in low-incidence regions to 17.9% to 32.0% in hospitals with outbreaks involving 5 or more health care workers. Higher seroprevalence was associated with working in a hospital where outbreaks occurred (adjusted prevalence ratio 4.16, 95% confidence interval [CI] 2.63-6.57), being a nurse or nursing assistant (adjusted prevalence ratio 1.34, 95% CI 1.03-1.74) or an orderly (adjusted prevalence ratio 1.49, 95% CI 1.12-1.97), and Black or Hispanic ethnicity (adjusted prevalence ratio 1.41, 95% CI 1.13-1.76). Lower seroprevalence was associated with working in the intensive care unit (adjusted prevalence ratio 0.47, 95% CI 0.30-0.71) or the emergency department (adjusted prevalence ratio 0.61, 95% CI 0.39-0.98). INTERPRETATION Health care workers in Quebec hospitals were at high risk of SARS-CoV-2 infection, particularly in outbreak settings. More work is needed to better understand SARS-CoV-2 transmission dynamics in health care settings.
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Affiliation(s)
- Nicholas Brousseau
- Institut national de santé publique du Québec (Brousseau, Ouakki, De Serres), Montréal, Que.; Centre de recherche du CHU de Québec-Université Laval (Brousseau, Morin, De Serres), Québec, Que.; Départements de médecine et de médecine des laboratoires (Savard), Centre Hospitalier de l'Université de Montréal; Centre de recherche du Centre Hospitalier de l'Université de Montréal (Savard); Department of Microbiology, Infectious Diseases & Immunology (Quach), CHU Sainte-Justine, Université de Montréal; Jewish General Hospital (Longtin); Divisions of Infectious Disease and Medical Microbiology (Cheng), McGill University Health Center, Montréal, Que.; CIUSSS de l'Estrie - CHUS (Carignan, Lévesque, Martin); Département de microbiologie et infectiologie (Carignan, Lévesque, Martin), Faculté de médecine et des sciences de la santé, Université de Sherbrooke, Sherbrooke, Que.; Département de médecine (Dufresne, Lavallée), CIUSSS-de-l'Est-de-l'Île-de-Montréal; CIUSSS du Nord-de-l'Île-de-Montréal (Leduc, Gauthier), Montréal, Que.; Hôpital de l'Enfant-Jésus du CHU de Québec (Bestman-Smith), Québec, Que.; CIUSSS de l'Ouest-de-l'Île-de-Montréal (Arrieta); CIUSSS du Centre-Sud-de-l'île-de-Montréal (Ishak), Montréal, Que.
| | - Laurianne Morin
- Institut national de santé publique du Québec (Brousseau, Ouakki, De Serres), Montréal, Que.; Centre de recherche du CHU de Québec-Université Laval (Brousseau, Morin, De Serres), Québec, Que.; Départements de médecine et de médecine des laboratoires (Savard), Centre Hospitalier de l'Université de Montréal; Centre de recherche du Centre Hospitalier de l'Université de Montréal (Savard); Department of Microbiology, Infectious Diseases & Immunology (Quach), CHU Sainte-Justine, Université de Montréal; Jewish General Hospital (Longtin); Divisions of Infectious Disease and Medical Microbiology (Cheng), McGill University Health Center, Montréal, Que.; CIUSSS de l'Estrie - CHUS (Carignan, Lévesque, Martin); Département de microbiologie et infectiologie (Carignan, Lévesque, Martin), Faculté de médecine et des sciences de la santé, Université de Sherbrooke, Sherbrooke, Que.; Département de médecine (Dufresne, Lavallée), CIUSSS-de-l'Est-de-l'Île-de-Montréal; CIUSSS du Nord-de-l'Île-de-Montréal (Leduc, Gauthier), Montréal, Que.; Hôpital de l'Enfant-Jésus du CHU de Québec (Bestman-Smith), Québec, Que.; CIUSSS de l'Ouest-de-l'Île-de-Montréal (Arrieta); CIUSSS du Centre-Sud-de-l'île-de-Montréal (Ishak), Montréal, Que
| | - Manale Ouakki
- Institut national de santé publique du Québec (Brousseau, Ouakki, De Serres), Montréal, Que.; Centre de recherche du CHU de Québec-Université Laval (Brousseau, Morin, De Serres), Québec, Que.; Départements de médecine et de médecine des laboratoires (Savard), Centre Hospitalier de l'Université de Montréal; Centre de recherche du Centre Hospitalier de l'Université de Montréal (Savard); Department of Microbiology, Infectious Diseases & Immunology (Quach), CHU Sainte-Justine, Université de Montréal; Jewish General Hospital (Longtin); Divisions of Infectious Disease and Medical Microbiology (Cheng), McGill University Health Center, Montréal, Que.; CIUSSS de l'Estrie - CHUS (Carignan, Lévesque, Martin); Département de microbiologie et infectiologie (Carignan, Lévesque, Martin), Faculté de médecine et des sciences de la santé, Université de Sherbrooke, Sherbrooke, Que.; Département de médecine (Dufresne, Lavallée), CIUSSS-de-l'Est-de-l'Île-de-Montréal; CIUSSS du Nord-de-l'Île-de-Montréal (Leduc, Gauthier), Montréal, Que.; Hôpital de l'Enfant-Jésus du CHU de Québec (Bestman-Smith), Québec, Que.; CIUSSS de l'Ouest-de-l'Île-de-Montréal (Arrieta); CIUSSS du Centre-Sud-de-l'île-de-Montréal (Ishak), Montréal, Que
| | - Patrice Savard
- Institut national de santé publique du Québec (Brousseau, Ouakki, De Serres), Montréal, Que.; Centre de recherche du CHU de Québec-Université Laval (Brousseau, Morin, De Serres), Québec, Que.; Départements de médecine et de médecine des laboratoires (Savard), Centre Hospitalier de l'Université de Montréal; Centre de recherche du Centre Hospitalier de l'Université de Montréal (Savard); Department of Microbiology, Infectious Diseases & Immunology (Quach), CHU Sainte-Justine, Université de Montréal; Jewish General Hospital (Longtin); Divisions of Infectious Disease and Medical Microbiology (Cheng), McGill University Health Center, Montréal, Que.; CIUSSS de l'Estrie - CHUS (Carignan, Lévesque, Martin); Département de microbiologie et infectiologie (Carignan, Lévesque, Martin), Faculté de médecine et des sciences de la santé, Université de Sherbrooke, Sherbrooke, Que.; Département de médecine (Dufresne, Lavallée), CIUSSS-de-l'Est-de-l'Île-de-Montréal; CIUSSS du Nord-de-l'Île-de-Montréal (Leduc, Gauthier), Montréal, Que.; Hôpital de l'Enfant-Jésus du CHU de Québec (Bestman-Smith), Québec, Que.; CIUSSS de l'Ouest-de-l'Île-de-Montréal (Arrieta); CIUSSS du Centre-Sud-de-l'île-de-Montréal (Ishak), Montréal, Que
| | - Caroline Quach
- Institut national de santé publique du Québec (Brousseau, Ouakki, De Serres), Montréal, Que.; Centre de recherche du CHU de Québec-Université Laval (Brousseau, Morin, De Serres), Québec, Que.; Départements de médecine et de médecine des laboratoires (Savard), Centre Hospitalier de l'Université de Montréal; Centre de recherche du Centre Hospitalier de l'Université de Montréal (Savard); Department of Microbiology, Infectious Diseases & Immunology (Quach), CHU Sainte-Justine, Université de Montréal; Jewish General Hospital (Longtin); Divisions of Infectious Disease and Medical Microbiology (Cheng), McGill University Health Center, Montréal, Que.; CIUSSS de l'Estrie - CHUS (Carignan, Lévesque, Martin); Département de microbiologie et infectiologie (Carignan, Lévesque, Martin), Faculté de médecine et des sciences de la santé, Université de Sherbrooke, Sherbrooke, Que.; Département de médecine (Dufresne, Lavallée), CIUSSS-de-l'Est-de-l'Île-de-Montréal; CIUSSS du Nord-de-l'Île-de-Montréal (Leduc, Gauthier), Montréal, Que.; Hôpital de l'Enfant-Jésus du CHU de Québec (Bestman-Smith), Québec, Que.; CIUSSS de l'Ouest-de-l'Île-de-Montréal (Arrieta); CIUSSS du Centre-Sud-de-l'île-de-Montréal (Ishak), Montréal, Que
| | - Yves Longtin
- Institut national de santé publique du Québec (Brousseau, Ouakki, De Serres), Montréal, Que.; Centre de recherche du CHU de Québec-Université Laval (Brousseau, Morin, De Serres), Québec, Que.; Départements de médecine et de médecine des laboratoires (Savard), Centre Hospitalier de l'Université de Montréal; Centre de recherche du Centre Hospitalier de l'Université de Montréal (Savard); Department of Microbiology, Infectious Diseases & Immunology (Quach), CHU Sainte-Justine, Université de Montréal; Jewish General Hospital (Longtin); Divisions of Infectious Disease and Medical Microbiology (Cheng), McGill University Health Center, Montréal, Que.; CIUSSS de l'Estrie - CHUS (Carignan, Lévesque, Martin); Département de microbiologie et infectiologie (Carignan, Lévesque, Martin), Faculté de médecine et des sciences de la santé, Université de Sherbrooke, Sherbrooke, Que.; Département de médecine (Dufresne, Lavallée), CIUSSS-de-l'Est-de-l'Île-de-Montréal; CIUSSS du Nord-de-l'Île-de-Montréal (Leduc, Gauthier), Montréal, Que.; Hôpital de l'Enfant-Jésus du CHU de Québec (Bestman-Smith), Québec, Que.; CIUSSS de l'Ouest-de-l'Île-de-Montréal (Arrieta); CIUSSS du Centre-Sud-de-l'île-de-Montréal (Ishak), Montréal, Que
| | - Matthew P Cheng
- Institut national de santé publique du Québec (Brousseau, Ouakki, De Serres), Montréal, Que.; Centre de recherche du CHU de Québec-Université Laval (Brousseau, Morin, De Serres), Québec, Que.; Départements de médecine et de médecine des laboratoires (Savard), Centre Hospitalier de l'Université de Montréal; Centre de recherche du Centre Hospitalier de l'Université de Montréal (Savard); Department of Microbiology, Infectious Diseases & Immunology (Quach), CHU Sainte-Justine, Université de Montréal; Jewish General Hospital (Longtin); Divisions of Infectious Disease and Medical Microbiology (Cheng), McGill University Health Center, Montréal, Que.; CIUSSS de l'Estrie - CHUS (Carignan, Lévesque, Martin); Département de microbiologie et infectiologie (Carignan, Lévesque, Martin), Faculté de médecine et des sciences de la santé, Université de Sherbrooke, Sherbrooke, Que.; Département de médecine (Dufresne, Lavallée), CIUSSS-de-l'Est-de-l'Île-de-Montréal; CIUSSS du Nord-de-l'Île-de-Montréal (Leduc, Gauthier), Montréal, Que.; Hôpital de l'Enfant-Jésus du CHU de Québec (Bestman-Smith), Québec, Que.; CIUSSS de l'Ouest-de-l'Île-de-Montréal (Arrieta); CIUSSS du Centre-Sud-de-l'île-de-Montréal (Ishak), Montréal, Que
| | - Alex Carignan
- Institut national de santé publique du Québec (Brousseau, Ouakki, De Serres), Montréal, Que.; Centre de recherche du CHU de Québec-Université Laval (Brousseau, Morin, De Serres), Québec, Que.; Départements de médecine et de médecine des laboratoires (Savard), Centre Hospitalier de l'Université de Montréal; Centre de recherche du Centre Hospitalier de l'Université de Montréal (Savard); Department of Microbiology, Infectious Diseases & Immunology (Quach), CHU Sainte-Justine, Université de Montréal; Jewish General Hospital (Longtin); Divisions of Infectious Disease and Medical Microbiology (Cheng), McGill University Health Center, Montréal, Que.; CIUSSS de l'Estrie - CHUS (Carignan, Lévesque, Martin); Département de microbiologie et infectiologie (Carignan, Lévesque, Martin), Faculté de médecine et des sciences de la santé, Université de Sherbrooke, Sherbrooke, Que.; Département de médecine (Dufresne, Lavallée), CIUSSS-de-l'Est-de-l'Île-de-Montréal; CIUSSS du Nord-de-l'Île-de-Montréal (Leduc, Gauthier), Montréal, Que.; Hôpital de l'Enfant-Jésus du CHU de Québec (Bestman-Smith), Québec, Que.; CIUSSS de l'Ouest-de-l'Île-de-Montréal (Arrieta); CIUSSS du Centre-Sud-de-l'île-de-Montréal (Ishak), Montréal, Que
| | - Simon F Dufresne
- Institut national de santé publique du Québec (Brousseau, Ouakki, De Serres), Montréal, Que.; Centre de recherche du CHU de Québec-Université Laval (Brousseau, Morin, De Serres), Québec, Que.; Départements de médecine et de médecine des laboratoires (Savard), Centre Hospitalier de l'Université de Montréal; Centre de recherche du Centre Hospitalier de l'Université de Montréal (Savard); Department of Microbiology, Infectious Diseases & Immunology (Quach), CHU Sainte-Justine, Université de Montréal; Jewish General Hospital (Longtin); Divisions of Infectious Disease and Medical Microbiology (Cheng), McGill University Health Center, Montréal, Que.; CIUSSS de l'Estrie - CHUS (Carignan, Lévesque, Martin); Département de microbiologie et infectiologie (Carignan, Lévesque, Martin), Faculté de médecine et des sciences de la santé, Université de Sherbrooke, Sherbrooke, Que.; Département de médecine (Dufresne, Lavallée), CIUSSS-de-l'Est-de-l'Île-de-Montréal; CIUSSS du Nord-de-l'Île-de-Montréal (Leduc, Gauthier), Montréal, Que.; Hôpital de l'Enfant-Jésus du CHU de Québec (Bestman-Smith), Québec, Que.; CIUSSS de l'Ouest-de-l'Île-de-Montréal (Arrieta); CIUSSS du Centre-Sud-de-l'île-de-Montréal (Ishak), Montréal, Que
| | - Jean-Michel Leduc
- Institut national de santé publique du Québec (Brousseau, Ouakki, De Serres), Montréal, Que.; Centre de recherche du CHU de Québec-Université Laval (Brousseau, Morin, De Serres), Québec, Que.; Départements de médecine et de médecine des laboratoires (Savard), Centre Hospitalier de l'Université de Montréal; Centre de recherche du Centre Hospitalier de l'Université de Montréal (Savard); Department of Microbiology, Infectious Diseases & Immunology (Quach), CHU Sainte-Justine, Université de Montréal; Jewish General Hospital (Longtin); Divisions of Infectious Disease and Medical Microbiology (Cheng), McGill University Health Center, Montréal, Que.; CIUSSS de l'Estrie - CHUS (Carignan, Lévesque, Martin); Département de microbiologie et infectiologie (Carignan, Lévesque, Martin), Faculté de médecine et des sciences de la santé, Université de Sherbrooke, Sherbrooke, Que.; Département de médecine (Dufresne, Lavallée), CIUSSS-de-l'Est-de-l'Île-de-Montréal; CIUSSS du Nord-de-l'Île-de-Montréal (Leduc, Gauthier), Montréal, Que.; Hôpital de l'Enfant-Jésus du CHU de Québec (Bestman-Smith), Québec, Que.; CIUSSS de l'Ouest-de-l'Île-de-Montréal (Arrieta); CIUSSS du Centre-Sud-de-l'île-de-Montréal (Ishak), Montréal, Que
| | - Christian Lavallée
- Institut national de santé publique du Québec (Brousseau, Ouakki, De Serres), Montréal, Que.; Centre de recherche du CHU de Québec-Université Laval (Brousseau, Morin, De Serres), Québec, Que.; Départements de médecine et de médecine des laboratoires (Savard), Centre Hospitalier de l'Université de Montréal; Centre de recherche du Centre Hospitalier de l'Université de Montréal (Savard); Department of Microbiology, Infectious Diseases & Immunology (Quach), CHU Sainte-Justine, Université de Montréal; Jewish General Hospital (Longtin); Divisions of Infectious Disease and Medical Microbiology (Cheng), McGill University Health Center, Montréal, Que.; CIUSSS de l'Estrie - CHUS (Carignan, Lévesque, Martin); Département de microbiologie et infectiologie (Carignan, Lévesque, Martin), Faculté de médecine et des sciences de la santé, Université de Sherbrooke, Sherbrooke, Que.; Département de médecine (Dufresne, Lavallée), CIUSSS-de-l'Est-de-l'Île-de-Montréal; CIUSSS du Nord-de-l'Île-de-Montréal (Leduc, Gauthier), Montréal, Que.; Hôpital de l'Enfant-Jésus du CHU de Québec (Bestman-Smith), Québec, Que.; CIUSSS de l'Ouest-de-l'Île-de-Montréal (Arrieta); CIUSSS du Centre-Sud-de-l'île-de-Montréal (Ishak), Montréal, Que
| | - Nicolas Gauthier
- Institut national de santé publique du Québec (Brousseau, Ouakki, De Serres), Montréal, Que.; Centre de recherche du CHU de Québec-Université Laval (Brousseau, Morin, De Serres), Québec, Que.; Départements de médecine et de médecine des laboratoires (Savard), Centre Hospitalier de l'Université de Montréal; Centre de recherche du Centre Hospitalier de l'Université de Montréal (Savard); Department of Microbiology, Infectious Diseases & Immunology (Quach), CHU Sainte-Justine, Université de Montréal; Jewish General Hospital (Longtin); Divisions of Infectious Disease and Medical Microbiology (Cheng), McGill University Health Center, Montréal, Que.; CIUSSS de l'Estrie - CHUS (Carignan, Lévesque, Martin); Département de microbiologie et infectiologie (Carignan, Lévesque, Martin), Faculté de médecine et des sciences de la santé, Université de Sherbrooke, Sherbrooke, Que.; Département de médecine (Dufresne, Lavallée), CIUSSS-de-l'Est-de-l'Île-de-Montréal; CIUSSS du Nord-de-l'Île-de-Montréal (Leduc, Gauthier), Montréal, Que.; Hôpital de l'Enfant-Jésus du CHU de Québec (Bestman-Smith), Québec, Que.; CIUSSS de l'Ouest-de-l'Île-de-Montréal (Arrieta); CIUSSS du Centre-Sud-de-l'île-de-Montréal (Ishak), Montréal, Que
| | - Julie Bestman-Smith
- Institut national de santé publique du Québec (Brousseau, Ouakki, De Serres), Montréal, Que.; Centre de recherche du CHU de Québec-Université Laval (Brousseau, Morin, De Serres), Québec, Que.; Départements de médecine et de médecine des laboratoires (Savard), Centre Hospitalier de l'Université de Montréal; Centre de recherche du Centre Hospitalier de l'Université de Montréal (Savard); Department of Microbiology, Infectious Diseases & Immunology (Quach), CHU Sainte-Justine, Université de Montréal; Jewish General Hospital (Longtin); Divisions of Infectious Disease and Medical Microbiology (Cheng), McGill University Health Center, Montréal, Que.; CIUSSS de l'Estrie - CHUS (Carignan, Lévesque, Martin); Département de microbiologie et infectiologie (Carignan, Lévesque, Martin), Faculté de médecine et des sciences de la santé, Université de Sherbrooke, Sherbrooke, Que.; Département de médecine (Dufresne, Lavallée), CIUSSS-de-l'Est-de-l'Île-de-Montréal; CIUSSS du Nord-de-l'Île-de-Montréal (Leduc, Gauthier), Montréal, Que.; Hôpital de l'Enfant-Jésus du CHU de Québec (Bestman-Smith), Québec, Que.; CIUSSS de l'Ouest-de-l'Île-de-Montréal (Arrieta); CIUSSS du Centre-Sud-de-l'île-de-Montréal (Ishak), Montréal, Que
| | - Maria-Jesus Arrieta
- Institut national de santé publique du Québec (Brousseau, Ouakki, De Serres), Montréal, Que.; Centre de recherche du CHU de Québec-Université Laval (Brousseau, Morin, De Serres), Québec, Que.; Départements de médecine et de médecine des laboratoires (Savard), Centre Hospitalier de l'Université de Montréal; Centre de recherche du Centre Hospitalier de l'Université de Montréal (Savard); Department of Microbiology, Infectious Diseases & Immunology (Quach), CHU Sainte-Justine, Université de Montréal; Jewish General Hospital (Longtin); Divisions of Infectious Disease and Medical Microbiology (Cheng), McGill University Health Center, Montréal, Que.; CIUSSS de l'Estrie - CHUS (Carignan, Lévesque, Martin); Département de microbiologie et infectiologie (Carignan, Lévesque, Martin), Faculté de médecine et des sciences de la santé, Université de Sherbrooke, Sherbrooke, Que.; Département de médecine (Dufresne, Lavallée), CIUSSS-de-l'Est-de-l'Île-de-Montréal; CIUSSS du Nord-de-l'Île-de-Montréal (Leduc, Gauthier), Montréal, Que.; Hôpital de l'Enfant-Jésus du CHU de Québec (Bestman-Smith), Québec, Que.; CIUSSS de l'Ouest-de-l'Île-de-Montréal (Arrieta); CIUSSS du Centre-Sud-de-l'île-de-Montréal (Ishak), Montréal, Que
| | - Magued Ishak
- Institut national de santé publique du Québec (Brousseau, Ouakki, De Serres), Montréal, Que.; Centre de recherche du CHU de Québec-Université Laval (Brousseau, Morin, De Serres), Québec, Que.; Départements de médecine et de médecine des laboratoires (Savard), Centre Hospitalier de l'Université de Montréal; Centre de recherche du Centre Hospitalier de l'Université de Montréal (Savard); Department of Microbiology, Infectious Diseases & Immunology (Quach), CHU Sainte-Justine, Université de Montréal; Jewish General Hospital (Longtin); Divisions of Infectious Disease and Medical Microbiology (Cheng), McGill University Health Center, Montréal, Que.; CIUSSS de l'Estrie - CHUS (Carignan, Lévesque, Martin); Département de microbiologie et infectiologie (Carignan, Lévesque, Martin), Faculté de médecine et des sciences de la santé, Université de Sherbrooke, Sherbrooke, Que.; Département de médecine (Dufresne, Lavallée), CIUSSS-de-l'Est-de-l'Île-de-Montréal; CIUSSS du Nord-de-l'Île-de-Montréal (Leduc, Gauthier), Montréal, Que.; Hôpital de l'Enfant-Jésus du CHU de Québec (Bestman-Smith), Québec, Que.; CIUSSS de l'Ouest-de-l'Île-de-Montréal (Arrieta); CIUSSS du Centre-Sud-de-l'île-de-Montréal (Ishak), Montréal, Que
| | - Simon Lévesque
- Institut national de santé publique du Québec (Brousseau, Ouakki, De Serres), Montréal, Que.; Centre de recherche du CHU de Québec-Université Laval (Brousseau, Morin, De Serres), Québec, Que.; Départements de médecine et de médecine des laboratoires (Savard), Centre Hospitalier de l'Université de Montréal; Centre de recherche du Centre Hospitalier de l'Université de Montréal (Savard); Department of Microbiology, Infectious Diseases & Immunology (Quach), CHU Sainte-Justine, Université de Montréal; Jewish General Hospital (Longtin); Divisions of Infectious Disease and Medical Microbiology (Cheng), McGill University Health Center, Montréal, Que.; CIUSSS de l'Estrie - CHUS (Carignan, Lévesque, Martin); Département de microbiologie et infectiologie (Carignan, Lévesque, Martin), Faculté de médecine et des sciences de la santé, Université de Sherbrooke, Sherbrooke, Que.; Département de médecine (Dufresne, Lavallée), CIUSSS-de-l'Est-de-l'Île-de-Montréal; CIUSSS du Nord-de-l'Île-de-Montréal (Leduc, Gauthier), Montréal, Que.; Hôpital de l'Enfant-Jésus du CHU de Québec (Bestman-Smith), Québec, Que.; CIUSSS de l'Ouest-de-l'Île-de-Montréal (Arrieta); CIUSSS du Centre-Sud-de-l'île-de-Montréal (Ishak), Montréal, Que
| | - Philippe Martin
- Institut national de santé publique du Québec (Brousseau, Ouakki, De Serres), Montréal, Que.; Centre de recherche du CHU de Québec-Université Laval (Brousseau, Morin, De Serres), Québec, Que.; Départements de médecine et de médecine des laboratoires (Savard), Centre Hospitalier de l'Université de Montréal; Centre de recherche du Centre Hospitalier de l'Université de Montréal (Savard); Department of Microbiology, Infectious Diseases & Immunology (Quach), CHU Sainte-Justine, Université de Montréal; Jewish General Hospital (Longtin); Divisions of Infectious Disease and Medical Microbiology (Cheng), McGill University Health Center, Montréal, Que.; CIUSSS de l'Estrie - CHUS (Carignan, Lévesque, Martin); Département de microbiologie et infectiologie (Carignan, Lévesque, Martin), Faculté de médecine et des sciences de la santé, Université de Sherbrooke, Sherbrooke, Que.; Département de médecine (Dufresne, Lavallée), CIUSSS-de-l'Est-de-l'Île-de-Montréal; CIUSSS du Nord-de-l'Île-de-Montréal (Leduc, Gauthier), Montréal, Que.; Hôpital de l'Enfant-Jésus du CHU de Québec (Bestman-Smith), Québec, Que.; CIUSSS de l'Ouest-de-l'Île-de-Montréal (Arrieta); CIUSSS du Centre-Sud-de-l'île-de-Montréal (Ishak), Montréal, Que
| | - Gaston De Serres
- Institut national de santé publique du Québec (Brousseau, Ouakki, De Serres), Montréal, Que.; Centre de recherche du CHU de Québec-Université Laval (Brousseau, Morin, De Serres), Québec, Que.; Départements de médecine et de médecine des laboratoires (Savard), Centre Hospitalier de l'Université de Montréal; Centre de recherche du Centre Hospitalier de l'Université de Montréal (Savard); Department of Microbiology, Infectious Diseases & Immunology (Quach), CHU Sainte-Justine, Université de Montréal; Jewish General Hospital (Longtin); Divisions of Infectious Disease and Medical Microbiology (Cheng), McGill University Health Center, Montréal, Que.; CIUSSS de l'Estrie - CHUS (Carignan, Lévesque, Martin); Département de microbiologie et infectiologie (Carignan, Lévesque, Martin), Faculté de médecine et des sciences de la santé, Université de Sherbrooke, Sherbrooke, Que.; Département de médecine (Dufresne, Lavallée), CIUSSS-de-l'Est-de-l'Île-de-Montréal; CIUSSS du Nord-de-l'Île-de-Montréal (Leduc, Gauthier), Montréal, Que.; Hôpital de l'Enfant-Jésus du CHU de Québec (Bestman-Smith), Québec, Que.; CIUSSS de l'Ouest-de-l'Île-de-Montréal (Arrieta); CIUSSS du Centre-Sud-de-l'île-de-Montréal (Ishak), Montréal, Que
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Zinszer K, McKinnon B, Bourque N, Pierce L, Saucier A, Otis A, Cheriet I, Papenburg J, Hamelin MÈ, Charland K, Carbonneau J, Zahreddine M, Savard A, Fortin G, Apostolatos A, Haley N, Ratté N, Laurin I, Nguyen CT, Conrod P, Boivin G, De Serres G, Quach C. Seroprevalence of SARS-CoV-2 Antibodies Among Children in School and Day Care in Montreal, Canada. JAMA Netw Open 2021; 4:e2135975. [PMID: 34812845 PMCID: PMC8611475 DOI: 10.1001/jamanetworkopen.2021.35975] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
IMPORTANCE Quebec prioritized in-person learning after the first wave of the COVID-19 pandemic, with school closures being implemented temporarily in selected schools or in hot-spot areas. Quebec's decision to keep most schools open was controversial, especially in Montreal, which was the epicenter of Canada's first and second waves; therefore, understanding the extent to which children were infected with SARS-CoV-2 provides important information for decisions about school closures. OBJECTIVE To estimate the seroprevalence of SARS-CoV-2 antibodies in children and teenagers in 4 neighborhoods of Montreal, Canada. DESIGN, SETTING, AND PARTICIPANTS This cohort study (the Enfants et COVID-19: Étude de séroprévalence [EnCORE] study) enrolled a convenience sample of children aged 2 to 17 years between October 22, 2020, and March 22, 2021, in Montreal, Canada. EXPOSURES Potential exposure to SARS-CoV-2. MAIN OUTCOMES AND MEASURES The main outcome was seroprevalence of SARS-CoV-2 antibodies, collected using dried blood spots (DBSs) and analyzed with a research-based enzyme-linked immunosorbent assay (ELISA). Parents also completed an online questionnaire that included questions on self-reported COVID-19 symptoms and tests, along with sociodemographic questions. RESULTS This study included 1632 participants who provided a DBS sample from 30 day cares, 22 primary schools, and 11 secondary schools. The mean (SD) age of the children who provided a DBS sample was 9.0 (4.4) years; 801 (49%) were female individuals, with 354 participants (22%) from day cares, 725 (44%) from primary schools, and 553 (34%) from secondary schools. Most parents had at least a bachelor's degree (1228 [75%]), and 210 (13%) self-identified as being a racial or ethnic minority. The mean seroprevalence was 5.8% (95% CI, 4.6%-7.0%) but increased over time from 3.2% (95% CI, 0.7%-5.8%) in October to November 2020 to 8.4% (95% CI, 4.4%-12.4%) in March to April 2021. Of the 95 children with positive SARS-CoV-2 antibody results, 78 (82%) were not tested or tested negative with reverse transcription-polymerase chain reaction (RT-PCR) testing, and all experienced mild (49 [52%]) or no clinical symptoms (46 [48%]). The children of parents who self-identified as belonging to a racial and ethnic minority group were more likely to be seropositive compared with children of White parents (adjusted seroprevalence ratio, 1.9; 95% CI, 1.1-2.6). CONCLUSIONS AND RELEVANCE These results provide a benchmark of the seroprevalence status in Canadian children. The findings suggest that there was more transmission occurring in children compared with what was being detected by RT-PCR, although children experienced few or mild symptoms. It will be important to continue monitoring the serological status of children, particularly in the context of new COVID-19 variants of concern and in the absence of mass vaccination campaigns targeting young children.
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Affiliation(s)
- Kate Zinszer
- University of Montreal, Montreal, Quebec, Canada
- Centre for Public Health Research, Montreal, Quebec, Canada
| | - Britt McKinnon
- University of Montreal, Montreal, Quebec, Canada
- Centre for Public Health Research, Montreal, Quebec, Canada
- University of Toronto, Toronto, Ontario, Canada
| | - Noémie Bourque
- University of Montreal, Montreal, Quebec, Canada
- Centre for Public Health Research, Montreal, Quebec, Canada
| | - Laura Pierce
- Centre for Public Health Research, Montreal, Quebec, Canada
| | - Adrien Saucier
- University of Montreal, Montreal, Quebec, Canada
- Centre for Public Health Research, Montreal, Quebec, Canada
| | - Alexandra Otis
- Centre for Public Health Research, Montreal, Quebec, Canada
| | | | - Jesse Papenburg
- Montreal Children’s Hospital, Montreal, Quebec, Canada
- McGill University Health Centre, Montreal, Quebec, Canada
| | | | - Katia Charland
- Centre for Public Health Research, Montreal, Quebec, Canada
| | | | | | - Ashley Savard
- Centre for Public Health Research, Montreal, Quebec, Canada
| | - Geneviève Fortin
- University of Montreal, Montreal, Quebec, Canada
- Centre for Public Health Research, Montreal, Quebec, Canada
| | | | - Nancy Haley
- Direction régionale de la santé publique du Centre intégré universitaire de santé et de services sociaux du Centre-Sud-de-l’Île-de-Montréal, Montreal, Quebec, Canada
| | - Nathalie Ratté
- Direction régionale de la santé publique du Centre intégré universitaire de santé et de services sociaux du Centre-Sud-de-l’Île-de-Montréal, Montreal, Quebec, Canada
| | - Isabel Laurin
- University of Montreal, Montreal, Quebec, Canada
- Direction régionale de la santé publique du Centre intégré universitaire de santé et de services sociaux du Centre-Sud-de-l’Île-de-Montréal, Montreal, Quebec, Canada
| | - Cat Tuong Nguyen
- Direction régionale de la santé publique du Centre intégré universitaire de santé et de services sociaux du Centre-Sud-de-l’Île-de-Montréal, Montreal, Quebec, Canada
| | - Patrica Conrod
- University of Montreal, Montreal, Quebec, Canada
- Research Centre of the Sainte-Justine University Hospital, Montreal, Quebec, Canada
| | - Guy Boivin
- Research Centre Laval University, Quebec City, Quebec, Canada
| | - Gaston De Serres
- National Institute of Public Health of Quebec, Quebec City, Quebec, Canada
| | - Caroline Quach
- University of Montreal, Montreal, Quebec, Canada
- Research Centre of the Sainte-Justine University Hospital, Montreal, Quebec, Canada
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Lewin A, Therrien R, De Serres G, Grégoire Y, Perreault J, Drouin M, Fournier MJ, Tremblay T, Beaudoin J, Beaudoin-Bussières G, Prévost J, Gendron-Lepage G, Finzi A, Bernier F, Bazin R, Germain M, Delage G. SARS-CoV-2 seroprevalence among blood donors in Québec, and analysis of symptoms associated with seropositivity: a nested case-control study. Can J Public Health 2021; 112:576-586. [PMID: 33999398 PMCID: PMC8127462 DOI: 10.17269/s41997-021-00531-6] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Accepted: 04/15/2021] [Indexed: 12/26/2022]
Abstract
OBJECTIVES A substantial proportion of individuals infected with SARS-CoV-2 do not experience noticeable symptoms typical of COVID-19. Our objectives were to evaluate the impact of the first wave of the pandemic in Québec by measuring SARS-CoV-2 antibody seroprevalence in a convenience sample of healthy blood donors and to study the association between seropositivity and the occurrence of COVID-19 symptoms. METHODS The study design was a cross-sectional serological survey with a nested case-control study. Residual blood samples from donations collected between May 25 and July 9, 2020 (well before vaccination rollout) in the province of Québec were tested for anti-Spike RBD antibodies by ELISA. Seropositive donors and a control group of seronegative donors were questioned about prior COVID-19 symptoms. All qualified blood donors were eligible for participation. RESULTS A total of 7691 blood donors were included in the study. After adjustments, the seroprevalence rate was 2.2% (95% CI 1.9-2.6). Seropositive donors reported one or more symptoms in a proportion of 52.2% (95% CI 44.2-60.1); this proportion was 19.1% (95% CI 13.4-26.1) among seronegative donors, suggesting that approximately 50-66% of all infections were asymptomatic. Univariate analysis of associations between symptoms and seropositivity revealed that except for rhinorrhea, all symptoms were significantly associated with seropositivity. CONCLUSION Assuming that blood donors are fairly representative of the general adult population, this study shows that less than 3% of 18-69-year-olds have been infected during the first wave of the pandemic in the province of Québec. Our data also confirm that many infections escaped detection, including a substantial proportion that were asymptomatic.
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Affiliation(s)
- Antoine Lewin
- Héma-Québec, Affaires Médicales et Innovation, 4045 Blvd. de la Côte-Vertu, Saint-Laurent, Montréal, QC, H4R 2W7, Canada
- Faculté de médecine et des sciences de la santé, Université de Sherbrooke, Sherbrooke, QC, J1H 5N4, Canada
| | - Roseline Therrien
- Héma-Québec, Qualité et développement, Montréal, QC, H4R 2W7, Canada
| | - Gaston De Serres
- Institut National de Santé Publique du Québec, Québec, QC, H2P 1E2, Canada
- Centre de recherche du CHU de Québec-Université Laval, Québec, QC, G1E 6W2, Canada
| | - Yves Grégoire
- Héma-Québec, Affaires Médicales et Innovation, Québec, QC, G1V 5C3, Canada
| | - Josée Perreault
- Héma-Québec, Affaires Médicales et Innovation, Québec, QC, G1V 5C3, Canada
| | - Mathieu Drouin
- Héma-Québec, Affaires Médicales et Innovation, Québec, QC, G1V 5C3, Canada
| | | | - Tony Tremblay
- Héma-Québec, Affaires Médicales et Innovation, Québec, QC, G1V 5C3, Canada
| | - Julie Beaudoin
- Héma-Québec, Qualité et développement, Montréal, QC, H4R 2W7, Canada
| | - Guillaume Beaudoin-Bussières
- Centre de Recherche du CHUM, Montréal, QC, H2X 0A9, Canada
- Département de Microbiologie, Infectiologie et Immunologie, Université de Montréal, Montréal, QC, H2X 0A9, Canada
| | - Jérémie Prévost
- Centre de Recherche du CHUM, Montréal, QC, H2X 0A9, Canada
- Département de Microbiologie, Infectiologie et Immunologie, Université de Montréal, Montréal, QC, H2X 0A9, Canada
| | | | - Andrés Finzi
- Centre de Recherche du CHUM, Montréal, QC, H2X 0A9, Canada
- Département de Microbiologie, Infectiologie et Immunologie, Université de Montréal, Montréal, QC, H2X 0A9, Canada
| | - France Bernier
- Héma-Québec, Qualité et développement, Montréal, QC, H4R 2W7, Canada
| | - Renée Bazin
- Héma-Québec, Affaires Médicales et Innovation, Québec, QC, G1V 5C3, Canada
| | - Marc Germain
- Héma-Québec, Affaires Médicales et Innovation, Québec, QC, G1V 5C3, Canada
| | - Gilles Delage
- Héma-Québec, Affaires Médicales et Innovation, 4045 Blvd. de la Côte-Vertu, Saint-Laurent, Montréal, QC, H4R 2W7, Canada.
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Tauzin A, Nayrac M, Benlarbi M, Gong SY, Gasser R, Beaudoin-Bussières G, Brassard N, Laumaea A, Vézina D, Prévost J, Anand SP, Bourassa C, Gendron-Lepage G, Medjahed H, Goyette G, Niessl J, Tastet O, Gokool L, Morrisseau C, Arlotto P, Stamatatos L, McGuire AT, Larochelle C, Uchil P, Lu M, Mothes W, De Serres G, Moreira S, Roger M, Richard J, Martel-Laferrière V, Duerr R, Tremblay C, Kaufmann DE, Finzi A. A single dose of the SARS-CoV-2 vaccine BNT162b2 elicits Fc-mediated antibody effector functions and T cell responses. Cell Host Microbe 2021; 29:1137-1150.e6. [PMID: 34133950 PMCID: PMC8175625 DOI: 10.1016/j.chom.2021.06.001] [Citation(s) in RCA: 125] [Impact Index Per Article: 41.7] [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: 03/22/2021] [Revised: 05/06/2021] [Accepted: 06/01/2021] [Indexed: 12/17/2022]
Abstract
While the standard regimen of the BNT162b2 mRNA vaccine for SARS-CoV-2 includes two doses administered 3 weeks apart, some public health authorities are spacing these doses, raising concerns about efficacy. However, data indicate that a single dose can be up to 90% effective starting 14 days post-administration. To assess the mechanisms contributing to protection, we analyzed humoral and T cell responses three weeks after a single BNT162b2 dose. We observed weak neutralizing activity elicited in SARS-CoV-2 naive individuals but strong anti-receptor binding domain and spike antibodies with Fc-mediated effector functions and cellular CD4+ T cell responses. In previously infected individuals, a single dose boosted all humoral and T cell responses, with strong correlations between T helper and antibody immunity. Our results highlight the potential role of Fc-mediated effector functions and T cell responses in vaccine efficacy. They also provide support for spacing doses to vaccinate more individuals in conditions of vaccine scarcity.
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Affiliation(s)
- Alexandra Tauzin
- Centre de Recherche du CHUM, Montréal, QC H2X 0A9, Canada; Département de Microbiologie, Infectiologie et Immunologie, Université de Montréal, Montreal, QC H2X 0A9, Canada
| | - Manon Nayrac
- Centre de Recherche du CHUM, Montréal, QC H2X 0A9, Canada; Département de Microbiologie, Infectiologie et Immunologie, Université de Montréal, Montreal, QC H2X 0A9, Canada
| | - Mehdi Benlarbi
- Centre de Recherche du CHUM, Montréal, QC H2X 0A9, Canada
| | - Shang Yu Gong
- Centre de Recherche du CHUM, Montréal, QC H2X 0A9, Canada; Department of Microbiology and Immunology, McGill University, Montreal, QC H3A 2BA, Canada
| | - Romain Gasser
- Centre de Recherche du CHUM, Montréal, 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, Montréal, QC H2X 0A9, Canada; Département de Microbiologie, Infectiologie et Immunologie, Université de Montréal, Montreal, QC H2X 0A9, Canada
| | | | - Annemarie Laumaea
- Centre de Recherche du CHUM, Montréal, 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, Montréal, QC H2X 0A9, Canada; Département de Microbiologie, Infectiologie et Immunologie, Université de Montréal, Montreal, QC H2X 0A9, Canada
| | - Jérémie Prévost
- Centre de Recherche du CHUM, Montréal, QC H2X 0A9, Canada; Département de Microbiologie, Infectiologie et Immunologie, Université de Montréal, Montreal, QC H2X 0A9, Canada
| | - Sai Priya Anand
- Centre de Recherche du CHUM, Montréal, QC H2X 0A9, Canada; Department of Microbiology and Immunology, McGill University, Montreal, QC H3A 2BA, Canada
| | | | | | | | | | - Julia Niessl
- Centre de Recherche du CHUM, Montréal, QC H2X 0A9, Canada; Département de Microbiologie, Infectiologie et Immunologie, Université de Montréal, Montreal, QC H2X 0A9, Canada; Consortium for HIV/AIDS Vaccine Development (CHAVD), La Jolla, CA, USA
| | - Olivier Tastet
- Centre de Recherche du CHUM, Montréal, QC H2X 0A9, Canada
| | - Laurie Gokool
- Centre de Recherche du CHUM, Montréal, QC H2X 0A9, Canada
| | | | | | - Leonidas Stamatatos
- Fred Hutchinson Cancer Research Center, Vaccine and Infectious Disease Division, Seattle, WA 98109, USA; University of Washington, Department of Global Health, Seattle, WA 98109, USA
| | - Andrew T McGuire
- Fred Hutchinson Cancer Research Center, Vaccine and Infectious Disease Division, Seattle, WA 98109, USA
| | - Catherine Larochelle
- Centre de Recherche du CHUM, Montréal, QC H2X 0A9, Canada; Département des Neurosciences, Université de Montréal, Montreal, QC H3C 3J7, Canada
| | - Pradeep Uchil
- Department of Microbial Pathogenesis, Yale University School of Medicine, New Haven, CT 06510, USA
| | - Maolin Lu
- Department of Microbial Pathogenesis, Yale University School of Medicine, New Haven, CT 06510, USA
| | - Walther Mothes
- Department of Microbial Pathogenesis, Yale University School of Medicine, New Haven, CT 06510, USA
| | - Gaston De Serres
- Institut National de Santé Publique du Québec, Quebec, QC, H2P 1E2, Canada
| | - Sandrine Moreira
- Laboratoire de Santé Publique du Québec, Institut National de Santé Publique du Québec, Sainte-Anne-de-Bellevue, QC H9X 3R5, Canada
| | - Michel Roger
- Centre de Recherche du CHUM, Montréal, QC H2X 0A9, Canada; Département de Microbiologie, Infectiologie et Immunologie, Université de Montréal, Montreal, QC H2X 0A9, Canada; Laboratoire de Santé Publique du Québec, Institut National de Santé Publique du Québec, Sainte-Anne-de-Bellevue, QC H9X 3R5, Canada
| | - Jonathan Richard
- Centre de Recherche du CHUM, Montréal, 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, Montréal, QC H2X 0A9, Canada; Département de Microbiologie, Infectiologie et Immunologie, Université de Montréal, Montreal, QC H2X 0A9, Canada
| | - Ralf Duerr
- Department of Microbiology, New York University School of Medicine, New York, NY 10016, USA
| | - Cécile Tremblay
- Centre de Recherche du CHUM, Montréal, 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, Montréal, QC H2X 0A9, Canada; Département de Médecine, Université de Montréal, Montreal, QC H3T 1J4, Canada; Consortium for HIV/AIDS Vaccine Development (CHAVD), La Jolla, CA, USA.
| | - Andrés Finzi
- Centre de Recherche du CHUM, Montréal, 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 2BA, Canada.
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Ducrocq J, Ndao M, Yansouni CP, Proulx JF, Mondor M, Hamel D, Lévesque B, De Serres G, Talbot D. Epidemiology associated with the exposure to Toxoplasma gondii in Nunavik's Inuit population using the 2017 Qanuilirpitaa cross-sectional health survey. Zoonoses Public Health 2021; 68:803-814. [PMID: 34254450 DOI: 10.1111/zph.12870] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Accepted: 06/03/2021] [Indexed: 02/01/2023]
Abstract
Foci of high seroprevalence against Toxoplasma gondii are observed in Nunavik, the Inuit land of Northern Quebec (Canada). Considering the rare occurrence of felids in the region, exposure is suspected to be driven by water- and food-borne transmission routes. Hypotheses were that drinking untreated water from natural sources and eating country food mostly raw increased the risk of exposure to the parasite. Data from 1,300 Inuit participants of the 2017 Nunavik Health Survey were included in three weighted robust Poisson regression models. The effect of three types of exposure variables: (1) water treatment (yes/no) and if country food was mostly eaten raw (yes/no); (2) main source of drinking water (bottled/municipal/natural) and frequency of country food consumption (continuous) and (3) drinking water risk (low/intermediate/high) and frequency of a raw country food consumption (continuous), on the presence of Toxoplasma antibodies were estimated. Models were adjusted for age, sex and ecological region, with multiple sensitivity analyses being performed. Toxoplasma gondii seroprevalences were consistently correlated with age quadratically, sex (prevalence ratio = PRwoman/man ranged from 1.18 to 1.22), ecological region (PRHudsonBay/HudsonStrait ranged from 2.18 to 2.41; PRHudsonBay/UngavaBay ranged from 1.52 to 1.59) and consuming bivalve mollusc/urchin (PR varied from 1.02 to 1.21) across all three models. Each increase of two consumptions per month of beluga (PR ranged from 1.01 to 1.03), seal liver (PR ranged from 1.01 to 1.02) and goose (PR ranged from 1.01 to 1.02) were also associated with seropositivity, albeit more clearly in models 2 and 3, while drinking water mainly from natural (PR of 1.47) or municipal (PR = 1.42) sources compared to bottled water, was correlated with seroprevalence, although results were compatible with the null. Our results suggest that both the oocyst- (mollusc/urchin, drinking water) and cyst-borne (walrus, seal liver and goose) transmission pathways could be present in Nunavik.
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Affiliation(s)
- Julie Ducrocq
- Université Laval, Québec, QC, Canada.,CHU de Québec-Université Laval Research Center, Axe santé des populations et pratiques optimales en santé, Québec, QC, Canada
| | - Momar Ndao
- National Reference Centre for Parasitology, Montréal, QC, Canada.,J.D. MacLean Centre for Tropical Diseases, McGill University Health Centre, Montréal, QC, Canada
| | - Cedric P Yansouni
- J.D. MacLean Centre for Tropical Diseases, McGill University Health Centre, Montréal, QC, Canada
| | | | - Myrto Mondor
- CHU de Québec-Université Laval Research Center, Axe santé des populations et pratiques optimales en santé, Québec, QC, Canada
| | - Denis Hamel
- Institut national de santé publique du Québec, Québec, QC, Canada
| | - Benoit Lévesque
- Université Laval, Québec, QC, Canada.,Institut national de santé publique du Québec, Québec, QC, Canada
| | - Gaston De Serres
- Université Laval, Québec, QC, Canada.,Institut national de santé publique du Québec, Québec, QC, Canada
| | - Denis Talbot
- Université Laval, Québec, QC, Canada.,CHU de Québec-Université Laval Research Center, Axe santé des populations et pratiques optimales en santé, Québec, QC, Canada
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48
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Zinszer K, McKinnon B, Bourque N, Zahreddine M, Charland K, Papenburg J, Fortin G, Hamelin MÈ, Saucier A, Apostolatos A, Pierce L, Savard-Lamothe A, Carbonneau J, Conrod P, Haley N, Laurin I, Boivin G, De Serres G, Quach C. Seroprevalence of anti-SARS-CoV-2 antibodies among school and daycare children and personnel: protocol for a cohort study in Montreal, Canada. BMJ Open 2021; 11:e053245. [PMID: 34244288 PMCID: PMC8275359 DOI: 10.1136/bmjopen-2021-053245] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Accepted: 06/25/2021] [Indexed: 12/25/2022] Open
Abstract
INTRODUCTION Further evidence is needed to understand the contribution of schools and daycares for the spread of COVID-19 in the context of diverse transmission dynamics and continually evolving public health interventions. The Enfants et COVID-19: Étude de séroprévalence (EnCORE) study will estimate the seroprevalence and seroconversion of SARS-CoV-2 among school and daycare children and personnel. In addition, the study will examine associations between seroprevalence and sociodemographic characteristics and reported COVID-19 symptoms and tests, and investigates changes in health, lifestyle and well-being outcomes. METHODS AND ANALYSIS This study includes children and personnel from 62 schools and daycares in four neighbourhoods in Montreal, Canada. All children aged 2-17 years attending one of the participating schools or daycares and their parents are invited to participate, as well as a sample of personnel members. Participants respond to brief questionnaires and provide blood samples, collected via dried blood spot, at baseline (October 2020-March 2021) and follow-up (May-June 2021). Questionnaires include sociodemographic and household characteristics, reported COVID-19 symptoms and tests, potential COVID-19 risk factors and prevention efforts and health and lifestyle information. Logistic regression using generalised estimating equations will be used to estimate seroprevalence and seroconversion, accounting for school-level clustering. ETHICS AND DISSEMINATION This study was approved by the research ethics boards of the Université de Montréal (CERSES) and the Centre Hospitalier Universitaire Sainte-Justine. Results will contribute to our knowledge about SARS-CoV-2 transmission in schools and daycares and will be made available to study participants and their families, school and public health decision-makers and the research community.
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Affiliation(s)
- Kate Zinszer
- Department of Social and Preventive Medicine, School of Public Health, University of Montreal, Montreal, Quebec, Canada
- Centre for Public Health Research, University of Montreal, Montreal, Quebec, Canada
| | - Britt McKinnon
- Centre for Public Health Research, University of Montreal, Montreal, Quebec, Canada
- Epidemiology Division, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Noémie Bourque
- Centre for Public Health Research, University of Montreal, Montreal, Quebec, Canada
| | - Monica Zahreddine
- Centre for Public Health Research, University of Montreal, Montreal, Quebec, Canada
| | - Katia Charland
- Centre for Public Health Research, University of Montreal, Montreal, Quebec, Canada
| | - Jesse Papenburg
- McGill University Health Centre, Montreal, Quebec, Canada
- Montreal Children's Hospital, Montreal, Quebec, Canada
| | - Geneviève Fortin
- Department of Social and Preventive Medicine, School of Public Health, University of Montreal, Montreal, Quebec, Canada
| | | | - Adrien Saucier
- Department of Social and Preventive Medicine, School of Public Health, University of Montreal, Montreal, Quebec, Canada
- Centre for Public Health Research, University of Montreal, Montreal, Quebec, Canada
| | - Alex Apostolatos
- Faculty of Medicine, University of Montreal, Montreal, Quebec, Canada
| | - Laura Pierce
- Centre for Public Health Research, University of Montreal, Montreal, Quebec, Canada
| | - Ashley Savard-Lamothe
- Department of Social and Preventive Medicine, School of Public Health, University of Montreal, Montreal, Quebec, Canada
| | - Julie Carbonneau
- Centre Hospitalier de l'Université Laval, Quebec, Quebec, Canada
| | - Patricia Conrod
- Department of Psychiatry, University of Montreal, Montreal, Quebec, Canada
- Le Centre Hospitalier Universitaire Sainte-Justine, Montreal, Quebec, Canada
| | - Nancy Haley
- Direction régionale de la santé publique de Montréal du CIUSSS du Centre-Sud-de-l'Île-de-Montréal, Montreal, Quebec, Canada
| | - Isabelle Laurin
- Direction régionale de la santé publique de Montréal du CIUSSS du Centre-Sud-de-l'Île-de-Montréal, Montreal, Quebec, Canada
| | - Guy Boivin
- Centre Hospitalier de l'Université Laval, Quebec, Quebec, Canada
| | - Gaston De Serres
- Institut national de sante publique du Quebec, Quebec, Quebec, Canada
| | - Caroline Quach
- Le Centre Hospitalier Universitaire Sainte-Justine, Montreal, Quebec, Canada
- Department of Microbiology, Infectious Diseases, and Immunology, University of Montreal, Montreal, Quebec, Canada
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Affiliation(s)
| | - Gaston De Serres
- Institut National de Santé Publique du Québec, Quebec City, QC, Canada
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Tauzin A, Nayrac M, Benlarbi M, Gong SY, Gasser R, Beaudoin-Bussières G, Brassard N, Laumaea A, Vézina D, Prévost J, Anand SP, Bourassa C, Gendron-Lepage G, Medjahed H, Goyette G, Niessl J, Tastet O, Gokool L, Morrisseau C, Arlotto P, Stamatatos L, McGuire AT, Larochelle C, Uchil P, Lu M, Mothes W, Serres GD, Moreira S, Roger M, Richard J, Martel-Laferrière V, Duerr R, Tremblay C, Kaufmann DE, Finzi A. A single BNT162b2 mRNA dose elicits antibodies with Fc-mediated effector functions and boost pre-existing humoral and T cell responses. bioRxiv 2021. [PMID: 33758857 DOI: 10.1101/2021.03.18.435972] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
The standard dosing of the Pfizer/BioNTech BNT162b2 mRNA vaccine validated in clinical trials includes two doses administered three weeks apart. While the decision by some public health authorities to space the doses because of limiting supply has raised concerns about vaccine efficacy, data indicate that a single dose is up to 90% effective starting 14 days after its administration. We analyzed humoral and T cells responses three weeks after a single dose of this mRNA vaccine. Despite the proven efficacy of the vaccine at this time point, no neutralizing activity were elicited in SARS-CoV-2 naïve individuals. However, we detected strong anti-receptor binding domain (RBD) and Spike antibodies with Fc-mediated effector functions and cellular responses dominated by the CD4 + T cell component. A single dose of this mRNA vaccine to individuals previously infected by SARS-CoV-2 boosted all humoral and T cell responses measured, with strong correlations between T helper and antibody immunity. Neutralizing responses were increased in both potency and breadth, with distinctive capacity to neutralize emerging variant strains. Our results highlight the importance of vaccinating uninfected and previously-infected individuals and shed new light into the potential role of Fc-mediated effector functions and T cell responses in vaccine efficacy. They also provide support to spacing the doses of two-vaccine regimens to vaccinate a larger pool of the population in the context of vaccine scarcity against SARS-CoV-2.
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