Efficacy of COVID-19 Vaccines in Patients with Hematological Malignancy Compared to Healthy Controls: A Systematic Review and Meta-analysis.

Background: The possibility of developing a severe coronavirus infectious (COVID-19) disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has increased, particularly in patients with hematological malignancies. These patients are more likely to produce less antibody protection due to the immunocompromised nature of the disease and the anticancer treatments. Therefore, the present systematic review intended to evaluate the seroconversion rate of COVID-19 vaccines in patients with hematological malignancies compared with healthy controls. Methods: A comprehensive systematic search was conducted in Medline via PubMed, EMBASE, and the World Health Organization COVID-19 Research Database, as well as other searches (i.e., reference list from article search and manual searches), from December 2020 to May 2022. The outcome of interest included estimating the seroconversion rates following COVID-19 vaccination in patients with hematological malignancies and comparing them with those in healthy controls. After two-step screening, the data were extracted and the summary measures were calculated using a random-effects model. Results: A total of 39 articles regarding patients with hematological malignancies were included in the present review. After the first vaccine dose, these patients had considerably lower antibody response rates (37.0%) compared with healthy controls (74.5%). Following the second vaccine dose, the seroconversion rate in patients reached 66.8%, whereas it peaked at 97.9% in the healthy controls following complete immunization. Notably, the BNT162b2 and ChAdOx1 vaccine combination achieved the highest seropositivity rate of approximately 70%. Multiple myeloma, chronic lymphocytic leukemia, and lymphoma were the cancers of interest in most of the studies. Conclusions: The results of the present study highlighted the comparatively low seropositivity rates in patients with hematological malignancies, with substantial variations in rates across disease groups. The findings emphasize the possibility of additional booster doses for these individuals to enhance their immunity against SARS-CoV-2.

Henoch-Schönlein purpura following mRNA COVID-19 vaccination: a case report.

The coronavirus disease 2019 (COVID-19) vaccine was developed to provide immunity against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which was first reported in 2019. The vaccine has proven to be effective in reducing severity and mortality and preventing infection. Henoch-Schönlein purpura is an autoimmune vasculitis (immunoglobulin A vasculitis). Historically, vaccines have been administered primarily to children, and Henoch-Schönlein purpura has often been reported in children following vaccination. However, since the start of COVID-19 vaccination, an increasing number of cases have been reported in adults. Here, we report a case of a patient who developed hematuria and proteinuria after receiving the messenger RNA COVID-19 vaccine. A 22-year-old man presented to the hospital with a lower extremity rash, bilateral ankle pain, and abdominal pain 18 days after receiving the COVID-19 vaccine. The man had no significant medical history and was not taking any medications. Laboratory tests showed normal platelet counts but elevated white blood cell counts and C-reactive protein and fibrinogen levels. He was treated with the non-steroidal anti-inflammatory drugs, pheniramine and prednisolone. At 40 days after starting treatment, C-reactive protein levels were within normal limits, and no hematuria was observed. Treatment was terminated when the purpura disappeared. This report is intended to highlight the need for further research to be proactive and carefully monitor for conditions associated with the COVID-19 vaccine.

mRNA COVID-19 vaccine safety among older adults from the Canadian National Vaccine Safety Network.

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.

Cross-Reactive Antibody Responses to Coronaviruses Elicited by SARS-CoV-2 Infection or Vaccination.

BACKGROUND: The newly emerged SARS-CoV-2 possesses shared antigenic epitopes with other human coronaviruses. We investigated if COVID-19 vaccination or SARS-CoV-2 infection may boost cross-reactive antibodies to other human coronaviruses. METHODS: Prevaccination and postvaccination sera from SARS-CoV-2 naïve healthy subjects who received three doses of the mRNA vaccine (BioNTech, BNT) or the inactivated vaccine (CoronaVac, CV) were used to monitor the level of cross-reactive antibodies raised against other human coronaviruses by enzyme-linked immunosorbent assay. In comparison, convalescent sera from COVID-19 patients with or without prior vaccination history were also tested. Pseudoparticle neutralization assay was performed to detect neutralization antibody against MERS-CoV. RESULTS: Among SARS-CoV-2 infection-naïve subjects, BNT or CV significantly increased the anti-S2 antibodies against Betacoronaviruses (OC43 and MERS-CoV) but not Alphacoronaviruses (229E). The prevaccination antibody response to the common cold human coronaviruses did not negatively impact the postvaccination antibody response to SARS-CoV-2. Cross-reactive antibodies that binds to the S2 protein of MERS-CoV were similarly detected from the convalescent sera of COVID-19 patients with or without vaccination history. However, these anti-S2 antibodies do not possess neutralizing activity in MERS-CoV pseudoparticle neutralization tests. CONCLUSIONS: Our results suggest that SARS-CoV-2 infection or vaccination may potentially modulate population immune landscape against previously exposed or novel human coronaviruses. The findings have implications for future sero-epidemiological studies on MERS-CoV.

Hesitation towards the COVID-19 vaccine in the United States: a digital ethnographic study. / Vacilación ante la vacuna contra el covid-19 en Estados Unidos de América: un estudio etnográfico digital.

Following the authorization the use of COVID-19 vaccines in babies age six months through children four years old in the United States, some individuals (parents, pediatricians, and communicators) framed COVID-19 vaccination as an issue of access, while many others expressed hesitancy and some resisted recommendations from the US Centers for Disease Control and Prevention. In this context, this study aimed to explore: 1) divergent reactions to the authorization of COVID-19 vaccine use in children aged six months to four years; and 2) opposing logics underlying attitudes towards pro-vaccination, anti-vaccination, and vaccine hesitancy regarding COVID-19 vaccines. To achieve this, a digital ethnography was conducted, involving monitoring of 5,700 reactions to a series of eight infographics published on social media by the John Hopkins Bloomberg School of Public Health, and participant observation in an online focus group over a one-year period, from December 2021 to December 2022, consisting of 18 mothers. The findings suggest that healthcare professionals should consider different notions of "risk" when interacting with patients, especially those who are hesitant to vaccinate.

Luego de que se autorizara en EEUU el uso de la vacuna contra el covid-19 en bebés de seis meses a niños y niñas de cuatro años, algunas personas (padres, madres, pediatras y comunicadores) plantearon la vacunación contra el covid-19 como una cuestión de acceso; sin embargo, muchas otras se mostraron reacias y otras se resistieron a las recomendaciones de los Centers for Disease Control and Prevention de EEUU. En este contexto, este estudio se propuso explorar: 1) reacciones divergentes ante la autorización de uso de la vacuna contra el covid-19 en niños y niñas de seis meses a cuatro años; y 2) lógicas contrapuestas que subyacen a las actitudes provacunación, antivacunación y vacilación ante las vacunas contra el covid-19. Para ello, se realizó una etnografía digital, con monitoreo de 5.700 reacciones a una serie de ocho infografías publicadas en las redes sociales por la John Hopkins Bloomberg School of Public Health, y observación participante en un grupo focal en línea a lo largo de un año, desde diciembre de 2021 hasta diciembre de 2022, conformado por 18 madres. Los resultados indican que el personal médico debe considerar diferentes nociones de "riesgo" al interactuar con los pacientes, especialmente aquellos que dudan en vacunarse.

Clinical outcomes and risk factors for SARS-CoV-2 breakthrough cases following vaccination with BNT162b2, CoronaVac, or ChAdOx1-S: A retrospective cohort study in Malaysia.

Background: The SARS-CoV-2 pandemic drove global vaccination. However, breakthrough infections raised concerns about vaccine performance, leading the World Health Organization (WHO) to recommend investigations thereof. This study aimed to evaluate the clinical outcomes (time to breakthrough infection, intensive care unit [ICU] admission, and in-hospital mortality) of hospitalised patients with SARS-CoV-2 breakthrough infection. This was the primary outcome and the risk factors associated with its severity were the secondary outcomes. Methods: This retrospective cohort study at a multispecialty tertiary hospital in Selangor, Malaysia included 200 fully adult vaccinated patients, with confirmed SARS-CoV-2 infection, admitted from September 2021 to February 2022. Participants were selected by simple random sampling. Infection severity was categorised as CAT 2-3 (mild-moderate) and 4-5 (severe-critical). Results: The time to breakthrough infection was significantly longer for BNT162B2 recipients (128.47 ± 46.21 days) compared to CoronaVac (94.09 ± 48.71 days; P = 0.001) and ChAdOx1-S recipients (90.80 ± 37.59 days; P = 0.019). No significant associations were found between SARS-CoV-2-related ICU admission, mortality, and the vaccines. Multivariable analysis identified vaccine type, variant of concern, ethnicity, and hypertension as significant predictors of severity. BNT162b2 and ChAdOx1-S recipients had significantly (81 % and 74 %, respectively) lower odds of CAT 4-5 infection compared to CoronaVac recipients. Indian patients had a significantly (83 %) lower chance of CAT 4-5 infection compared to Malay patients. Patients with breakthrough infections during the Omicron period had a significantly (58 %) lower risk of CAT 4-5 compared to those in the Delta period. The CAT 4-5 risk was significantly (nearly threefold) higher in hypertensive patients. Conclusion: The results support the Malaysian Ministry of Health's recommended booster three months after primary vaccination and the WHO's recommended heterologous booster following CoronaVac. Certain ethnic groups, hypertensive patients, and viral variants may require attention in future pandemics.

Trusted sources of information on COVID-19 vaccine in Uganda.

BACKGROUND: The COVID-19 pandemic has dramatically impacted communities worldwide, particularly in developing countries. To successfully control the pandemic, correct information and more than 80% vaccine coverage in a population were required. However, misinformation and disinformation could impact this, thus increasing COVID-19 vaccine hesitancy in communities. Several studies observed the effect of misinformation and disinformation on COVID-19 vaccine acceptance and other responses to the pandemic in the African continent. Thus, the most trusted sources of information on COVID-19 vaccines are critical for the successful management and control of the pandemic. This study aimed to assess the most trusted sources of information on COVID-19 vaccines during the pandemic in Uganda. METHODS: We conducted a cross-sectional study on 587 adult population members in northern Uganda. Single-stage stratified and systematic sampling methods were used to select participants from northern Uganda. An interviewer-administered questionnaire with an internal validity of Cronbach's α = 0.72 was used for data collection. An Institution Review Board (IRB) approved this study and Stata version 18 was used for data analysis. A Pearson Chi-square (χ2) analysis was conducted to assess associations between trusted sources of COVID-19 vaccine information and selected independent variables. Fisher's exact test considered associations when the cell value following cross-tabulation was < 5. A P-value < 0.05 was used as evidence for an association between trusted sources of information and independent variables. All results were presented as frequencies, proportions, Chi-square or Fisher's exact tests, and P-values at 95% Confidence Intervals (CI). RESULTS: In a study of 587 participants, most were males, 335(57.1%), in the age group of 25-34 years, 180(31.4%), and the most trusted source of COVID-19 vaccine information were the traditional media sources for example, Televisions, Radios, and Newspapers, 349(33.6%). There was no significant association between sex and trusted sources of COVID-19 vaccine information. However, by age-group population, COVID-19 vaccine information was significantly associated with internet use (14.7% versus 85.3%; p = 0.02), information from family members (9.4% versus 90.6%; p < 0.01), and the Government/Ministry of Health (37.9% versus 62.1%; p < 0.01). Between healthcare workers and non-health workers, it was significantly associated with internet use (32.2% versus 67.8%; p = 0.03), healthcare providers (32.5% versus 67.5%; p < 0.018), the Government/Ministry of Health (31.1% versus 68.9%; p < 0.01), and scientific articles (44.7% versus 55.3%; p < 0.01). CONCLUSION: The most trusted sources of COVID-19 vaccine information in northern Uganda were Televisions, Radios, and Newspapers. The trusted sources of COVID-19 vaccine information were not significantly different between males and females. However, there were significant differences among age groups and occupations of participants with younger age groups (≤ 44 years) and non-healthcare workers having more trust in Televisions, Radios, and Newspapers. Thus, for effective management of an epidemic, there is a need for accurate communication so that misinformation, disinformation, and malinformation in the era of "infodemic" do not disrupt the flow of correct information to communities.

The Effect of COVID-19 Vaccination on Outpatient Antibiotic Prescribing in Older Adults: A Self-Controlled Risk-Interval Study.

BACKGROUND: Coronavirus disease 2019 (COVID-19) vaccination has been associated with reduced outpatient antibiotic prescribing among older adults with laboratory-confirmed severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). We assessed the impact of COVID-19 vaccination on outpatient antibiotic prescribing in the broader population of older adults, regardless of SARS-CoV-2 infection status. METHODS: We included adults aged ≥65 years who received their first, second, and/or third COVID-19 vaccine dose from December 2020 to December 2022. We used a self-controlled risk-interval design and included cases who received an antibiotic prescription 2-6 weeks before vaccination (pre-vaccination or control interval) or after vaccination (post-vaccination or risk interval). We used conditional logistic regression to estimate the odds of being prescribed (1) any antibiotic, (2) a typical "respiratory" infection antibiotic, or (3) a typical "urinary tract" infection antibiotic (negative control) in the post-vaccination interval versus the pre-vaccination interval. We accounted for temporal changes in antibiotic prescribing using background monthly antibiotic prescribing counts. RESULTS: 469 923 vaccine doses met inclusion criteria. The odds of receiving any antibiotic or a respiratory antibiotic prescription were lower in the post-vaccination versus pre-vaccination interval (aOR, .973; 95% CI, .968-.978; aOR, .961; 95% CI, .953-.968, respectively). There was no association between vaccination and urinary antibiotic prescriptions (aOR, .996; 95% CI, .987-1.006). Periods with high (>10%) versus low (<5%) SARS-CoV-2 test positivity demonstrated greater reductions in antibiotic prescribing (aOR, .875; 95% CI, .845-.905; aOR, .996; 95% CI, .989-1.003, respectively). CONCLUSIONS: COVID-19 vaccination was associated with reduced outpatient antibiotic prescribing in older adults, especially during periods of high SARS-CoV-2 circulation.

Consequences of COVID-19 Vaccine Hesitancy Among Healthcare Providers During the First 10 Months of Vaccine Availability: Scoping Review.

BACKGROUND: Throughout the COVID-19 pandemic, healthcare providers (HCPs)-including nurses-have played important roles in the vaccination effort. It is expected that COVID-19 vaccine hesitancy among HCPs has numerous consequences; however, the scope of these consequences and their impacts on providers, patients, and the broader healthcare system remained unclear. PURPOSE: To identify existing and emerging evidence to understand the state of knowledge of the consequences of COVID-19 vaccine hesitancy among HCPs. METHODS: A scoping review was completed based upon the JBI scoping review methodology. The databases searched included OVID Medline, EBSCOhost CINAHL, ProQuest Nursing and Allied Health Source, ProQuest APA PsycInfo, and ProQuest Dissertations and Theses. The final literature search was completed on June 2, 2022. Studies were screened and retrieved based on predefined inclusion and exclusion criteria using Covidence reference management software. Data extraction followed criteria recommended in the JBI scoping review framework with additional relevant variables identified by the authors. RESULTS: A total of 33 sources were included in the review. Consequences of HCP COVID-19 vaccine hesitancy were grouped under three themes and seven subthemes. Consequences affecting HCPs included health-related, psychosocial, and employment-related consequences. Consequences affecting patients pertained to COVID-19 vaccination communication and COVID-19 vaccination practices of HCPs. Consequences to the healthcare system involved consequences to coworkers and employment/attendance/staffing-related consequences. CONCLUSIONS: Healthcare provider COVID-19 vaccine hesitancy was found to have numerous consequences. By understanding the scope and extent of these consequences, healthcare leaders, researchers, and HCPs can work together to protect providers, patients, and healthcare systems.

Systematic documentation of the introduction of COVID-19 vaccines in Latin America and the Caribbean.

Objective: To document the process of introducing COVID-19 vaccines in a selection of Latin American and Caribbean countries, including the lessons learned and the strengths and weaknesses, and similarities and differences among programs. Methods: This descriptive study is based on a systematic evaluation of the process of introducing COVID-19 vaccines in Argentina, Belize, Brazil, Costa Rica, Panama and Peru. Data were collected through a questionnaire distributed to key stakeholders. Six informants from each of the included countries participated in this study. The period of the study was from December 2021 through September 2022. Results: The main strengths reported by countries were health workers' commitment to delivering vaccinations, evidence-based decision-making, the development of plans for vaccine introduction, the participation of national immunization technical advisory groups, the availability of economic resources and positive actions from the respective Ministry of Health. The main challenges were the actions of antivaccination groups, problems with electronic immunization registries, a lack of vaccines, delays in the delivery of vaccines and the scarcity of health personnel at the local level. Conclusions: Commitment, the participation of multiple sectors, the availability of resources and preparedness planning were some of the many strengths shown by countries introducing COVID-19 vaccines. Weaknesses included third parties' interests, the lack of information systems and difficulty in accessing vaccines and vaccine services. There is a window of opportunity for countries to maintain the good practices that allowed for the processes' strengths and to assess the identified weaknesses to invigorate immunization programs and prepare for future health crises.

Who is getting COVID-19 boosters? A latent class analysis in a nationally representative sample of Mexican adults 60 years and over.

OBJECTIVE: Estimate COVID-19 vaccine booster uptake and identify sociodemographic profiles associated with vaccine booster uptake in Mexican adults aged 60 and older. METHODS: Using data from the 2022 National Health and Nutrition Survey, we estimated COVID-19 booster uptake in Mexican adults 60 and older. We conducted a latent class analysis using sociodemographic characteristics and then estimated group-specific booster prevalence. RESULTS: Adults aged 60 and older with a completed vaccination schedule had 80.3% booster coverage. Two groups showed the lowest coverage: 1) unemployed and informal working men with elementary education with low socioeconomic status (73.8% boosted), and 2) female homekeepers with elementary education or less living in rural areas (77.0% boosted). CONCLUSIONS: Our analysis points to the need to reach out to men and women with elementary education or less who live in rural areas to strengthen booster campaigns in the future.

The effect of COVID-19 vaccine to the Omicron variant in children and adolescents: a systematic review and meta-analysis.

Background: Omicron (B.1.1.529), a variant of SARS-CoV-2, has emerged as a dominant strain in COVID-19 pandemic. This development has raised concerns about the effectiveness of vaccination to Omicron, particularly in the context of children and adolescents. Our study evaluated the efficacy of different COVID-19 vaccination regimens in children and adolescents during the Omicron epidemic phase. Methods: We searched PubMed, Cochrane, Web of Science, and Embase electronic databases for studies published through March 2023 on the association between COVID-19 vaccination and vaccine effectiveness (VE) against SARS-CoV-2 infection in children and adolescents at the Omicron variant period. The effectiveness outcomes included mild COVID-19 and severe COVID-19. This study followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and was prospectively registered in PROSPERO (CRD42023390481). Results: A total of 33 studies involving 16,532,536 children were included in the analysis. First, in children and adolescents aged 0-19 years, the overall VE of the COVID-19 vaccine is 45% (95% confidence interval [CI]: 40 to 50%). Subgroup analysis of VE during Omicron epidemic phase for different dosage regimens demonstrated that the VE was 50% (95% CI: 44 to 55%) for the 2-dose vaccination and 61% (95% CI: 45 to 73%) for the booster vaccination. Upon further analysis of different effectiveness outcomes during the 2-dose vaccination showed that the VE was 41% (95% CI: 35 to 47%) against mild COVID-19 and 71% (95% CI: 60 to 79%) against severe COVID-19. In addition, VE exhibited a gradual decrease over time, with the significant decline in the efficacy of Omicron for infection before and after 90 days following the 2-dose vaccination, registering 54% (95% CI: 48 to 59%) and 34% (95% CI: 21 to 56%), respectively. Conclusion: During the Omicron variant epidemic, the vaccine provided protection against SARS-CoV-2 infection in children and adolescents aged 0-19 years. Two doses of vaccination can provide effective protection severe COVID-19, with booster vaccination additionally enhancing VE.

Lessons we learned during the past four challenging years in the COVID-19 era: pharmacotherapy, long COVID complications, and vaccine development.

About four years have passed since the detection of the first cases of COVID-19 in China. During this lethal pandemic, millions of people have lost their lives around the world. Since the first waves of COVID-19 infection, various pharmacotherapeutic agents have been examined in the management of COVID-19. Despite all these efforts in pharmacotherapy, drug repurposing, and design and development of new drugs, multiple organ involvement and various complications occurred during COVID-19. Some of these complications became chronic and long-lasting which led to the "long COVID" syndrome appearance. Therefore, the best way to eradicate this pandemic is prophylaxis through mass vaccination. In this regard, various vaccine platforms including inactivated vaccines, nucleic acid-based vaccines (mRNA and DNA vaccines), adenovirus-vectored vaccines, and protein-based subunit vaccines have been designed and developed to prevent or reduce COVID-19 infection, hospitalization, and mortality rates. In this focused review, at first, the most commonly reported clinical presentations of COVID-19 during these four years have been summarized. In addition, different therapeutic regimens and their latest status in COVID-19 management have been listed. Furthermore, the "long COVID" and related signs, symptoms, and complications have been mentioned. At the end, the effectiveness of available COVID-19 vaccines with different platforms against early SARS-CoV-2 variants and currently circulating variants of interest (VOI) and the necessity of booster vaccine shots have been summarized and discussed in more detail.

Psychiatric adverse events associated with the COVID-19 vaccines approved in the Republic of Korea: a systematic review.

This systematic review evaluated psychiatric adverse events (AEs) following vaccination against coronavirus disease 2019 (COVID-19). We included studies that reported or investigated psychiatric AEs in individuals who had received an approved COVID-19 vaccine in the Republic of Korea. Systematic electronic searches of Ovid-Medline, Embase, CENTRAL, and KoreaMed databases were conducted on March 22, 2023. Risk of bias was assessed using the Risk of Bias Assessment Tool for Non-randomized Studies 2.0. The study protocol was registered in the International Prospective Register of Systematic Reviews (CRD42023449422). Of the 301 articles initially selected, 7 were included in the final analysis. All studies reported on sleep disturbances, and 2 highlighted anxiety-related AEs. Sleep disorders like insomnia and narcolepsy were the most prevalent AEs, while depression was not reported. Our review suggests that these AEs may have been influenced by biological mechanisms as well as the broader psychosocial context of the COVID-19 pandemic. Although this study had limitations, such as a primary focus on the BNT162b2 vaccine and an observational study design, it offered a systematic, multi-vaccine analysis that fills a critical gap in the existing literature. This review underscores the need for continued surveillance of psychiatric AEs and guides future research to investigate underlying mechanisms, identify risk factors, and inform clinical management.

COVID-19 infection among people with disabilities in 2021 prior to the Omicron-dominant period in the Republic of Korea: a cross-sectional study.

BACKGROUND: This study investigated the characteristics of coronavirus disease 2019 (COVID-19) among individuals with disabilities on a nationwide scale in the Republic of Korea, as limited research has examined this population. METHODS: Between January 1 and November 30, 2021, a total of 5,687 confirmed COVID-19 cases among individuals with disabilities were reported through the Korea Disease Control and Prevention Agency's COVID-19 web reporting system. Follow-up continued until December 24, and demographic, epidemiological, and clinical characteristics were analyzed. RESULTS: Individuals with disabilities represented approximately 1.5% of confirmed cases, with a mean age of 58.1 years. Most resided in or near metropolitan areas (86.6%) and were male (60.6%). Frequent sources of infection included home (33.4%) and contact with confirmed cases (40.7%). Many individuals (75.9%) had underlying conditions, and 7.7% of cases were severe. People with disabilities showed significantly elevated risk of severe infection (adjusted odds ratio [aOR], 1.63; 95% confidence interval [CI], 1.47-1.81) and mortality (aOR, 1.65; 95% CI, 1.43-1.91). Vaccination against COVID-19 was associated with significantly lower risk of severe infection (aORs for the first, second, and third doses: 0.60 [95% CI, 0.42-0.85], 0.28 [95% CI, 0.22-0.35], and 0.16 [95% CI, 0.05-0.51], respectively) and death (adjusted hazard ratios for the first and second doses: 0.57 [95% CI, 0.35-0.93] and 0.30 [95% CI, 0.23-0.40], respectively). CONCLUSION: Individuals with disabilities showed higher risk of severe infection and mortality from COVID-19. Consequently, it is critical to strengthen COVID-19 vaccination initiatives and provide socioeconomic assistance for this vulnerable population.

Engaging Long-Term Care Workers in Research: Recruitment Approaches and Participant Characteristics From a Randomized Controlled Trial to Improve COVID-19 Vaccine Confidence.

OBJECTIVE: To describe and compare the recruitment methods employed in a randomized controlled trial targeting long-term care workers, and resulting participant baseline characteristics. DESIGN: We used a multifaceted recruitment process to enroll long-term care workers in our 3-arm randomized controlled trial comparing 2 interventions to enhanced usual practice, for improving COVID-19 vaccine confidence and other outcomes. SETTING AND PARTICIPANTS: Adult long-term care workers living in the United States employed within the last 2 years were invited to join the study. Participants also had to meet specific screening criteria related to their degree of worry about the vaccine and/or their vaccination status. METHODS: We used a participatory approach to engage our long-term care stakeholders in codesigning and executing a combination of recruitment methods, including targeted e-recruitment, paid e-recruitment, and in-person recruitment. Participants were screened, consented, and enrolled online. We implemented a participant verification process to ensure the integrity of our study data, and used a tailored participant management platform to manage enrollment. RESULTS: We enrolled 1930 long-term care workers between May 2022 and January 2023. We met our enrollment target, despite each recruitment method having limitations. Total variable costs of approximately $102,700 were incurred and differed on a per-enrolled participant basis across methods: $25.73 for targeted e-recruitment, $57.12 for paid e-recruitment, and $64.92 for in-person methods. Our sample differed from the national population in age, gender, race/ethnicity, education, and role in long-term care. Differences were also observed between online and in-person recruitment methods. CONCLUSIONS AND IMPLICATIONS: Our results support the feasibility of enrolling a large number of long-term care workers in a randomized controlled trial to increase COVID-19 vaccine confidence. Findings build upon the evidence base for engaging this important population in research, a critical step to improving long-term care resident health and well-being. Results from our trial are anticipated in 2024.

BBIBP-CorV vaccine effectiveness against COVID-19 in patients aged 60 years and older during the Delta-dominant period in the Federation of Bosnia and Herzegovina, a test-negative case-control study.

COVID-19 vaccine uptake in the Federation of Bosnia and Herzegovina (FBiH) accelerated in the second half of 2021, with greater vaccine availability. In this study, we estimated the vaccine effectiveness (VE) of complete primary series BBIBP-CorV vaccine against COVID-19 in patients aged 60 years and older, during the Delta-dominant period, using a test-negative case-control design. Surveillance sites were 11 primary health care centers (PHC) collecting patient data from October 1, 2021, to January 4, 2022, retrospectively according to a common protocol. In total, we included 1711 participants in the analysis: 933 cases and 778 controls. Of the 933 cases, 508 (54.4 %) had mild and 425 (45.6 %) had moderate to severe disease presentation. We observed no effectiveness against mild COVID-19. Overall vaccine effectiveness was 65.0 % (95 %CI: 40.1-79.5) against moderate to severe COVID-19. In time since vaccination analysis, VE was 78.7 % (95 % CI: 54.8-89.9) in patients who received their last dose < 90 days before onset; 66.0 % (95 % CI: -0.5-88.5) in those 90-119 days before onset; 42.1 % (95 % CI: -88.6-82.3) in those 120-149 days before onset and 45.0 % (95 % CI: -94.0-84.4) in those ≥ 150 days before onset. In our study, two doses of BBIBP-CorV provided considerable protection against moderate to severe COVID-19 in older adults, highest within 3 months after second dose, during the Delta-dominant period. Point estimates declined thereafter, suggesting a need for additional doses.