RESUMO
BackgroundThere is limited seroepidemiological evidence on the magnitude and long-term durability of antibody titers of mRNA and non-mRNA vaccines in the Qatari population. This study was conducted to generate evidence on long-term anti-S IgG antibodies titers and their dynamics in individuals who have completed a primary COVID-19 vaccination schedule. MethodsA total of 300 participants who received any of the following vaccines BNT162b2/Comirnaty or mRNA-1273 or ChAdOx1-S/Covishield or COVID-19 Vaccine Janssen/Johnson or BBIBP-CorV or Covaxin were enrolled in our study. All sera samples were tested by chemiluminescent microparticle immunoassay (CMIA) for the quantitative determination of IgG antibodies to SARS-CoV-2, receptor-binding domain (RBD) of the S1 subunit of the spike protein of SARS-CoV-2. Antibodies against SARS-CoV-2 nucleocapsid (SARS-CoV-2 N-protein IgG) were also determined. Kaplan-Meier survival curves were used to compare the time from the last dose of the primary vaccination schedule to the time by which anti-S IgG antibodies titers fell into the lowest quartile (range of values collected) for the mRNA and non-mRNA vaccines. ResultsParticipants vaccinated with mRNA vaccines had higher median anti-S IgG antibody titers. Participants vaccinated with the mRNA-1273 vaccine had the highest median anti-S-antibody level of 13720.9 AU/mL (IQR 6426.5 to 30185.6 AU/mL) followed by BNT162b2 (median, 7570.9 AU/ml; IQR, 3757.9 to 16577.4 AU/mL); while the median anti-S antibody titer for non-mRNA vaccinated participants was 3759.7 AU/mL (IQR, 2059.7-5693.5 AU/mL). The median time to reach the lowest quartile was 3.53 months (IQR, 2.2-4.5 months) and 7.63 months (IQR, 6.3-8.4 months) for the non-mRNA vaccine recipients and Pfizer vaccine recipients, respectively. However, more than 50% of the Moderna vaccine recipients did not reach the lowest quartile by the end of the follow-up period. ConclusionsThis evidence on anti-S IgG antibody titers, their durability and decay over time should be considered for the utility of these assays in transmission dynamics after the full course of primary vaccination.
RESUMO
Background: In India, access to medicine in the public sector is significantlyaffected by the efficiency of the drug procurement system and allied processesand policies. This study was conducted in two socioeconomically different states:Bihar and Tamil Nadu. Both have a pooled procurement system for drugs butfollow different models. In Bihar, the volumes of medicines required are pooledat the state level and rate contracted (an open tender process invites biddersto quote for the lowest rate for the list of medicines), while actual invoicing andpayment are done at district level. In Tamil Nadu, medicine quantities are alsopooled at state level but payments are also processed at state level upon receiptof laboratory quality-assurance reports on the medicines.Methods: In this cross-sectional survey, a range of financial and non-financial datarelated to procurement and distribution of medicine, such as budget documents,annual reports, tender documents, details of orders issued, passbook details andpolicy and guidelines for procurement were analysed. In addition, a so-called ABCanalysis of the procurement data was done to to identify high-value medicines.Results: It was observed that Tamil Nadu had suppliers for 100% of the drugson their procurement list at the end of the procurement processes in 2006, 2007and 2008, whereas Bihar’s procurement agency was only able to get suppliersfor 56%, 59% and 38% of drugs during the same period. Further, it was observedthat Bihar’s system was fuelling irrational procurement; for example, fluconazole(antifungal) alone was consuming 23.4% of the state’s drug budget and was beingprocured by around 34% of the districts during 2008–2009. Also, the ratios ofprocurement prices for Bihar compared with Tamil Nadu were in the range of 1.01to 22.50. For 50% of the analysed drugs, the price ratio was more than 2, that is,Bihar’s procurement system was procuring the same medicines at more than twicethe prices paid by Tamil Nadu.Conclusion: Centralized, automated pooled procurement models like that ofTamil Nadu are key to achieving the best procurement prices and highest possibleaccess to medicines
