Impact of SARS-CoV-2 Vaccines on Covid-19 Incidence and Mortality in the United States

BackgroundDespite safe and effective vaccines to prevent Severe Acute Respiratory Syndrome coronavirus 2 (SARS-CoV-2) infections and disease, a substantial minority of the US remains resistant to getting vaccinated. It is imperative to know if expanding vaccination rates could reduce community-wide Coronavirus 2019 (COVID-19) disease, not just among those vaccinated. MethodsNegative binomial models were used to estimate associations between U.S. county-level vaccination rates and county-wide COVID-19 incidence and mortality between April 23rd and September 30th, 2021. A two-week lag and a four-week lag were introduced to assess vaccination rate impact on incidence and mortality, respectively. Stratified analyses were performed for county vaccination rates 40%, and before and after Delta became the dominant variant. FindingsAmong 3,070 counties, each percentage increase in population vaccination rates reduced county-wide COVID-19 incidence by 0{middle dot}9% (relative risk (RR) 0. 9910 (95% CI: 0{middle dot}9869, 0{middle dot}9952)) and mortality by 1{middle dot}9% (RR 0{middle dot}9807 (95% CI: 0{middle dot}9745, 0{middle dot}9823)). Among counties with vaccination coverage >40%, each percentage increase in vaccination rates reduced COVID-19 disease by 1{middle dot}5%, RR 0{middle dot}9850 (95% CI: 0{middle dot}9793, 0{middle dot}9952) and mortality by 2{middle dot}7% (RR 0{middle dot}9727 (95% CI: 0{middle dot}9632, 0{middle dot}9823)). These associations were not observed among counties with <40% vaccination rates. Increasing vaccination rates from 40% to 80% would have reduced COVID-19 cases by 45{middle dot}4% (RR 0{middle dot}5458 (95% CI: 0{middle dot}4335, 0{middle dot}6873)) and deaths by 67{middle dot}0% (RR 0{middle dot}3305 (95% CI: 0{middle dot}2230, 0{middle dot}4898)). An estimated 5,989,952 COVID-19 cases could have been prevented and 127,596 lives saved had US population vaccination rates increased from 40% to 80%. InterpretationsIncreasing U.S. SARS-CoV-2 vaccination rates results in population-wide reductions in COVID-19 incidence and mortality. Furthermore, increasing vaccination rates above 40% has protective effects among non-vaccinated persons. Given ongoing vaccine hesitancy in the U.S., increasing vaccination rates could better protect the entire community and potentially reach herd immunity. FundingNational Cancer Institute

The protective effects of green tea drinking and garlic intake on lung cancer, in a low cancer risk area of Jiangsu province, China / 中华流行病学杂志

Objective To understand the relationship between green tea drinking and/or garlic consumption and lung cancer.Methods A population-based case-control study was conducted in Ganyu county,Jiangsu province.Epidemiological data including demography,lifestyle,environmental exposures and dietary habits were collected by face-to-face interviews using a standardized questionnaire.Unconditional logistic regression was used to estimate adjusted odds ratios (OR) and their 95％ confidence intervals (CI) in both univariate and multivariate analyses.Results Both green tea drinking and garlic consumption were inversely associated with lung cancer and the adjusted ORs were:0.78 (95％CI:0.65-0.95) for green tea,0.79 (95％ CI:0.66-0.95) for garlic intake,and 0.69 (95％CI:0.53-0.89) for both,respectively.They also modified the associations of smoking,fried food intake and cooking oil under high-temperature with lung cancer as risk factors.Potential interactions were found between garlic or green tea and the risk factors of lung cancer.Conclusion Both green tea drinking and garlic consumption might serve as protective factors on lung cancer.

A meta-analysis on overweight, obesity and the risk of breast cancer in Chinese female population / 中华预防医学杂志

<p><b>OBJECTIVE</b>To estimate the association between overweight, obesity and the risk of breast cancer in Chinese female population.</p><p><b>METHODS</b>Literatures published in China and abroad about overweight, obesity and breast cancer risk among Chinese females were searched. We used "breast cancer", "overweight", "obesity", "weight", "body mass index" and "risk factors" as keywords, to retrieve papers in Chinese literature databases including CNKI, Wanfang and Weipu database. The same strategy was used to retrieve English papers in English literature database including Embase database, PubMed, Science Direct, Elsevier and Cochrane database, supplemented by literature tracing method. Time range was from the founding of each database to April 2012. A total of 124 research papers were collected. Using Stata11.2 software, meta-analysis was conducted, combined odds ratio (OR) and 95% confidence interval (CI) were calculated to estimate the associations between overweight, obesity and the risk of breast cancer in Chinese female population.</p><p><b>RESULTS</b>Eighteen studies were included in meta-analysis, among them 12 studies were in Chinese and 6 were in English, with a number of 7217 cases and 81 605 controls. Results showed a 7.7% increased risk of breast cancer among overweight or obesity women (OR = 1.08, 95%CI: 1.04 - 1.12). Compared with normal BMI women, the OR (95%CI) of overweight or obesity women were 1.07 (1.03 - 1.11) and 1.56 (1.29 - 1.84) before and after the adjustment of menopausal status.</p><p><b>CONCLUSION</b>Overweight, obesity may be important risk factors of breast cancer in Chinese female population. The intervention and control activities may reduce the risk of breast cancer at population level.</p>

A Meta-analysis on tea drinking and the risk of lung cancer in Chinese population / 中华流行病学杂志

Objective To examine the association between tea drinking and the risk of lung cancer in Chinese population.Methods All relevant published articles in Chinese and English literature database were identified.Meta-analysis was conducted.Combined odds ratio (OR) and 95％ confidence interval (CI) were calculated to estimate the associations and dose-response relationship between tea drinking and the risk of lung cancer.Results Twelve studies were included.An inverse association with lung cancer was observed on tea drinkers when compared to non-tea drinkers (OR=0.66,95％CI:0.49-0.89).Conclusion Tea drinking might serve as a protective factor on lung cancer in the Chinese population.

Effect of phosphorylated-ERK1/2 on NF-κB p65 expression in substantia nigra of mice with MPTP-induced Parkinson's disease / 第二军医大学学报

Objective To mvestigate the effect of phospholated-ERKl/2 on NF-κB p65 expresson nn the substania nigra(SN) of l-msthyi-4-phenyi-l,2, 3, 6-tetrahydropyeidine (MPTP)-induced mouse model of Parkinson's disease(PD). Methods PD mouse model was induced by MPTP and the behavoor of mouse was observed. Immunohistochemistry and Western bloiting analysis were used to observe the changes in expression of tyrosine hydroxylase (TH), NF-κB p65 and p-ERKl/2 in the SN of midbrain. Meanwhite, the above changes were also observed after treatment with U0126, a specific inhibitor of ERK. Results 1 h after the third MPTP administration, there were much more p-ERKl/2 positive cells than NF-κB p65 positive cells in the SN. 24 h after the fifth injection of MPTP, NF-κB p65 positive cells were significantly increased and p-ERKl/2 positive celiswere decreased, accompanted by marked loss of TH positive neurons. The above changes were greatly alleviated in animais treated with U0l26. Conclusion ERKl/2 pathway may regulate NF-κB p65 activation in MPTP-induced mouse model of Parkinson's disease, which leads to loss of dopamine neurons.

P38MAPK pathway regulates COX-2 and caspase-3 expression in a mouse model of Parkinson disease / 南方医科大学学报

<p><b>OBJECTIVE</b>To investigate the effect of p38 mitogen-activated protein kinase (p38MAPK) on the expression of COX-2 and caspase-3 in the substania nigra (SN) of mice with MPTP-induced Parkinson disease (PD).</p><p><b>METHODS</b>C57BL/CN mice were treated with MPTP to prepare a subacute PD model, and their behavioral changes following the treatment were observed. Immunohistochemistry and Western blotting were performed to detect the expression of tyrosine hydroxylase (TH), COX-2 and phosphorylation of P38MAPK in the SN and their changes following treatment with SB203580, a specific inhibitor of P38MAPK.</p><p><b>RESULTS</b>The 7-day model group showed typical symptoms of PD with decrements of TH-positive neurons and TH protein level in the SN of the midbrain by about 65% and 75%, respectively (P<0.01). In the 3-day model group, the COX-2-, caspase-3- and phosphorylated P38MAPK-immunoreactive cells and their protein levels in the SN increased markedly with obvious loss of TH-positive neurons. Administration of SB203580 obviously lessened the above changes (P<0.01).</p><p><b>CONCLUSION</b>P38MAPK regulates the inflammation and apoptosis in the SN of the mouse model of subacute PD, and SB203580 may provide some neuroprotective effect.</p>

Effect of phosphorylated-ERK1/2 on inducible nitric oxide synthase expression in the substantia nigra of mice with MPTP-induced Parkinson disease / 南方医科大学学报

<p><b>OBJECTIVE</b>To investigate the effect of phosphorylated-ERK1/2 (p-ERK1/2) on inducible nitric oxide synthase (iNOS) expression in the substantia nigra (SN) of a mouse model of Parkinson's disease (PD), and explore the possible mechanism of dopaminergic (DA) neuron loss in the SN of the midbrain in PD.</p><p><b>METHODS</b>PD was induced by intraperitoneal injections of 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine(MPTP) in C57BL/6N mice, and the behavioral changes of the PD mouse model were observed. Immunohistochemistry and Western blotting were used to detect the number of positive cells and the expressions of tyrosine hydroxylase (TH), p-ERK1/2 and iNOS in the SN of the PD mice, and their changes following Rg1 treatment were assessed.</p><p><b>RESULTS</b>The PD mice exhibited typical symptoms of PD, in which the number of TH-positive neurons and TH expression were significantly reduced by about 77% and 75% (P<0.01), respectively, 7 days after the 5th injection of MPTP as compared with those in the control group. Rg1 pretreatment significantly decreased the number of TH-positive neurons and TH expression by 44% and 41% (P<0.01), respectively. p-ERK1/2 expression was not observed in the cell nuclei until 1.5 h after the third injection of MPTP, and increased markedly at 6 h. Rg1 pretreatment significantly inhibited the expression of p-ERK1/2 and iNOS (P<0.01). A significant positive correlation was noted between the expression of p-ERK1/2 and iNOS (P<0.01).</p><p><b>CONCLUSION</b>P-ERK1/2 may regulate the expression of iNOS to induce DA neuron loss in the SN of PD, and Rg1 may protect the DA neurons possibly by depressing nuclear translocation of P-ERK1/2.</p>

Ginsenoside Rg1 modulates COX-2 expression in the substantia nigra of mice with MPTP-induced Parkinson disease through the P38 signaling pathway / 南方医科大学学报

<p><b>OBJECTIVE</b>To investigate the role of P38 signaling pathway in modulating the expression of cyclooxygenase-2 (COX-2) in the substantia nigra (SN) of mice with 1-methyl-4-phenyl-1, 2, 3, 6-tetrahydropyridine (MPTP)-induced Parkinson disease (PD), and explore the possible mechanism of the dopaminergic (DA) neuron death in PD and the effects of ginsenoside Rg1 on the P38 signaling pathway and DA neurons.</p><p><b>METHODS</b>C57BL6 mice were treated with MPTP to produce the subacute PD model, and the behavioral changes were observed. Immunohistochemistry and Western blotting for tyrosine hydroxylase (TH), COX-2, prostaglandin E2 (PGE2) and phosphorylated P38 (p-P38) were used to observe the changes of positive cell number in the midbrain after treatment with ginsenoside Rg1.</p><p><b>RESULTS</b>Compared with the control mice, the mice with PD presented with typical symptoms of PD. The number of p-P38-, COX-2-, and PGE2-positive cells significantly increased in the SN area 6 h after the 3rd injection of 30 mg/kg MPTP (P<0.01). The number of TH-positive neurons in the PD model group was substantially reduced by about 60% (P<0.01) in 24 h after the 5th injection of MPTP. In mice with ginsenoside Rg1 treatment, the number of p-P38-, COX-2-, and PGE2-positive cells was reduced obviously 6 h after the 3rd injection of MPTP as compared with that in the model group (P<0.01). The number of TH-positive neurons in the SN was decreased by only 30% (P<0.01 vs control group) 24h after the 5th injection of MPTP.</p><p><b>CONCLUSION</b>P38 signaling pathway may play an important role in modulating COX-2 expression in the SN in the early stage of MPTP-induced subacute PD, and ginsenoside Rg1 may act on the P38 signaling pathway to protect the DA neurons in PD.</p>

A case-control study on the relationship between methyl-tetra-hydrofolic acid reductase 677 gene polymorphism and the risk of stomach cancer / 中华流行病学杂志

<p><b>OBJECTIVE</b>To explore the relationship between methyl-tetra-hydrofolic acid (MTHFR) 677 gene polymorphism and the risk of stomach cancer.</p><p><b>METHODS</b>A population based case-control study was conducted and polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) method was used to detect its genotypes.</p><p><b>RESULTS</b>Among cases with stomach cancer, the frequency of C/C, C/T, T/T genotype were 25.8%, 54.6%, 19.6%, compared with controls as 34.5%, 50.9%, 14.6% respectively. Using C/C genotype as reference, the OR of C/T or T/T genotype was 1.52 (95% CI: 1.04 - 2.23). 53.3% C and 46.7% T allele were distributed in stomach cancer cases, while 60.0% C and 40.0% T in controls. The OR for T allele in relation to C allele was 1.31 (1.02 - 1.69) when C allele was used as reference. In addition, the present study showed that MTHFR677 AnyT genotype might interact with smoking, moldy food intake, wheat porridge intake, eating salty food and Hp CagA infection to increase the risk of stomach cancer. No interaction was observed between MTHFR677 AnyT genotype and alcohol drinking or green tea intake.</p><p><b>CONCLUSION</b>MTHFR677 AnyT genotype, might increase the risk of stomach cancer development and the genotype might also interact with other environmental risk factors to increase the risk of stomach cancer.</p>

A case-control study on drinking green tea and decreasing risk of cancers in the alimentary canal among cigarette smokers and alcohol drinkers / 中华流行病学杂志

<p><b>OBJECTIVE</b>To explore the role of green tea in decreasing the risks of gastric cancer, liver cancer, esophageal cancer among alcohol drinkers or cigarette smokers.</p><p><b>METHODS</b>A population based case-control study was conducted in Taixing, Jiangsu province.</p><p><b>RESULTS</b>In Taixing city, identified cases of stomach, liver and esophageal cancers were chosen with informed consent. The numbers were 206, 204, 218 respectively. Controls were chosen from normal population having lived in the area for longer than 10 years, also with informed consent. Green tea drinking seemed to have decreased 81%, 78%, 39% risk for the development of gastric cancer, liver cancer and esophageal cancer among alcohol drinkers. It might also have decreased 16%, 43%, 31% on the risks of developing the three kinds of cancers among cigarette smokers. Interaction assessment showed that drinking green tea could significantly decrease the risk of gastric cancer and liver cancer among alcohol drinkers, with ORs of interaction item 0.23 (95% CI: 0.10 - 0.55) and 0.25 (95% CI: 0.11 - 0.57) respectively.</p><p><b>CONCLUSION</b>Habit of drinking green tea seemed to have significant protective effects on the development of both gastric and liver cancer among alcohol drinkers while, green tea also having some protective effect on esophageal cancer among alcohol drinkers and on three kinds of cancers among cigarette smokers.</p>

Study on the protective effect of green tea on gastric, liver and esophageal cancers / 中华预防医学杂志

<p><b>OBJECTIVE</b>To assess the protective effect of drinking green tea on the development of gastric, liver and esophageal cancers.</p><p><b>METHODS</b>A population based study was conducted in Taixing, Jiangsu province, including 206, 204, 218 cases, respectively, and 415 population controls.</p><p><b>RESULTS</b>Green tea decreased the development of gastric cancer risk by 40%. Dose-response relationships were observed between the length of time, concentration and quantity of green tea drinking and its protective effects on gastric cancer. For individuals who drink green tea for more than 250 g per month, the risk of gastric cancer reduced about 60%. Green tea might have protective effect on liver cancer. However, no protective effect of green tea was observed on esophageal cancer.</p><p><b>CONCLUSION</b>Green tea drinking might be a protective factor for gastric cancer. However, the protective effects of green tea on liver and esophageal cancer were not obvious.</p>