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1.
BMJ Glob Health ; 7(8)2022 08.
Artigo em Inglês | MEDLINE | ID: mdl-35914832

RESUMO

BACKGROUND: A few studies have assessed the epidemiological impact and the cost-effectiveness of COVID-19 vaccines in settings where most of the population had been exposed to SARS-CoV-2 infection. METHODS: We conducted a cost-effectiveness analysis of COVID-19 vaccine in Kenya from a societal perspective over a 1.5-year time frame. An age-structured transmission model assumed at least 80% of the population to have prior natural immunity when an immune escape variant was introduced. We examine the effect of slow (18 months) or rapid (6 months) vaccine roll-out with vaccine coverage of 30%, 50% or 70% of the adult (>18 years) population prioritising roll-out in those over 50-years (80% uptake in all scenarios). Cost data were obtained from primary analyses. We assumed vaccine procurement at US$7 per dose and vaccine delivery costs of US$3.90-US$6.11 per dose. The cost-effectiveness threshold was US$919.11. FINDINGS: Slow roll-out at 30% coverage largely targets those over 50 years and resulted in 54% fewer deaths (8132 (7914-8373)) than no vaccination and was cost saving (incremental cost-effectiveness ratio, ICER=US$-1343 (US$-1345 to US$-1341) per disability-adjusted life-year, DALY averted). Increasing coverage to 50% and 70%, further reduced deaths by 12% (810 (757-872) and 5% (282 (251-317) but was not cost-effective, using Kenya's cost-effectiveness threshold (US$919.11). Rapid roll-out with 30% coverage averted 63% more deaths and was more cost-saving (ICER=US$-1607 (US$-1609 to US$-1604) per DALY averted) compared with slow roll-out at the same coverage level, but 50% and 70% coverage scenarios were not cost-effective. INTERPRETATION: With prior exposure partially protecting much of the Kenyan population, vaccination of young adults may no longer be cost-effective.


Assuntos
Vacinas contra COVID-19 , COVID-19 , COVID-19/prevenção & controle , Análise Custo-Benefício , Humanos , Quênia/epidemiologia , SARS-CoV-2 , Adulto Jovem
2.
Sci Rep ; 12(1): 13293, 2022 Aug 02.
Artigo em Inglês | MEDLINE | ID: mdl-35918372

RESUMO

Many countries have secured larger quantities of COVID-19 vaccines than their population is willing to take. The abundance and the large variety of vaccines created not only an unprecedented intensity of vaccine related public discourse, but also a historical moment to understand vaccine hesitancy better. Yet, the heterogeneity of hesitancy by vaccine types has been neglected in the existing literature so far. We address this problem by analysing the acceptance and the assessment of five vaccine types. We use information collected with a nationally representative survey at the end of the third wave of the COVID-19 pandemic in Hungary. During the vaccination campaign, individuals could reject the assigned vaccine to wait for a more preferred alternative that enables us to quantify revealed preferences across vaccine types. We find that hesitancy is heterogenous by vaccine types and is driven by individuals' trusted source of information. Believers of conspiracy theories are more likely to evaluate the mRNA vaccines (Pfizer and Moderna) unacceptable. Those who follow the advice of politicians are more likely to evaluate vector-based (AstraZeneca and Sputnik) or whole-virus vaccines (Sinopharm) acceptable. We argue that the greater selection of available vaccine types and the free choice of the individual are desirable conditions to increase the vaccination rate in societies.


Assuntos
COVID-19 , Anormalidades Urogenitais , Vacinas , Vacinas Virais , COVID-19/epidemiologia , COVID-19/prevenção & controle , Vacinas contra COVID-19 , Humanos , Pandemias , Aceitação pelo Paciente de Cuidados de Saúde , Vacinação
3.
BMC Geriatr ; 22(1): 637, 2022 08 02.
Artigo em Inglês | MEDLINE | ID: mdl-35918635

RESUMO

BACKGROUND: In France, the increase in COVID-19 vaccine uptake among older adults slowed down between May and June 2021. Using the data from a national survey, we aimed to assess COVID-19 vaccine uptake among French residents aged 65 years and older, particularly at risk of severe form of the infection, and identify factors associated with non-vaccination. METHODS: A cross-sectional online survey collected the immunization status/intention to get the COVID-19 vaccine, reasons for vaccination/non-vaccination and factors potentially associated with vaccine uptake between May 10 and 23, 2021 among a large sample of French residents. Characteristics of participants were compared according to immunization status. Factors potentially associated with non-vaccination were computed into a multivariate logistic regression. RESULTS: Among the 1941 survey participants, 1612 (83%) reported having received at least one dose of COVID-19 vaccine. Among the 329 unvaccinated, 197 (60%) declared having the intention to get vaccinated. Younger age (adjusted odds ratio (aOR) = 1.50; 95% confidence interval (CI), 1.05-2.14), thinking previously having COVID-19 (aOR = 4.01; 95% CI, 2.17-7.40), having suffered economic impact due to the pandemic (aOR = 2.63; 95% CI, 1.71-4.04), reporting an "unsafe" opinion about COVID-19 vaccine safety (aOR = 6.79; 95% CI, 4.50-10.26), reporting an "unsupportive" opinion about vaccination in general (aOR = 4.24; 95% CI, 2.77-6.49) were independent risk factors for non-vaccination. On the other hand, trust in COVID-19 vaccine information delivered by the doctor (aOR = 0.28; 95% CI, 0.16-0.48) and trust in the government's actions (aOR = 0.50; 95% CI, 0.34-0.74) were independent protective factors for non-vaccination. Political affiliation also remained significantly associated with vaccine uptake. CONCLUSIONS: Despite high overall COVID-19 vaccine uptake among the study participants, differences in vaccine uptake according to the level of concerns regarding COVID-19 vaccine safety, socioeconomic profile and trust in the government were observed. Our results reinforce the importance of "reaching out" vaccination strategy that specifically targets the most vulnerable fringe of older adult population.


Assuntos
COVID-19 , Vacinas , Idoso , COVID-19/epidemiologia , COVID-19/prevenção & controle , Vacinas contra COVID-19 , Estudos Transversais , Humanos , Vacinação
4.
BMC Pregnancy Childbirth ; 22(1): 611, 2022 Aug 02.
Artigo em Inglês | MEDLINE | ID: mdl-35918665

RESUMO

BACKGROUND: Pregnant women are at high risk for affliction by coronavirus disease 2019 (COVID-19). Vaccination is a main strategy to prevent and manage the COVID-19 pandemic. However, hesitancy about COVID-19 vaccination (HACV) is a major public health threat and a major barrier to herd immunity. The aim of the study was to evaluate pregnant women's HACV based on the Health Belief Model (HBM). METHODS: This cross-sectional study was conducted in 2021-2022. Participants were 352 pregnant women selected from several healthcare centers in the north of Iran. Instruments for data collection were a demographic questionnaire, a COVID-19 Knowledge Questionnaire, a COVID-19 Health Belief Questionnaire, and a question about HACV. Logistic regression analysis was used to assess the effects of the study variables on HACV. RESULTS: The rate of HACV was 42.61%. In the regression model, the three factors of perceived benefits (aOR: 0.700; 95% CI: 0.594 to 0.825), cues to action (aOR: 0.621; 95% CI: 0.516 to 0.574), and history of reproductive problems (aOR: 2.327; 95% CI: 0.1.262 to 4.292) had significant effects on HACV (P <  0.001). CONCLUSION: HACV is highly prevalent among pregnant women. The perceived benefits and cues to action components of HBM have significant effects on pregnant women's HACV, while the perceived threat component has no significant effect on it. HBM is a good model to explain HACV among pregnant women. Educational interventions are necessary to improve pregnant women's awareness of the risks of COVID-19 for them and their fetus.


Assuntos
COVID-19 , Gestantes , COVID-19/epidemiologia , COVID-19/prevenção & controle , Vacinas contra COVID-19/uso terapêutico , Estudos Transversais , Feminino , Modelo de Crenças de Saúde , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Pandemias , Gravidez , Inquéritos e Questionários , Vacinação
5.
Zhonghua Wei Zhong Bing Ji Jiu Yi Xue ; 34(6): 576-580, 2022 Jun.
Artigo em Chinês | MEDLINE | ID: mdl-35924510

RESUMO

OBJECTIVE: To evaluate the clinical effect of awake prone positioning (APP) for common coronavirus disease 2019 (COVID-19) caused by Omicron variant. METHODS: Retrospectively analyze the clinical data of patients with COVID-19 caused by Omicron variant admitted by medical team of Tianjin Third Central Hospital during the period of supporting Tianjin COVID-19 designated hospital from January 8 to February 20, 2022. Patients who met the diagnostic criteria for common COVID-19 and had risk factors for developing severe disease or had pulse oxygen saturation (SpO2) ≤ 0.93 after exercise without supplementary oxygen were enrolled. Patients were divided into APP group and control group according to whether they completed the daily 12-hours APP in the first three days after enrollment. Demographic characteristics, clinical symptoms, COVID-19 vaccination status, laboratory examination, disease progression (progression to severe), time to nucleic acid negative conversion, length of hospital stay, and adverse reactions and tolerability [visual analog scale (VAS) score (the higher the score, the worse the tolerability] during APP were evaluated in two groups. Interleukin-6 (IL-6), C-reactive protein (CRP), SpO2/inhaled oxygen concentration (FiO2) ratio and ROX index (ROXI) were compared between two groups at enrollment, 3rd and 7th day after enrollment. RESULTS: There were no significant differences in demographic characteristics, clinical symptoms, vaccination rates of COVID-19 and laboratory tests between the two groups. There were no statistically significant differences in IL-6, CRP, SpO2/FiO2 ratio and ROXI between two groups at the time of enrollment. Compared with the group at the time of enrollment, SpO2/FiO2 ratio and ROXI in APP group increased significantly at the 3rd day after enrollment [SpO2/FiO2 ratio: 461.90 (457.10, 466.70) vs. 446.67 (437.14, 457.10), ROXI: 25.40 (23.33, 25.93) vs. 22.57 (21.86, 24.40), all P < 0.05], and the levels of IL-6 and CRP in control group were significantly increased [IL-6 (ng/L): 18.30 (6.50, 37.75) vs. 7.40 (5.10, 11.15), CRP (mg/L): 11.46 (2.11, 17.96) vs. 4.11 (1.72, 9.05), all P < 0.05]. At the 3rd day of enrollment, the levels of IL-6 and CRP in APP group were significantly lower than those in control group [IL-6 (ng/L): 7.35 (4.35, 12.80) vs. 18.30 (6.50, 37.75), CRP (mg/L): 4.52 (1.98, 9.66) vs. 11.46 (2.11, 17.96), all P < 0.05], while SpO2/FiO2 ratio and ROXI were significantly higher than those in control group [SpO2/FiO2 ratio: 461.90 (457.10, 466.70) vs. 446.67 (441.90, 459.52), ROXI: 25.40 (23.33, 25.93) vs. 23.31 (22.10, 24.66), all P < 0.05]. At the 7th day of enrollment,there were no significant differences in IL-6, CRP, SpO2/FiO2 ratio and ROXI between two groups. There were no severe cases in both groups. The time of nucleic acid negative conversion and length of hospital stay in APP group were significantly shorter than those in control group [10.0 (8.0, 12.0) days vs. 11.0 (9.0, 13.0) days, 12.0 (10.0, 14.0) days vs. 14.0 (12.0,16.0) days, respectively, all P < 0.05]. The main adverse reaction during APP was back pain, and the incidence in APP group was slightly lower than that in control group, but the difference was not statistically significant [17.9% (17/95) vs. 26.5% (27/102), P = 0.149]. VAS score in control group was significantly higher than that in APP group [score: 2.5 (2.0, 4.0) vs. 2.0 (1.0, 3.0), P = 0.004]. CONCLUSIONS: In common COVID-19 patients caused by Omicron variant with high risk factors for progression to severe disease or decreased oxygen reserve capacity, early APP can shorten the time of nucleic acid negative conversion and the length of hospital stay, but its effect on preventing disease progression cannot be determined.


Assuntos
COVID-19 , Ácidos Nucleicos , Proteína C-Reativa , Vacinas contra COVID-19 , Progressão da Doença , Humanos , Interleucina-6 , Oxigênio , Decúbito Ventral , Estudos Retrospectivos , SARS-CoV-2 , Vigília
6.
PLoS One ; 17(8): e0269268, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35913955

RESUMO

With the progression of global vaccination against coronavirus disease 2019 (COVID-19), embolic and thrombotic events (ETEs) following COVID-19 vaccination continue to be reported. To date, most reports on the type of COVID-19 vaccine and ETEs have been based on clinical trials, and other reports include a small number of cases. Further, the relationship between the type of COVID-19 vaccine and ETEs has not been clarified. It is important to elucidate trends in the development of ETEs after vaccination, which is a crucial concern for both prospective patients and healthcare providers. In this retrospective, pharmacovigilance study, we analyzed the Vaccine Adverse Event Reporting System (VAERS) reports from January 1, 2020 to June 18, 2021, and performed signal detection and time-to-onset analysis of adverse events by calculating the reported odds ratio (ROR) to understand ETE trends after COVID-19 vaccination based on the vaccine type. Using VAERS, we could collect data about several ETEs associated with COVID-19 vaccination. Nine adverse events associated with ETEs were reported following the administration of viral vector vaccines. The median time to ETE onset was 6 (interquartile range: 2-17) days for mRNA vaccines and 11 (interquartile range: 4-21) days for viral vector vaccines. This study suggests that VAERS aids in disequilibrium analysis to examine the association between vaccine type and ETEs after COVID-19 vaccination. Additionally, the tendency to develop ETEs and the number of days taken to develop ETEs varied depending on the type of the COVID-19 vaccine. Thus, vaccinators and healthcare providers should consider the primary diseases associated with ETEs while selecting vaccines for administration and carefully monitor patients following vaccination for potential ETEs based on the characteristics of vaccine type-specific onset period.


Assuntos
Vacinas contra COVID-19 , COVID-19 , Embolia , Farmacovigilância , Trombose , Sistemas de Notificação de Reações Adversas a Medicamentos , COVID-19/prevenção & controle , Vacinas contra COVID-19/efeitos adversos , Embolia/induzido quimicamente , Humanos , Estudos Prospectivos , Estudos Retrospectivos , Trombose/induzido quimicamente , Estados Unidos , Vacinação/efeitos adversos
7.
Nat Commun ; 13(1): 4466, 2022 Aug 01.
Artigo em Inglês | MEDLINE | ID: mdl-35915081

RESUMO

SARS-CoV-2 variants of concern have continuously evolved and may erode vaccine induced immunity. In this observational cohort study, we determine the risk of breakthrough infection in a fully vaccinated cohort. SARS-CoV-2 anti-spike IgG levels were measured before first SARS-CoV-2 vaccination and at day 21-28, 90 and 180, as well as after booster vaccination. Breakthrough infections were captured through the Danish National Microbiology database. incidence rate ratio (IRR) for breakthrough infection at time-updated anti-spike IgG levels was determined using Poisson regression. Among 6076 participants, 127 and 364 breakthrough infections due to Delta and Omicron variants were observed. IRR was 0.29 (95% CI 0.15-0.56) for breakthrough infection with the Delta variant, comparing the highest and lowest quintiles of anti-spike IgG. For Omicron, no significant differences in IRR were observed. These results suggest that quantitative level of anti-spike IgG have limited impact on the risk of breakthrough infection with Omicron.


Assuntos
COVID-19 , SARS-CoV-2 , Anticorpos Antivirais , Vacinas contra COVID-19 , Humanos , Imunoglobulina G
8.
Sci Rep ; 12(1): 13207, 2022 Aug 01.
Artigo em Inglês | MEDLINE | ID: mdl-35915123

RESUMO

Sputnik-V (Gam-COVID-Vac) is a heterologous, recombinant adenoviral (rAdv) vector-based, COVID-19 vaccine now used in > 70 countries. Yet there is a shortage of data on this vaccine's performance in diverse populations. Here, we performed a prospective cohort study to assess the reactogenicity and immunologic outcomes of Sputnik-V vaccination in Kazakhstan. COVID-19-free participants (n = 82 at baseline) were followed at day 21 after Sputnik-V dose 1 (rAd5) and dose 2 (rAd26). Self-reported local and systemic adverse events were captured using questionnaires. Blood and nasopharyngeal swabs were collected to perform SARS-CoV-2 diagnostic and immunologic assays. We observed that most of the reported adverse events were mild-to-moderate injection site or systemic reactions, no severe or potentially life-threatening conditions were reported, and dose 1 appeared to be more reactogenic than dose 2. The seroconversion rate was 97% post-dose 1, remaining the same post-dose 2. The proportion of participants with detectable virus neutralization was 83% post-dose 1, increasing to 98% post-dose 2, with the largest relative increase observed in participants without prior COVID-19 exposure. Dose 1 boosted nasal S-IgG and S-IgA, while the boosting effect of dose 2 on mucosal S-IgG, but not S-IgA, was only observed in subjects without prior COVID-19. Systemically, vaccination reduced serum levels of growth regulated oncogene (GRO), which correlated with an elevation in blood platelet count. Overall, Sputnik-V dose 1 elicited both blood and mucosal SARS-CoV-2 immunity, while the immune boosting effect of dose 2 was minimal. Thus, adjustments to the current vaccine dosing regimen are necessary to optimize immunization efficacy and cost-effectiveness. While Sputnik-V reactogenicity is similar to that of other COVID-19 vaccines, the induced alterations to the GRO/platelet axis warrant investigation of the vaccine's effects on systemic immunology.


Assuntos
Vacinas contra COVID-19 , COVID-19 , Imunogenicidade da Vacina , Anticorpos Antivirais , COVID-19/prevenção & controle , Vacinas contra COVID-19/imunologia , Humanos , Imunoglobulina A , Imunoglobulina G , Membrana Mucosa , Estudos Prospectivos , SARS-CoV-2
9.
BMC Health Serv Res ; 22(1): 982, 2022 Aug 01.
Artigo em Inglês | MEDLINE | ID: mdl-35915483

RESUMO

BACKGROUND: Considering the importance of intention to receive COVID-19 vaccine among healthcare workers and its role in maintaining their health and inhibiting the epidemic spread of Covid-19, the present study was done to identify the changes in intention to receive COVID-19 vaccine rate in two different time points and it's determinants based on the dimensions of the health belief model among healthcare workers in Iran. METHODS: Two cross-sectional surveys performed to investigate COVID-19 vaccination intent and associated factors based on the health belief model. The first conducted on 1244 participants from August 18 to 23, 2020, and the second on 1514 participants from February 5 to April 29, 2021, both using a questionnaire of intent to accept COVID-19 vaccination. The questionnaire distribution platform in both surveys was similarly, WhatsApp and Telegram social and working virtual groups of HCWs. Data were analyzed with SPSS-16 software for descriptive and analytical statistics. RESULTS: In the first survey, 58.4% (95% CI: 0.55-0.61%) of healthcare workers intended to receive the COVID-19 vaccine, the rate dropped to 45.7% (95% CI: 0.43-0.48%) in the second survey (P < 0.001). The regression analysis indicated six factors that were significantly associated with higher intention to receive COVID-19 vaccine: being a female (OR = 1.84, 95% CI (1.11-3.03)), history of Covid-19 infection (OR = 1.54, 95% CI (1.09-2.18), perceptions of Covid-19 disease (OR = 1.13, 95% CI (1.01-1.28)), perceived benefits of COVID-19 vaccine (OR = 1.34, 95% CI (1.22-1.47)), prosocial norms for COVID-19 vaccination (OR = 1.25, 95% CI (1.21-1.29)), and COVID-19 vaccine safety/cost concerns (OR = 1.25, 95% CI (1.17-1.33)). CONCLUSIONS: Present study showed an undesirable rate of intention to receive COVID-19 vaccine among healthcare workers, especially decreasing over the time, emphasize the need of interventions to promote healthcare workers' intention to receive the vaccine and reduce the spread of COVID-19 disease.


Assuntos
COVID-19 , Vacinas contra Influenza , Influenza Humana , COVID-19/epidemiologia , COVID-19/prevenção & controle , Vacinas contra COVID-19 , Estudos Transversais , Feminino , Pessoal de Saúde , Humanos , Influenza Humana/prevenção & controle , Intenção , Inquéritos e Questionários , Vacinação
10.
Int J Med Sci ; 19(7): 1122-1130, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35919814

RESUMO

Background: SARS-CoV-2 infection causes immune response and produces protective antibodies, and these changes may persist after patients discharged from hospital. Methods: This study conducted a one-year follow-up study on patients with COVID-19 to observe the dynamic changes of circulating leukocyte subsets and virus-specific antibodies. Results: A total of 66 patients with COVID-19 and 213 healthy patients with inactivated SARS-CoV-2 vaccination were included. The virus-specific total antibody, IgG and IgM antibody of patients after one year of recovery were higher than those of healthy vaccinated participants (94.13 vs 4.65, 2.67 vs 0.44, 0.09 vs 0.06, respectively) (P < 0.001). Neutrophil count (OR = 1.73, 95% CI: 1.10-2.70, P = 0.016) and neutrophil-to-lymphocyte ratio (OR = 1.59, 95% CI: 1.05-2.41, P = 0.030) at discharge were the influencing factors for the positivity of virus-specific IgG antibody in patients after one year of recovery. The counts of CD4+ and CD8+ T, B and NK cells increased with the time of recovery, and remained basically stable from 9 to 12 months after discharge. After 12 months, the positivity of IgG antibody was 85.3% and IgM was 11.8%, while the virus-specific antibody changed dynamically in patients within one year after discharge. Conclusions: The SARS-CoV-2 specific antibody of recovered patients showed dynamic fluctuation after discharge, while the leukocyte subsets gradually increased and basically stabilized after 9 months.


Assuntos
COVID-19 , Anticorpos Antivirais , Vacinas contra COVID-19 , Seguimentos , Humanos , Imunoglobulina G , Leucócitos , SARS-CoV-2
11.
12.
JAMA Netw Open ; 5(8): e2227437, 2022 Aug 01.
Artigo em Inglês | MEDLINE | ID: mdl-35921107

RESUMO

Importance: Children aged 6 months through 4 years have become eligible for COVID-19 vaccination, but little is known about parental intentions regarding, concerns about, or facilitators to COVID-19 vaccination for this age group. Objectives: To evaluate parental intentions, concerns, and facilitators for COVID-19 vaccination for children aged 6 months through 4 years and to help inform the US Centers for Disease Control and Prevention Advisory Committee on Immunization Practices' deliberations and recommendations for COVID-19 vaccination for children aged 6 months through 4 years. Design, Setting, and Participants: This cross-sectional study fielded an online survey from February 2 to 10, 2022, among a nonprobability sample of US parents of children aged 6 months through 4 years who were recruited through Qualtrics using quota-based sampling for respondent gender, race and ethnicity, and child age group. Main Outcomes and Measures: COVID-19 vaccination intentions, time to COVID-19 vaccination, COVID-19 vaccination concerns and facilitators, and trusted COVID-19 vaccination locations for children aged 6 months through 4 years. Results: The final weighted sample of 2031 participants (73.5% participation rate) had more respondents who identified as male (985; weighted percentage, 54.8%) or White (696; weighted percentage, 66.2%), were aged 25 to 49 years (1628; weighted percentage, 85.6%), had at least a bachelor's degree (711; weighted percentage, 40.0%), lived in a metropolitan area (1743; weighted percentage, 82.9%) or the South (961; weighted percentage, 43.4%), or received at least 1 dose of a COVID-19 vaccine (1205; weighted percentage, 59.8%). Half of respondents (645; weighted percentage, 45.6%) indicated that they "definitely" or "probably" will vaccinate their child aged 6 months through 4 years once they became eligible. However, only one-fifth (396; weighted percentage, 19.0%) indicated they would get a COVID-19 vaccine for their child in this age group within 3 months of them becoming eligible for vaccination. Vaccine safety and efficacy were parents' top concerns, and receiving more information about safety and efficacy were the top facilitators to COVID-19 vaccination for this age group. A doctor's office or clinic and local pharmacy were the most trusted COVID-19 vaccination locations for this age group. Conclusions and Relevance: These results suggest that only a minority of parents of children in this age group are eager to vaccinate their children within the first few months of eligibility, with widespread concerns about COVID-19 vaccination for this age group. Thus, considerable efforts to increase parental COVID-19 vaccine confidence for children aged 6 months through 4 years may be needed to maximize COVID-19 vaccination for this age group in the United States.


Assuntos
Vacinas contra COVID-19 , COVID-19 , Adulto , COVID-19/epidemiologia , COVID-19/prevenção & controle , Vacinas contra COVID-19/uso terapêutico , Criança , Estudos Transversais , Humanos , Intenção , Masculino , Pais , Estados Unidos/epidemiologia , Vacinação , Adulto Jovem
13.
JAMA Netw Open ; 5(8): e2225162, 2022 Aug 01.
Artigo em Inglês | MEDLINE | ID: mdl-35921109

RESUMO

Importance: Data about the duration of protection of 2 and 3 doses of BNT162b2 in children and adolescents are needed to help inform recommendations for boosters in this age group. Objective: To evaluate vaccine effectiveness (VE) and durability associated with 2 doses of BNT162b2 against Delta- and Omicron-related emergency department (ED) and urgent care (UC) encounters among adolescents aged 12 to 17 years and to estimate VE associated with 3 doses against these same outcomes. Design, Setting, and Participants: This test-negative case-control study was conducted at Kaiser Permanente Southern California, an integrated health care system using electronic health records in the US. Participants included Kaiser Permanente Southern California members ages 12 to 17 years with an ED or UC encounter from November 1, 2021, through March 18, 2022, for acute respiratory infection who were tested for SARS-CoV-2 via a reverse transction-polymerase chain reaction test. Analyses were conducted from March 21 to June 22, 2022. Exposures: BNT162b2 vaccination status ascertained from electronic health records and state registry data. Main Outcomes and Measures: The main outcome was VE associated with BNT162b2 against ED and UC encounters related to Delta or Omicron variant SARS-CoV-2 infection. Results: Analyses were conducted among 3168 adolescents, including 1004 with ED visits and 2164 with UC visits. Median (IQR) age was 15 (13-16) years, and 1461 (46.1%) were boys. In adjusted analyses, VE associated with 2 doses of BNT162b2 against ED or UC encounters was highest within the first 2 months for both Delta (89% [95% CI, 69% to 96%]) and Omicron (73% [95% CI, 54% to 84%]) variants but waned to 49% (95% CI, 27% to 65%) for the Delta variant and 16% (95% CI, -7% to 34%) for the Omicron variant at 6 months and beyond. A third dose of BNT162b2 was associated with improved protection against the Omicron variant (87% [95% CI, 72% to 94%]) after a median (IQR) of 19 (9-32) days after dose 3. Conclusions and Relevance: These findings suggest that 2 doses of the BNT162b2 COVID-19 vaccine were associated with high levels of protection against ED and UC encounters related to the Delta and Omicron variants of SARS-CoV-2 in the first few months after vaccination. However, effectiveness waned over time, especially against Omicron. A third dose of BNT162b2 was associated with improved protection against Omicron beyond that seen initially after 2 doses, underscoring the importance of boosters for adolescents aged 12 to 17 years.


Assuntos
COVID-19 , Vacinas , Adolescente , Assistência Ambulatorial , Vacina BNT162 , COVID-19/epidemiologia , COVID-19/prevenção & controle , Vacinas contra COVID-19 , Estudos de Casos e Controles , Criança , Serviço Hospitalar de Emergência , Feminino , Humanos , Masculino , SARS-CoV-2
14.
Health Aff (Millwood) ; 41(8): 1202-1207, 2022 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-35914210

RESUMO

We investigated racial and ethnic disparities in COVID-19 vaccine uptake, using data from the Centers for Disease Control and Prevention. As of March 29, 2022, uptake of the first dose was higher among Hispanic and Asian people than among White and Black people. In contrast, uptake rates of the booster were higher among Asian and White people than among Black and Hispanic people.


Assuntos
COVID-19 , Brancos , Afro-Americanos , Vacinas contra COVID-19 , Etnicidade , Disparidades em Assistência à Saúde , Humanos , Estados Unidos
15.
Front Immunol ; 13: 894872, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35924236

RESUMO

Guillain-Barré syndrome (GBS) is an autoimmune neurological disorder often preceded by viral illnesses or, more rarely, vaccinations. We report on a unique combination of postcoronavirus disease 2019 (COVID-19) vaccine GBS that occurred months after a parainfectious COVID-19-related GBS. Shortly after manifesting COVID-19 symptoms, a 57-year-old man developed diplopia, right-side facial weakness, and gait instability that, together with electrophysiology and cerebrospinal fluid examinations, led to a diagnosis of post-COVID-19 GBS. The involvement of cranial nerves and IgM seropositivity for ganglioside GD1b were noteworthy. COVID-19 pneumonia, flaccid tetraparesis, and autonomic dysfunction prompted his admission to ICU. He recovered after therapy with intravenous immunoglobulins (IVIg). Six months later, GBS recurred shortly after the first dose of the Pfizer/BioNTech vaccine. Again, the GBS diagnosis was confirmed by cerebrospinal fluid and electrophysiology studies. IgM seropositivity extended to multiple gangliosides, namely for GM3/4, GD1a/b, and GT1b IgM. An IVIg course prompted complete recovery. This case adds to other previously reported observations suggesting a possible causal link between SARS-CoV-2 and GBS. Molecular mimicry and anti-idiotype antibodies might be the underlying mechanisms. Future COVID-19 vaccinations/revaccinations in patients with previous para-/post-COVID-19 GBS deserve a reappraisal, especially if they are seropositive for ganglioside antibodies.


Assuntos
Vacinas contra COVID-19 , COVID-19 , Síndrome de Guillain-Barré , Autoanticorpos , COVID-19/complicações , Vacinas contra COVID-19/efeitos adversos , Gangliosídeos , Síndrome de Guillain-Barré/diagnóstico , Síndrome de Guillain-Barré/etiologia , Humanos , Imunoglobulina M/uso terapêutico , Imunoglobulinas Intravenosas/uso terapêutico , Masculino , Pessoa de Meia-Idade , SARS-CoV-2
16.
PLoS One ; 17(8): e0272570, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35930572

RESUMO

INTRODUCTION: With fragile health care systems, sub-Saharan Africa countries like Ethiopia are facing a complex epidemic, and become difficult to control the noble coronavirus. The use of COVID-19 preventive measures is strongly recommended. This study aimed to assess the adherence of COVID-19 mitigation measures and associated factors among health care workers. METHODS: A facility-based cross-sectional study was conducted among health care workers at referral hospitals in the Amhara regional state of Ethiopia from May 15 to June 10; 2021. It was a web-based study using an online questionnaire. STATA 14.2 was used for data analysis. Variables with a p-value<0.05 at 95% confidence level in multivariable analysis were declared as statistically significant using binary logistic regression. RESULT: Adherence to COVID-19 mitigation measures was 50.24% in the current study. The odd of adherence of participants with a monthly income of ≥12801birr was 15% whereas the odds of adherence of participants who hesitate to take the COVID 19 vaccine were 10% as compared to those who don't hesitate. Participants who had undergone COVID-19 tests adhered 6.64 times more than their counterparts. Those who believe adequate measurements are taken by the government adhered 4.6 times more than those who believe not adequate. Participants who believe as no risk of severe disease adhered 16% compared to those with fear of severe disease. Presence of households aged >60years adhered about 7.9 times more than with no households aged>60. Participants suspected of COVID-19 diagnosis adhered 5.7 times more than those not suspected. CONCLUSION: In this study, a significant proportion of healthcare workers did not adhere to COVID-19 mitigation measures. Hence, giving special attention to healthcare workers with a monthly income of ≥12801 birr, being hesitant towards COVID-19 vaccine, being aged 26-30, and perceiving no risk of developing a severe infection is crucial to reduce non-adherence.


Assuntos
COVID-19 , COVID-19/epidemiologia , COVID-19/prevenção & controle , Teste para COVID-19 , Vacinas contra COVID-19 , Estudos Transversais , Etiópia/epidemiologia , Pessoal de Saúde , Hospitais , Humanos , Encaminhamento e Consulta
17.
Ann Saudi Med ; 42(4): 223-228, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35933607

RESUMO

BACKGROUND: The rate of severe acute respiratory syndrome coronavirus 2 (SARS CoV-2) infection and immunogenicity of a single dose of ChAdOx1 vaccine at 16 weeks post-vaccination among young and healthy participants remains unclear in Saudi Arabia. OBJECTIVES: Assess the rate of subsequent infection and immunogenicity of a single dose of ChAdOx1 vaccine at 16 weeks post-vaccination in a sample of healthy and young participants. DESIGN: Cross-sectional study SETTING: Academic teaching hospital in Riyadh, Saudi Arabia SUBJECTS AND METHODS: Healthy participants 18-50 years of age, who received one dose of ChAdOx1 vaccine and had no history of SARS CoV-2 infection were recruited, and blood samples were obtained 16 weeks after vaccination to assess immunogenicity using a commercially available kit. MAIN OUTCOME MEASURES: The rate of SARS-CoV-2 infection within 16 weeks post-vaccination. SAMPLE SIZE: 385 participants with median (IQR) age of 34 (29-38) years. RESULTS: Eleven (2.8%) participants acquired polymerase chain reaction (PCR)-confirmed infection within 16 weeks after a single dose of ChAdOx1 vaccine (mean [SD] 42.5 [28] days post-vaccination). No hospital or intensive care unit admissions occurred among the subjects in this sample. Females were significantly over-represented in PCR-confirmed cases of SARS-CoV-2 infection, with 10 of 11 infections occurring in females (P=.006). Antibody response against anti-spike IgG were detectable in 92.7% of subjects at 16 weeks' post-vaccination. The median anti-spike IgG level after vaccination was 273.1 (IQR 107-1052 AU/mL). However, the anti-nucleocapsid IgG antibody demonstrated a sensitivity of only 20%. CONCLUSION: A single dose of ChAdOx1 vaccine in healthy and young individuals was associated with a low, single-digit rate of PCR-confirmed infection, most of which were mild. LIMITATIONS: Small sample size and single-center. CONFLICT OF INTEREST: None.


Assuntos
COVID-19 , Vacinas Virais , Adulto , Anticorpos Antivirais , COVID-19/epidemiologia , COVID-19/prevenção & controle , Vacinas contra COVID-19 , Estudos Transversais , Feminino , Humanos , Imunoglobulina G , Recém-Nascido , SARS-CoV-2 , Arábia Saudita/epidemiologia , Vacinação
18.
Perm J ; 26(2): 64-68, 2022 Jun 29.
Artigo em Inglês | MEDLINE | ID: mdl-35933671

RESUMO

Given the stalling improvement in vaccine hesitancy rates in the United States (US), it is important to understand why a chronically ill group, patients with left-ventricular assist devices (LVADs), might not get vaccinated and to delineate the barriers they may face in seeking care. We conducted an online survey to characterize the attitudes of patients with LVADs toward COVID-19 vaccination, identify their willingness to seek care during the pandemic, and characterize barriers to doing so. Our survey showed that the rate of vaccine hesitancy among LVAD patients is similar to that of the general population in the US. This rate is higher than expected for a chronically ill group at risk of severe COVID-19 infection. We also found that LVAD patients perceive barriers to seeking care during the pandemic. We recommend that LVAD care teams emphasize that patients should seek care for emergency medical conditions despite their fears of contracting COVID-19. Based on our results, we also recommend vaccine uptake education for this population focused on patients' concerns about serious side effects and not enough research done on the vaccine.


Assuntos
COVID-19 , Coração Auxiliar , Vacinas contra Influenza , Influenza Humana , COVID-19/prevenção & controle , Vacinas contra COVID-19/uso terapêutico , Humanos , Pandemias/prevenção & controle , Estados Unidos , Vacinação
19.
Front Immunol ; 13: 911164, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35935962

RESUMO

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccines provide essential tools for the control of the COVID-19 pandemic. A number of technologies have been employed to develop SARS-CoV-2 vaccines, including the inactivated SARS-CoV-2 particles, mRNA to express viral spike protein, recombinant spike proteins, and viral vectors. Here, we report the use of the vaccinia virus Tiantan strain as a vector to express the SARS-CoV-2 spike protein. When it was used to inoculate mice, robust SARS-CoV-2 spike protein-specific antibody response and T-cell response were detected. Sera from the vaccinated mice showed strong neutralizing activity against the ancestral Wuhan SARS-CoV-2, the variants of concern (VOCs) B.1.351, B.1.617.2, and the emerging B.1.1.529 (omicron). This finding supports the possibility of developing a new type of SARS-CoV-2 vaccine using the vaccinia virus vector.


Assuntos
COVID-19 , Vacinas Virais , Animais , Anticorpos Antivirais , COVID-19/prevenção & controle , Vacinas contra COVID-19 , Humanos , Camundongos , Pandemias , SARS-CoV-2/genética , Glicoproteína da Espícula de Coronavírus , Vírus Vaccinia/genética
20.
Int J Nanomedicine ; 17: 3325-3341, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35937077

RESUMO

Purpose: Current vaccines for the SARS-CoV-2 virus mainly induce neutralizing antibodies but overlook the T cell responses. This study aims to generate an exosomal vaccine carrying T cell epitope peptides of SARS-CoV-2 for the induction of CD8+ T cell response. Methods: Thirty-one peptides presented by HLA-A0201 molecule were conjugated to the DMPE-PEG-NHS molecules, and mixed with DSPE-PEG to form the peptide-PEG-lipid micelles, then fused with exosomes to generate the exosomal vaccine, followed by purification using size-exclusion chromatography and validation by Western blotting, liquid nuclear magnetic resonance (NMR) test and transmission electron microscopy. Furthermore, the exosomal vaccine was mixed with Poly (I:C) adjuvant and subcutaneously administered for three times into the hybrid mice of HLA-A0201/DR1 transgenic mice with wild-type mice. Then, the epitope-specific T cell responses were detected by ex vivo ELISPOT assay and intracellular cytokine staining. Results: The exosomal vaccine was purified from the Peak 2 fraction of FPLC and injected into the hybrid mice for three times. The IFN-γ spot forming units and the frequencies of IFN-γ+/CD8+ T cells were 10-82-fold and 13-65-fold, respectively, higher in the exosomal vaccine group compared to the Poly (I:C) control group, without visible organ toxicity. In comparison with the peptides cocktail vaccine generated in our recent work, the exosomal vaccine induced significantly stronger T cell response. Conclusion: Exosomal vaccine loading T cell epitope peptides of SARS-CoV-2 virus was initially generated without pre-modification for both peptides and exosomes, and elicited robust CD8+ T cell response in HLA-A transgenic mice.


Assuntos
COVID-19 , Vacinas , Animais , Linfócitos T CD8-Positivos , COVID-19/prevenção & controle , Vacinas contra COVID-19 , Epitopos de Linfócito T , Humanos , Camundongos , Camundongos Transgênicos , Peptídeos , Poli I-C , SARS-CoV-2
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