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1.
Clin Infect Dis ; 79(3): 690-700, 2024 Sep 26.
Artigo em Inglês | MEDLINE | ID: mdl-38562001

RESUMO

BACKGROUND: Evaluation of the impact of a hepatitis B virus (HBV) prevention program that incorporates maternal antiviral prophylaxis on mother-to-child transmission (MTCT) is limited using real-world data. METHODS: We analyzed data on maternal HBV screening, neonatal immunization, and post-vaccination serologic testing (PVST) for hepatitis B surface antigen (HBsAg) among at-risk infants born to HBV carrier mothers from the National Immunization Information System during 2008-2022. Through linkage with the National Health Insurance Database, information on maternal antiviral therapy was obtained. Multivariate logistic regression was performed to explore MTCT risk in relation to infant-mother characteristics and prevention strategies. RESULTS: In total, 2 460 218 deliveries with maternal HBV status were screened. Between 2008 and 2022, the annual HBsAg and hepatitis B e antigen (HBeAg) seropositivity rates among native pregnant women decreased from 12.2% to 2.6% and from 2.7% to 0.4%, respectively (P for both trends < .0001). Among the 22 859 at-risk infants who underwent PVST, the MTCT rates differed between infants born to HBsAg-positive/HBeAg-negative and HBeAg-positive mothers (0.75% and 6.33%, respectively; P < .001). MTCT risk increased with maternal HBeAg positivity (odds ratio [OR], 9.29; 95% confidence interval [CI], 6.79-12.73) and decreased with maternal antiviral prophylaxis (OR, 0.28; 95% CI, .16-.49). For infants with maternal HBeAg positivity, MTCT risk was associated with mothers born in the immunization era (OR, 1.40; 95% CI, 1.17-1.67). CONCLUSIONS: MTCT was related to maternal HBeAg positivity and effectively prevented by maternal prophylaxis in the immunized population. At-risk infants born to maternal vaccinated cohorts might possibly pose further risk.


Assuntos
Antígenos de Superfície da Hepatite B , Vacinas contra Hepatite B , Hepatite B , Transmissão Vertical de Doenças Infecciosas , Complicações Infecciosas na Gravidez , Humanos , Feminino , Transmissão Vertical de Doenças Infecciosas/prevenção & controle , Gravidez , Hepatite B/prevenção & controle , Recém-Nascido , Adulto , Antígenos de Superfície da Hepatite B/sangue , Antígenos de Superfície da Hepatite B/imunologia , Complicações Infecciosas na Gravidez/prevenção & controle , Complicações Infecciosas na Gravidez/virologia , Vacinas contra Hepatite B/administração & dosagem , Vacinas contra Hepatite B/imunologia , Lactente , Antígenos E da Hepatite B/sangue , Testes Sorológicos , Adulto Jovem , Vírus da Hepatite B/imunologia , Vacinação , Programas de Rastreamento , Masculino
2.
BMC Public Health ; 24(1): 1259, 2024 May 08.
Artigo em Inglês | MEDLINE | ID: mdl-38720278

RESUMO

INTRODUCTION: Worldwide, it has been reported that fully vaccinated people still die of COVID-19-associated symptoms, generating public uncertainty about the safety and effectiveness of the vaccines. Hence, this research is aimed at assessing the incidence of COVID-19 breakthrough infection among vaccinated Health Workers and the possible effect of changes in the practice of post-vaccination safety precautions. METHOD: This was a Health facility-based descriptive cross-sectional study. Data were collected using self-administered questionnaires distributed at the participant's work unit across the selected health facilities. The nasopharyngeal specimen was also obtained from the participants and analysed using STANDARD Q COVID-19 Ag Test rapid chromatographic immunoassay for the detection of antigens to SARS-CoV-2. All data were input and analyzed using SPSS version 20. RESULTS: There was a statistically significant relationship between the vaccination status of respondents and the post-vaccination test result (χ2 = 6.816, df = 1, p = 0.009). The incidence of COVID-19 infection among the vaccinated and unvaccinated HCWs was 2% and 8% respectively. 5 of the 15 respondents who tested positive for COVID-19 had been fully vaccinated. However, all 5 of them did not practice safety measures after vaccination. None of the respondents who practised safety measures after vaccination tested positive for COVID-19. The remaining 10 respondents that tested positive for COVID-19 had not been vaccinated though they practised safety precautions. CONCLUSION: Vaccination and the practice of safety precautions will go a long way to preventing future COVID-19 breakthrough infections.


Assuntos
Infecções Irruptivas , Vacinas contra COVID-19 , COVID-19 , Pessoal de Saúde , Adulto , Feminino , Humanos , Masculino , Infecções Irruptivas/prevenção & controle , Infecções Irruptivas/virologia , COVID-19/prevenção & controle , COVID-19/epidemiologia , Vacinas contra COVID-19/administração & dosagem , Estudos Transversais , Pessoal de Saúde/estatística & dados numéricos , Incidência , Nigéria , Inquéritos e Questionários , Vacinação/estatística & dados numéricos , Adulto Jovem
3.
BMC Public Health ; 24(1): 58, 2024 01 02.
Artigo em Inglês | MEDLINE | ID: mdl-38166939

RESUMO

BACKGROUND: While mother-to-child transmission (MTCT) of hepatitis B virus (HBV) remains a significant challenge in China, research investigating the effectiveness of the September 2017 pilot program to eliminate MTCT of HIV, syphilis, and HBV is limited. Baoan district, which has a higher-than-average rate of hepatitis B infection among pregnant women and strong support from the government, was one of six national pilot districts selected for the program. Therefore, this study aims to assess the progress and implementation of the elimination of MTCT of HBV in Baoan district over a period of 5 years. METHODS: Data was collected from the national information system for the prevention of MTCT, registration forms, and follow-up forms of pregnant women and their live births from 2018 to 2022. Joinpoint models were used to analyze changing trends over time, calculating annual percentage change (APC) and the corresponding 95% confidence interval (95%CI). Multivariate logistic regression models were used to analyze risk factors for HBV MTCT. RESULTS: From 2018 to 2022, the coverage of HBV screening during pregnancy increased from 98.29 to 99.55% (APC = 0.30, P = 0.012). The coverage of HBV early screening within 13 gestational weeks increased from 40.76 to 86.42% (APC = 18.88, P = 0.033). The prevalence of maternal HBV infection declined by an APC of - 3.50 (95% CI -6.28 ~ - 0.63). The coverage of antiviral therapy among high-risk pregnant women increased from 63.59 to 90.04% (APC = 11.90, P = 0.031). Coverage for timely administration of hepatitis B immunoglobulin, hepatitis B birth dose vaccine, and three-dose hepatitis B vaccination remained consistently above 97.50%. The coverage of post-vaccination serological testing (PVST) in high-risk infants was 56.15% (1352/2408), and the MTCT rate of HBV was 0.18%. Mothers with high-school education or below (OR = 3.76, 95% CI 1.04 ~ 13.60, P = 0.04) and hepatitis B e antigen (HBeAg) positivity (OR = 18.89, 95% CI 1.98 ~ 18.50, P = 0.01) had increased MTCT risk. CONCLUSIONS: The implementation of comprehensive prevention strategies in Baoan district, including screening, treatment, and immunoprophylaxis, has proven effective in maintaining the MTCT of HBV at an extremely low level. However, it remains crucial to raise public awareness, specifically on the importance of improving the coverage of PVST for infants exposed to HBV.


Assuntos
Hepatite B , Complicações Infecciosas na Gravidez , Lactente , Feminino , Gravidez , Humanos , Vírus da Hepatite B , Antígenos de Superfície da Hepatite B , Transmissão Vertical de Doenças Infecciosas/prevenção & controle , Hepatite B/diagnóstico , Hepatite B/epidemiologia , Hepatite B/prevenção & controle , Antígenos E da Hepatite B , Vacinas contra Hepatite B/uso terapêutico , Complicações Infecciosas na Gravidez/epidemiologia , Complicações Infecciosas na Gravidez/prevenção & controle , Complicações Infecciosas na Gravidez/tratamento farmacológico , China/epidemiologia
4.
Matern Child Health J ; 28(4): 767-774, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-38358537

RESUMO

BACKGROUND: Chronic hepatitis-B virus (HBV) infection due to mother-to-child transmission (MTCT) during the perinatal period is an important global health concern. Chile is a low-prevalence country with an increasing migratory inflow from Latin- American countries, with intermediate to high endemic rates of HBV infection, and until 2021, there is no universal maternal screening. This study aimed to evaluate infant outcomes using a risk-based strategy of maternal screening to prevent MTCT of hepatitis B virus (HBV) in a low-prevalence country. METHODS: This prospective study included infants born to HBsAg-positive women detected using a local risk-based strategy. The exposed infants received immunoprophylaxis (IP) and follow-up to evaluate their clinical outcomes and immune responses through post-serological vaccine testing (PSVT) after completing the three- dose schedule of the HBV vaccine. RESULTS: A total of 99 HBsAg-positive mothers were detected. Seventy-six (82%) infants completed the follow-up and had PSVT between 9 and 12 months of age. 55.2% female, the median gestational age was 39 weeks (25-41) and the median birth weight was 3,130g (816-4,400 g). All patients received IP with recombinant HBV vaccine plus hepatitis-B virus immunoglobulin (HBIG) and three doses of the HBV vaccine. There were no cases of HBV infection, and 96% (72) responded to immunization with HBsAg antibodies (anti-HBsAg) >10 UI/ml, with a median level of 799 IU/ml. CONCLUSIONS: A high-risk strategy can be implemented in countries with non-universal screening for VHB. Timely IP plus high-uptake VHB vaccination in infants born to HBsAg-positive mothers was associated with a high immunogenic response and absence of MTCT.


Assuntos
Hepatite B Crônica , Hepatite B , Complicações Infecciosas na Gravidez , Gravidez , Lactente , Feminino , Humanos , Masculino , Hepatite B Crônica/diagnóstico , Hepatite B Crônica/epidemiologia , Hepatite B Crônica/prevenção & controle , Antígenos de Superfície da Hepatite B/uso terapêutico , Prevalência , Estudos Prospectivos , Transmissão Vertical de Doenças Infecciosas/prevenção & controle , Vírus da Hepatite B , Hepatite B/epidemiologia , Hepatite B/prevenção & controle , Vacinas contra Hepatite B/uso terapêutico , Complicações Infecciosas na Gravidez/prevenção & controle
5.
Artigo em Japonês | MEDLINE | ID: mdl-39284722

RESUMO

Objective This study aimed to examine the existence of healthy vaccinee bias, a source of distortion in the evaluation of vaccine efficacy, through analysis without random assignment using real data on post-vaccination symptoms from the Nagoya Study, a large epidemiological study of human papillomavirus (HPV) vaccine post-vaccination symptoms.Methods For three school years of individuals born in 1997, 1998, and 1999, as the HPV vaccine had a 2-year target period, 3,246 were first vaccinated at age 14 years and 3,961 were unvaccinated. The proportion of symptom onset in these 7,207 individuals during the unvaccinated period at age 13 years was compared by birth year to examine the presence of a healthy vaccinee bias.Results Only four symptoms were significantly higher among unvaccinated participants, such as the proportion of "severe headache," which occurred in 2010 among those born in 1997, "hyperventilation," which occurred in 2011 among those born in 1998, "fatigue" and "sudden vision loss," which occurred in 2012 among those born in 1999. Healthy vaccinee biases are rarely observed.Conclusion Underestimation of the odds ratio of HPV vaccination due to healthy vaccinee bias is limited, and the claim that the supposedly high odds ratio in the Nagoya Study was masked by a healthy vaccinee bias is invalid.

6.
BMC Infect Dis ; 23(1): 5, 2023 Jan 05.
Artigo em Inglês | MEDLINE | ID: mdl-36604613

RESUMO

BACKGROUND: The Pfizer BioNTech COVID-19 vaccine was the first to receive emergency authorization and approval from the FDA. Therefore, it is preferred by most recipients; however, many people are concerned about the vaccine's side effects. At the time of the study, December 2021, Palestine lacked a national reporting system for monitoring adverse vaccine effects. Therefore, this study investigates the post-vaccine adverse events following the Pfizer/BioNTech COVID-19 Vaccine administration in Palestine and identifies the occurrence, extent, and severity among university staff, employees, and students at Birzeit University. METHOD: A questionnaire-based retrospective cross-sectional study was conducted using a university website (Ritaj), social media platforms (e.g., Facebook and Telegram), and in-person interviews. The Chi-square, Fisher's exact, and McNemar's tests were used to investigate significant relationships. Data were analyzed using SPSS version 22. RESULTS: In total, 1137 participants completed the questionnaire, 33.2% were males, and the mean age was 21.163 years. All participants received at least one dose of the Pfizer-BioNTech COVID-19 vaccine. Approximately one-third of participants reported no adverse effects after receiving the first, second, or third doses (34%, 33.6%, and 32.5%, respectively). The most commonly reported adverse events were fever, chills, headache, fatigue, pain and swelling at the injection site, muscle pain, and joint pain. Allergic reactions were reported by 12.7% of the participants; furthermore, participants with a history of allergy or anaphylaxis before vaccination had a significantly higher tendency for post-vaccination allergic reactions. Eight participants reported rare side effects, including 7 (0.6%) cases of thrombocytopenia and one (0.1%) case of myocarditis. Males aged less than 20 years and smokers were significantly less likely to complain of adverse events. The number of reported side effects was significantly higher after the second vaccine dose than after the first dose. Finally, participants infected with COVID-19 before vaccination was significantly associated with side effects such as fever, chills, shortness of breath, and persistent cough. CONCLUSION: In this study, the most common post- BNT162b2 Vaccination reported self-limiting side effects similar to those reported by Pfizer/BioNTech Company. However, higher rates of allergic reactions were reported in this sample. Rare side effects, such as thrombocytopenia and myocarditis, were reported by 8 participants. COVID vaccines have been developed at an accelerated pace, and vaccine safety is a top priority; therefore, standard monitoring through a national adverse event reporting system is necessary for safety assurance. Continuous monitoring and long-term studies are required to ensure vaccine safety.


Assuntos
Vacinas contra COVID-19 , COVID-19 , Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos , Hipersensibilidade , Miocardite , Adulto , Feminino , Humanos , Masculino , Adulto Jovem , Vacina BNT162 , COVID-19/prevenção & controle , Vacinas contra COVID-19/efeitos adversos , Estudos Transversais , Estudos Retrospectivos , Universidades
7.
Neurol Sci ; 44(5): 1505-1513, 2023 May.
Artigo em Inglês | MEDLINE | ID: mdl-36622478

RESUMO

IMPORTANCE: Vaccines are a safe and efficacious way to prevent a variety of infectious diseases. Over the course of their existence, vaccines have prevented immeasurable morbidity and mortality in humans. Typical symptoms of systemic immune activation are common after vaccines and may include local soreness, myalgias, nausea, and malaise. In the vast majority of cases, the severity of the infectious disease outweighs the risk of mild adverse reactions to vaccines. Rarely, vaccines may be associated with neurological sequela that ranges in severity from headache to transverse myelitis, acute disseminated encephalomyelitis, and Guillain-Barre syndrome (GBS). Often, a causal link cannot be confirmed, and it remains unclear if disease onset is directly related to a recent vaccination. OBSERVATIONS: This review serves to summarize reported neurologic sequelae of commonly used vaccines. It will also serve to discuss potential pathogenesis. It is important to note that many adverse events or reactions to vaccines are self-reported into databases, and causal proof cannot be obtained. CONCLUSIONS AND RELEVANCE: Recognition of reported adverse effects of vaccines plays an important role in public health and education. Early identification of these symptoms can allow for rapid diagnosis and potential treatment. Vaccines are a safe option for prevention of infectious diseases.


Assuntos
Encefalomielite Aguda Disseminada , Síndrome de Guillain-Barré , Mielite Transversa , Vacinas , Humanos , Encefalomielite Aguda Disseminada/induzido quimicamente , Síndrome de Guillain-Barré/induzido quimicamente , Mielite Transversa/induzido quimicamente , Vacinação/efeitos adversos , Vacinas/efeitos adversos
8.
Herz ; 48(3): 195-205, 2023 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-37195428

RESUMO

The causes of cardiac inflammation during the COVID-19 pandemic are manifold and complex, and may have changed with different virus variants and vaccinations. The underlying viral etiology is self-evident, but its role in the pathogenic process is diverse. The view of many pathologists that myocyte necrosis and cellular infiltrates are indispensable for myocarditis does not suffice and contradicts the clinical criteria of myocarditis, i.e., a combination of serological evidence of necrosis based on troponins or MRI features of necrosis, edema, and inflammation based on prolonged T1 and T2 times and late gadolinium enhancement. The definition of myocarditis is still debated by pathologists and clinicians. We have learned that myocarditis and pericarditis can be induced by the virus via different pathways of action such as direct viral damage to the myocardium through the ACE2 receptor. Indirect damage occurs via immunological effector organs such as the innate immune system by macrophages and cytokines, and then later the acquired immune system via T cells, overactive proinflammatory cytokines, and cardiac autoantibodies. Cardiovascular diseases lead to more severe courses of SARS-CoV­2 disease. Thus, heart failure patients have a double risk for complicated courses and lethal outcome. So do patients with diabetes, hypertension, and renal insufficiency. Independent of the definition, myocarditis patients benefitted from intensive hospital care, ventilation, if needed, and cortisone treatment. Postvaccination myocarditis and pericarditis affect primarily young male patients after the second RNA vaccine. Both are rare events but severe enough to deserve our full attention, because treatment according to current guidelines is available and necessary.


Assuntos
COVID-19 , Miocardite , Pericardite , Humanos , Masculino , SARS-CoV-2 , Autoimunidade , Pandemias , Meios de Contraste , Gadolínio/uso terapêutico , Inflamação , Pericardite/terapia , Arritmias Cardíacas , Citocinas , Vacinação
9.
J Cell Mol Med ; 26(4): 1293-1305, 2022 02.
Artigo em Inglês | MEDLINE | ID: mdl-35043552

RESUMO

SARS-CoV-2 vaccines are highly efficient against severe forms of the disease, hospitalization and death. Nevertheless, insufficient protection against several circulating viral variants might suggest waning immunity and the need for an additional vaccine dose. We conducted a longitudinal study on the kinetics and persistence of immune responses in healthcare workers vaccinated with two doses of BNT162b2 mRNA vaccine with or without prior SARS-CoV-2 infection. No new infections were diagnosed during follow-up. At 6 months, post-vaccination or post-infection, despite a downward trend in the level of anti-S IgG antibodies, the neutralizing activity does not decrease significantly, remaining higher than 75% (85.14% for subjects with natural infection, 88.82% for vaccinated after prior infection and 78.37% for vaccinated only). In a live-virus neutralization assay, the highest neutralization titres were present at baseline and at 6 months follow-up in persons vaccinated after prior infection. Anti-S IgA levels showed a significant descending trend in vaccinated subjects (p < 0.05) after 14 weeks. Cellular immune responses are present even in vaccinated participants with declining antibody levels (index ratio 1.1-3) or low neutralizing activity (30%-40%) at 6 months, although with lower T-cell stimulation index (p = 0.046) and IFN-γ secretion (p = 0.0007) compared to those with preserved humoral responses.


Assuntos
Vacina BNT162/imunologia , COVID-19/imunologia , Imunidade Celular , Imunidade Humoral , Adulto , Anticorpos Neutralizantes/sangue , Anticorpos Neutralizantes/imunologia , Anticorpos Antivirais/sangue , Anticorpos Antivirais/imunologia , Pessoal de Saúde , Humanos , Imunoglobulina A/sangue , Imunoglobulina A/imunologia , Imunoglobulina G/sangue , Imunoglobulina G/imunologia , Interferon gama/sangue , Interferon gama/imunologia , Cinética , Estudos Longitudinais , Pessoa de Meia-Idade , Glicoproteína da Espícula de Coronavírus/imunologia , Fatores de Tempo
10.
Clin Infect Dis ; 74(5): 821-828, 2022 03 09.
Artigo em Inglês | MEDLINE | ID: mdl-34137815

RESUMO

BACKGROUND: Although mRNA-based severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccines report >90% efficacy, breakthrough infections occur. Little is known about their effectiveness against SARS-CoV-2 variants, including the highly prevalent B.1.427/B.1.429 variant. METHODS: In this quality improvement project, we collected demographic and clinical information from post-vaccine SARS-CoV-2 cases (PVSCs), defined as healthcare personnel (HCP) with positive SARS-CoV-2 nucleic acid amplification test after receiving ≥1 vaccine dose. Available specimens were tested for L452R, N501Y, and E484K mutations using reverse-transcription polymerase chain reaction. Mutation prevalence was compared among unvaccinated, early post-vaccinated (≤14 days after dose 1), partially vaccinated (positive test >14 days after dose 1 and <14 days after dose 2), and fully vaccinated (>14 days after dose 2) PVSCs. RESULTS: From December 2020 to April 2021, ≥23 090 HCP received ≥1 dose of an mRNA-based SARS-CoV-2 vaccine, and 660 HCP cases of SARS-CoV-2 occurred, of which 189 were PVSCs. Among the PVSCs, 114 (60.3%), 49 (25.9%), and 26 (13.8%) were early post-vaccination, partially vaccinated, and fully vaccinated, respectively. Of 261 available samples from vaccinated and unvaccinated HCP, 103 (39.5%), including 42 PVSCs (36.5%), had the L452R mutation presumptive of B.1.427/B.1.429. When adjusted for community prevalence of B.1.427/B.1.429, PVSCs did not have significantly elevated risk of B.1.427/B.1.429 compared with unvaccinated HCP. CONCLUSIONS: Most PVSCs occurred prior to expected onset of full, vaccine-derived immunity. Presumptive B.1.427/B.1.429 was not more prevalent in post-vaccine cases than in unvaccinated SARS-CoV-2 HCP. Continued infection control measures, particularly <14 days post-vaccination, and continued variant surveillance in PVSCs are imperative to control future SARS-CoV-2 surges.


Assuntos
COVID-19 , SARS-CoV-2 , Centros Médicos Acadêmicos , COVID-19/epidemiologia , COVID-19/prevenção & controle , Vacinas contra COVID-19 , Atenção à Saúde , Humanos , Incidência , SARS-CoV-2/genética , Vacinação
11.
J Viral Hepat ; 29(4): 280-288, 2022 04.
Artigo em Inglês | MEDLINE | ID: mdl-35075747

RESUMO

To evaluate the cost-effectiveness of the post-vaccination serologic testing (PVST) plus active-passive immunoprophylaxis of infants born to hepatitis B surface antigen (HBsAg)-positive mothers, a Markov model was constructed by R 4.0.1 to compare the current strategy (three-dose HepB plus HBIG) and the PVST strategy (post-vaccination serologic testing plus the current strategy) for infants of HBsAg-positive mothers. Costs and utility scores were assessed from a field survey. Other model inputs were extracted from published literature and unpublished data from the Zhejiang provincial center for disease control and prevention (Zhejiang CDC). We calculated the incremental cost-effectiveness ratio (ICER) as the main result within 1-year cycle length with a 81 horizon among 50,000 infants and performed one-way sensitivity analysis and probabilistic sensitivity analysis to explore the reliability of outcome. The ICER was -4130.18 yuan/quality-adjusted life year (QALY) for the PVST strategy compared with the current strategy from the societal perspective. It was estimated that the PVST strategy would save about 3,809,546 yuan and prevent loss of 922.37 QALYs within 81 cycles among 50,000 infants. ICER was most sensitive to the discount rate, and the cost-effectiveness acceptability curves showed that the PVST strategy reached a probability of being 100% cost-effective below willing to pay (107,624 yuan). In conclusion, the PVST strategy had increased the utility and reduced cost among infants born to HBsAg-positive mothers. The PVST strategy is a more cost-effective choice for infants born to HBsAg-positive mothers than the current strategy, and further promotion of the PVST project is recommended.


Assuntos
Antígenos de Superfície da Hepatite B , Hepatite B , China , Análise Custo-Benefício , Feminino , Hepatite B/prevenção & controle , Vacinas contra Hepatite B , Humanos , Lactente , Cadeias de Markov , Mães , Reprodutibilidade dos Testes , Vacinação
12.
BMC Neurol ; 22(1): 309, 2022 Aug 22.
Artigo em Inglês | MEDLINE | ID: mdl-35996074

RESUMO

BACKGROUND: To prevent the spread of the novel coronavirus disease 2019 (COVID-19) infection, various vaccines have been developed and used in a large number of people worldwide. One of the most commonly used vaccines is the mRNA vaccine developed by Moderna. Although several studies have shown this vaccine to be safe, the full extent of its side effects has not yet been known. Miller-Fisher syndrome (MFS) is a rare condition that manifests ophthalmoplegia, ataxia, and loss of tendon reflexes. It is a subtype of Guillain-Barré syndrome and an immune-mediated disease related to serum IgG anti-GQ1b antibodies. Several vaccines including those for COVID-19 have been reported to induce MFS. However, there have been no reports of MFS following Moderna COVID-19 vaccine administration. CASE PRESENTATION: A 70-year-old man was referred to our hospital due to diplopia that manifested 1 week after receiving the second Moderna vaccine dose. The patient presented with restricted abduction of both eyes, mild ataxia, and loss of tendon reflexes. He was diagnosed with MFS based on his neurological findings and detection of serum anti-GQ1b antibodies. The patient was administered intravenous immunoglobulin, and his symptoms gradually improved. Five days after admission, the patient showed peripheral facial paralysis on the right side. This symptom was suggested to be a delayed onset of peripheral facial nerve palsy following MFS that gradually improved by administration of steroids and antiviral drugs. CONCLUSION: There have been no previous reports of MFS after Moderna COVID-19 vaccination. This case may provide new information about the possible neurological side effects of COVID-19 vaccines.


Assuntos
Vacina de mRNA-1273 contra 2019-nCoV , COVID-19 , Paralisia Facial , Síndrome de Miller Fisher , Vacina de mRNA-1273 contra 2019-nCoV/efeitos adversos , Idoso , COVID-19/complicações , Nervo Facial/fisiopatologia , Paralisia Facial/induzido quimicamente , Humanos , Masculino , Síndrome de Miller Fisher/induzido quimicamente , Síndrome de Miller Fisher/diagnóstico , Vacinação/efeitos adversos
13.
J Appl Microbiol ; 133(3): 1969-1974, 2022 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-35801660

RESUMO

AIMS: Presence of anti-S1 region of SARS-CoV-2 spike protein was analysed, at two and eight months, in 477 immunocompetent healthcare workers in Zaragoza, Spain, vaccinated with mRNA-1273 (Moderna) or BNT162b2 (Pfizer). METHODS AND RESULTS: Antibody analysis was performed with Alinity i System (Abbott). At 2 months, 100% of vaccinated had anti-S1 IgG (mean = 13,285 AU ml-1 ). This value was significantly higher with Moderna (18,192 AU ml-1 ) than with Pfizer (10,441 AU ml-1 ). The mean value of anti-S1 IgG after vaccination was significantly higher in patients with than without previous infection (18,539 vs. 7919 AU ml-1 ); in both groups was significantly higher with Moderna than with Pfizer (21,881 vs. 15,733 AU ml-1 and 11,949 vs. 6387 AU ml-1 ), respectively. At 8 months, 100% of patients were IgG positive, with higher levels with Moderna than with Pfizer. Nevertheless, in ensemble of cases, a mean decrease of antibody levels of 11,025 AU ml-1 was observed. CONCLUSION: At 2 and 8 months after vaccination, IgG response persists with both vaccines but with important decrease which suggests the need for revaccination. SIGNIFICANCE AND IMPACT OF STUDY: The study contributes to know the immune status after vaccination with two of more used anti-SARS-CoV-2 vaccines. This knowledge is important for establishing the best vaccination strategy.


Assuntos
Vacinas contra COVID-19 , COVID-19 , Imunidade Humoral , Vacina de mRNA-1273 contra 2019-nCoV , Anticorpos Antivirais , Vacina BNT162 , COVID-19/prevenção & controle , Vacinas contra COVID-19/imunologia , Pessoal de Saúde , Humanos , Imunoglobulina G , SARS-CoV-2 , Espanha , Glicoproteína da Espícula de Coronavírus/imunologia , Vacinação
14.
Neurol Sci ; 43(6): 3503-3507, 2022 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-35275317

RESUMO

INTRODUCTION: Post-ChAdOx1 vaccine (AZD1222) adverse events following immunization (AEFI) are uncommon. Recently described neurological events include thrombocytopenia with thrombosis syndrome (TTS) with cerebral venous thrombosis and Guillain-Barré syndrome. There are very few AEFI reports following COVID vaccination from India, because of underreporting or other factors. A few cases of acute transverse myelitis (ATM) and post-vaccinal encephalitis have also been reported. MATERIALS AND METHODS: Over 11 months, in 2 districts of Kerala, India, 8.19 million people were vaccinated with the ChAdOx1 vaccine. RESULTS: During this period, we encountered five cases of autoimmune central nervous system (CNS) AEFI following ChAdOX1 (Oxford/AstraZeneca, Covishield™) vaccination. These included three cases of acute disseminated encephalomyelitis (ADEM), one case of opsoclonus myoclonus ataxia syndrome (OMAS), and one case of limbic encephalitis. The calculated crude incidence of post-ChAdOX1 autoimmune CNS AEFI was approximately 0.24 cases per million for encephalitis and 0.36 per million for ADEM. This was compared to the crude annual incidence of community-acquired ADEM worldwide (3.2-4 per million) and the crude annual incidence of community-acquired encephalitis in India (8.35-10 per million). CONCLUSION: There was no increase in the incidence of post-vaccination CNS AEFI (ADEM or encephalitis) as compared to the community incidence of ADEM or encephalitis. While this emphasizes the safety of ChAdOX1 nCoV-19 vaccination for COVID-19, it is important to recognize these post-vaccination autoimmune syndromes early to initiate immunosuppressive therapy.


Assuntos
COVID-19 , Encefalite , Encefalomielite Aguda Disseminada , Síndrome de Opsoclonia-Mioclonia , Vacinas , Vacinas contra COVID-19/efeitos adversos , Sistema Nervoso Central , ChAdOx1 nCoV-19 , Encefalite/etiologia , Humanos , SARS-CoV-2 , Vacinação/efeitos adversos
15.
J Stroke Cerebrovasc Dis ; 31(2): 106238, 2022 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-34915308

RESUMO

COVID 19 infection continues to afflict people worldwide. Neurological complications of COVID infection are common. We report a case of fulminant reversible cerebrovascular constriction syndrome (RCVS) in a patient with breakthrough COVID 19 infection who was fully vaccinated. A 64 year old lady, fully vaccinated 2 months back, presented with headache, drowsiness, partial seizures, visual impairment and quadriplegia. Her nasopharyngeal swab was tested positive for SARS COV2 on real time PCR assay. MRI brain FLAIR images showed multifocal hyperintensities with MR angiogram showing arterial vasoconstriction suggestive of RCVS. Despite initiation of nimodipine, patient's symptoms worsened and she succumbed to sepsis. RCVS following COVID infection has been reported to have a benign outcome. However, despite vaccination, fulminant RCVS following a breakthrough COVID infection was observed in our patient.


Assuntos
Vacinas contra COVID-19/efeitos adversos , COVID-19/prevenção & controle , Sepse , Vasoespasmo Intracraniano/tratamento farmacológico , COVID-19/complicações , Vacinas contra COVID-19/administração & dosagem , Transtornos Cerebrovasculares , ChAdOx1 nCoV-19 , Evolução Fatal , Feminino , Humanos , Pessoa de Meia-Idade , SARS-CoV-2 , Sepse/complicações , Sepse/mortalidade , Vasoconstrição , Vasoespasmo Intracraniano/diagnóstico por imagem , Vasoespasmo Intracraniano/etiologia
16.
J Pak Med Assoc ; 72(9): 1792-1796, 2022 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-36280978

RESUMO

OBJECTIVE: To assess adverse effects post-vaccination in healthcare professionals in the first vaccinated group against coronavirus disease-2019. METHODS: The retrospective study was conducted at the Indus Hospital, Badin, The prospective study was conducted at the vaccination unit of a university hospital in Tekirdag, Turkey, from January to February 2021, and comprised healthcare professionals who came for receiving the second dose of the coronavirus disease-2019 inactivated severe acute respiratory syndrome coronavirus 2 vaccine 28 days after the first dose. Data was analysed using SPSS 18. RESULTS: Of the 1088 subjects, 714(65.6%) were female with mean age 29.85±9.2 years and 374(34.4%) were male with mean age 29.57±9.85 years. Overall, local pain in the vaccinated area 495(45.5%), fatigue 266(24.4%), headache 261(23.9%) and muscle pain 197(18.1%) were very common adverse effects. CONCLUSIONS: Inactivated severe acute respiratory syndrome coronavirus 2 vaccine was found to be safe.


Assuntos
Vacinas contra COVID-19 , COVID-19 , Pessoal de Saúde , Adulto , Feminino , Humanos , Masculino , Adulto Jovem , Anticorpos Antivirais , COVID-19/epidemiologia , COVID-19/prevenção & controle , Vacinas contra COVID-19/efeitos adversos , Estudos Prospectivos , Estudos Retrospectivos , SARS-CoV-2 , Vacinas de Produtos Inativados/efeitos adversos
17.
Wiad Lek ; 75(4 pt 2): 929-937, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35633320

RESUMO

OBJECTIVE: The aim: The present study was carried out on patients recovered from COVID-19, including those patients who have taken vaccine and those who have not. PATIENTS AND METHODS: Materials and methods: The patients were recruited via an online panel and surveyed at different regions of Iraq from June 1, 2021, to August 30, 2021. RESULTS: Results: Our results demonstrated that the highest percentage of people recommended Pfizer vaccine followed by Sinopharm, while AstraZeneca vaccine was least recommended. CONCLUSION: Conclusions: The efficacy of different vaccines differed significantly; the highest effectiveness was observed with Pfizer vaccine followed by AstraZeneca and Sinopharm with effectiveness ranging from 94%, 89%, and 74%, respectively. Further, the highest percentage of re-infected patients was observed with Sinopharm vaccine followed by Astra Zeneca and Pfizer vaccine, respectively. Also, the highest percent of re-infection with masking used was seen in the case of Sinopharm vaccine followed by AstraZeneca and Pfizer vaccine. Although, we observed that post-vaccination symptoms were lowest than pre-vaccination symptoms, the percent of asymptomatic cases post-vaccination was highest than pre-vaccination cases for all vaccines.


Assuntos
COVID-19 , Vacinas , COVID-19/prevenção & controle , Vacinas contra COVID-19/uso terapêutico , Humanos , Iraque , Vacinação
18.
J Viral Hepat ; 28(10): 1413-1421, 2021 10.
Artigo em Inglês | MEDLINE | ID: mdl-34310810

RESUMO

In 2016, China officially proposed for the first time that infants born to HBsAg-positive mothers should be tested for HBsAg and anti-HBs 1-2 months after their third dose of HepB, also known as the post-vaccination serological testing programme. This study aimed to systematically evaluate the implementation and influencing factors of PVST to further reduce HBV infection risk in infants and improve the protective effect of HepB to the greatest extent. A prospective observational study was conducted to investigate the interruption of MTCT of hepatitis B. Univariate and multivariate analyses were applied to explore factors associated with the PVST follow-up rate among HBsAg-positive mothers and their infants. Additionally, bivariate analysis was performed on HBsAg and anti-HBs results in infants born to HBsAg-positive mothers. Here, the participation rate of PVST was 67.08% among 2120 pairs of positive mothers and infants. The HBsAg-positive rate among participants was 0.77%, whereas the anti-HBs positive rate was 96.84%, and both negative rates were 2.39%. Among infants with double negative results (34), only 15 completed three doses of HepB and PVST again, and 14 (93.33%) of which the antibody test results turned positive. Older mothers with high educational levels who reside in the local area were the most likely to PVST follow-up. The PVST programme is necessary to evaluate the HepB response status of newborns after vaccination. Moreover, revaccination for susceptible infants can effectively improve the MTCT-blocking rate of hepatitis B. Therefore, the scope of PVST projects in Zhejiang and China should be expanded.


Assuntos
Antígenos de Superfície da Hepatite B , Hepatite B , Feminino , Seguimentos , Hepatite B/prevenção & controle , Anticorpos Anti-Hepatite B , Vacinas contra Hepatite B , Humanos , Recém-Nascido , Transmissão Vertical de Doenças Infecciosas/prevenção & controle , Mães , Estudos Prospectivos , Vacinação
19.
Trop Anim Health Prod ; 53(2): 217, 2021 Mar 20.
Artigo em Inglês | MEDLINE | ID: mdl-33745013

RESUMO

Biannual vaccination of the cattle with inactivated foot-and-mouth disease (FMD) vaccine is the control strategy in endemic countries. Reduction in the milk yield is one of the main reasons for poor compliance of the cattle owners to FMD vaccination. As it can adversely affect the herd immunity, the present study aimed to quantify the losses in the milk yield post-FMD vaccination. Retrospective data on the milk yield (kg) recordings, days in milk, parity, and age at vaccination of the Deoni and crossbred cows were collected from 10 days before (-10) to 10 days after (+10) FMD vaccination (dpv). Days in milk were categorized into three stages of lactation for Deoni and crossbred cows. Age (month) was categorized into four classes. Least squares means of the milk yield were generated after adjusting for year, age, parity, and stage of lactation. Based on exploratory data analysis, the corrected milk yield records from -2 to +2 dpv for 5 years comprising 614 data points on Deoni cows (n=54) and 488 data points on crossbred cows (n=55) were used for the final analysis. Because of the correlated errors on the corrected milk yield, linear mixed model ANOVA was done by fitting dpv as fixed effect and cow as random effect, and the results revealed the effect of dpv was non-significant (P>0.05) in either breed. With respect to dpv 0, a marginal reduction of 90 g in the corrected milk yield in the Deoni cow was recorded on dpv 1, while the reduction was about 360 g on dpv 0 as compared dpv -1 in the crossbred cow. It was concluded that FMD vaccination caused a transient non-significant reduction in the milk yield in the Deoni and crossbred cows.


Assuntos
Febre Aftosa , Leite , Animais , Bovinos , Feminino , Febre Aftosa/prevenção & controle , Lactação , Paridade , Gravidez , Estudos Retrospectivos , Vacinação/veterinária
20.
Indian J Public Health ; 65(4): 422-424, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34975092

RESUMO

Guillain-Barré syndrome (GBS) is an acute inflammatory demyelinating disorder of the peripheral nerve. Different variants of GBS can produce a wide array of symptoms among which motor weakness, areflexia without bladder-bowel involvement are commonly encountered. ChAdOx1 nCoV-19 is a recombinant Corona Virus Vaccine and it is incorporated into India's coronavirus disease-2019 (COVID-19) vaccination program. Few rare instances of serious neurological complications have been reported following COVID-19 vaccination. Our case received 2 dose of COVID-19 vaccine. After receiving 1st dose he had rapid onset of ascending paralysis without any sensory and bladder bowel involvement. He received Intra Venous Immuno Globulin and Injection prednisolone for 5 days. Following that his lower limb weakness resolved rapidly but there was no improvement in upper limb weakness. Nerve conduction study showed demyelinating etiology and along with clinical features, it was appeared to be a case of GBS. However, more evidence is needed before establishing the causal relationship between COVID-19 vaccines and GBS.


Assuntos
COVID-19 , Síndrome de Guillain-Barré , Vacinas contra COVID-19 , ChAdOx1 nCoV-19 , Síndrome de Guillain-Barré/induzido quimicamente , Humanos , Índia , Masculino , SARS-CoV-2 , Vacinação
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