ABSTRACT
28 Figure 1a) Frequency of a detectable antibody response after each vaccination for 80 heart transplant recipients, b) Interval change in anti-spike antibody titres between the 2nd ChAdOx1 nCoV-19 vaccine and the 3rd dose mRNA (BNT162b2) booster vaccine.[Figure omitted. See PDF]Conclusions/ImplicationsHeart transplant recipients who received 2 doses of the ChAdOx1 nCoV-19 viral vector vaccine and a mRNA booster vaccine failed to develop a detectable antibody response in 44% of cases. These findings highlight the importance of maintaining protective measures for transplant recipients, particularly those on more intensive immunosuppressive regimens, both at a personal and public health level, as well as investigating additional strategies to protect this vulnerable patient cohort.
ABSTRACT
SARS-CoV-2 is responsible for causing the COVID-19 pandemic and over 4 million deaths globally. Clinical symptoms range from asymptomatic infection, viral syndrome, and pneumonia, to acute respiratory distress syndrome. Guillain-Barre syndrome (GBS), an acute demyelinating inflammatory polyneuropathy, may be a manifestation of infection and must be recognized quickly by clinicians to avoid neurological deterioration in these patients. Here, we present an interesting case of GBS in a patient with a previous COVID-19 infection. A 63-year-old male with a past medical history of hypertension, chronic obstructive pulmonary disease, obesity, and recent COVID-19 infection just five weeks prior to the presentation without COVID-19 vaccination presented to a family medicine clinic due to a history of falls as well as lower extremity numbness, weakness, and paresthesias for the past 36 hours. The patient's MRI and lumbar puncture were unremarkable and the patient was transferred to a tertiary care center. The patient was diagnosed with GBS secondary to his COVID-19 infection five weeks prior. He received a standard five-dose regimen of 400 mg/kg/day of intravenous immunoglobulin and demonstrated rapid improvement in response to therapy. Temporal factors associated with disease such as the seemingly delayed onset of symptoms after COVID-19 viral infection in comparison to other cases of GBS, as well as the rapid progression of symptomatology, are of note. Healthcare providers should still consider GBS as a possibility in patients with a relatively distant history of COVID-19 infections. Rapid progression of symptoms should also be monitored as this may result in earlier respiratory morbidity and mortality in the absence of appropriate diagnosis and treatment.
ABSTRACT
This review critically assesses the body of research about Measles-Mumps-and-Rubella (MMR) vaccine attitudes and uptake in the United Kingdom (UK) over the past 10 years. We searched PubMed and Scopus, with terms aimed at capturing relevant literature on attitudes about, and uptake of, the MMR vaccine. Two researchers screened for abstract eligibility and after de-duplication 934 studies were selected. After screening, 40 references were included for full-text review and thematic synthesis by three researchers. We were interested in the methodologies employed and grouped findings by whether studies concerned: (1) Uptake and Demographics;(2) Beliefs and Attitudes;(3) Healthcare Worker Focus;(4) Experimental and Psychometric Intervention;and (5) Mixed Methods. We identified group and individual level determinants for attitudes, operating directly and indirectly, which influence vaccine uptake. We found that access issues, often ignored within the public "anti-vax" debate, remain highly pertinent. Finally, a consistent theme was the effect of misinformation or lack of knowledge and trust in healthcare, often stemming from the Wakefield controversy. Future immunisation campaigns for children, including for COVID-19, should consider both access and attitudinal aspects of vaccination, and incorporate a range of methodologies to assess progress, taking into account socio-economic variables and the needs of disadvantaged groups.