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1.
Int J Infect Dis ; 2022 Apr 09.
Article in English | MEDLINE | ID: covidwho-1778204

ABSTRACT

OBJECTIVES: determining COVID19 status is important for global epidemiology and individual-level vaccination decision-making. SARS CoV-2 Infection can generally only be detected during a 7-10 days period using PCR or rapid antigen testing, and infection specific anti nucleocapsid IgG assays are not universally available. We determined whether SARS-CoV-2 anti spike (anti-S) IgG levels could discriminate between vaccination and past infection when interpreted alongside vaccination timing. METHODS: We measured SARS CoV2 IgG levels anti-spike Anti-S-IgG level in 535 vaccinated Israeli healthcare workers with known previous infection status 6-8 months post dose 2. RESULTS: Anti-S IgG levels above 1000 AU/ml at that time point was 93.3% predictive of infection in the previous 3 months, whereas the negative predictive value for infection in the past 3 months of a level below that threshold was 99.5%. CONCLUSION: When interpreted alongside vaccination timing, anti-S serological assays can confirm or exclude previous infection within the previous 3 months.

2.
PLoS One ; 17(4): e0266232, 2022.
Article in English | MEDLINE | ID: covidwho-1775453

ABSTRACT

BACKGROUND: As of July 2021, there has been more than 185 million documented cases of the novel coronavirus (SARS-CoV-2) infections and more than 4 million deaths globally. Despite more than 90% of documented cases being classified as "recovered" from SARS-CoV-2 infection, a proportion of patients reported a wide variety of persisting symptoms after the initial onset or acute phase of the infection, often referred to as "Long Covid". As data on the symptomatology of post-acute SARS-CoV-2 infection gradually becomes available, there is an urgent need to organise and synthesise the data in order to define what constitutes Long Covid and assist with its management in clinical and community settings. METHODS: This protocol follows the Preferred Reporting Items for Systematic Review and Meta-analysis Protocols (PRISMA-P) guidelines. A comprehensive literature search strategy will be developed in accordance with the Cochrane highly sensitive search guidelines. The following electronic databases will be searched for studies to include in the systematic review and meta-analysis: MEDLINE (via PubMed), Scopus, Google Scholar, Web of Science (Web of Knowledge), Science direct, EMBASE, Mednar, Psych INFO, and EBSCOhost. Dual screening will be applied at every screening stage. Two reviewers will independently screen titles, abstracts and full text of potentially eligible studies following the predefined inclusion and exclusion criteria in order to select studies to include in the review. As heterogeneity is anticipated between the included studies, data will be pooled in a meta-analysis using a random effects model. A clustering analytic approach will be applied to identify symptoms groupings and assign the symptoms into clusters. R statistical software will be used for the meta-analysis. Highly heterogenous data will be synthesised narratively. The studies will be assessed, for quality using quality assessment tools appropriate for each study design. Two reviewers will independently undertake the quality of studies assessments. DISSEMINATION PLANS: Findings of the systematic review will be disseminated through a peer-reviewed publication and presentation of findings at conferences, workshops and government and private sector stakeholder engagement meetings. CLINICAL TRIAL REGISTRATION: PROSPERO registration number: CRD4202126589. https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD4202126589.


Subject(s)
COVID-19 , COVID-19/complications , COVID-19/epidemiology , Humans , Mental Health , Meta-Analysis as Topic , SARS-CoV-2 , Systematic Reviews as Topic
3.
EuropePMC; 2022.
Preprint in English | EuropePMC | ID: ppcovidwho-329806

ABSTRACT

Background Vaccination is a key tool to mitigate the impact of the COVID-19 pandemic. In Israel, COVID-19 vaccines became available to adults in December 2020 and to 5–11-year-old children in November 2021. Ahead of the vaccine roll-out in children, we aimed to determine whether parents intended to vaccinate their children and describe reasons for their intentions. Methods We recruited parents on social media and collected information on parental socio-demographic characteristics, COVID-19 vaccine history, intention to vaccinate their children against COVID-19, and reasons for parental decisions, using an anonymous online survey. We identified associations between parental characteristics and intention to vaccinate children using a logistic regression model and described reasons for intentions to vaccinate or not using proportions together with 95% confidence intervals (CI). Results 1837 parents participated. Parental non-vaccination and having experienced major vaccination side effects were strongly associated with non-intention to vaccinate their children (OR 0.09 and 0.18 respectively, p<0.001). Compared with others, parents who were younger, lived in the socio-economically deprived periphery, and belonged to the Arab population had lower intentions to vaccinate their children. Commonly stated reasons for non-intention to vaccinate included vaccine safety and efficacy (53%, 95%CI 50-56) and the belief that COVID-19 was a mild disease (73%, 95%CI 73-79). The most frequently mentioned motives for intending to vaccine children was returning to normal social and educational life (89%, 95%CI 87-91). Conclusion Parental socio-demographic background and their own vaccination experience was associated with intention to vaccinate their children aged 5-11. Intention to vaccinate was mainly for social and economic reasons rather than health, whereas non-intention to vaccinate mainly stemmed from health concerns. Understanding rationales for COVID-19 vaccine rejection or acceptance, as well as parental demographic data, can pave the way for intentional educational campaigns to encourage not only vaccination against COVID-19, but also regular childhood vaccine programming. Highlights Parental intention to vaccinate 5-11 children is much lower than vaccine coverage in parental age groups Being unvaccinated and having experienced side effects following vaccination were the greatest negative predictors in parents of intention to vaccinate their children Parents were more likely to accept a COVID-19 vaccine for their children to allow them to return to daily social life and to ensure economic security in the family Parents were more likely to reject a COVID-19 vaccination for health reasons such as safety concerns or due the belief that COVID-19 was a mild disease in children

4.
Clin Infect Dis ; 2022 Mar 12.
Article in English | MEDLINE | ID: covidwho-1740831

ABSTRACT

BACKGROUND: We determined circulating anti-S SARS-CoV-2 IgG antibody titres in a vaccinated healthcare workers (HCWs) cohort from Northern Israel in the 11 months following primary vaccination according to age, ethnicity and previous infection status. METHODS: All consenting HCWs were invited to have their IgG levels measured before vaccination and at 6 subsequent timepoints using a quantitative S1/S2 IgG assay. All HCWs with suspected COVID-19 were PCR tested. We described trends in circulating IgG geometric mean concentration (GMC) by age, ethnicity, timing of boosting and previous infection status and compared strata using Kruskall-Wallis tests. RESULTS: Among 985 vaccinated HCWs, IgG titres between 1 month post 2 nd dose to pre-boosting gradually decreased in all age groups. Younger or previously infected individuals had higher initial post-vaccination IgG levels (p<0.001 in both cases); differences substantially decreased or disappeared at 7-9 months, before boosting. The proportion of individuals infected prior to initiating vaccination and re-infected after dose 1 was comparable to the proportion of breakthrough infection post-dose 2 in those not previously infected (4.2 vs 4.7%). Pre-infection IgG levels in the 40 participants with breakthrough infection after dose 2 were similar to levels measured at the same timepoint in vaccinated HCWs who remained uninfected (p>0.3). Post-dose3 IgG levels were more than 10-fold those 1month post-dose 2. CONCLUSIONS: Immunity waned in all age groups and previously infected individuals, reversed by boosting. IgG titres decrease and reinfections in individuals with hybrid immunity (infection+vaccination) suggests they may also require further doses. Our study also highlights the difficulty in determining protective IgG levels.

5.
BMJ Open ; 12(3): e055278, 2022 03 01.
Article in English | MEDLINE | ID: covidwho-1723800

ABSTRACT

OBJECTIVE: To determine characteristics associated with COVID-19 vaccine coverage among individuals aged 50 years and above in England since the beginning of the programme. DESIGN: Observational cross-sectional study assessed by logistic regression and mean prevalence margins. SETTING: COVID-19 vaccinations delivered in England from 8 December 2020 to 17 May 2021. PARTICIPANTS: 30 624 257/61 967 781 (49.4%) and 17 360 045/61 967 781 (28.1%) individuals in England were recorded as vaccinated in the National Immunisation Management System with a first dose and a second dose of a COVID-19 vaccine, respectively. INTERVENTIONS: Vaccination status with COVID-19 vaccinations. MAIN OUTCOME MEASURES: Proportion, adjusted ORs and mean prevalence margins for individuals not vaccinated with dose 1 among those aged 50-69 years and dose 1 and 2 among those aged 70 years and above. RESULTS: Of individuals aged 50 years and above, black/African/Caribbean ethnic group was the least likely of all ethnic groups to be vaccinated with dose 1 of the COVID-19 vaccine. However, of those aged 70 years and above, the odds of not having dose 2 was 5.53 (95% CI 5.42 to 5.63) and 5.36 (95% CI 5.29 to 5.43) greater among Pakistani and black/African/Caribbean compared with white British ethnicity, respectively. The odds of not receiving dose 2 was 1.18 (95% CI 1.16 to 1.20) higher among individuals who lived in a care home compared with those who did not. This was the opposite to that observed for dose 1, where the odds of being unvaccinated was significantly higher among those not living in a care home (0.89 (95% CI 0.87 to 0.91)). CONCLUSIONS: We found that there are characteristics associated with low COVID-19 vaccine coverage. Inequalities, such as ethnicity are a major contributor to suboptimal coverage and tailored interventions are required to improve coverage and protect the population from SARS-CoV-2.


Subject(s)
COVID-19 Vaccines , COVID-19 , Adult , Aged , COVID-19/epidemiology , COVID-19/prevention & control , England/epidemiology , Humans , Middle Aged , SARS-CoV-2 , Vaccination
6.
EuropePMC; 2020.
Preprint in English | EuropePMC | ID: ppcovidwho-324701

ABSTRACT

COVID19 was first reported in England at the end of January 2020, and by mid-June over 150,000 cases were reported. We assume that, similarly to influenza-like illnesses, people who suffer from COVID19 may query for their symptoms prior to accessing the medical system (or in lieu of it). Therefore, we analyzed searches to Bing from users in England, identifying cases where unexpected rises in relevant symptom searches occurred at specific areas of the country. Our analysis shows that searches for "fever" and "cough" were the most correlated with future case counts, with searches preceding case counts by 16-17 days. Unexpected rises in search patterns were predictive of future case counts multiplying by 2.5 or more within a week, reaching an Area Under Curve (AUC) of 0.64. Similar rises in mortality were predicted with an AUC of approximately 0.61 at a lead time of 3 weeks. Thus, our metric provided Public Health England with an indication which could be used to plan the response to COVID19 and could possibly be utilized to detect regional anomalies of other pathogens.

7.
EuropePMC; 2021.
Preprint in English | EuropePMC | ID: ppcovidwho-314842

ABSTRACT

Previous research has demonstrated that various properties of infectious diseases can be inferred from online search behaviour. In this work we use time series of online search query frequencies to gain insights about the prevalence of COVID-19 in multiple countries. We first develop unsupervised modelling techniques based on associated symptom categories identified by the United Kingdom's National Health Service and Public Health England. We then attempt to minimise an expected bias in these signals caused by public interest -- as opposed to infections -- using the proportion of news media coverage devoted to COVID-19 as a proxy indicator. Our analysis indicates that models based on online searches precede the reported confirmed cases and deaths by 16.7 (10.2 - 23.2) and 22.1 (17.4 - 26.9) days, respectively. We also investigate transfer learning techniques for mapping supervised models from countries where the spread of disease has progressed extensively to countries that are in earlier phases of their respective epidemic curves. Furthermore, we compare time series of online search activity against confirmed COVID-19 cases or deaths jointly across multiple countries, uncovering interesting querying patterns, including the finding that rarer symptoms are better predictors than common ones. Finally, we show that web searches improve the short-term forecasting accuracy of autoregressive models for COVID-19 deaths. Our work provides evidence that online search data can be used to develop complementary public health surveillance methods to help inform the COVID-19 response in conjunction with more established approaches.

8.
Sci Rep ; 12(1): 2373, 2022 02 11.
Article in English | MEDLINE | ID: covidwho-1684110

ABSTRACT

Prior work has shown the utility of using Internet searches to track the incidence of different respiratory illnesses. Similarly, people who suffer from COVID-19 may query for their symptoms prior to accessing the medical system (or in lieu of it). To assist in the UK government's response to the COVID-19 pandemic we analyzed searches for relevant symptoms on the Bing web search engine from users in England to identify areas of the country where unexpected rises in relevant symptom searches occurred. These were reported weekly to the UK Health Security Agency to assist in their monitoring of the pandemic. Our analysis shows that searches for "fever" and "cough" were the most correlated with future case counts during the initial stages of the pandemic, with searches preceding case counts by up to 21 days. Unexpected rises in search patterns were predictive of anomalous rises in future case counts within a week, reaching an Area Under Curve of 0.82 during the initial phase of the pandemic, and later reducing due to changes in symptom presentation. Thus, analysis of regional searches for symptoms can provide an early indicator (of more than one week) of increases in COVID-19 case counts.


Subject(s)
COVID-19/epidemiology , Disease Hotspot , Search Engine/statistics & numerical data , Cough/epidemiology , England/epidemiology , Fever/epidemiology , Humans
9.
PLoS One ; 17(2): e0263069, 2022.
Article in English | MEDLINE | ID: covidwho-1666765

ABSTRACT

OBJECTIVE: Studies have demonstrated a potential correlation between low vitamin D status and both an increased risk of infection with SARS-CoV-2 and poorer clinical outcomes. This retrospective study examines if, and to what degree, a relationship exists between pre-infection serum 25-hydroxyvitamin D (25(OH)D) level and disease severity and mortality due to SARS-CoV-2. PARTICIPANTS: The records of individuals admitted between April 7th, 2020 and February 4th, 2021 to the Galilee Medical Center (GMC) in Nahariya, Israel, with positive polymerase chain reaction (PCR) tests for SARS-CoV-2 (COVID-19) were searched for historical 25(OH)D levels measured 14 to 730 days prior to the positive PCR test. DESIGN: Patients admitted to GMC with COVID-19 were categorized according to disease severity and level of 25(OH)D. An association between pre-infection 25(OH)D levels, divided between four categories (deficient, insufficient, adequate, and high-normal), and COVID-19 severity was ascertained utilizing a multivariable regression analysis. To isolate the possible influence of the sinusoidal pattern of seasonal 25(OH)D changes throughout the year, a cosinor model was used. RESULTS: Of 1176 patients admitted, 253 had records of a 25(OH)D level prior to COVID-19 infection. A lower vitamin D status was more common in patients with the severe or critical disease (<20 ng/mL [87.4%]) than in individuals with mild or moderate disease (<20 ng/mL [34.3%] p < 0.001). Patients with vitamin D deficiency (<20 ng/mL) were 14 times more likely to have severe or critical disease than patients with 25(OH)D ≥40 ng/mL (odds ratio [OR], 14; 95% confidence interval [CI], 4 to 51; p < 0.001). CONCLUSIONS: Among hospitalized COVID-19 patients, pre-infection deficiency of vitamin D was associated with increased disease severity and mortality.


Subject(s)
COVID-19/blood , COVID-19/epidemiology , SARS-CoV-2/genetics , Severity of Illness Index , Vitamin D Deficiency/blood , Vitamin D Deficiency/epidemiology , Vitamin D/analogs & derivatives , Adult , Aged , Aged, 80 and over , COVID-19/mortality , COVID-19/virology , Comorbidity , Female , Humans , Israel/epidemiology , Male , Middle Aged , Patient Admission , Prognosis , Retrospective Studies , Risk Factors , Vitamin D/blood
10.
Epidemiol Infect ; 149: e257, 2021 12 27.
Article in English | MEDLINE | ID: covidwho-1586092
11.
EuropePMC; 2021.
Preprint in English | EuropePMC | ID: ppcovidwho-296641

ABSTRACT

Abstract Background: We determined circulating anti-S SARS-CoV-2 IgG antibody titres in a vaccinated healthcare workers (HCWs) cohort from Northern Israel in the 11 months following primary vaccination according to age, ethnicity, boosting timing and previous infection status. Methods: All consenting HCWs were invited to have their circulating IgG levels measured before vaccination and at 6 subsequent timepoints. All HCWs with suspected COVID-19 were PCR tested. We described trends in circulating IgG geometric mean concentration by age, ethnicity, timing of boosting and previous infection status and compared strata using Kruskall-Wallis tests. Results: Among 985 vaccinated HCWs. IgG titres gradually decreased in all groups over the study duration. Younger or previously infected individuals had higher initial IgG levels (p<0.001 in both cases);differences substantially decreased or disappeared at 7-9 months, before boosting. Pre-infection IgG levels in infected participants were similar to levels measured at the same timepoint in HCWs who remained uninfected (p>0.3). IgG GMC in those boosted 6-7 months after dose 2 was lower compared with those boosted 8-9 months after (1999-vs 2736, p=0.02). Conclusions: Immunity waned 6 months post-priming in all age groups and in previously infected individuals, reversed by boosting. IgG titres decrease among previously infected individuals and the proportion of reinfected individuals in this group, comparable to the proportion of breakthrough infection in previously uninfected individuals suggests individuals with hybrid immunity (infection+vaccination) may also require further doses. Our study also highlights the difficulty in determining protective IgG levels and the need to clarify the optimal timing in 3 dose regimens

12.
2021.
Preprint in English | Other preprints | ID: ppcovidwho-296143

ABSTRACT

In England, the National Immunisation Management System (NIMS) has been used to deliver COVID-19 vaccinations across England, monitor vaccine coverage, and assess vaccine effectiveness and safety. The NIMS was developed by a joint collaboration between a range of health and digital government agencies. Vaccinations delivered at large vaccination sites, pharmacies, hospitals and in primary care are entered on a point of care application which is verified using the unique NHS number in a centralised system containing information for everyone resident and registered with a GP in England. Vaccination details and additional data from hospital and GP records (such as priority groups) are sent to NHS Digital for data linkage. The NIMS constantly receives updated details from NHS Digital for all individuals and these data are provided to Public Health England (PHE) in a secure environment. PHE primarily use the NIMS for vaccine coverage, vaccine effectiveness and safety. Daily access to individual-level vaccine data has allowed PHE to rapidly and accurately estimate vaccine coverage and provide some of the world’s first vaccine effectiveness estimates. Other countries evaluating the roll-out and effect of COVID-19 vaccine programmes should consider a vaccine register or immunisation information system similar to the NIMS.

13.
2021.
Preprint in English | Other preprints | ID: ppcovidwho-296142

ABSTRACT

Objective To determine characteristics associated with COVID-19 vaccine coverage among individuals aged 50 years and above in England since the beginning of the programme. Design Observational cross-sectional study assessed by logistic regression and mean prevalence margins. Setting COVID-19 vaccinations delivered in England from 08 December 2020 – 17 May 2021. Participants 30,624,257/ 61,967,781 (49.4%) and 17,360,045/ 61,967,781 (28.1%) individuals in England were recorded as vaccinated in the National Immunisation Management System with a first dose and a second dose of a COVID-19 vaccine, respectively. Interventions Vaccination status with COVID-19 vaccinations. Main Outcome Measures Proportion, adjusted odds ratios and mean prevalence margins for individuals not vaccinated with dose 1 among those aged 50-69 years old and dose 1 and 2 among those aged 70 years old and above. Results Among individuals aged 50 years and above, Black/African/Caribbean ethnic group was the least likely of all ethnic groups to be vaccinated with dose 1 of the COVID-19 vaccine. However, among those aged 70 years and above, the odds of not having dose 2 was 5.53 (95% CI 5.42 to 5.63) and 5.36 (90% CI 5.29 to 5.43) greater among Pakistani and Black/African/Caribbean compared to White British ethnicity, respectively. The odds of not receiving dose 2 was 1.18 (95% CI 1.16 to 1.20) higher among individuals who lived in a care home compared to those who did not. This was the opposite to that observed for dose 1, where the odds of not being vaccinated was significantly higher among those not living in a care home (0.89 (95% CI 0.87 to 0.91)). Conclusions We found that there are characteristics associated with low COVID-19 vaccine coverage. Inequalities, such as ethnicity are a major contributor to suboptimal coverage and tailored interventions are required to improve coverage and protect the population from SARS-CoV-2. Article summary Strengths and Limitations of this study This is the is the first study assessing characteristics associated with COVID-19 vaccine coverage for all individuals aged 50 years and above in England. This study uses data from the National Immunisation Management System (NIMS) which is based on all individuals in England with a registered NHS number. This centralised national system captures individual level data for both vaccination status and demographic characteristics and allows for linkage to other datasets such as health care worker and care home resident status. This study does not include those without an NHS number and, therefore, it is possible we have underestimated the number of vaccines delivered and odds of not being vaccinated for characteristics such as ethnic groups where we have seen the greatest impact. Residual errors in data entry on the point of care apps at the vaccination sites may have also occurred, though these errors are not likely to be widespread.

14.
Lancet Reg Health Eur ; 12: 100234, 2022 Jan.
Article in English | MEDLINE | ID: covidwho-1487886

ABSTRACT

Background: COVID19 vaccination coverage in Israel varies among population groups. Comparing crude coverage between groups is misleading because of different age structures and socio-economic differences. To describe inequalities in COVID19 vaccine initiation in Israel we analysed the interaction of age and population groups in terms of dose 1 vaccine coverage. Methods: We calculated cumulative age-specific first COVID19 vaccine coverage by population group (Ultra-Orthodox Jewish, Arab, General Jewish). We calculated the relative differences in vaccine coverage between population groups within each age group, and between age groups within each population, using ANOVA and binomial regression after adjusting for socio-economic status. Findings: 8,507,723 individuals in 268 cities were included. Compared with the general Jewish population, coverage was lowest in the Ultra-Orthodox population in all age groups (range -12% among 60+ to -52.8% among 10-19 years olds, p<0.001). In all groups, the proportion of vaccinated individuals in younger age groups relative to those aged 60+ decreased with decreasing age and were smallest in the Ultra-Orthodox groups. For example, within the general Jewish population, people aged 20-29 were 14% less likely to be vaccinated than those aged 60+ while within the Ultra-Orthodox population it was 34.5. Interpretation: In all age groups, the Ultra-Orthodox population had the lowest vaccine coverage. Differences persisted after adjusting for socio-economic status. The younger the age group, the more Ultra-Orthodox Jews were diverging from age peers in terms of initiating COVID19 vaccination, suggesting a generational effect. Tailored approaches are urgently required to encourage vaccination among under-immunized groups in Israel. Funding: No specific funding was received.

15.
Lancet Infect Dis ; 21(12): e387-e398, 2021 12.
Article in English | MEDLINE | ID: covidwho-1458583

ABSTRACT

Migrant populations are one of several underimmunised groups in the EU or European Economic Area (EU/EEA), yet little is known about their involvement in outbreaks of vaccine-preventable diseases. This information is vital to develop targeted strategies to improve the health of diverse migrant communities. We did a systematic review (PROSPERO CRD42019157473; Jan 1, 2000, to May 22, 2020) adhering to PRISMA guidelines, to identify studies on vaccine-preventable disease outbreaks (measles, mumps, rubella, diphtheria, pertussis, polio, hepatitis A, varicella, Neisseria meningitidis, and Haemophilus influenzae) involving migrants residing in the EU/EEA and Switzerland. We identified 45 studies, reporting on 47 distinct vaccine-preventable disease outbreaks across 13 countries. Most reported outbreaks involving migrants were of measles (n=24; 6496 cases), followed by varicella (n=11; 505 cases), hepatitis A (n=7; 1356 cases), rubella (n=3; 487 cases), and mumps (n=2; 293 cases). 19 (40%) outbreaks, predominantly varicella and measles, were reported in temporary refugee camps or shelters. Of 11 varicella outbreaks, nine (82%) were associated with adult migrants. Half of measles outbreaks (n=11) were associated with migrants from eastern European countries. In conclusion, migrants are involved in vaccine-preventable disease outbreaks in Europe, with adult and child refugees residing in shelters or temporary camps at particular risk, alongside specific nationality groups. Vulnerability varies by disease, setting, and demographics, highlighting the importance of tailoring catch-up vaccination interventions to specific groups in order to meet regional and global vaccination targets as recommended by the new Immunisation Agenda 2030 framework for action. A better understanding of vaccine access and intent in migrant groups and a greater focus on co-designing interventions is urgently needed, with direct implications for COVID-19 vaccine delivery.


Subject(s)
Disease Outbreaks , Transients and Migrants , Vaccine-Preventable Diseases/epidemiology , Adult , Child , Disease Outbreaks/prevention & control , Europe/epidemiology , Humans , Immunization Programs , Refugee Camps , Refugees , Vaccination , Vaccine-Preventable Diseases/prevention & control
16.
Epidemiol Infect ; 149: e239, 2021 08 17.
Article in English | MEDLINE | ID: covidwho-1360170

ABSTRACT

Between December 2020 and March 2021, we measured anti-SARS-CoV-2 IgG titres among 725 Israeli hospital workers vaccinated against COVID-19. Infection post-dose 1 vaccination did not increase IgG titres, and individuals infected post-dose 1 had IgG levels comparable to never-infected individuals who received a single dose, lower than fully vaccinated, never-infected individuals. This suggests dose 2, currently not offered to those infected post-dose 1, may be required in these individuals. Larger studies should confirm whether individuals infected post-dose 1 need the second.


Subject(s)
COVID-19 Vaccines/economics , COVID-19 Vaccines/immunology , COVID-19/prevention & control , Immunization Schedule , SARS-CoV-2/immunology , Antibodies, Viral/blood , COVID-19/blood , Humans , Immunoglobulin G/blood , Israel/epidemiology , Vaccination
17.
Int J Technol Assess Health Care ; 37(1): e77, 2021 Jul 16.
Article in English | MEDLINE | ID: covidwho-1315573

ABSTRACT

Emergency preparedness is a continuous quality improvement process through which roles and responsibilities are defined to effectively anticipate, respond to, and recover from the impact of emergencies. This process results in documented plans that provide a backbone structure for developing the core capacities to address health threats. Nevertheless, several barriers can impair an effective preparedness planning, as it needs a 360° perspective to address each component according to the best evidence and practice. Preparedness planning shares common principles with health technology assessment (HTA) as both encompass a multidisciplinary and multistakeholder approach, follow an iterative cycle, adopt a 360° perspective on the impact of intervention measures, and conclude with decision-making support. Our "Perspective" illustrates how each HTA domain can address different component(s) of a preparedness plan that can indeed be seen as a container of multiple HTAs, which can then be used to populate the entire plan itself. This approach can allow one to overcome preparedness barriers, providing an independent, systematic, and robust tool to address the components and ensuring a comprehensive evaluation of their value in the mitigation of the impact of emergencies.


Subject(s)
Civil Defense/organization & administration , Disaster Planning/organization & administration , Technology Assessment, Biomedical/organization & administration , Civil Defense/economics , Civil Defense/standards , Disaster Planning/economics , Disaster Planning/standards , Evidence-Based Practice/standards , Humans
18.
19.
Eurosurveillance ; 25(19):7, 2020.
Article in English | ProQuest Central | ID: covidwho-1202500

ABSTRACT

Using electronic health records, we assessed the early impact of coronavirus disease (COVID-19) on routine childhood vaccination in England by 26 April 2020. Measles-mumps-rubella vaccination counts fell from February 2020, and in the 3 weeks after introduction of physical distancing measures were 19.8% lower (95% confidence interval: −20.7 to −18.9) than the same period in 2019, before improving in mid-April. A gradual decline in hexavalent vaccination counts throughout 2020 was not accentuated by physical distancing.

20.
Euro Surveill ; 26(11)2021 03.
Article in English | MEDLINE | ID: covidwho-1181332

ABSTRACT

BackgroundA multi-tiered surveillance system based on influenza surveillance was adopted in the United Kingdom in the early stages of the coronavirus disease (COVID-19) epidemic to monitor different stages of the disease. Mandatory social and physical distancing measures (SPDM) were introduced on 23 March 2020 to attempt to limit transmission.AimTo describe the impact of SPDM on COVID-19 activity as detected through the different surveillance systems.MethodsData from national population surveys, web-based indicators, syndromic surveillance, sentinel swabbing, respiratory outbreaks, secondary care admissions and mortality indicators from the start of the epidemic to week 18 2020 were used to identify the timing of peaks in surveillance indicators relative to the introduction of SPDM. This timing was compared with median time from symptom onset to different stages of illness and levels of care or interactions with healthcare services.ResultsThe impact of SPDM was detected within 1 week through population surveys, web search indicators and sentinel swabbing reported by onset date. There were detectable impacts on syndromic surveillance indicators for difficulty breathing, influenza-like illness and COVID-19 coding at 2, 7 and 12 days respectively, hospitalisations and critical care admissions (both 12 days), laboratory positivity (14 days), deaths (17 days) and nursing home outbreaks (4 weeks).ConclusionThe impact of SPDM on COVID-19 activity was detectable within 1 week through community surveillance indicators, highlighting their importance in early detection of changes in activity. Community swabbing surveillance may be increasingly important as a specific indicator, should circulation of seasonal respiratory viruses increase.


Subject(s)
COVID-19/prevention & control , Epidemiological Monitoring , Physical Distancing , COVID-19/epidemiology , Humans , United Kingdom/epidemiology
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