ABSTRACT
Background: In the canton De Vaud, 604'633 individuals received at least one dose of COVID-19 vaccine. An online evaluation form was built to identify patients at increased risk of anaphylaxis and facilitate the in-center triage. Aim: To evaluate the outcomes of the vaccination, allergic reactions and satisfaction level of this online screening method. Methods: Individuals with documented allergy to any vaccine components and/or who suffer from severe allergic reactions to infused or injectable drugs were asked to fill an online form to define their eligibility for mRNA vaccines by an allergist. Several months after this assessment, a survey was sent back to get feedback on the outcomes of the vaccination status. Results: 3519 (0.58%) individuals underwent online risk assessment for mRNA vaccines. Of those, 1658 (47%) completed the survey. 80.4% had received two doses. Frequent adverse events included fever (24%), headache (27%), fatigue (39%) and muscular/articular pain (28%). Of the 420 (27%) who reported to be asthmatic, 12.8% complained worsening of asthma control after vaccination. Severe allergic reactions were reported in 24 (1.5%) cases and, after online review, considered as possible in 10 cases (0.6%). The median satisfaction and reassurance of the online form were 91/100 and 98/100, respectively. Satisfaction was significantly influenced by age and the number of vaccines received (0-vs-1-vs-2). Conclusions: Providing an online assessment for vaccine eligibility from an allergist reassured the allergic population and may represent a valuable tool to increase vaccine adherence.
ABSTRACT
The Covid-19 pandemic imposes new diagnostic strategies in order to optimize the medical care of our patients. The current bibliography, although of low quality, shows a sensitivity of 56 to 83% for the Covid-19 PCR. Even though one negative test can exclude a Covid-19 in the majority of cases, the NPV (Negative Predictive Value) decreases with increasing prevalence (pre-test probability). This finding suggests the need for strict auto-isolation of patients until the resolution of their symptoms. For patients that present with typical symptoms, who have a presumed Covid-19 prevalence of 40-50%, a negative test should be interpreted with caution and a repeat test may be needed.
ABSTRACT
This paper summarizes the main knowledge on mRNA vaccines in September 2021. The only contraindication for a 1st dose of vaccine is an allergy to one of the components of the vaccine, but a specialized consultation is possible for an eventual split vaccination under medical supervision. Serious side effects are rare and consist mainly of myocarditis, shingles and appendicitis, but the risk/benefit ratio is always favorable for vaccination. Efficacy against severe COVID-19 is > 90 % after 6 months, and this against all variants. It is recommended to vaccinate pregnant women. A 3rd dose is not recommended at this time, except for immunosuppressed individuals without detectable antibodies after 2 doses. Vaccine mixing is possible, including with a viral vector vaccine.
ABSTRACT
The need to curb the circulation of SARS-CoV-2 virus in the community and to diagnose those at risk of developing complications implies that an appropriate test should be chosen according to the epidemiological and clinical context. Rapid antigen tests, either nasopharyngeal or nasal, have the advantage of reflecting contagiousness better than PCR and giving an immediate result, reason why they are used as first-line for community diagnosis and screening. A rapid test allows immediate management of outpatients and does not falsely attribute the current acute episode to a previous SARS-CoV-2 infection. PCR, whether nasopharyngeal or buccosalivary, is useful for epidemiological surveillance, including that of new variants, as well as identification of severe COVID in the post-infectious phase.