ABSTRACT
Vaccination is an important part of the fight against COVID-19 virus. A predictor of the proportion of people who will actually take a vaccination is the willingness to vaccinate among the population. Literature shows that vaccination willingness among people with lower socioeconomic status is lower than among other groups. In this contribution we describe to what extent this is also the case in the Netherlands and show how risk perception, trust in the effects and safety of the vaccine, and health literacy may be related to this. Finally, we highlight a number of intervention strategies that can make a positive contribution to vaccination willingness among lower educated groups.
ABSTRACT
BACKGROUND: Vaccination against COVID-19 has started in several countries already and is on its way in others. However, there is an important hesitance towards the vaccine. The aim of this study is to evaluate the vaccination hesitance and main concerns towards the vaccine among surgeons. METHODS: An anonymous survey of 16 questions was sent to 138 Belgian surgeons before the start of vaccination in Belgium. The questions were divided into sections, evaluating demographics, COVID-19 test status and symptoms, the surgeon's opinion on the COVID-19 vaccination and their main concerns. RESULTS: Ninety-three out of 138 surgeons (67.4%) completed the survey: two-third of them were residents. Sixty-nine surgeons (74.2%) do want to get vaccinated. Forty-two surgeons (45.2%) feel like they do not have enough information about the vaccine. Residents feel significantly more underinformed than consultants (52.3% and 29.0%, respectively). Surgeons who feel to be well-informed are more willing to get vaccinated (92.2%) compared to those who feel to have a lack of information (52.4%). The main concerns among surgeons include effectiveness (26.9%), safety and side effects (19.4%) and organisation and vaccination strategy (12.9%). Twenty-five surgeons (26.9%) have no concerns at all. CONCLUSION: Most surgeons (74.2%) are ready for their COVID-19 vaccine. However, some of the surgeons are still doubtful about the vaccine. A lack of information plays a major role in their scepticism. A strong communication strategy is necessary to educate, reassure and motivate surgeons to get vaccinated.
ABSTRACT
This journal issue includes s of papers presented at the conference. Topics discussed are: sleeping characteristics among primary school children in Gampaha District, Sri Lanka;cosmetic effects of post thyroidectomy scar and evaluation of patient satisfaction;post-vaccination symptoms of COVID-19 vaccines among adults in Galle;multiple chest trauma in a victim of road traffic collision;anatomical variations of renal vein in a group of Sri Lankan cadavers;hospital acquired infections among patients in Intensive Care Units in Teaching Hospital, Karapitiya;serum Vitamin D level among 1 to 5-year-old children in Galle Municipality and Bope Poddala MOH area.
ABSTRACT
Objectives: Patients with Systemic Lupus Erythematosus (SLE) are predisposed to serious infections due to immunocompromise, comorbidities, immunomodulatory and/or immunosuppressive therapy, as well as the lack of these medications faced by patients dependent on the Sistema Unico de Saude (SUS) during the COVID-19 pandemic. Studies revealed a low risk of worsening disease activity after vaccination against SARS-CoV-2 and safety in the continuity of immunomodulatory therapy during the vaccination stages. Thus, immunization against COVID-19 is an important pillar in reducingmorbidity and mortality related to infectious conditions and SLE. This study had the objective to understand the disease activity in SLE patients after vaccination against COVID-19. Method(s): This is an observational, longitudinal, ambidirectional study with follow-up of subgroups of patients with immune-mediated rheumatic diseases immunized with vaccines made available by the Programa Nacional de Imunizacao (Butantan Institute, Pfizer/BioNTech, BioManguinhos/Fiocruz and Janssen). Data from the SLE disease activity index 2000 (SLEDAI-2 K) and sociodemographic data were collected and stored via an online platform, with a comparison of the index before and after each dose. This study was approved by the local Research Ethics Committee, and it is associated to the SAFER Project from Brazilian Society of Rheumatology. Result(s): A total of 223 patients were included, of which 83% were female and 39% had SLE, 36.7 +/- 11.76 years old. Regarding the disease activity, at inclusion the mean PGA score(SD) was 2,61 +/- 2,77. After the 1st dose it was 1.38 +/- 2.17, after the 2nd dose it was 2,35 +/- 2,99, after the 3rd dose it was 2,19 +/- 2,58 and after the 4th dose 1.18 +/- 1.88. The mean SLEDAI-2 K score at inclusion was 7,27 +/- 9,70, after the 1st dose it was 2,75 +/- 5,29, after the 2nd dose it was 4,73 +/- 6,40, after the 3rd dose 3,33 +/- 5,51 and after the 4th dose 2.12 +/- 4.27. 6% of the patients referred worsening disease activity after the 1st dose, 14,3%after the 2nd dose, and no patient reportedworsening of disease activity after the 3rd and 4th doses. Conclusion(s): Vaccination did not contribute toworsening disease activity of the SLE patientss studied, according to the indices used to assess disease activity.
ABSTRACT
Objectives: Immunization against SARS-CoV-2 is an effective strategy to reduce morbidity and mortality in the face of the COVID-19 pandemic. People with Immune-mediated Rheumatic Diseases (IMRD) also benefited from this campaign. However, there is a limited amount of data on the outcome of vaccination in these patients, in terms of those who were infected by the virus. This study had the objective to evaluate the rate of COVID-19 cases in patients with IMRD after vaccination against SARS-CoV-2. Method(s): Observational, longitudinal and ambidirectional study with follow-up of subgroups of patients with IMRD immunized with vaccines made available by the National Immunization Plan (inactivated adsorbed vaccine registered by the Instituto Butantan (IB), recombinant vaccines registered by Bio Manguinhos/ Fiocruz and by Janssen, and Pfizer/BioNTech). Sociodemographic data and questionnaires on flu syndrome, laboratory confirmation of infection and need for hospitalization and outcomes were collected and stored via an online platform. This study is associated to the SAFER Project from the Brazilian Society of Rheumatology and it was approved by the local Research Ethics Committee. Result(s): A total of 223 patients aged over 18 years, mean age 42.79 +/- 15.18 years, were included. All were within the inclusion/exclusion criteria, with 83% being female. The main IMRD included were systemic lupus erythematosus (39%) and rheumatoid arthritis (33.6%). After the 1st dose, 1.45% of patients had COVID-19, 50% sought health services (emergency care), without the need for hospitalization and after the 2nd dose, 1.5% had the disease, of which none sought health services, required hospitalization or had a negative outcome. After the 3rd dose,: 2.9%were infected with SARS-CoV-2 one month later, 15.6% two to three months later and 5.5% four to six months later, all with laboratory confirmation;only 4% presenting any serious complication;there were no deaths. After the 4th dose, 9.1%of patients had COVID-19, of which 40%were hospitalized, without the need for assisted ventilation;half of these patients had a serious complication, but there no deaths. Conclusion(s): In this study, we observed the effectiveness of the vaccine in preventing severe cases of COVID-19 and complications of SARS-CoV-2 infection.
ABSTRACT
Objectives: Chronic Inflammatory Immune-mediated Diseases (CIMD) can cause pain and severe discomfort to the patient, leading to significant reductions in his/her quality of life. Vaccination against COVID-19 has proven to be an efficient method in preventing cases and serious repercussions. However, there is insufficient evidence on the safety of these vaccines in the CIMD population. Objective(s): To assess disease activity in adolescent patients with CIMD after vaccination against SARS-CoV-2. Method(s): Observational, longitudinal, ambidirectional study with follow-up of groups of adolescent patients with CIMDwho received the vaccine provided by the National Immunization Program -Pfizer/BioNTech. Sociodemographic and clinical disease activity data were collected before and after each vaccine dose. Data were stored through an online platform (REDCap). This study is associated to the SAFER Project from the Brazilian Society of Rheumatology and was approved by the local Research Ethics Committee. Result(s): Nineteen adolescents aged between 12 and 17 years were included, all of whom met the inclusion/exclusion criteria. Of the total, 31.6% have Juvenile Idiopathic Arthritis (JIA)-14.33 +/- 2.25 years of age, whose subtypes included persistent oligoarticular JIA (16.7%), Polyarticular Rheumatoid Factor (RF) negative (33.3%), Polyarticular RF positive (16.7%) and Systemic (33.3%);68.4% have Systemic Lupus Erythematosus (SLE) -14.77 +/- 1.96 years of age. Regarding JIA patients, at inclusion, the mean disease activity assessed by the physician was 3 +/- 3.83 and 3.25 +/- 3.77 as assessed by the patient. After the 1st dose, the mean activity assessed by the physician was 2.8 +/- 3.9 and after the 2nd dose it was 3 +/- 4.24. Themean activity after the first dose as assessed by the patient was 3.2 +/- 3.96, and after the 2nd dose it was 2.8 +/- 3.11. In the SLE patients, at inclusion, the mean degree of disease activity was 1.92 +/- 1.83 and of the SLEDAI-2 K was 4.67 +/- 5.14. After the 1st dose, the mean disease activity was 1.11 +/- 1.96, and after the 2nd dose, it was 2.25 +/- 2.76. After the 1st dose, the SLEDAI-2 K was 1.11 +/- 1.76, and after the 2nd dose it was 4.25 +/- 5.28. No reports of worsening of disease activity after the vaccine were found. Conclusion(s): The vaccination proved not to contribute to worsening of clinical activity of rheumatic diseases in adolescents, without significant changes in SLE assessment indices and in the personal and medical assessment of JIA patients.
ABSTRACT
Background: The COVID-19 vaccines were developed unprecedentedly and have proven safe and efficacious in reducing transmissibility and severe infection. The impact of mRNA-based COVID-19 vaccines on atrial arrhythmias (AA) incidence is unknown. Objective(s): To analyze the incidence of AA after COVID-19 vaccination in patients with a cardiac implantable electronic device (CIED). Method(s): BIOTRONIK Home Monitoring data and Medicare claims data from CERTITUDE patients implanted with a CIED between 2010-20 were utilized to identify recipients of one or more doses of the COVID-19 vaccine in 2021. Those who had influenza vaccination in 2020 were also identified in the same cohort as a control. From remote monitoring data, the number of atrial high rate events (AHR) and % burden of AA in the three months post-vaccination was compared to the preceding three months using Wilcoxon signed rank test. Kruskal-Wallis test was used for group difference comparisons. New AF diagnosis was determined from ICD-10 diagnosis codes in Medicare claims. Result(s): First and 2nd doses of COVID vaccine (50% Pfizer, 47% Moderna, and 3% J&J) were administered to 7757 and 6579 individuals with a CIED (age 76.2 (+/-9.0) y, 49% males), respectively. In the same cohort, 4723 (61%) individuals received the influenza vaccine. A statistically significant increase in the number of AHR episodes and % burden of AA was noted in the three months post-vaccination compared to the preceding three months after the 1st and 2nd doses of the COVID-19 vaccine (Figure). No such association was noted following influenza vaccination. In subgroup analysis, AHR episodes increased significantly in age groups >70 and men. Post-vaccination increase in AHR episodes was more significant in those without a pre-vaccination history of AHR episodes (mean increase of AHR 6.9+/-88.4, p<0.001) and was non-significant in those with a preceding history of AHR (p=0.8). Among the 764 patients with no AF diagnosis in claims preceding the first COVID-19 vaccine, 87 (11.4%) developed a new AF diagnosis or AHR event in the first three months post-vaccination. Conclusion(s): We report a small but significant increase in the number of CIED-detected atrial arrhythmias following vaccination for COVID-19 but not influenza, specifically in men and age >70 years. Acknowledging the immense public health benefit of COVID-19 vaccines, our results should prompt increased awareness of evaluating for AF in this high-risk group following vaccination. [Formula presented]Copyright © 2023
ABSTRACT
A prerequisite for effective vaccination is the formation of proper collective immunity in society. The attitudes of healthcare professionals towards vaccination directly impact the population's adherence to this method. Objective. To study the attitude of healthcare professionals toward COVID-19 vaccination. Material and methods. The sociological survey method with the author's questionnaire based on GoogleForm was used. In the sur-vey, 450 physicians aged 25 to 70 participated voluntarily. It was a cross-sectional study carried out in the autumn of 2021. Results. Of those surveyed, the majority (86.8%) of physicians and almost all (96.1%) nurses were vaccinated against COVID-19. When studying the motivation for vaccine prophylaxis, a direct average strength of a statistically significant correlation between the adherence to COVID-19 vaccination and the emergence of a sense of safety was established (rxy =0.346;p<0.05). The most common reasons for the refusal of doctors from vaccination were the fear of complications, beliefs about low protection against infection and the subsequent decrease in immunity. According to healthcare professionals, the most effective means of prevention, in descending order, were a healthy lifestyle, the absence of fear of becoming ill, vaccination, drugs that stimulate immunity, the use of barrier measures, and other means. Conclusion. The ambiguous attitude of healthcare professionals towards vaccination against COVID-19 does exist and deserves the closest attention. Considering the issue's complexity, further research on the attitude of healthcare professionals toward vaccination is required.Copyright © 2023, Media Sphera Publishing Group. All rights reserved.
ABSTRACT
The development and implementation of vaccines are expected to reduce the incidence of the death to a certain extent and control the spread of the COVID-19. At the national level, different countries have adopted different measures on vaccination according to national conditions and policies to control the COVID-19, which have different degrees of impact. This study selects data on vaccination in the US and the UK from March 2021 to May 2022, explores the differences between the death and vaccination in two countries by building multiple linear regression models respectively. Research indicates that people vaccination in the US has a greater effect on new death than UK. When people vaccination drops by 7.648e-06 units, new death increases by one unit. However, from the model of UK, when people vaccination drops by 1.406e-06 units, new death increases by one unit. From the analysis of the result, the difference between the US and the UK might be due to national policies, medical systems and public attitudes toward the government and vaccination. © 2023 SPIE.
ABSTRACT
Ziel/Aim The global SARS-CoV-2 vaccination campaign brought attention to a recent pitfall in tumor staging by PET/CT. Several publications reported a non-specific F-18-FDG tracer uptake in axillary lymph nodes after COVID-19 vaccination. Ga-68-FAPI PET/CT is a new oncologic imaging tool that may overcome this limitation. Methodik/Methods For this purpose, we compared the tracer uptake in a head-to-head and same-day F-18-FDG and Ga-68-FAPI PET/CT study. 11 patients from our prospective database (NCT04571086) were included showing vaccine-related tracer uptake in axillary lymph nodes up to 6 weeks after COVID- 19 vaccination. Ergebnisse/Results Among the total of 11 patients, all (n = 11) showed visual positive uptake in the lymph nodes ipsilateral to the injection side on F-18-FDG PET. None (n = 0) of the included patients showed significant tracer uptake on Ga-68-FAPI PET. Follow-up imaging confirmed reactive nodal uptake in all patients. The tumor detection efficacy for these patients was 73 % for F-18-FDG and 94 % for Ga-68-FAPI. Schlussfolgerungen/Conclusions In our case series, Ga-68-FAPI demonstrated resistance to vaccine-related pitfalls while presenting superior tumor detection.
ABSTRACT
Objectives: BIOBADAGUAY is the Paraguayan/Uruguayan registry of adverse events in patients with inflammatory rheumatic conditions under biologic therapy (BT). Three years have elapsed from the first case of coronavirus and data about South American patients with COVID are still scarce. In this study we analyzed the frequency and clinical outcomes of COVID-19 in a cohort of patients with rheumatic diseases from Paraguay. Method(s): A cross sectional study of Paraguayan patients with rheumatic diseases from BIOBADAGUAY and controls without BT. Clinical, epidemiological, and COVID-19 data were analyzed. Only cases confirmed by SARSCoV-2 positive PCR test were included. Descriptive analysis were performed for this study. Result(s): 832 patients were included (696 under BT and 136 controls). 116 (13.9%) had COVID-19. 22 had a second infection and 9 a third reinfection. Table 1 shows characteristic of COVID-19 patients. The most frequent diagnosis was rheumatoid arthritis (n = 93, 80.2%) followed by ankylosing spondylitis (n = 6, 5.2%), undifferentiated spondylarthritis (n = 5, 4.3%), psoriatic arthritis (n = 4, 3.4%), juvenile onset arthritis (n = 2, 1.7%), vasculitis (n = 2, 1.7%). Only 1 case (0.8%) were registered for Still's disease, enteropathic spondylarthritis, systemic sclerosis and seronegative polyarthritis, respectively. When comorbidities were analyzed, 46 (39.6%) patients had at least one (Table 1). Of the total treatments received: 65 (56.0%) had methotrexate, 53 (45.7%) leflunomide, 3 (2.5%) sulfasalazine, 15 (12.9%) hydroxychloroquine, 25 (21.5%) glucocorticoid, 52 (44.8%) anti-TNF and 20 (17.2%) non-anti-TNF. COVID-19 severity outcomes were: 101(87%) non severe, 31 (26.7%) severe and 1 fatal(0.8%). 189 (90.9%) patients received vaccination and the mean number of doses were 2.5 doses. 55 (26.4%) had COVID prior to vaccination Conclusion(s): In this study we examined the frequency of COVID-19 in Paraguayan patients with rheumatic diseases. In this cohort of rheumatologic patients, COVID 19 severity was similar to the one in the general population.
ABSTRACT
The new coronavirus infection (COVID-19) caused by the SARS-CoV-2 virus continues to spread rapidly worldwide, despite the increased prevention and treatment measures being taken. Vaccination is one of the most cost-effective and effective methods of preventing infectious diseases in the modern world, including one of the most effective methods of combating COVID-19. Over several centuries of history, vaccination has proven its effectiveness in saving people's lives, reducing the spread of infectious diseases among the population, as well as reducing mortality. The effectiveness of immunization against COVID-19 is an urgent problem at the moment, especially when it comes to vaccination. The aim of the work is to study the effect of vaccination on the incidence of a new coronavirus infection among residents of the Saratov Region. Material and methods. Methods of retrospective epidemiological analysis of trends in the epidemic process COVID-19 were used. The obtained materials were processed using methods of variational statistics (Excel program). The analysis was based on data from daily monitoring of laboratory diagnostic results (more than 1780 thousand PCR diagnostic studies were conducted during the epidemic), COVID-19 cases and deaths, taking into account the coverage of the population with preventive vaccinations. The statistical significance of the differences was assessed according to the Student's criterion. The differences were considered significant at t<=2. Results and discussion. As of June 30, 2021, more than 267 thousand people or 11% of the population of the Saratov region were fully vaccinated against COVID-19. There were no complications after the introduction of vaccines. In the structure of all medical immunobiological preparations that were immunized, the proportion of the vaccine "Gam-COVID-Vac" was 97.88%, "Epivaccorona" - 1.69% and "Covivac" - 0.43%. According to preliminary data, 361 of the vaccinated people were infected with SARS-CoV-2, of which: 255 (70.6%) had a mild course of the disease with manifestations of catarrhal syndrome, 84 (23.3%) had community-acquired pneumonia, 22 (6%) had no symptoms of the disease. No deaths have been registered among the vaccinated. The overall incidence of COVID-19 among vaccinated was 0.06%. The incidence rate of COVID-19 among the vaccinated population is 6.025+/-0.15 per 10 thousand people, which is significantly lower (t>2) than among the unvaccinated (103.8+/-0.63 per 10 thousand people), efficiency index - 17.23, epidemiological efficiency coefficient - 94.20% Conclusion. Insufficient coverage of the population of the Saratov Region with vaccination (as of June 30, 2021, 11% were fully vaccinated) does not allow to influence the reduction of the incidence of COVID-19. The high epidemiological effectiveness of COVID-19 vaccination of the adult population with domestic vaccines, including people over 65 years of age, has been revealed.Copyright © 2022 Geotar Media Publishing Group
ABSTRACT
The COVID-19 pandemic has been going on for three years since the novel Coronavirus outbreak in Wuhan, China, at the end of 2019. At first people didn't take it seriously and didn't take any precautions. The virus has spread around the world, causing dizziness, nausea and even kidney failure in severe cases. Today, as people's awareness of COVID-19 has increased, more and more people are willing to wear masks, but there are still many people who are unwilling to wear masks. Some people refuse to wear masks because they have been vaccinated against COVID-19. Vaccines do help in reducing transmission rates, but they are not 100% effective. Even vaccinated people can catch the virus and spread it to others. Analysis of data from Singapore over a period of time shows that masks and vaccines provide two different types of protection, one for the group and the other for the individual. Both masks and vaccines are necessary for the safety of individuals and others. © 2023 SPIE.
ABSTRACT
Objectives: To evaluate the safety and immunogenicity of CoronaVac and ChAdOx1 vaccines against SARS-CoV-2 in patients with Rheumatoid Arthritis (RA). Method(s): These data are from the 'SAFER (Safety and Efficacy on COVID-19 Vaccine in Rheumatic Diseases)' study, a Brazilian multicentric longitudinal phase IV study to evaluate COVID-19 vaccine in immunomediated rheumatic diseases (IMRDs). Adverse events (AEs) in patients with RA were assessed after two doses of ChAdOx1 or CoronaVac. Stratification of postvaccination AEs was performed using a diary, filled out daily. The titers of neutralizing antibodies against the receptor-biding domain of SARS-CoV-2 (anti-RBD) were measured by chemilumine scence test after each dose of immunizers. Proportions between groups were compared using the Chi-square and Fisher's exact tests for categorical variables. Clinical Disease Activity Index (CDAI) before and after vaccination was assessed using the McNemar test. Result(s): A total of 188 patients with RA were included in the study, most of them were female. CoronaVac was used in 109 patients and ChAdOx1 in 79. Only mild AEs were observed. The more common AEs after the first dose were pain at injection site (46,7%), headache (39,4%), arthralgia (39,4%) and myalgia (30,5%), and ChAdOx1 had a higher frequency of pain at the injection site (66% vs 32 %, p alpha 0.001) arthralgia (62% vs 22%, p alpha 0.001) and myalgia (45% vs 20%, p alpha 0.001) compared to CoronaVac. The more common AEs after the second dose were pain at the injection site (37%), arthralgia (31%), myalgia (23%) and headache (21%). Arthralgia (41,42 % vs 25 %, p = 0.02) and pain at injection site (51,43% vs 27%, p = 0.001) were more common with ChAdOx1. No patients had a flare after vaccination. The titers of anti-RBDafter two doses of ChAdOx1 were higher compared to two doses of CoronaVac (6,03 BAU/mL vs 4,67 BAU/mL, p alpha 0,001). Conclusion(s): The frequency of local adverse effects, particularly pain at injection site, was high. AEs were more frequent with ChAdOx1, especially after the first dose. The use of the immunizers dis not change the degree of inflammatory activity of the disease. In patients with RA, ChAdOx1 was more immunogenic than CoronaVac. .
ABSTRACT
Background/Aims It is recognised that immunosuppressive medications, often relied upon in the management of autoimmune rheumatic disease, inhibit vaccine-induced immunity against the SARS-CoV-2 virus. A key challenge for rheumatologists is maximising immunity provided by the vaccine in their patients. Recent data has implicated methotrexate (MXT), a commonly used disease modifying anti-rheumatic drug (DMARD), in reducing patients' vaccine-induced immunity against the virus and studies have demonstrated the effectiveness of pausing MXT medication for 2-weeks after receiving the vaccine in boosting patients' immunity. There is a lack of data exploring the impact of concurrent biologic-DMARD (b-DMARD) use with MXT on COVID-19 infection rates in vaccinated individuals. This analysis forms part of a larger programme of research (clinicaltrials.gov NCT04542031) exploring COVID-19 in patients with rheumatic disease. Here we provide a comparative analysis of COVID-19 infection rates between patients taking MXT either with or without b-DMARD therapy and those on no immunosuppression. Methods We distributed two web-based questionnaires via SMS-messaging in April 2020 and December 2021 and two interim monitoring questionnaires in December 2020 and June 2021. All rheumatology patients with a valid mobile telephone number under follow up at the Royal Wolverhampton Trust were invited to participate in the study;those that consented received follow up questionnaires. We collected information on demographics, rheumatology diagnosis and treatment, vaccination status, and COVID-19 infection rates. Data were collected 7-days following questionnaire distribution. Results Initial questionnaires were sent to 7911 active follow up patients, 1636/ 7911 (21%) responded and consented to further follow up;906/1636 (55.4%) provided a complete response to the final survey which was subsequently linked to survey one enabling analysis. Responders were female (622/906, 68.7%), white (865, 95.5%), 60 years or above (519, 57.3%), and vaccinated (898/906;99.1%). Of those vaccinated significantly more patients that were on any immunosuppressive therapy compared to those on no immunosuppression (92/530 (17.4%) vs. 26/368 (7.1%);p<0.001), and more in the MXT monotherapy group compared to no immunosuppression (33/222 (14.9%) vs. 26/368 (7.1%);p=0.001) contracted COVID-19. Similar numbers in the MTX and b-DMARD and b-DMARD without MXT groups (23/140 (16.4%) vs. 36/168 (21.4%);p=0.23) contracted COVID-19. Conclusion Recent trial data from the VROOM study has demonstrated that omitting a patients MXT therapy for a 2-week period following administration of the COVID-19 vaccine doubles their antibody response. This data highlights that the risk of COVID-19 infection in vaccinated rheumatology patients is doubled in patients on any immunosuppressive medication compared to those on no immunosuppression, while there is no significant difference in infection rates between patients on MXT and a b-DMARD and b-DMARD therapy without MXT. Further work exploring the impact of different types of immunosuppression on COVID-19 vaccine-induced immunity and simple interventions to maximise this immunity in immunosuppressed individuals is required.
ABSTRACT
Objectives: To evaluate the humoral immune response to the third dose (booster) of vaccine against SARS-CoV-2 in patients with autoimmune rheumatic diseases who were seronegative after a two-dose regimen. Method(s): Observational study. Patients with autoimmune rheumatic diseases who had not achieved seroconversion after a two-dose vaccine schedule against SARS-CoV-2 were included. To assess the humoral immune response, anti-RBD IgG (S protein receptor binding domain) neutralizing antibody titers were determined by ELISA (cutoff titer 200). The determination was made between 30 to 45 days after the third dose. Result(s): From 66 patients who received SARS-CoV-2 vaccination, 18 patients (29.5%) were seronegative after a two-dose schedule. 61% had SLE, 77% had comorbidities (61% with hypertension, p = 0.03). Patients were on treatment: 10 with prednisone (8 with doses greater than 10 mg/d, p = 0.01), 10 with hydroxychloroquine, one with methotrexate, one with leflunomide, four with azathioprine, five with my cophenolatemofetil and five with rituximab (they are the total number of non-responders on biological treatment, p = 0.03). Regarding the primary vaccination regimen, 11 received BBIBP-CorV (p = 0.01), 5 AZD1222, 1 Gam-COVID-Vac and 1 mRNA1273/Gam-COVID-Vac heterologous scheme. Of these 18 non-responders, 14 received a third dose;nine patients (62%) presented anti-RBD IgG detectable. Of the five patients who did not respond to the booster vaccination, three had received BBIBP-CorV as the initial schedule and the vaccines applied as a third dose were Ad5-nCoV (1), BNT162b2 (1), AZD 1222 (2) and Gam-COVID-Vac (1). They were being treated with: rituximab (2), azathioprine (2) and mycophenolate mofetil (1). Treatment with higher doses of prednisone was the only factor associated with non-seroconversion to the third dose (8 +/- 4.5;p 0.02). Conclusion(s): The third dose of SARS-CoV-2 vaccine allowed to improve the serological response to vaccination, achieving a seroconversion of 62% in this group of patients.
ABSTRACT
AIM: There is a discussion about COVID-19 vaccination rates among healthcare workers (HCW), especially nurses. The primary question for this review was: "What are the attitudes of nurses, compared to other HCW, towards COVID-19 vaccination?" The secondary questions included the proportion of nurses with intention to get vaccinated, what prevents the nurses from accepting the vaccine and what enables them to accept the vaccine. METHODS: The PRISMA-ScR format for scoping reviews was chosen to respect the novelty of COVID-19 vaccines. Database search (PubMed/MEDLINE, PROquest and EBSCO) was performed for original studies in English language, from all geographies, with most recent search on March 20, 2022. Vaccination acceptance rates were charted for nurses and nursing students in one category, and HCW other than nurses in the other category. The evolution in time of the nurses attitude to vaccine acceptance relative to that of HCW other than nurses was charted post hoc. The factors associated with COVID-19 vaccination intention according to the WHO categories (contextual influences, individual/ group influences, and vaccine/vaccination specific issues) were reviewed as narrative summary. RESULTS: Total 58 eligible studies were selected, all with cross-sectional study design, including 95418 healthcare workers of whom 33130 were nurses and 7391 were nursing students, from 44 countries in Europe, Americas, Africa and Asia. Trust in science, in doctors, in experts and in governments were the main contextual factors increasing vaccination acceptance mentioned in the studies, while altruism and collective protection, or protecting a person at risk at home was mentioned only few times. The nurses were less likely to accept vaccination compared to doctors and other HCWs at the onset, eg. before vaccine rollout, and this difference decreased with time (p = 0.022). Being older (n = 25 studies), being male (n = 23), having higher degree of education (n = 7), and having more years of clinical practice (n = 4) were associated with higher vaccination acceptance. Percieved individual risk of having severe COVID-19 (n = 14) or working in a COVID-19 dedicated units (n = 5) was mentioned in a minority of studies. The main vaccine-releated factors associated with higher vaccination intention were trust in the vaccine and its efficacy and safety, general vaccinatoin acceptance and specifically having had influenza vaccination in previous years (n = 21 studies). A significant factor associated with higher vaccine acceptance was high "vaccine knowledge", "vaccine literacy", "understanding the vaccine" or "understanding benefits and barriers of vaccination" (n = 17 studies). CONCLUSIONS: Nurses have been more hesitant to accept COVID-19 vaccination than other healthcare professions at the beginning, but with time this difference disappeared. This general nurse attitude of wait-and-see reported in the studies corresponds with real-life data from practicing healthcare workers as reported by the Czech Institute of Health Information and Statistics on vaccination against COVID-19. Trust in scientific structures and vaccine makers increases the vaccine acceptance. The acceptance increases also with higher age, increasing level of education, longer clinical experience, and also with being a male. Vaccine literacy and having participated in previous vaccination programmes, especially influenza vaccine, were identified as independent modifiable factors increasing vaccination acceptance.
ABSTRACT
Aim: There is a discussion about COVID-19 vaccination rates among healthcare workers (HCW), especially nurses. The primary question for this review was: "What are the attitudes of nurses, compared to other HCW, towards COVID-19 vaccination?" The secondary questions included the proportion of nurses with intention to get vaccinated, what prevents the nurses from accepting the vaccine and what enables them to accept the vaccine. Method(s): The PRISMA-ScR format for scoping reviews was chosen to respect the novelty of COVID-19 vaccines. Database search (PubMed/MEDLINE, PROquest and EBSCO) was performed for original studies in English language, from all geographies, with most recent search on March 20, 2022. Vaccination acceptance rates were charted for nurses and nursing students in one category, and HCW other than nurses in the other category. The evolution in time of the nurses attitude to vaccine acceptance relative to that of HCW other than nurses was charted post hoc. The factors associated with COVID-19 vaccination intention according to the WHO categories (contextual influences, individual/ group influences, and vaccine/vaccination specific issues) were reviewed as narrative summary. Result(s): Total 58 eligible studies were selected, all with cross-sectional study design, including 95418 healthcare workers of whom 33130 were nurses and 7391 were nursing students, from 44 countries in Europe, Americas, Africa and Asia. Trust in science, in doctors, in experts and in governments were the main contextual factors increasing vaccination acceptance mentioned in the studies, while altruism and collective protection, or protecting a person at risk at home was mentioned only few times. The nurses were less likely to accept vaccination compared to doctors and other HCWs at the onset, eg. before vaccine rollout, and this difference decreased with time (p = 0.022). Being older (n = 25 studies), being male (n = 23), having higher degree of education (n = 7), and having more years of clinical practice (n = 4) were associated with higher vaccination acceptance. Percieved individual risk of having severe COVID-19 (n = 14) or working in a COVID-19 dedicated units (n = 5) was mentioned in a minority of studies. The main vaccine-releated factors associated with higher vaccination intention were trust in the vaccine and its efficacy and safety, general vaccinatoin acceptance and specifically having had influenza vaccination in previous years (n = 21 studies). A significant factor associated with higher vaccine acceptance was high "vaccine knowledge", "vaccine literacy", understanding the vaccine" or "understanding benefits and barriers of vaccination" (n = 17 studies). Conclusion(s): Nurses have been more hesitant to accept COVID-19 vaccination than other healthcare professions at the beginning, but with time this difference disappeared. This general nurse attitude of wait-and-see reported in the studies corresponds with real-life data from practicing healthcare workers as reported by the Czech Institute of Health Information and Statistics on vaccination against COVID-19. Trust in scientific structures and vaccine makers increases the vaccine acceptance. The acceptance increases also with higher age, increasing level of education, longer clinical experience, and also with being a male. Vaccine literacy and having participated in previous vaccination programmes, especially influenza vaccine, were identified as independent modifiable factors increasing vaccination acceptance.Copyright © 2023, Czech Medical Association J.E. Purkyne. All rights reserved.
ABSTRACT
Organ transplant recipients are at a high risk of infection with high hospitalization rate, critical rate and fatality, due to low immune function caused by taking immunosuppressants for a period of long time after organ transplantation. Currently, vaccination is recognized as an effective approach to prevent infection. Organ transplant recipients may be vaccinated according to individual conditions. However, the sensitivity to vaccines may decline in organ transplant recipients. The types, methods and timing of vaccination have constantly been the hot spots of clinical trials. In this article, the general principles, specific vaccines and SARS-CoV-2 vaccines of vaccination in organ transplant recipients were briefly reviewed, aiming to provide reference for the vaccination of organ transplant recipients. Moreover, current status of SARS-CoV-2 vaccination for organ transplant recipients was illustrated under the global outbreak of novel coronavirus pneumonia pandemic.Copyright © 2022 Journal of Zhongshan University. All Rights Reserved.
ABSTRACT
[Background] The COVID-19 pandemic hints at the importance of modernizing disease control system. To understand the scientific research strength of our country's disease control system in recent years is conducive to formulating more targeted policies or measures to promote the modernization of the disease control system. [Objective] To understand the scientific research strength and research hotspots of China's provincial-level centers for disease control and prevention (CDCs) from 2011 to 2020, and provide evidence for the development of scientific research work, discipline construction, and talent team construction in CDCs in the future. [Methods] The Science Citation Index Expanded (SCIE) and Social Science Citation Index (SSCI) of the Web of Science Core Collection were used to retrieve SCI-indexed English papers published by 31 provincial CDCs (excluding Taiwan Province, Hong Kong and Macau Special Administrative Regions) in our country from 2011 to 2020, and to screen literature with provincial CDCs as the first affiliation for bibliometric analysis and visual analysis. Bibliometric analysis included the SCI-indexed publications of different provincial CDCs (as co-affiliation and the first affiliation), the number of SCI-indexed papers published by provincial CDCs (as the first affiliation) and funding rates by years, the high-frequency authors of SCI-indexed papers published by provincial CDCs (as the first affiliation) and their distribution, and the characteristics of the journals. Visual analysis software Citespace 5.8.R1 was used to draw keyword co-occurrence maps, cluster information tables, and emergence maps to provide information on research hotspots and their evolution. [Results] From 2011 to 2020, the number of SCI-indexed papers from 31 provincial CDCs was 8 420 (including co-affiliation), of which 2 060 papers listed provincial CDCs as the first affiliation. The provincial CDCs of Zhejiang, Jiangsu, Shanghai, Beijing, Shandong, and Guangdong were the leading six institutes in terms of the total number of SCI-indexed papers contributed as co-affiliation or the first affiliation. There was a large gap in the total number of SCI-indexed papers among the provincial CDCs. The highest total number of SCI-indexed papers contributed by provincial CDCs as the first affiliation was Zhejiang CDC (448 papers), while the lowest number was Xinjiang CDC (only 1 paper). From 2011 to 2020, the total number of SCI-indexed papers contributed by the 31 provincial CDCs as the first affiliation showed an overall increasing trend. Except for 2011, which was 63.1%, the funding rates in other years exceeded 70%. In terms of high-frequency authors, 13 first authors published >=10 SCI-indexed papers: Zhang Yingxiu from Shandong CDC had the highest number of SCI-indexed papers (47), followed by Hu Yu from Zhejiang CDC. Zhejiang, Jiangsu, Beijing, Guangdong, Shanghai, and Shandong still ranked the top six of >=4 first authored-SCI papers. In terms of journal characteristics, the top 20 journals with the highest number of SCI papers published a total of 862 papers, accounting for 41.8% (862/2 060), and PLOS ONE ranked the first (188 papers). The research hotspots were mainly concentrated in the fields of infection, child health, and epidemiology. The main keywords of the first three cluster categories were related to the research fields of adolescent overweight and obesity, HIV, and vaccine immunity. The results of keyword emergence showed that research hotspots shifted from overweight, obesity, and body mass index to antibodies, vaccines/vaccination, and cohorts. [Conclusion] The past ten years have witnessed increasing numbers of SCI-indexed papers published by provincial CDCs in our country and a stubbornly high funding rate. However, the gap among the provincial CDCs is still large seeing that economically developed eastern provincial CDCs published more SCI-indexed papers. Research hotspots have gradually shifted from overweight, obesity, and body mass index to antibodies, vaccines/vaccination, and cohorts.Copyright © 022 Shanghai Municipal Center for Disease Control and Prevention. All rights reserved.