ABSTRACT
Changes reflect replenished stockpiles of approved equipment.
Subject(s)
COVID-19 , Decontamination/standards , United States Food and Drug Administration/standards , Ventilators, Mechanical/standards , COVID-19/prevention & control , COVID-19/transmission , Health Personnel/organization & administration , Health Personnel/standards , Humans , Personal Protective Equipment , United StatesSubject(s)
Antiviral Agents/administration & dosage , COVID-19 Drug Treatment , Controlled Clinical Trials as Topic/ethics , Evidence-Based Medicine/ethics , Placebos/administration & dosage , COVID-19/mortality , Controlled Clinical Trials as Topic/standards , Evidence-Based Medicine/standards , Humans , Placebos/standards , United States , United States Food and Drug Administration/standardsABSTRACT
PURPOSE: To describe the characteristics of adverse event reporting in the United States (US) Food and Drug Administration Adverse Event Reporting System (FAERS) before and after the outbreak of the COVID-19 pandemic. METHODS: We included all FAERS reports from the US and Canada from November 7, 2019 to July 15, 2020 and divided the study period into three equal time intervals (pre-pandemic, first pandemic, second pandemic). We focused on methotrexate, a broadly used drug unrelated to COVID-19, and (hydroxy)chloroquine, another broadly used drug implicated in COVID-19 treatment. Using descriptive statistics, we compared reporting characteristics before and after the COVID-19 outbreak. RESULTS: During the study period, 366 998 cases (60% female, median age: 59 years) were submitted to FAERS. The daily median number of reports (1796 in the pre-pandemic, 1810 in the second pandemic time interval) and other characteristics remained stable. The daily median number of reports for methotrexate decreased from 28 in the pre-pandemic to 15 in the second pandemic time interval, with no considerable differences in other characteristics. The daily median number of reports for (hydroxy)chloroquine increased slightly from 1 in the pre-pandemic to 3 in the second pandemic time interval, while there were also changes in the demographics of cases and an increase in the proportion of cases reported by health professionals. CONCLUSIONS: The overall reporting to FAERS did not change after the outbreak of the COVID-19 pandemic. However, some stimulated reporting was observed for (hydroxy)chloroquine, highlighting the need for caution when conducting pharmacovigilance analyses with substances related to COVID-19.
Subject(s)
Adverse Drug Reaction Reporting Systems/standards , COVID-19 Drug Treatment , United States Food and Drug Administration/standards , Adolescent , Adult , Aged , Aged, 80 and over , COVID-19/epidemiology , Canada/epidemiology , Child , Child, Preschool , Databases, Factual/standards , Female , Humans , Hydroxychloroquine/adverse effects , Infant , Infant, Newborn , Male , Methotrexate/adverse effects , Middle Aged , United States/epidemiology , Young AdultSubject(s)
COVID-19 Drug Treatment , COVID-19 Vaccines/adverse effects , COVID-19/epidemiology , Nervous System Diseases/chemically induced , Nervous System Diseases/epidemiology , COVID-19 Vaccines/administration & dosage , Centers for Disease Control and Prevention, U.S./standards , Humans , United States/epidemiology , United States Food and Drug Administration/standardsSubject(s)
COVID-19 Vaccines/supply & distribution , COVID-19/epidemiology , COVID-19/prevention & control , Health Communication/methods , United States Food and Drug Administration/organization & administration , Cultural Competency , Health Communication/standards , Humans , Pandemics , SARS-CoV-2 , Trust , United States , United States Food and Drug Administration/standardsABSTRACT
The Food and Drug Administration (FDA) approves vaccines when their benefits outweigh the risks for their intended use. In this article we review the standard FDA approach to vaccine evaluation, which underpins its current approaches to assessment of vaccines to prevent coronavirus disease 2019 (COVID-19). The FDA has established pathways to accelerate vaccine availability before approval, such as Emergency Use Authorization, and to channel resources to high-priority products and allow more flexibility in the evidence required for approval, including accelerated approval based on surrogate markers of effectiveness. Among the thirty-five new vaccines approved in the US from 2006 through October 2020, about two-thirds of their pivotal trials used the surrogate outcome of immune system response, and only one-third evaluated actual disease incidence. Postapproval safety surveillance of new vaccines, and particularly vaccines receiving expedited approval, is crucial. This has generally been accomplished through such mechanisms as the Centers for Disease Control and Prevention (CDC) and FDA Vaccine Adverse Event Reporting System, the CDC Vaccine Safety Datalink, and the CDC Clinical Immunization Safety Assessment Project. Adverse events detected in this way may lead to changes in a vaccine's recommended use or withdrawal from the market. Regulatory oversight of new vaccines must balance speed with rigor to effectively address the pandemic.
Subject(s)
COVID-19 Vaccines/pharmacology , COVID-19/prevention & control , Drug Approval/organization & administration , Pharmaceutical Preparations/standards , United States Food and Drug Administration/standards , Centers for Disease Control and Prevention, U.S./standards , Humans , Immunization/adverse effects , Patient Safety , Risk Assessment , SARS-CoV-2 , United StatesSubject(s)
Betacoronavirus , Biomedical Research/standards , Clinical Trials as Topic/standards , Coronavirus Infections/epidemiology , Pneumonia, Viral/epidemiology , United States Food and Drug Administration/standards , Biomedical Research/trends , COVID-19 , Coronavirus Infections/prevention & control , Humans , Pandemics/prevention & control , Pneumonia, Viral/prevention & control , SARS-CoV-2 , United States/epidemiology , United States Food and Drug Administration/trendsABSTRACT
Potential pitfalls in the development, deployment and interpretation of antibody tests for COVID-19 are discussed. Lessons learned from the experience with the introduction of antibody tests for HIV are highlighted.Each test will need to be separately vetted for performance and clinical implementation based upon rigorous clinical trial data. The issues we highlight will also be similarly important for vaccine and therapeutic drug efficacy trials.