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3.
Int Marit Health ; 72(3): 179-182, 2021.
Article in English | MEDLINE | ID: covidwho-1450931

ABSTRACT

The increasing availability of safe and authorised coronavirus disease 2019 (COVID-19) vaccines for the first time provides the opportunity to vaccinate seafarers on board their ships while in port. Speedy vaccination of seafarers secures their health and serves to avoid the international propagation of COVID-19 virus variants via maritime traffic. As a port medical clinic, we will share our practical vaccination experience on board of merchant vessels in German/European ports with our esteemed coastal colleagues to stimulate their participation in this endeavour. You will have to adapt the procedure to your national particularities, otherwise please freely share the information with interested parties. Detailed guidance on COVID-19 vaccination in shipping and accompanying legal issues was published by the International Chamber of Shipping (www.ics-shipping.org).


Subject(s)
COVID-19 Vaccines/administration & dosage , COVID-19/prevention & control , Naval Medicine/methods , COVID-19 Vaccines/therapeutic use , Humans , Occupational Medicine/methods , SARS-CoV-2 , Ships , Vaccination/standards
6.
Dtsch Med Wochenschr ; 146(16): 1085-1090, 2021 Aug.
Article in German | MEDLINE | ID: covidwho-1366846

ABSTRACT

Since the end of 2019 a new coronavirus, SARS-CoV-2, first identified in Wuhan, China, is spreading around the world partially associated with a high death toll. Besides hygienic measurements to reduce the spread of the virus vaccines have been confected, partially based on the experiences with Ebola virus vaccine, based on recombinant human or chimpanzee adenovirus carrying the spike protein and its ACE2 receptor binding domain (RBD). Further vaccines are constructed by spike protein coding mRNA incorporated in lipid nano vesicles that after entry in human cells produce spike protein. Both vaccine types induce a strong immune response that lasts for months possibly for T-cell immunity a few years. Due to mutations in the coronavirus genome in several parts of the world variants selected, that were partially more pathogenic and partially easier transmissible - variants of concern (VOC). Until now vaccinees are protected against the VOC, even when protection might be reduced compared to the Wuhan wild virus.An open field is still how long the vaccine induced immunity will be sufficient to prevent infection and/or disease; and how long the time period will last until revaccination will be required for life saving protection, whether a third vaccination is needed, and whether revaccination with an adenovirus-based vaccine will be tolerated.


Subject(s)
COVID-19 Vaccines/immunology , COVID-19/prevention & control , Immune System/physiology , SARS-CoV-2/immunology , Vaccination/standards , COVID-19/epidemiology , COVID-19/physiopathology , Humans , Immune System/immunology , Immunity, Cellular , Immunity, Humoral , Time Factors
7.
Endocrinol Metab (Seoul) ; 36(4): 757-765, 2021 08.
Article in English | MEDLINE | ID: covidwho-1359308

ABSTRACT

Since the first outbreak of coronavirus disease 2019 (COVID-19), ongoing efforts have been made to discover an efficacious vaccine against COVID-19 to combat the pandemic. In most countries, both mRNA and DNA vaccines have been administered, and their side effects have also been reported. The clinical course of COVID-19 and the effects of vaccination against COVID-19 are both influenced by patients' health status and involve a systemic physiological response. In view of the systemic function of endocrine hormones, endocrine disorders themselves and the therapeutics used to treat them can influence the outcomes of vaccination for COVID-19. However, there are very limited data to support the development of clinical guidelines for patients with specific medical backgrounds based on large clinical trials. In the current severe circumstances of the COVID-19 pandemic, position statements made by clinical specialists are essential to provide appropriate recommendations based on both medical evidence and clinical experiences. As endocrinologists, we would like to present the medical background of COVID-19 vaccination, as well as precautions to prevent the side effects of COVID-19 vaccination in patients with specific endocrine disorders, including adrenal insufficiency, diabetes mellitus, osteoporosis, autoimmune thyroid disease, hypogonadism, and pituitary disorders.


Subject(s)
COVID-19 Vaccines/standards , COVID-19/prevention & control , Endocrine System Diseases , Endocrinologists/standards , Societies, Medical/standards , Vaccination/standards , COVID-19/epidemiology , COVID-19/immunology , COVID-19 Vaccines/administration & dosage , COVID-19 Vaccines/adverse effects , Endocrine System Diseases/epidemiology , Endocrine System Diseases/immunology , Humans , Practice Guidelines as Topic/standards , Republic of Korea/epidemiology
9.
Ann Thorac Surg ; 112(5): 1707-1715, 2021 11.
Article in English | MEDLINE | ID: covidwho-1347031

ABSTRACT

EXECUTIVE SUMMARY: Cardiothoracic surgical patients are at risk of increased coronavirus disease severity. Several important factors influence the administration of the coronavirus disease vaccine in the perioperative period. This guidance statement outlines current information regarding vaccine types, summarizes recommendations regarding appropriate timing of administration, and provides information regarding side effects in the perioperative period for cardiac and thoracic surgical patients.


Subject(s)
COVID-19 Vaccines/pharmacology , COVID-19/prevention & control , Cardiovascular Diseases/surgery , Perioperative Care/methods , Practice Guidelines as Topic , Thoracic Surgical Procedures , Vaccination/standards , COVID-19/epidemiology , Cardiovascular Diseases/epidemiology , Comorbidity , Humans , Pandemics
10.
Eur J Med Res ; 26(1): 87, 2021 Aug 06.
Article in English | MEDLINE | ID: covidwho-1344125

ABSTRACT

BACKGROUND: COVID-19 infection is a major threat to patients and health care providers around the world. One solution is the vaccination against SARS-CoV-2. METHODS: We performed a comprehensive query of the latest publications on the prevention of viral infections including the recent vaccination program and its side effects. RESULTS: The situation is evolving rapidly and there is no reasonable alternative to population-scale vaccination programs as currently enrolled. CONCLUSION: Therefore, regulatory authorities should consider supplementing their conventional mandate of post-approval pharmacovigilance, which is based on the collection, assessment, and regulatory response to emerging safety findings.


Subject(s)
COVID-19 Vaccines/administration & dosage , COVID-19/prevention & control , Informed Consent/standards , Pharmacovigilance , SARS-CoV-2/immunology , Vaccination/standards , COVID-19/immunology , COVID-19/virology , Disclosure , Humans
11.
Expert Rev Clin Pharmacol ; 14(11): 1413-1425, 2021 Nov.
Article in English | MEDLINE | ID: covidwho-1334128

ABSTRACT

INTRODUCTION: Lung transplant patients are immunocompromised because of the medication they receive to prevent rejection, and as a consequence are susceptible to (respiratory) infections. Adequate vaccination strategies, including COVID-19 vaccination, are therefore needed to minimize infection risks. AREAS COVERED: The international vaccination guidelines for lung transplant patients are reviewed, including the data on immunogenicity and effectivity of the vaccines. The impact on response to vaccination of the various categories of immunosuppressive drugs, used in the posttransplant period, on response to vaccination is described. A number of immunosuppressive and/or anti-inflammatory drugs also is used for controlling the immunopathology of severe COVID-19. Current available COVID-19 vaccines, both mRNA or adenovirus based are recommended for lung transplant patients. EXPERT OPINION: In order to improve survival and quality of life, infections of lung transplant patients should be prevented by vaccination. When possible, vaccination should start already during the pre-transplantation period when the patient is on the waiting list. Booster vaccinations should be given post-transplantation, but only when immunosuppression has been tapered. Vaccine design based on mRNA technology could allow the design of an array of vaccines against other respiratory viruses, offering a better protection for lung transplant patients.


Subject(s)
COVID-19 Vaccines , COVID-19/prevention & control , Immunocompromised Host , Immunogenicity, Vaccine/immunology , Lung Transplantation , Quality of Life , Vaccination , COVID-19/epidemiology , COVID-19 Vaccines/classification , COVID-19 Vaccines/immunology , COVID-19 Vaccines/pharmacology , Humans , Immunocompromised Host/drug effects , Immunocompromised Host/immunology , Lung Transplantation/methods , Lung Transplantation/psychology , Practice Guidelines as Topic , SARS-CoV-2 , Vaccination/methods , Vaccination/standards
13.
PLoS One ; 16(7): e0254734, 2021.
Article in English | MEDLINE | ID: covidwho-1315893

ABSTRACT

As the COVID-19 pandemic drags into its second year, there is hope on the horizon, in the form of SARS-CoV-2 vaccines which promise disease suppression and a return to pre-pandemic normalcy. In this study we critically examine the basis for that hope, using an epidemiological modeling framework to establish the link between vaccine characteristics and effectiveness in bringing an end to this unprecedented public health crisis. Our findings suggest that a return to pre-pandemic social and economic conditions without fully suppressing SARS-CoV-2 will lead to extensive viral spread, resulting in a high disease burden even in the presence of vaccines that reduce risk of infection and mortality. Our modeling points to the feasibility of complete SARS-CoV-2 suppression with high population-level compliance and vaccines that are highly effective at reducing SARS-CoV-2 infection. Notably, vaccine-mediated reduction of transmission is critical for viral suppression, and in order for partially-effective vaccines to play a positive role in SARS-CoV-2 suppression, complementary biomedical interventions and public health measures must be deployed simultaneously.


Subject(s)
COVID-19/prevention & control , Vaccination/statistics & numerical data , Age Factors , Basic Reproduction Number , COVID-19/epidemiology , COVID-19/transmission , COVID-19 Vaccines/administration & dosage , COVID-19 Vaccines/immunology , COVID-19 Vaccines/standards , Feasibility Studies , Humans , Immunity, Herd , Immunogenicity, Vaccine , Models, Statistical , Mortality/trends , SARS-CoV-2/immunology , SARS-CoV-2/physiology , Vaccination/standards
17.
PLoS One ; 16(6): e0253208, 2021.
Article in English | MEDLINE | ID: covidwho-1269921

ABSTRACT

BACKGROUND: Carceral facilities are epicenters of the COVID-19 pandemic, placing incarcerated people at an elevated risk of COVID-19 infection. Due to the initial limited availability of COVID-19 vaccines in the United States, all states have developed allocation plans that outline a phased distribution. This study uses document analysis to compare the relative prioritization of incarcerated people, correctional staff, and other groups at increased risk of COVID-19 infection and morbidity. METHODS AND FINDINGS: We conducted a document analysis of the vaccine dissemination plans of all 50 US states and the District of Columbia using a triple-coding method. Documents included state COVID-19 vaccination plans and supplemental materials on vaccine prioritization from state health department websites as of December 31, 2020. We found that 22% of states prioritized incarcerated people in Phase 1, 29% of states in Phase 2, and 2% in Phase 3, while 47% of states did not explicitly specify in which phase people who are incarcerated will be eligible for vaccination. Incarcerated people were consistently not prioritized in Phase 1, while other vulnerable groups who shared similar environmental risk received this early prioritization. States' plans prioritized in Phase 1: prison and jail workers (49%), law enforcement (63%), seniors (65+ years, 59%), and long-term care facility residents (100%). CONCLUSIONS: This study demonstrates that states' COVID-19 vaccine allocation plans do not prioritize incarcerated people and provide little to no guidance on vaccination protocols if they fall under other high-risk categories that receive earlier priority. Deprioritizing incarcerated people for vaccination misses a crucial opportunity for COVID-19 mitigation. It also raises ethical and equity concerns. As states move forward with their vaccine distribution, further work must be done to prioritize ethical allocation and distribution of COVID-19 vaccines to incarcerated people.


Subject(s)
COVID-19 Vaccines/administration & dosage , COVID-19/prevention & control , Health Care Rationing/organization & administration , Prisoners/statistics & numerical data , Vaccination/standards , Age Factors , Aged , COVID-19/epidemiology , COVID-19/transmission , Family , Health Care Rationing/standards , Humans , Middle Aged , Pandemics/prevention & control , Police/statistics & numerical data , Risk Factors , United States/epidemiology , Vulnerable Populations/statistics & numerical data
18.
Curr Opin Allergy Clin Immunol ; 21(4): 401-409, 2021 08 01.
Article in English | MEDLINE | ID: covidwho-1258804

ABSTRACT

PURPOSE OF REVIEW: Whereas the COVID-19 pandemic has changed our lives worldwide, we hope that vaccination can combat the disease. We propose how to evaluate suspected severe allergic reactions to the vaccines so that as many as possible may be safely vaccinated. RECENT FINDINGS: Rare cases of severe allergic reactions after COVID-19 vaccination have been observed, seemingly at a higher frequency than for other vaccines. Few excipients are likely to have caused these reactions. IgE-mediated reactions to polyethylene glycol (PEG) and its derivatives are the most suspected, albeit hitherto unproven, causes. We suggest to make a diagnosis based on skin tests with PEG and PEG derivatives and that these be considered in relation to the decisions required before the first and the second vaccine dose. A vaccine without these excipients is available, but published data about its side effects are limited. SUMMARY: The underlying immunological mechanisms of the rare severe allergic reactions to the COVID-19 vaccines are poorly understood and need to be clarified. Identifying those who have an undiagnosed allergy to PEG and PEG derivatives is crucial before vaccination, and these substances are found in laxatives, cosmetics and in 30% of all our medications today.


Subject(s)
COVID-19 Vaccines/adverse effects , COVID-19/prevention & control , Drug Hypersensitivity/diagnosis , Excipients/adverse effects , Pandemics/prevention & control , COVID-19/epidemiology , COVID-19/immunology , COVID-19/virology , COVID-19 Vaccines/chemistry , COVID-19 Vaccines/immunology , Clinical Decision-Making , Drug Hypersensitivity/etiology , Drug Hypersensitivity/prevention & control , Excipients/administration & dosage , Humans , Polyethylene Glycols/administration & dosage , Polyethylene Glycols/adverse effects , SARS-CoV-2/immunology , Skin Tests/standards , Vaccination/standards
19.
Indian J Med Ethics ; VI(1): 1-5, 2021.
Article in English | MEDLINE | ID: covidwho-1257358

ABSTRACT

The Covid-19 pandemic is raging, taking heavy toll of lives and livelihoods. The need for safe and effective vaccine(s) is urgent. Vaccine research has progressed rapidly and a few vaccine candidates have passed trial Phases 1 and 2, confirming reasonable safety and immunogenicity parameters. They are ready for large scale Phase 3 trials to quantify protective efficacy, if any, and to detect uncommon but serious adverse effects, if any. These developments present unprecedented opportunities and challenges, scientific and ethical. Globally hundreds die every day due to Covid-19, and emergency/compassionate use of vaccine candidates that are ready for Phase 3 trials are likely to save lives. We perceive an ethical imperative to allow such vaccination for those at high risk of death and voluntarily make such informed choice - for them protection delayed will be tantamount to protection denied.


Subject(s)
Biomedical Research/ethics , Biomedical Research/standards , COVID-19 Vaccines/standards , COVID-19/prevention & control , Pandemics/prevention & control , Vaccination/ethics , Vaccination/standards , Humans , India , Practice Guidelines as Topic , SARS-CoV-2 , Time Factors
20.
JAMA Netw Open ; 4(4): e217097, 2021 04 01.
Article in English | MEDLINE | ID: covidwho-1198343

ABSTRACT

Importance: A significant proportion of COVID-19 transmission occurs silently during the presymptomatic and asymptomatic stages of infection. Children, although important drivers of silent transmission, are not included in the current COVID-19 vaccination campaigns. Objective: To estimate the benefits of identifying silent infections among children as a proxy for their vaccination. Design, Setting, and Participants: This study used an age-structured disease transmission model, parameterized with census data and estimates from published literature, to simulate the estimated synergistic effect of interventions in reducing attack rates during the course of 1 year among a synthetic population representative of the US demographic composition. The population included 6 age groups of 0 to 4, 5 to 10, 11 to 18, 19 to 49, 50 to 64, and 65 years or older based on US census data. Data were analyzed from December 12, 2020, to February 26, 2021. Exposures: In addition to the isolation of symptomatic cases within 24 hours of symptom onset, vaccination of adults was implemented to reach a 40% to 60% coverage during 1 year with an efficacy of 95% against symptomatic and severe COVID-19. Main Outcomes and Measures: The combinations of proportion and speed for detecting silent infections among children that would suppress future attack rates to less than 5%. Results: In the base-case scenarios with an effective reproduction number Re = 1.2, a targeted approach that identifies 11% of silent infections among children within 2 days and 14% within 3 days after infection would bring attack rates to less than 5% with 40% vaccination coverage of adults. If silent infections among children remained undetected, achieving the same attack rates would require an unrealistically high vaccination coverage (≥81%) of this age group, in addition to 40% vaccination coverage of adults. The estimated effect of identifying silent infections was robust in sensitivity analyses with respect to vaccine efficacy against infection and reduced susceptibility of children to infection. Conclusions and Relevance: In this simulation modeling study of a synthetic US population, in the absence of vaccine availability for children, a targeted approach to rapidly identify silent COVID-19 infections in this age group was estimated to significantly mitigate disease burden. These findings suggest that without measures to interrupt transmission chains from silent infections, vaccination of adults is unlikely to contain the outbreaks in the near term.


Subject(s)
Asymptomatic Infections/epidemiology , Basic Reproduction Number/statistics & numerical data , COVID-19 , Disease Transmission, Infectious , Vaccination Coverage/statistics & numerical data , Vaccination , Adult , Aged , COVID-19/epidemiology , COVID-19/prevention & control , COVID-19/transmission , COVID-19 Vaccines/supply & distribution , Child , Computer Simulation , Disease Transmission, Infectious/prevention & control , Disease Transmission, Infectious/statistics & numerical data , Female , Humans , Infant, Newborn , Male , SARS-CoV-2 , United States/epidemiology , Vaccination/methods , Vaccination/standards
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