Using regression tree analysis to examine demographic and geographic characteristics of COVID-19 vaccination trends over time, United States, May 2021-April 2022, National Immunization Survey Adult COVID Module.

Using data from the nationally representative National Immunization Survey (NIS), we applied conditional linear regression tree methodology to examine relationships between demographic and geographic factors and propensity of receiving various doses of COVID-19 vaccine over time; these analyses identified temporal changes in these relationships that heretofore had not been identified using conventional logistical regression methodologies. Three regression tree models were built using an R package, Recursive Partitioning for Modeling Survey (rpms), to examine propensities over time of receiving a (1) first dose of a two-dose COVID-19 mRNA primary vaccination series or single dose of the Janssen vaccine (vaccine initiation), (2) primary series completion, and (3) monovalent booster dose, using a conditional linear effect model. Persons ≥50 years were more likely to complete a primary series and receive a first booster dose; persons reporting having received non-COVID-19 vaccines recently were more likely to initiate vaccination, complete the primary series, and get a first booster dose; persons reporting having work or school requirements were more likely to complete the primary series. Persons not reporting having received non-COVID-19 vaccines in 2 years but reporting having work or school vaccination requirements were more likely to initiate vaccination than those without work/school requirements. Among persons not reporting having received non-COVID-19 vaccines in 2 years and not reporting having work or school vaccination requirements, those aged ≥50 years were more likely to initiate vaccination than were younger adults. Propensity of receiving various doses was correlated with age, having recently received non-COVID 19 vaccines, and having vaccination requirements at work or school. Regression tree methodology enabled modeling of different COVID-19 vaccination dose propensities as a linear effect of time, revealed changes in relationships over time between demographic factors and propensity of receipt of different doses, and identified populations that may benefit from vaccination outreach efforts.

Parental Attitudes and Hesitancy About COVID-19 Vaccination Versus Routine Childhood Vaccination in a Selected Hospital in the United Arab Emirates: A Cross-Sectional Study.

Background: A complex interplay of social and political influences, cultural and religious beliefs, the availability and interpretation of health and scientific information, individual and population experiences with health systems, and government policies contributes to the anxiety about vaccines and their programs that results in vaccine hesitancy. Vaccine hesitancy is becoming a serious threat to vaccination programs; in 2019, the World Health Organization (WHO) listed it as one of the top ten global health threats. The negative impacts of antivaccination movements are blamed for the major portion of the global resistance to vaccination. Objective: To evaluate and compare parental attitudes and reluctance regarding routine childhood vaccinations versus COVID-19 vaccines among children in the United Arab Emirates (UAE). Methods: A study of 102 parents with children admitted to SAQR Hospital in Ras Al Khaimah, UAE, was conducted using a convenience sample approach in a descriptive cross-sectional study. One-on-one interviews were conducted to gather data using the standardized Vaccine Hesitancy Scale (VHS) questionnaire developed by the WHO. Statistical Package for Social Sciences version 25 was used for data analysis. Results: Vaccine-hesitant respondents are also highly resistant to the required proof of vaccination. A statistically significant difference (P = .000) was observed between parental reluctance to receive the COVID-19 vaccination and routine childhood vaccination. Parental knowledge of the COVID-19 vaccine hesitancy (P = .001) and confidence (P = .000) showed a statistically significant correlation. No significant correlation was observed with sociodemographic factors. Conclusion: The impact of vaccine hesitancy on herd immunity, social, psychological, and public health strategies to combat vaccine hesitancy was observed in this study with various challenges to overcome in COVID-19 vaccination campaigns. Expanding access to and acceptance of vaccines among parents in low- and middle-income nations, as well as raising vaccination rates among those who express a lack of confidence in vaccines.

[Corona vaccination under immunosuppression]. / Coronaimpfung unter Immunsuppression.

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) continues to play a major role as a severe and potentially fatal airway infection, especially in vulnerable patient groups. In view of the thin data situation on the influence of treatment and response to vaccination, at the beginning of the corona pandemic it was a major challenge to predict the tolerability and effectiveness in patients with inflammatory rheumatic diseases under immunomodulation or immunosuppression. In the meantime, numerous studies have addressed the questions of response and tolerability, at least for the COVID-19 vaccination. Even in the first months of the vaccination campaign, a small study on a single center cohort could show that apart from patients with B­cell depletion, all included patients showed a seroconversion after the first two vaccinations. This resulted in neither an increased occurrence of exacerbations of the underlying disease nor new autoimmune phenomena. Various studies have since then confirmed these data.

A Survey on Population Perceived Factors Influencing COVID-19 Vaccination in South Indian Districts.

The COVID-19 pandemic has posed unprecedented challenges to global public health, necessitating the rapid development and distribution of vaccines. Despite the availability of effective vaccines, vaccination uptake remains varied across different regions and populations. This study aims to investigate the factors influencing COVID-19 vaccination uptake in South Indian districts, with a focus on understanding public perceptions. Utilizing a cross-sectional survey methodology, data were collected from a representative sample of residents in selected South Indian districts. The survey explored a range of variables including demographic characteristics, knowledge and awareness about COVID-19 vaccines, perceived risks and benefits, trust in healthcare systems, and sources of vaccine-related information. The preliminary analysis indicates that vaccine uptake is significantly influenced by factors such as age, educational level, and socioeconomic status. High levels of vaccine hesitancy were associated with misinformation, concerns about vaccine safety and efficacy, and distrust in government and healthcare authorities. Conversely, individuals with higher education levels and those who received accurate information from trusted sources showed a greater willingness to get vaccinated. Social and cultural beliefs also played a crucial role in influencing vaccination attitudes, stressing the need for the importance of culturally sensitive health communication strategies. The study investigates a range of factors, including demographic characteristics such as age, gender, education level, and socio-economic status, as well as psychological and social determinants like the perceived risk of COVID-19, trust in vaccines, and the influence of misinformation. This study underscores the need for targeted public health interventions to address vaccine hesitancy and improve vaccination rates in South India. By identifying the key factors influencing vaccination decisions, policymakers and healthcare providers can develop more effective communication and outreach programs tailored to the unique needs and concerns of the population. Enhanced efforts in education, transparency, and community engagement are essential to fostering greater public trust and achieving higher vaccination coverage.

Identifying Population Segments by Differing Levels of COVID-19 Vaccine Confidence and Evaluating Subsequent Uptake of COVID-19 Prevention Behaviors: Web-Based, Longitudinal, Probability-Based Panel Survey.

BACKGROUND: The COVID-19 pandemic prompted the launch of the US Department of Health and Human Services' COVID-19 Public Education Campaign to boost vaccine confidence and uptake among adults, as vaccines are key to preventing severe illness and death. OBJECTIVE: Past segmentation research relevant to COVID-19 behavior has found important differences in attitudes, sociodemographics, and subsequent COVID-19 prevention behaviors across population segments. This study extends prior work by incorporating a more comprehensive set of attitudes, behaviors, and sociodemographic variables to identify population segments by differing levels of COVID-19 vaccine confidence and evaluate differences in their subsequent uptake of COVID-19 prevention behaviors. METHODS: Data were obtained from 5 waves (January 2021 to June 2022) of a web-based longitudinal, probability-based panel survey of US adults (N=4398) administered in English and in Spanish. Participants were recruited from NORC at the University of Chicago's national AmeriSpeak panel and were invited to participate across multiple waves. Latent class cluster analysis estimated segments of respondents based on over 40 COVID-19 attitudes, beliefs, behaviors, and sociodemographics as reported in wave 1. Survey-weighted cross-tabulations and bivariate regression analyses assessed differences in COVID-19 vaccine uptake, booster uptake, mask use, and social distancing in all segments across all 5 survey waves. RESULTS: A total of 6 segments (hardline nonintenders, prevention-compliant nonintenders, burned-out waiters, anxious waiters, skeptical confidents, and ready confidents) were identified, which differed by their COVID-19 vaccine confidence, prevention-related attitudes and behaviors, and sociodemographics. Cross-tabulations and regression results indicated significant segment membership differences in COVID-19 vaccine and booster timing, mask use, and social distancing. Results from survey-weighted cross-tabulations comparing COVID-19 vaccine and booster uptake across segments indicate statistically significant differences in these outcomes across the 6 segments (P<.001). Results were statistically significant for each segment (P<.01 for booster uptake among burned-out waiters; P<.001 for all other coefficients), indicating that, on average, respondents in segments with lower intentions to vaccinate reported later receipt of COVID-19 vaccines and boosters relative to the timing of vaccine and booster uptake among ready confidents. CONCLUSIONS: Results extend previous research by showing that initial beliefs and behaviors relevant to COVID-19 vaccination, mask use, and social distancing are important for understanding differences in subsequent compliance with recommended COVID-19 prevention measures. Specifically, we found that across respondent segments, the probability of vaccine and booster uptake corresponded with both COVID-19 vaccine confidence and mask use and social distancing compliance; more compliant segments were more likely to get vaccinated or boosted than less compliant segments given similar levels of vaccine confidence. These findings help identify appropriate audiences for campaigns. Results highlight the use of a comprehensive list of attitudes, behaviors, and other individual-level characteristics that can serve as a basis for future segmentation efforts relevant to COVID-19 and other infectious diseases.

COVID-19 vaccine uptake inequality among older adults: A multidimensional demographic analysis.

BACKGROUND: Age, race, ethnicity, and sex are important determinants of coronavirus disease of 2019 (COVID-19) outcomes. Older adults (65 years and older) are at the highest risk of COVID-19 morbidity and mortality. Analyzing their vaccine uptake by subclassifying demographics is rare and can assist vaccination policies. This study investigates COVID-19 dose 1 and 2 vaccine uptakes among them by race, ethnicity, and sex. METHODS: Immunization registry data were used to calculate temporal changes in older adults' COVID-19 vaccine uptake by race, ethnicity, race-sex, and ethnicity-sex in Kentucky's most populous county, Jefferson County, during the first 6 quarters of the COVID-19 vaccination program. RESULTS: By May 2022, the county's Asian residents had the highest dose 1 and 2 vaccination rates (97.0% and 80.4%), then White residents (90.0% and 80.2%). Black residents had one of the lowest COVID-19 vaccination rates (87.3% and 77.3%). The rate among Hispanic residents (82.0% and 66.4%) was considerably lower than non-Hispanic residents (90.2% and 80.1%). The rates were consistently lower in males. CONCLUSIONS: Racial, ethnic, and sex-based COVID-19 vaccine inequalities were largely maintained during the study period. Vaccine rollout practices and promotional programs should aim to boost the uptake of the COVID-19 vaccination among racial minority and male older adults.

A scoping review on adult patients with de novo glomerular diseases following COVID-19 infection or vaccine.

BACKGROUND: There are increasing reports of glomerular disease (GD) following COVID-19 infection and vaccination. Current evidence on the possible link between COVID-19 infection or vaccination and GD is conflicting. OBJECTIVE: The present study undertakes a scoping review of research to describe the relationship between COVID-19 infection and vaccination with GD and the common management strategies and overall outcomes of the disease to identify knowledge gaps and guide further research. ELIGIBILITY CRITERIA: All original research studies published in English until 5th September 2022 were considered for inclusion in the review. Exclusion criteria were animal studies, autopsy studies, and data involving patients who were paediatric patients (< 16 years), were transplant recipients, had a recurrence of glomerular disease, had concomitant cancer or non-COVID-19 infection which may cause glomerular disease, or did not receive a renal biopsy. SOURCES OF EVIDENCE: The five electronic databases searched were MEDLINE, PubMed, Scopus, EMBASE, and Cochrane. METHODS: Two separate search strings related to COVID-19, and glomerular disease were combined using the Boolean operator 'AND'. Filters were used to limit publications to original research studies published in English. Search results from each database were imported into Covidence software ( www.covidence.org ) and used for de-duplication, article screening, and data extraction. Descriptive analyses were used to summarise demographics, diagnoses, and treatment outcomes. RESULTS: After removing duplicates, 6853 titles and abstracts were screened. Of the 188 studies included, 106 studies described 341 patients with GD following COVID-19 infection and 82 described 146 patients with GD following a COVID-19 vaccination. IgA nephropathy was the most common GD pathology reported following COVID-19 vaccination with GD most common following mRNA vaccines. Collapsing focal segmental glomerulosclerosis was the most common GD following COVID-19 infection. Immunosuppressive treatment of GD was more common in the vaccine cohort than in the infection cohort. CONCLUSION: Despite the significant number of COVID-19 infections and vaccinations around the world, our understanding of GD associated with COVID-19 infection and vaccination remains poor, and more research is needed to understand the possible relationship better.

COVID-19: to vaccinate or not to vaccinate - that is the question.

SARS-CoV-2 is a virus which infects the respiratory tract and may cause severe, occasionally life-threatening disease COVID-19. In more than 5% of symptomatic patients the infection is associated with post-acute symptoms. The initial contact of the virus with the immune system of the nasopharynx and oropharynx induces a mucosal immune response manifested by the production of secretory IgA (sIgA) antibodies which may contribute to the restriction of the infection to the upper respiratory tract and an asymptomatic or clinically mild disease. The current systemically administered vaccines protected against the severe COVID-19 infection and its post-acute sequelae. However, they do not induce antibodies in mucosal secretions in SARS-CoV-2-naive individuals. In contrast, in those who previously experienced mucosal infection, systemically administered vaccines may stimulate sIgA production. The clinical benefit of systemic vaccination convincingly documented in tens of millions of individuals overshadows the rare, sometimes controversial reports of complications encountered after vaccination. The inability of current SARS-CoV-2 vaccines to induce mucosal immune responses and to prevent the spreading of the virus by external secretions demonstrates the mutual independence of mucosal and systemic compartments of the immune system, and thus emphasizes need for the development of vaccines inducing protective immune responses in both compartments.

Acceptance of COVID-19 Vaccination and Vaccine Hesitancy Among People with Chronic Diseases in Thailand: Role of Attitudes and Vaccine Literacy Towards Future Implications.

Introduction: Vaccination is an important strategy to prevent or reduce hospitalizations and mortality caused by COVID-19 infection. However, some people with chronic diseases are hesitant to get the COVID-19 vaccination. Objective: This study aimed to assess the acceptance of COVID-19 vaccination and associated factors among people with chronic diseases. Methods: A cross-sectional online survey was conducted between May and August 2021. A sample of 457 Thai adults living with one or more chronic diseases was drawn from a larger online survey. Results: Participants were 19 to 89 years old. The three most commonly reported chronic diseases were hypertension, diabetes, and obesity. The acceptance rate of COVID-19 vaccination was 89.1%. Forty-six percent of respondents had received the COVID-19 vaccination, and 43.1% intended to get the vaccine. Reasons for vaccine hesitancy/refusal included concerns about adverse side effects from the vaccines including long-term effects that might complicate their disease condition. Multiple logistic regression analyses revealed that having a bachelor's degree or higher [aOR 4.40; 95% CI: 2.12-9.14], being employed [aOR 2.11; 95% CI: 1.03-4.39], and having positive attitudes [aOR 2.36; 95% CI: 1.69-3.29] and negative attitudes [aOR 0.38; 95% CI: 0.27-0.55] predicted acceptance of the COVID-19 vaccination. Vaccine literacy was significantly associated with acceptance of COVID-19 vaccination in binary logistic regression analyses, but it was not retained in the multiple logistic regression model. Conclusion: Vaccine literacy and attitudes influence acceptance of COVID-19 vaccination in people with chronic diseases.

mRNA-1273 vaccination induces polyfunctional memory CD4 and CD8 T cell responses in patients with solid cancers undergoing immunotherapy or/and chemotherapy.

Introduction: Research has confirmed the safety and comparable seroconversion rates following SARS-CoV-2 vaccination in patients with solid cancers. However, the impact of cancer treatment on vaccine-induced T cell responses remains poorly understood. Methods: In this study, we expand on previous findings within the VOICE trial by evaluating the functional and phenotypic composition of mRNA-1273-induced T cell responses in patients with solid tumors undergoing immunotherapy, chemotherapy, or both, compared to individuals without cancer. We conducted an ELISpot analysis on 386 participants to assess spike-specific T cell responses 28 days after full vaccination. Further in-depth characterization of using flow cytometry was performed on a subset of 63 participants to analyze the functional phenotype and differentiation state of spike-specific T cell responses. Results: ELISpot analysis showed robust induction of spike-specific T cell responses across all treatment groups, with response rates ranging from 75% to 80%. Flow cytometry analysis revealed a distinctive cytokine production pattern across cohorts, with CD4 T cells producing IFNγ, TNF, and IL-2, and CD8 T cells producing IFNγ, TNF, and CCL4. Variations were observed in the proportion of monofunctional CD4 T cells producing TNF, particularly higher in individuals without cancer and patients treated with chemotherapy alone, while those treated with immunotherapy or chemoimmunotherapy predominantly produced IFNγ. Despite these differences, polyfunctional spike-specific memory CD4 and CD8 T cell responses were comparable across cohorts. Notably, immunotherapy-treated patients exhibited an expansion of spike-specific CD4 T cells with a terminally differentiated effector memory phenotype. Discussion: These findings demonstrate that systemic treatment in patients with solid tumors does not compromise the quality of polyfunctional mRNA-1273-induced T cell responses. This underscores the importance of COVID-19 vaccination in patients with solid cancers undergoing systemic treatment.

Characteristics and predictors of Long Covid in children: a 3-year prospective cohort study.

Background: Children can develop Long Covid, however long term outcomes and their predictors are poorly described in these patients. The primary aim is to describe characteristics and predictors of Long Covid in children assessed in-clinics up to 36 months post-SARS-CoV-2 infection, as well as investigate the role of vaccines in preventing Long Covid, risk of reinfections and development of autoimmune diseases. Methods: Children aged 0-18 years old with confirmed SARS-CoV-2 infection were invited for a prospective follow-up assessment at a peadiatric post-covid clinic in Rome, Italy, at serial intervals (3-, 6-, 12-, 18-, 24- and 36-months post-infection onset, between 01/02/2020 and 28/02/2024). Long Covid was defined as persistence of otherwise unexplained symptoms for at least three months after initial infection. Findings: 1319 patients were initially included, 1296 reached the 3 months follow-up or more. Of the patients who underwent multiple follow-ups, 23.2% (301), 169 (13.2%), 89 (7.9%), 67 (6.1%), 47 (7.1%) were diagnosed with Long Covid at 3-6-12-18-24 months, respectively For the primary outcome of Long Covid at three months, age >12 years (P < 0.001, OR 11.33, 95% CI 4.2; 15.15), comorbidities (P = 0.008, OR 1.83, 95% CI 1.06; 2.44), being infected with original variants (P < 0.001, OR 4.77, 95% CI 2.46; 14.47), female sex (P < 0.001, OR 1.62, 95% CI 1.02; 1.89) were statistically significant risk factors. Age >12 years (P = 0.002, OR 9.37, 95% CI 1.58; 8.64), and infection with original (P = 0.012, OR 3.52, 95% CI 1.32; 8.64) and alfa (P < 0.001, OR 4.09, 95% CI 2.01; 8.3) SARS-CoV-2 variants remained statistically significant risk factors for Long Covid duration for at least 18 months. Vaccination was associated with a lower risk of long covid at 3, 6 and 12 months for older children and a lower risk of reinfections. Being infected with the original SARS-CoV-2 variant was associated with a higher risk of new-onset autoimmune diseases ((P = 0.035, 95% CI 1.12; 2.4). One patient was diagnosed with Long Covid after a re-infection. Interpretation: This is the longest follow-up study of children with SARS-CoV-2 infection, showing a significant and long-lasting burden of Long Covid in the pediatric population. Our findings highlight the urgent need of investing in pediatric Long Covid in order to find effective diagnostic and therapeutic approaches, as well can inform preventive strategies in case of future pandemics. Funding: This study has been funde by Pfizer non-competitive grant, granted to DB (#65925795).

Association Between SARS-CoV-2 Vaccination and Development of Antinuclear Antibodies Among Students.

INTRODUCTION: Antinuclear antibodies (ANA) are the hallmark of many connective tissue disorders (including lupus), which comprise roughly 5% to 10% of chronic debilitating diseases causing morbidity and mortality. In society, fear of these diseases increases illness-related uncertainty because the prognosis of progression is often difficult to determine and at least some symptoms fluctuate unpredictably. In the anti-vaccination movement, the question of the possible connection between vaccination and connective tissue disorders and other autoimmune diseases has grown to rank as an important argument for rejecting vaccination. In 2021, every fifth Polish first-degree nursing student decided to not be vaccinated against COVID-19. OBJECTIVE: This study aimed to explore the prevalence of antinuclear antibodies in students vaccinated and unvaccinated against COVID-19. PARTICIPANTS AND METHODS: A single university cross-sectional study was performed in a small academic centre in Poland, where 210 students were recruited in 2022. All the participants were screened for SARS-CoV-2 IgG and antinuclear antibodies. RESULTS: The mean age of the students who rejected vaccination was higher than that of those who were vaccinated. Among nursing students, 30.0% of vaccinated and 58.3% of unvaccinated individuals had COVID-19. The frequency of antinuclear antibodies was 3 times lower in vaccinated students than in unvaccinated students (2/159 vs 2/51; P > .05). CONCLUSION: The results of our study did not confirm the rationality of rejecting vaccinations against COVID-19 for fear of developing autoimmune diseases among healthy students.

Exploring cognitive impairments and the efficacy of phosphatidylcholine and computer-assisted cognitive training in post-acute COVID-19 and post-acute COVID-19 Vaccination Syndrome.

Purpose: The COVID-19 pandemic has led to millions of confirmed cases worldwide, resulting in numerous deaths and hospitalizations. Long-term symptoms after infection or vaccination, known as Post-acute COVID-19 Syndrome (PACS) or Post-acute COVID-19 Vaccination Syndrome (PACVS), present a challenge for the healthcare system. Among the various neurological symptoms, cognitive impairments are frequently observed in PACS/PACVS patients. This study aimed to understand cognitive deficits in PACS/PACVS patients and evaluated potential treatment options, including phosphatidylcholine and computer-assisted cognitive training (CCT). Methods: The Neuro-COVID Outpatient Clinic at Evangelic Hospital Vienna evaluated n = 29 PACS/PACVS patients from May 2023 to October 2023. Enrolled patients were divided into three therapy schemes: Group A received phosphatidylcholine, B received phosphatidylcholine plus access to a computer-assisted cognitive training program, and C (divided into two subgroups) served as a control group. Cognitive impairments were evaluated in multiple assessments (initial and during therapy) using the COGBAT test. Simultaneously, an assessment of the quality of life was conducted using the WHOQOL-BREF. Results: Primary cognitive impairments, especially attentional deficits were notably evident compared to the general population. While all treatment groups showed cognitive improvement (significant or with a positive trend, but without reaching the level of statistical significance) after therapy, no significant interaction was found between assessment time points and treatment schemes for overall cognitive performance, attention, memory, and executive functions, suggesting consistency across the groups. The WHOQOL-BREF primarily demonstrated deficits in the domains of physical health and psychological well-being. Conclusion: This study examined the impact of PACS/PACVS on cognitive performance and evaluated phosphatidylcholine and CCT as potential treatment options. Patients with PACS/PACVS showed notable cognitive deficits, especially in the domain attention. While the effectiveness of phosphatidylcholine and CCT in treating cognitive deficits was inconclusive, the study indicated the possibility of spontaneous remission of cognitive deficits in PACS/PACVS.

MPO-ANCA-positive rapidly progressive glomerulonephritis after COVID-19 vaccination during treatment of plaque psoriasis with bimekizumab.

A 75-year-old man presented with MPO-ANCA-positive rapidly progressive glomerulonephritis after COVID-19 vaccination during the treatment of plaque psoriasis vulgaris with bimekizumab. Bimekizumab, an anti-IL17 monoclonal antibody, was regularly administered to control the activity of plaque psoriasis. After receiving the sixth COVID-19 vaccine, his kidney function rapidly declined over the course of weeks. Urinalysis showed microscopic hematuria and proteinuria with deformed red blood cells and granular cast. The immunology test was positive for MPO-ANCA. The patient was clinically diagnosed with MPO-ANCA-associated glomerulonephritis. As the patient lost his appetite and developed lower extremity edema with low eGFR (< 15 ml/min/1.73m2) on admission day, hemodialysis induction was initiated along with methylprednisolone pulse, followed by oral prednisolone. The kidney function and urine volume were improved in response to immunosuppressive therapy, and withdrawal from hemodialysis was considered. However, the patient developed a catheter infection due to methicillin-sensitive Staphylococcus aureus 2 weeks after the initial prednisolone treatment, causing a decline in kidney function. Antibiotics treatment for the catheter infection was effective, but kidney function remained low, resulting in dependence on regular hemodialysis. COVID-19 vaccination provides significant improvement in overall prognosis; however, there have been reports of kidney function decline and exacerbation of hematuria in patients with IgA nephropathy following vaccination. The incidence of MPO-ANCA-associated glomerulonephritis after COVID-19 vaccination was rare. Data accumulation is warranted to understand the risk factors for secondary MPO-ANCA glomerulonephritis after COVID-19 vaccination. Regular monitoring of urinalysis and kidney function after COVID-19 vaccination is recommended in patients with psoriasis vulgaris treated with IL17 monoclonal antibodies.

COVID-19 vaccine-associated vasculitis: A systematic review.

Objectives: Post-COVID-19 vaccine-associated vasculitis stands as one of the most serious side effects attributed to COVID-19 vaccines. This complication encompasses diverse manifestations which vary in presentation and severity. Moreover, it can impact patients across all age groups, with a notably elevated incidence in the elderly. This systematic review seeks to review and evaluate the spectrum of vasculitis manifestations linked to COVID-19 vaccination. Methods: A systematic review of the literature was done by searching through PubMed, Google Scholar, and Scopus up to October 2022. Articles including data about sex, age at diagnosis, vasculitis clinical manifestations, type of vaccination, most commonly used investigations, comorbid medical conditions, treatments, and clinical outcomes were included in the final analysis. Furthermore, vasculitis flare-ups post-vaccination were considered part of this review. Results: A total number of 117 studies describing 158 patients developing vasculitis following COVID-19 vaccination were included in the final analysis. Among the patients who developed vasculitis, the most administered type of vaccination was the mRNA vaccine subtype (n = 103), followed by the viral vector vaccines (n = 42) and inactivated viral vaccines (n = 10). On the other hand, about 38% of vasculitis-related symptoms occurred after the administration of the first dose of the vaccine and 37% occurred after taking the second dose. The skin (60.7%) and the kidneys (27.8%) were the most affected organs and complete remission was achieved in 111 patients (70%), while partial remission occurred in 11% of the patient population. Conclusion: COVID-19 vaccine-induced vasculitis is a rare occurrence associated with COVID-19 vaccines. It generally presents a favorable prognosis and outcomes for the vast majority of patients, ultimately leading to full remission within days. This review emphasizes the notion that the advantages of COVID-19 vaccines outweigh the potential risks, particularly for individuals with compromised immune systems.

Patient engagement as a collaborative process in a large Dutch COVID-19 vaccination study (RECOVAC) - insight into the contribution of patient engagement and learnings for the future.

BACKGROUND: The need for patient engagement in health research has been increasingly acknowledged and accepted in recent years. However, implementation is still limited due to lack of evidence on its value and lack of guidance on how to implement patient engagement. This study aims to provide insight into the contribution of patient engagement in the RECOVAC project, which studied COVID-19 vaccination in kidney patients, and formulate concrete practice-based action perspectives for patient engagement. METHODS: We used a qualitative participatory mixed methods approach, based on the Patient Engagement Monitoring and Evaluation (PEME) framework. Patient engagement and data collection were based on the Reflexive Monitoring in Action (RMA) approach. Data collection included participant observations, open ended questionnaires and interactive reflection sessions. Qualitative analysis was done via a thematic approach. RESULTS: We have described the process of patient engagement systematically, provided insight in its value and found that there is a need for clear aims, expectations and preparations from the start of the engagement process. We have shown that reflection throughout the process is of utmost importance and the same applies to clear communication between researchers and patient representatives. By being part of the consortium patient representatives had direct access to information, straight from the source, on for example the vaccination schedule and medication availability and had indirect influence on decisions made by the National Institute for Public Health and the Environment (RIVM) on preventive measures and treatment against COVID-19. Having experienced patient representatives is important, otherwise training needs to be provided. We also found that patient engagement had impact on conduct and outcomes of research activities itself and may have impact on future research and patient engagement activities in general. CONCLUSION: Patient engagement has changed the course of the project. Concrete practice-based action perspectives have been formulated, which are already being implemented by the Dutch Kidney Patients Association (NVN). Studying patient engagement in a high pace project with high public interest has resulted in lessons learned and will help prepare and implement patient involvement in future research projects. CLINICAL TRIAL REGISTRATION: The RECOVAC studies in which the patient engagement took place are registered at clinicialtrial.gov (NCT04741386 registration date 2021-02-04, NCT04841785 registration date 2021-03-22 and NCT05030974 registration date 2021-08-20).

This article is about the extensive engagement of patients in a scientific research project and what that engagement adds to the project. Although researchers acknowledge the importance of engagement of patients in research projects, it is not happening very often, Because there is not enough scientific evidence on the value of patient engagement and not enough guidance for researcher on how to implement it in their research. We used the Patient Engagement Monitoring and Evaluation (PEME) framework and qualitative participatory mixed methods research to provide insight into patient involvement in the RECOVAC project, which studied COVID-19 vaccination in kidney patients. We also formulated practical guidance for researchers who want to engage patients in their research. We describe the process of patient engagement in the RECOVAC project; what went well and what could be improved. We found that it is important to prepare well, keep reflecting on the engagement process throughout the project with all stakeholders of the project, communicate clearly and have experienced patient representatives involved or have training available for them. Patient engagement had impact on the conduct and outcome of the research activities itself and on activities outside of the project (e.g., doctors changing their conversations with their patients). We can conclude that involving patients changed the project and its outcomes to better fit with the needs of patients. A guideline has been made and is already implemented by the Dutch Kidney Patients Association. The lessons learned from this project will help researchers involve patients in their future projects.

Management of COVID-19 in Ophthalmology.

From its outbreak in early 2020, the new SARS-CoV-2 infection has deeply affected the entire eye care system for several reasons. Since the beginning of the COVID-19 pandemic, ophthalmologists were among the "high-risk category" for contracting the SARS-CoV-2 infection based on the notion that the eye was suspected to be a site of inoculation, infection, and transmission. Clinical ophthalmologists have been required to learn and promptly recognize the ocular manifestations associated with the COVID-19 disease, with its treatments and vaccinations. Restriction measures, lockdown periods, guidelines to prevent SARS-CoV-2 infection transmission, and the use of telemedicine and artificial intelligence modalities have induced profound modifications. These changes, which are most likely to be irreversible, influence routine clinical practice, education, and research, thus giving rise to a "new ophthalmology in the COVID era". This book chapter aims to provide several notions regarding COVID-19 in ophthalmology, including the SARS-CoV-2 virus infection and transmission modalities; the ocular manifestation associated with the COVID-19 disease; the drugs and vaccines used for COVID-19; the precautions adopted in the ophthalmic practice to limit the spread of the virus; the consequences of the pandemic on the ophthalmic patients, clinicians, and the entire eye care system; and, the future of ophthalmology in the era of "COVID new normal".

Parsonage-Turner Syndrome Following AstraZeneca COVID-19 Vaccination.

INTRODUCTION: Parsonage-Turner Syndrome is an uncommon cause of shoulder pain. CASE REPRESENTATION: Herein, we present the case of a male in his 40s, who was presented with a 3-month history of acute onset of intense shoulder pain, which decreased rapidly leaving behind a residual upper limb weakness. The diagnosis of Parsonage-Turner Syndrome following COVID-19 vaccination was made based on electroneuromyography and magnetic resonance imaging findings. The patient responded well to analgesics and rehabilitation. CONCLUSION: A better knowledge of this disease and early recognition are crucial to prevent unnecessary tests and interventions.

Religious belongings and Covid-19 vaccination.

INTRODUCTION: Vaccine hesitancy poses a complex global challenge. Our study investigates correlations between COVID-19 vaccination rates, religious demographics, and educational performance. MATERIALS AND METHODS: Using cross-sectional analysis, data from reputable sources were analyzed for correlations using Pearson's correlation and linear regression. RESULTS: We found statistically significant positive correlations between COVID-19 vaccination rates and PISA scores, Catholic populations, non-religious, and atheist populations. Conversely, negative correlations were observed with Muslim and Eastern Orthodox populations. Our findings suggest potential influences of religious beliefs and educational attainment on vaccination rates. CONCLUSION: The data reveals a positive correlation between COVID-19 vaccination rates and the percentages of Catholic, Non-Religious, and Atheist populations, while indicating a negative correlation between COVID-19 vaccination rates and the percentages of Muslim and Eastern Orthodox populations. These findings underscore the potential significance of engaging religious leaders in promoting vaccinations as a strategy to address vaccine hesitancy.