COVID-19 vaccine uptake and its determinants among teenagers and their parents in Zhejiang, China: An online cross-sectional study

Objective:To examine COVID-19 vaccine uptake and its determinants among teenagers and their parents in Zhejiang,China.Methods:An online cross-sectional study was conducted among parents of teenagers in Zhejiang,China from May 1 to 31,2022.Data were interpreted via univariate and multivariate analyses using the statistical package for the social sciences(SPSS)program.Results:A total of 11115(96.11%)participants and 11449(99.00%)of their children in Zhejiang,China had been vaccinated against COVID-19.Children whose parents did not receive COVID-19 vaccination were 19 times(aOR 18.96,95%CI 12.36-29.08)more likely to be unvaccinated than their counterparts.In addition,children with no previous influenza vaccination,those whose parents doubted the COVID-19 vaccine’s safety or effectiveness,were 6.11 times(aOR 6.11,95%CI 2.80-13.34),8.27 times(aOR 8.27,95%CI 5.33-12.83),and 2.69 times(aOR 2.69,95%CI 1.11-6.50)more likely to be unvaccinated than their counterparts,respectively.COVID-19 vaccine uptake varied between different sociodemographic groups.However,the odds of receiving the COVID-19 vaccine decreased as age and education level increased.The main refusal reasons claimed by participants were that they had medical conditions that may not qualify them for vaccination(53.78%),followed by safety concerns about the vaccine(13.56%),not knowing where to get vaccinated(6.44%),and concerns about fertility issues(5.56%).Conclusions:Despite a highly encouraging level of COVID-19 vaccine uptake in Zhejiang,China,the elderly and highly educated people had lower COVID-19 vaccine uptake.It is suggested that tailored health education strategies should be taken to increase the COVID-19 vaccine uptake in such groups.Furthermore,with vaccination rates at such a high level,the pandemic is still ongoing,and public confidence in vaccines may decline.Thus,sufficient evidence-based information regarding COVID-19 vaccines should be provided to the public.

Socio-Demographic and Economic Factors Associated with Uptake of COVID-19 Vaccine among Pregnant Women at Pumwani Maternity Hospital in Nairobi County, Kenya

Introduction: Pregnant women are a highly vulnerable population for COVID-19 with increased risk of hospitalization, intensive-care unit admission, invasive ventilation support, and mortality. Objective: This study determined the socio-demographic and economic factors associated with the uptake of COVID-19 vaccine among pregnant women utilizing antenatal care services in Pumwani Maternity Hospital, Nairobi County-Kenya. Methods: The study was carried out from 15 June to 23 July 2023. Systematic sampling was used to select 302 women from whom data was collected through face-to-face interviews using a pre-tested semi-structured questionnaire. Data was analyzed using SPSS software in which bivariate and multivariate logistic regression analyses were done at a significance level of p Results: A total of 302 pregnant women participated in the study. Of these, 105 (34.8%) were aged between twenty-six (26) and thirty (30) years. The mean age of the women was 28.60 ± (SD = 5.297). The uptake of the COVID-19 vaccine was 41.1%. The common side effects reported to be associated with the vaccines were fever, headache, joint pain, vomiting and skin rash. Uptake of the COVID-19 vaccine was significantly associated with being married (AOR = 3.65, 95% CI: 0.62 - 1.80, p = 0.001), having a secondary level of education (AOR = 3.78, 95% CI: 0.99 - 2.88, p = 0.001) and being employed (COR = 2.66, 95% CI: 1.31 - 3.06, p = 0.001). Conclusion: COVID-19 vaccination uptake remains low among pregnant women in seeking ANC in Nairobi. The individual factors associated with the uptake of COVID-19 vaccine among pregnant Women at Pumwani maternity hospital in Nairobi County were being married, having secondary level of education and being employed. Integration of the COVID-19 vaccine with other routine vaccinations as per the national immunization program in Kenya and the enhancement of education regarding the safety and efficacy of the COVID-19 vaccine in pregnancy and breastfeeding and economic empowerment of women are recommended.

COVID-19 Vaccination Uptake and Associated Factors in Selected Communities in Two Southwestern States in Nigeria

Introduction: COVID-19 vaccine uptake and acceptance have been a major global concern due to the prevalent misinformation and disinformation that has characterized the vaccine rollout worldwide. This study aimed to assess COVID-19 vaccine uptake and acceptance, and associated factors among selected community members in two states in southwestern Nigeria. Method: We conducted a cross-sectional study using a multistage sampling technique. Fifty catchment settlements of 10 health facilities in each of Oyo and Ogun States targeted for a COVID-19 infection prevention and control intervention were randomly selected. Four households were targeted per settlement. All households that refused access were replaced, to ensure a minimum of four households randomly selected per settlement. The primary household decision-maker was interviewed in each household. Information elicited included respondents’ sociodemographic characteristics, health history, knowledge, risk and benefit perception about the COVID-19 vaccine, vaccine uptake, and willingness to be vaccinated. The study was conducted from July–August 2021. Data were analyzed using SPSS IBM version 23. Result: Four hundred household decision-makers were surveyed in Oyo and Ogun states, after replacement. The mean age of the respondents was 43.0 ± 11.0 years. The majority, 346 (86.5%) had heard about COVID-19 vaccination, but only 47 (13.6%) had received a COVID-19 vaccination. Of the 299 respondents who reported not receiving a COVID-19 vaccination, 166 (55.5%) were willing to be vaccinated. In univariate analysis, respondents who were female had tertiary education, perceived that COVID-19 vaccines are free and accessible, perceived that COVID-19 vaccines have minimal side effects, and perceived higher benefits of COVID-19 vaccination had higher odds of being vaccinated. In contrast, younger respondents, respondents with higher knowledge scores on COVID-19 preventive measures, and with chronic illness had lower likelihoods of being vaccinated. In multivariate analysis, only the respondent’s age, perception score on COVID-19 vaccine benefits, knowledge score on IPC measures, and positive response on accessibility and safety were significant after adjusting for other factors. Conclusion: COVID-19 vaccine uptake rate as well as willingness to receive vaccination were low in the study setting. There is an urgent need for policymakers to embark on well-designed campaigns to address barriers to COVID-19 vaccination to increase vaccine uptake.

Clinical application of COVID-19 vaccine in liver transplant recipients

Background:Solid organ transplant(SOT)activities,such as liver transplant,have been greatly influenced by the pandemic of coronavirus disease 2019(COVID-19),a disease caused by severe acute respiratory syndrome coronavirus 2(SARS-CoV-2).Immunosuppressed individuals of liver transplant recipients(LTRs)tend to have a high risk of COVID-19 infection and related complications.Therefore,COVID-19 vaccination has been recommended to be administered as early as possible in LTRs.Data sources:The keywords“liver transplant”,“SARS-CoV-2”,and“vaccine”were used to retrieve articles published in PubMed.Results:The antibody response following the 1st and 2nd doses of vaccination was disappointingly low,and the immune responses among LTRs remarkably improved after the 3rd or 4th dose of vaccination.Although the 3rd or 4th dose of COVID-19 vaccine increased the antibody titer,a proportion of patients remained unresponsive.Furthermore,recent studies showed that SARS-CoV-2 vaccine could trigger adverse events in LTRs,including allograft rejection and liver injury.Conclusions:This review provides the recently reported data on the antibody response of LTRs following various doses of vaccine,risk factors for poor serological response and adverse events after vaccination.

Adverse Side Effects of COVID-19 Vaccines in Older Adults: A Comprehensive Review of Current Research

The purpose of this research review was to examine current scientific literature on COVID-19 vaccine-induced side effects in older adults. We reviewed studies focusing on side effects categorized into cardiologic, immunologic, neurologic, and ocular groups. Cardiologic side effects included myocarditis, pericarditis, and myocardial infarction. Immunologic conditions examined were anaphylaxis and vaccine-induced immune thrombotic thrombocytopenia. Neurologic side effects included Guillain-Barré syndrome and Bell’s Palsy. Ocular side effects covered ocular swelling, submacular hemorrhage, and corneal graft rejection after keratoplasty and Descemet membrane endothelial keratoplasty. Additionally, less common side effects in older adults were reviewed but found to be statistically rare. Overall, COVID-19 vaccine-induced side effects in elderly populations were rare. We concluded that the vaccine’s efficacy in preventing excess deaths due to COVID-19 is significant, and the risk of these rare side effects does not justify foregoing vaccination in at-risk individuals. Patients at higher risk for these side effects should be informed, and additional considerations should be made by their treating physician. This review aims to increase awareness of rare vaccine-induced side effects to encourage further studies, enhancing understanding of their etiology and prevalence in at-risk older adult populations.

COVID-19 Vaccine Acceptance and Hesitancy among Pregnant Women: A Knowledge, Attitude, and Perceived Risks Survey in Lusaka, Zambia

Introduction: The coronavirus disease 2019 (COVID-19) is an infectious disease of the respiratory tract caused by SARS-CoV-2. Since its emergence, there have been increased rates of transmission and spread, morbidity and mortality which led to the development of COVID-19 vaccines to address the pandemic. This study assessed acceptance, knowledge, attitude, and perceived risks regarding COVID-19 vaccines among pregnant women attending antenatal care at two First-Level Hospitals in Lusaka, Zambia. Materials and Methods: This was a cross-sectional study that was conducted among 241 pregnant women using a questionnaire from August 2023 to October 2023 in two First-Level Hospitals in Lusaka district, Zambia. The collected data were analyzed using IBM Statistical Package for Social Sciences (SPSS) version 22.0. Statistical analysis was performed using a Chi-square test. The statistical significance was set at a 95% confidence level. Results: Of the 241 participants, 107 (42.7%) were aged between 24 and 34 years. Overall, 64.3% accepted the COVID-19 vaccines, of which 122 (50.6%) were already vaccinated. Further, 203 (84.6%) of the pregnant women had good knowledge, and 199 (82.6%) had positive attitudes towards COVID-19 vaccines. However, 58.5% thought COVID-19 vaccines were not safe and could cause infertility. Alongside this, 70.1% thought that COVID-19 vaccines were harmful during pregnancy. Having good knowledge of COVID-19 vaccines was associated with age (p = 0.049), education status (p = 0.001), and employment status (p = 0.001). Having a positive attitude towards COVID-19 vaccines was associated with education status (p = 0.001) and employment status (p = 0.001). Conclusion: This study found that most pregnant women had good knowledge, and positive attitudes, and the majority accepted the COVID-19 vaccine. Encouragingly, most of the pregnant women who accepted the COVID-19 vaccines were already vaccinated. Most pregnant women thought that COVID-19 vaccines had side effects, were not safe, and could be harmful during pregnancy. Consequently, this could have contributed to the hesitancy to receive a vaccine among some participants. The findings of this study demonstrate the need to provide pregnant women with continuous educational programs on the benefits of vaccinations for themselves and their children.

Acceptance of COVID-19 vaccine and its related determinants in Nigeria:An online survey

BACKGROUND Vaccine hesitancy is a major challenge in the fight against the coronavirus disease 2019(COVID-19)pandemic.Identifying the sociodemographic factors associated with vaccine acceptance among Nigerians is crucial for improving vaccine uptake.AIM To assess the acceptance rate of COVID-19 vaccine and its related determinants among Nigerians.METHODS An online cross-sectional survey(observational study)was conducted between February 2021 and May 2021,using a questionnaire hosted on SurveyMonkey.The invitation to take part in the poll was sent out to participants through social networking platforms.A logistic regression was used to determine which sociodemographic factors were associated with vaccine acceptance constructs.RESULTS A total of 1800 persons responded to the survey,a larger proportion of whom were males(53.9%)and within the age group of 21-30 years(29.4%)and earned an average income of less than$500 per month(43.3%).Only 0.56%of participants had a high perceived risk of COVID-19 infection,while only 1.11%had a perceived risk of dying from COVID-19.The perception rate of the COVID-19 vaccine among participants was 51.1%,while the acceptance rate was 63.9%.There was no significant association between the COVID-19 vaccine acceptance rate and related determinants assessed,particularly age(χ²=3.049,P=0.550),sex(χ²=0.102,P=0.749),average income(χ²=3.802,P=0.875),and religion(χ²=2.819,P=0.420).Participants with chronic conditions demonstrated a higher acceptance rate compared to the general population.CONCLUSION Despite the positive perception observed and substantial vaccine acceptance rate among the study participants,more public health interventions are still needed to enhance vaccine acceptability in Nigeria.

Analysis of Public Sentiment regarding COVID-19 Vaccines on the Social Media Platform Reddit

This study undertakes a thorough analysis of the sentiment within the r/Corona-virus subreddit community regarding COVID-19 vaccines on Reddit. We meticulously collected and processed 34,768 comments, spanning from November 20, 2020, to January 17, 2021, using sentiment calculation methods such as TextBlob and Twitter-RoBERTa-Base-sentiment to categorize comments into positive, negative, or neutral sentiments. The methodology involved the use of Count Vectorizer as a vectorization technique and the implementation of advanced ensemble algorithms like XGBoost and Random Forest, achieving an accuracy of approximately 80%. Furthermore, through the Dirichlet latent allocation, we identified 23 distinct reasons for vaccine distrust among negative comments. These findings are crucial for understanding the community’s attitudes towards vaccination and can guide targeted public health messaging. Our study not only provides insights into public opinion during a critical health crisis, but also demonstrates the effectiveness of combining natural language processing tools and ensemble algorithms in sentiment analysis.

Refractory Ventricular Fibrillation with Underlying Coronary Artery Disease after COVID-19 Vaccine-Kounis Syndrome or Coincidence

A 63-year-old man with diabetes and asymptomatic coronary artery disease developed refractory ventricular arrhythmia at 20 hours at rest after his second COVID-19 vaccine. Despite significant stenosis in the coronary arteries, there was no evidence of acute or old myocardial infarction, heart failure, myocarditis or structural abnormalities on post-mortem to account for the substrate for the fatal arrhythmia. The refractory and incessant nature of the ventricular fibrillation and post-mortem finding of a grossly elevated unexplained IgE level (in the absence of acute myocardial infarction) suggested the possibility of Kounis Syndrome or allergic acute coronary syndrome.

A Case of Investigation and Diagnosis of Immune Thrombocytopenic Purpura After Vaccination of COVID-19 Inactivated Vaccine

Objective:Analyze the relationship between inoculating one case of the COVID-19 inactivated vaccine(Vero cell)and immune thrombocytopenic purpura to provide a reference for the standardized handling of adverse events following immunization.Methods:According to the"National Monitoring Program for Suspected Adverse Reactions to Vaccinations,"an on-site investigation,data collection and analysis,expert group diagnosis,and medical association assessment were conducted on a case of immune thrombocytopenic purpura in District A of Chongqing after vaccination with the inactivated COVID-19 vaccine.The assessment report was delivered to the three relevant parties,the case was reviewed,and the experience was summarized.Results:The investigation and diagnosis by the district-level vaccination abnormal reaction expert group concluded that the disease that occurred after vaccination with the COVID-19 inactivated vaccine was secondary immune thrombocytopenic purpura,an abnormal reaction to the vaccination.The medical damage was classified as Level II Grade B.The vaccine production enterprise raised objections to this conclusion.After re-assessment by the municipal-level medical association,the conclusion was consistent with that of the district-level medical association.The vaccine production enterprise did not raise any further objections.Conclusion:Through active collaboration among district and municipal-level medical associations,disease control institutions,and vaccination units,the recipients have been promptly and effectively treated,providing financial support for their subsequent treatment and safeguarding their rights.The investigation and disposal procedures for adverse events following immunization in Chongqing are clear,and the mechanism is sound.It is necessary to continue strengthening the monitoring of adverse events following immunization according to the existing plan and to ensure timely and standardized handling.Simultaneously,it is crucial to strengthen vaccine management and vaccination management.

Overcoming Challenges in COVID-19 Vaccination among Ethnic Minority Groups in Bangladesh: A Qualitative Exploration

This study aimed to explore the barriers affecting COVID-19 vaccine uptake among ethnic minorities and to propose strategies to strengthen government initiatives for inclusive vaccination. Grounded in social constructivism, this qualitative study was conducted in the greater Sylhet Division, where many ethnic communities live. Using purposive sampling, semi-structured interviews were conducted with 49 participants, including ethnic men and women, community leaders, and healthcare providers. Two focus group discussions (FGDs) were also conducted to ensure data validation, and the results were analyzed using thematic analysis, which revealed several factors, such as free vaccinations, media, close community-knit healthcare centers, informal communication that positively influenced vaccine uptake, such as awareness campaigns, informal communication, media involvement, and free vaccine availability. However, socio-economic and technological barriers pose significant challenges, including misconceptions about vaccines, limited access to technology, long distances to vaccination centers, inconvenient service hours, and reliance on traditional medicine. To promote inclusive vaccination, the study recommends establishing localized vaccine camps, improving technological infrastructure such as the Internet and network access, enhancing communication strategies, providing special services for women, the elderly and disabled individuals, and ensuring a reliable vaccine supply. Future researchers could apply longitudinal studies, including a lager study area and broader range of participants to address the missing perspectives in the current study.

COVID-19 vaccination produces exercise-responsive SARS-CoV-2 specific T-cells regardless of infection history

Background:The mobilization and redistribution of severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)specific T-cells and neutralizing antibodies(nAbs)during exercise is purported to increase immune surveillance and protect against severe coronavirus disease 2019(COVID-19).We sought to determine if COVID-19 vaccination would elicit exercise-responsive SARS-CoV-2 T-cells and transiently alter nAb titers.Methods:Eighteen healthy participants completed a 20-min bout of graded cycling exercise before and/or after receiving a COVID-19 vaccine.All major leukocyte subtypes were enumerated before,during,and after exercise by flow cytometry,and immune responses to SARS-CoV-2 were determined using whole blood peptide stimulation assays,T-cell receptor(TCR)-βsequencing,and SARS-CoV-2 nAb serology.Results:COVID-19 vaccination had no effect on the mobilization or egress of major leukocyte subsets in response to intensity-controlled graded exercise.However,non-infected participants had a significantly reduced mobilization of CD4+and CD8+naive T-cells,as well as CD4+central memory T-cells,after vaccination(synthetic immunity group);this was not seen after vaccination in those with prior SARS-CoV-2 infection(hybrid immunity group).Acute exercise after vaccination robustly mobilized SARS-CoV-2 specific T-cells to blood in an intensity-dependent manner.Both groups mobilized T-cells that reacted to spike protein;however,only the hybrid immunity group mobilized T-cells that reacted to membrane and nucleocapsid antigens.nAbs increased significantly during exercise only in the hybrid immunity group.Conclusion:These data indicate that acute exercise mobilizes SARS-CoV-2 specific T-cells that recognize spike protein and increases the redistribution of nAbs in individuals with hybrid immunity.

Covid-19 vaccination in pregnancy and placental pathology

Objective:To describe and determine the association between Covid-19 vaccination in pregnancy and placental pathology.Methods:Conducted in a tertiary hospital in Medan,Indonesia,from April 30th 2022 to June 30th 2022,this single-center cross-sectional study involved Covid-19 vaccinated and unvaccinated women with singleton full-term pregnancies delivering live fetuses via cesarean section.Maternal characteristics,placental pathologies,and the placental index were documented at enrollment.The association between Covid-19 vaccination status and placental pathology was assessed.Results:The study enrolled 200 pregnant women,including 110 vaccinated women and 90 unvaccinated women.No significant differences were observed in birthweight(P=0.48),placental index(P=0.48),and placental pathology findings[intervillous bleeding(P=0.20),increased syncytial knots(P=0.83),chorangiosis(P=0.13),villous stromal edema(P=0.13),vascular dilation and congestion(P=0.13),and vascular wall thrombus(P=0.71)]between the vaccinated and unvaccinated groups.Conclusions:This study revealed no statistically significant association between Covid-19 vaccination and placental pathology.The findings support the safety of Covid-19 vaccination during pregnancy,in regards to changes of the placental pathology.

Knowledge, attitudes, and practices regarding Covid-19 and their relationship with Covid-19 booster vaccination status among women with infertility

Objective:To elucidate the relationship among knowledge,attitudes,and practices regarding Covid-19 and their relationship with booster vaccination status among women with infertility.Methods:This questionnaire-based cross-sectional study was performed online and offline among women with infertility who visited an infertility clinic in Jakarta,Indonesia.We assessed the patient’s knowledge,attitudes,and practices regarding Covid-19 and their relationship with booster vaccination status and sociodemographic profile.Results:A total of 178 subjects participated in this study,and most participants(92.6%)had received booster Covid-19 vaccines.From the questionnaire,74.2%had good knowledge,and 99.4%had good attitudes regarding Covid-19;however,only 57.9%of patients had good practices.A weak positive correlation existed between knowledge and attitudes(r=0.11,P=0.13)and a moderate negative correlation between attitudes and practices(r=-0.44,P=0.56).Participants’knowledge about vaccines and infertility was correlated with booster vaccination status(P=0.04).Academic background(P=0.01)and attitudes(P=0.01)were also correlated with booster vaccination status.The significant determinants of hesitance of receiving Covid-19 booster vaccines were high school education or below(OR=0.08,95%CI 0.02-0.36)and poor practices(OR=0.21,95%CI 0.05-0.95).Conclusions:The majority of the participants had received the Covid-19 booster vaccine and had good knowledge and attitudes but poor practices regarding Covid-19.Most participants had poor knowledge about the relationship between infertility and the Covid-19 vaccine.The general population should be more informed and reminded about practices to prevent Covid-19 and the relationship between vaccination and fertility to increase the number of people who receive Covid-19 booster vaccines.

COVID-19 infection and inactivated vaccination:Impacts on clinical and immunological profiles in Chinese children with type 1 diabetes

BACKGROUND The coronavirus disease 2019(COVID-19)pandemic has been linked to an increased incidence of diabetes and diabetic ketoacidosis(DKA).However,the relationship between COVID-19 infection and progression to type 1 diabetes(T1D)in children has not been well defined.AIM To evaluate the influence of COVID-19 infection and inactivated vaccine adminis-tration on the progression of T1D among Chinese children.METHODS A total of 197 newly diagnosed patients with T1D were retrospectively enrolled from Children's Hospital of Fudan University between September 2020 and December 2023.The patients were divided into three groups based on their history of COVID-19 infection and vaccination:the infection group,the vacci-nation-only group,and the non-infection/non-vaccination group.Comprehensive clinical assessments and detailed immunological evaluations were performed to delineate the characteristics and immune responses of these groups.RESULTS The incidence of DKA was significantly higher in the COVID-19 infection group(70.2%)compared to the non-infection/non-vaccination group(62.5%)and vac-scination-only group(45.6%;P=0.015).Prior COVID-19 infection was correlated with increased DKA risk(OR:1.981,95%CI:1.026-3.825,P=0.042),while vacci-nation was associated with a reduced risk(OR:0.558,95%CI:0.312-0.998,P=0.049).COVID-19 infection mildly altered immune profiles,with modest dif-ferences in autoantibody positivity,lymphocyte distribution,and immunoglobulin levels.Notably,HLA-DR3 po-sitive children with a history of COVID-19 infection had an earlier T1D onset and lower fasting C-peptide levels than the HLA-DR3 negative children with a history of infection(both P<0.05).CONCLUSION COVID-19 infection predisposes children to severe T1D,characterized by enhanced DKA risk.Inactivated vaccination significantly lowers DKA incidence at T1D onset.These findings are valuable for guiding future vaccination and T1D risk surveillance strategies in epidemic scenarios in the general pediatric population.

COVID-19 Vaccination Status and Severe Outcomes among Patients Hospitalized for COVID-19 in West Africa, Togo, 2021

Objectives: More than a year after its introduction, COVID-19 vaccination coverage was low in the Togolese population and little data were available on its benefits for hospitalized patients. This study aimed to describe the impact of COVID-19 vaccination on the prognosis of hospitalized patients. Methods: This was a retrospective cohort study of patients admitted to the Centre Hospitalier Régional Lomé Commune (Togo) between June 1, 2021 and May 31, 2022. Primary outcomes (admission to the intensive care unit and death) were presented with frequency and proportion. Mortality rates were presented by sociodemographic and clinical characteristics and compared by appropriate statistical tests. Factors associated with inpatient death were described by performing a Cox proportional hazard regression. Results: A total of 604 patients were hospitalized (50.0% women). The mean age was 54.03 ±17.1 years. Only 55 patients were fully vaccinated (9.1%). ICU admission was significantly more frequent in unvaccinated patients than in vaccinated ones (63.0% vs. 38.2%;p Conclusion: COVID-19 vaccination had a significant benefit for patients with COVID-19 infection in terms of reducing the risk of death. Based on real-world data from sub-Saharan Africa, this information can help optimize the benefit of COVID-19 vaccination by raising community awareness and increasing vaccine coverage while reducing hesitancy.

Revaccination after Acute Kidney Injury Associated with Prior COVID-19 Vaccination: Case Report

Background: Acute kidney injury associated with proteinuria has been reported following vaccination against SARS-CoV-2 several times since 2021. Decisions about subsequent revaccination in these patients have been difficult because of the uncertainty of the consequences of doing so, and the absence of publications to help determine whether revaccination may be considered safe or not. Purpose: We present a case report of a 59-year-old Canadian man who developed severe acute kidney injury associated with moderate proteinuria following his first COVID-19 vaccine with the Moderna vaccine (an mRNA vaccine). He required haemodialysis for 2 weeks, which was initiated when his creatinine reached 1002 μmol/l. A kidney biopsy showed changes consistent with acute tubular necrosis. The patient was cautioned that repeat vaccination might result in further kidney injury which might be irreversible. However, he badly wanted to attempt a second COVID-19 vaccination, to facilitate a family vacation across several countries in Europe, at a time when travel restrictions were in place in many countries for persons who had not completed a course of vaccines. Method: Following deliberations, the patient chose to try a different type of Covid-19 vaccine. On this occasion, he was vaccinated with the Novavax vaccine (a subunit COVID-19 vaccine). Following this, close monitoring of his urine to detect proteinuria and blood testing for acute kidney injury were carried out on days 1, 3, 7, and 60 after vaccination. Furthermore, a year after his repeat vaccination, his kidney function and urinalysis were again assessed. Result and Conclusions: The patient did not develop acute kidney injury or worsening proteinuria following repeat vaccination. It remains unclear if acute kidney injury with proteinuria is caused by Covid-19 vaccination, or simply an incidental association. This case report suggests that it is may be reasonable for patients with acute kidney injury after COVID-19 vaccination to consider trying a different type of vaccine. In situations where a new virulent strain of virus emerges or in patients at risk of severe complication from infection, it may be reasonable to consider revaccination following appropriate counselling with close monitoring of renal function.

Evaluation of COVID-19 Cases and Vaccinations in the State of Georgia, United States: A Spatial Perspective

This study evaluates the distribution of COVID-19 cases and mass vaccination campaigns from January 2020 to April 2023. There are over 235,000 COVID-19 cases and over 733,000 vaccinations across the 159 counties in the state of Georgia. Data on COVID-19 was acquired from usafact.org while the vaccination records were obtained from COVID-19 vaccination tracker. The spatial patterns across the counties were analyzed using spatial statistical techniques which include both global and local spatial autocorrelation. The study further evaluates the effect of vaccination and selected socio-economic predictors on COVID-19 cases across the study area. The result of hotspot analysis reveals that the epicenters of COVID-19 are distributed across Cobb, Fulton, Gwinnett, and DeKalb counties. It was also affirmed that the vaccination records followed the same pattern as COVID-19 cases’ epicenters. The result of the spatial error model performed well and accounted for a considerable percentage of the regression with an adjusted R squared of 0.68, Akaike Information Criterion (AIC) 387.682 and Breusch-Pagan of 9.8091. ESDA was employed to select the main explanatory variables. The selected variables include vaccination, population density, percentage of people that do not have health insurance, black race, Hispanic and these variables accounted for 68% of the number of COVID-19 cases in the state of Georgia during the study period. The study concludes that both COVID-19 cases and vaccinated individuals have spatial peculiarities across counties in Georgia state. Lastly, socio-economic variables and vaccination are very important to reduce the vulnerability of individuals to COVID-19 disease.

Behcet's disease-related panuveitis following COVID-19 vaccination:A case report

BACKGROUND Behcet's disease(BD)is an inflammatory disorder known for various symptoms,including oral and genital ulcers and ocular inflammation.Panuveitis,a severe eye condition,is rare as the first sign of BD.CASE SUMMARY We present an unusual case of a 30-year-old man who developed panuveitis after receiving the mRNA-based coronavirus disease 2019(COVID-19)vaccine(Moderna).Laboratory tests ruled out infections,but he had a positive HLA-B51 result and a history of genital ulcer and oral ulcers,leading to a BD diagnosis.Treatment with corticosteroids improved his condition.Interestingly,he had another episode of panuveitis after the second mRNA vaccine dose,which also responded to corticosteroids.CONCLUSION This case highlights the rare onset of BD following mRNA COVID-19 vaccination,suggesting a potential link between these vaccines and BD's eye symptoms,emphasizing the importance of quick treatment in similar cases.

COVID-19 mortality paradox(United States vs Africa):Mass vaccination vs early treatment

The coronavirus disease 2019(COVID-19)mortality rate in 55 African countries is almost 4.5 times lower than in the coronavirus disease 2019(COVID-19)despite Africa having over 4.2 times more people.This mortality paradox is also evident when comparing Nigeria,a heavily populated,poorly vaccinated and weakly mandated country to Israel,a small,highly vaccinated and strictly mandated country.Nigeria has almost 4 times lower COVID mortality than Israel.In this Field of Vision perspective,I explain how this paradox has evolved drawing upon my academic,clinical and social experience.Since April 2020,I’ve developed and been using the Egyptian immune-modulatory Kelleni’s protocol to manage COVID-19 patients including pediatric,geriatric,pregnant,immune-compromised and other individuals suffering from multiple comorbidities.It’s unfortunate that severe acute respiratory syndrome coronavirus 2 is still evolving accompanied by more deaths.However in Africa,we’ve been able to live without anxiety or mandates throughout the pandemic because we trust science and adopted early treatment using safe,and effective repurposed drugs that have saved the majority of COVID-19 patients.This article represents an African and Egyptian tale of honor.