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 ...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.展开更多
Inactivated COVID-19 vaccines have been widely used to vaccinate the Chinese population.However,limited literature exists to explore the effect of obesity on the humoral and cellular immune response to these vaccines....Inactivated COVID-19 vaccines have been widely used to vaccinate the Chinese population.However,limited literature exists to explore the effect of obesity on the humoral and cellular immune response to these vaccines.In this study,132 high BMI(Body mass index)(obesity and overweight,BMI≥24 kg/m^(2))and 82 normal BMI(BMI<24 kg/m^(2))participants were enrolled.Adverse events(AEs),Spike receptor-binding domain IgG antibody(anti-RBD-IgG),neutralizing antibodies(NAbs),and specific B-cell and T-cell responses were evaluated 21–105 days after full-course inactivated COVID-19 vaccination.The overall incidence of AEs was similar in individuals with and without obesity/overweight.No serious vaccine-related AEs occurred.Individuals with obesity/overweight had a reduced seropositivity rate of NAbs compared to those with normal BMI.Anti-RBD-IgG and NAbs titers in the high BMI group were significantly lower than those in the normal BMI group.The frequencies of RBD-specific memory B cells(MBCs)and the numbers of spike-specific TNF-α+spot-forming cells(SFCs)in individuals with obesity/overweight were reduced compared with those noted in individuals without obesity/overweight.A similar trend of weakened humoral responses was also observed in individuals with central obesity.Our study results suggested that inactivated COVID-19 vaccines were safe and well tolerated but induced poor humoral and cellular immune responses in Chinese individuals with obesity/overweight.展开更多
Background:Immunosuppressive medication reduces the immunogenicity of the coronavirus disease 2019(COVID-19)vaccines in patients with rheumatic and musculoskeletal diseases(RMDs).However,the underlying mechanism remai...Background:Immunosuppressive medication reduces the immunogenicity of the coronavirus disease 2019(COVID-19)vaccines in patients with rheumatic and musculoskeletal diseases(RMDs).However,the underlying mechanism remains unclear.The primary aim of our study was to dissect the impact of immunosuppressive medication on cellular and humoral immune responses in RMD patients receiving the inactivated COVID-19 vaccine.Methods:A total of 28 RMD patients and five healthy controls(HCs)receiving two doses of the inactivated COVID-19 vaccine(Sinovac-CoronaVac)were prospectively enrolled.Blood samples were collected before the primary vaccination(Week 0)and one week after the second vaccination(Week 5).Neutralizing antibody(nAb)titers and autoantibody titers were measured by a pseudovirus-based neutralization assay and enzyme-linked immunosorbent assay,respectively.CD4^(+)T-cell and CD19^(+)B-cell subsets and serum cytokines were analyzed by flow cytometry.Results:The inactivated COVID-19 vaccine was immunogenic in RMD patients and HCs after the second vaccination,but the nAb titers were lower in RMD patients than those in HCs.Only patients with systemic lupus erythematosus(SLE)had notably increased nAb titers.Remarkably,IgG^(+)CD27^(+),IgG^(+)IgG1^(+),and IgG^(+)IgG1^(−)B cells were reduced,whereas IgG−IgG1^(+)B cells,and total IgA and IgG titers were markedly increased.However,Tfh cell and Tfr cell subsets and cytokines produced by Tfh cells were not increased.The flare rate was low in RMD patients with comparable autoantibody titers,unchanged CD4^(+)T cell subsets and serum proinflammatory cytokines(interleukin[IL]-6,IL-17,interferon-γ,and tumor necrosis factor-α)after the second vaccination.Conclusions:Immunosuppressive therapy decreased the immunogenicity of the vaccine and maintained a low flare rate by selectively modulating B cell but not CD4^(+)T cell responses in RMD patients receiving the inactivated COVID-19 vaccine.Optimization of the treatment regimen might ensure a durable and robust COVID-19 vaccination response.展开更多
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 corona...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.展开更多
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 ...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.展开更多
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 de...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.展开更多
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 No...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.展开更多
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 surveillan...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.展开更多
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,...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.展开更多
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 c...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.展开更多
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 as...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.展开更多
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 descr...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.展开更多
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 dif...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.展开更多
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 th...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.展开更多
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 para...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.展开更多
Routine pediatric vaccination is one of the most effective public health inter-ventions for the control of a number of fatal diseases.However,during the coronavirus disease 2019 pandemic,routine pediatric vaccination ...Routine pediatric vaccination is one of the most effective public health inter-ventions for the control of a number of fatal diseases.However,during the coronavirus disease 2019 pandemic,routine pediatric vaccination rates were severely affected by disruptions of health services and vaccine confidence issues.Governments and the United Nations have taken measures to re-establish routine pediatric vaccination,while additional efforts are needed to catch up and develop plans to ensure routine vaccination services for the future pandemics.展开更多
Introduction: Almost a year after the start of the COVID-19 pandemic, Senegal embarked on a vaccination campaign to protect its population. The objective of this study was to identify the factors influencing the COVID...Introduction: Almost a year after the start of the COVID-19 pandemic, Senegal embarked on a vaccination campaign to protect its population. The objective of this study was to identify the factors influencing the COVID-19 vaccination practices within a health training university in Dakar. Methodology: This was a cross-sectional, descriptive and analytical study carried out from October 21 2021 to February 21 2022 among students at the Elhadj Ibrahima Niass private University in Dakar, Senegal. A 28-question online questionnaire was sent to all students enrolled at the university during this period. Results: Of the 576 students who responded, the average age was 22.60 years, with females predominating (57.81%). Medical students accounted for 66.14% of participants, pharmacy 22.40% and dental surgery 11.46%. Of these, 42.01% were bachelor’s students, 29.51% master’s students and 28.47% doctoral students. Vaccination coverage was 50.35%. Students who considered COVID-19 to be very dangerous were more likely to be vaccinated (OR = 5.05 [2.24-11.9]). Those with poor knowledge of vaccines were less likely to be vaccinated (OR = 0.07 [0.03-0.18]), as were those with poor knowledge of contraindications to vaccination (OR = 0.49 [0.28-0.86]). No association was found between vaccination status and socio-demographic or educational characteristics. Conclusion: In view of the importance of knowledge about COVID-19 vaccination, our results suggest that it is important to involve health students in the Ministry of Health’s awareness-raising strategies, because their support is necessary for better public awareness.展开更多
Introduction: Vaccination against COVID-19 has proven highly effective in preventing severe forms of the disease. However, the literature reports several cases associating renal damage and the anti-COVID vaccine. The ...Introduction: Vaccination against COVID-19 has proven highly effective in preventing severe forms of the disease. However, the literature reports several cases associating renal damage and the anti-COVID vaccine. The aim of our work was to report a case series of patients who developed glomerulopathy after anti-COVID-19 vaccine. We evaluated the type of vaccine, the clinico-biological profile, and the anatomopathological, therapeutic and evolutionary aspects. Material and Methods: Prospective descriptive study conducted at the Nephrology Department of CHU IbnSina in Rabat between December 2021 and June 2022 including 9 patients who presented with glomerulopathy after the 1st dose of anti-COVID-19 vaccine. We excluded patients followed for nephropathy. Results: The mean age of our patients was 33 ± 16 years with a sex ratio of 0.8. Six patients received an inactivated vaccine, 2 patients received a mRNA vaccine and 1 patient received a viral vector vaccine. The mean delay between the onset of signs and the date of the first vaccine dose was 3.1 +/? 0.65 months (1 - 6 months). All patients had a nephrotic syndrome, 2 pure and 7 impure: 3 patients had acute renal failure and microscopic hematuria, 2 patients had microscopic hematuria and 2 patients had acute renal failure. Histologically, focal segmental glomerulosclerosis (FSGS) was noted in 4 patients, lupus nephropathy in 3, and membranous nephropathy (MN) in 2. Specific treatment was administered to each patient, depending on the histological type of renal involvement and the context. After 6 months, complete remission was achieved in 5 patients, with no improvement in 2, and one patient was placed on hemodialysis. One patient died of another cause. Conclusion: The causal link between anti-COVID 19 vaccination and renal disease is highly probable, but remains to be confirmed.展开更多
Objective:The present study aimed to document the economic profiles of inactivated COVID-19 vaccines in Hong Kong SAR,Indonesia,China's Mainland,Philippines,Singapore,and Thailand,the evidence on which is currentl...Objective:The present study aimed to document the economic profiles of inactivated COVID-19 vaccines in Hong Kong SAR,Indonesia,China's Mainland,Philippines,Singapore,and Thailand,the evidence on which is currently absent.Methods:Decision tree models were developed to assess the cost-effectiveness of two doses of inactivated COVID-19 vaccines at a population vaccination rate of 50%in the base case,which was an estimate of feasible vaccination coverage according to previous studies.Epidemiological,mortality,cost,and health state utility information were sourced from the literature.Vaccine efficacy against COVID-19 cases by severity were estimated using metaanalyses of publicly accessible phase 3 trial results of inactivated vaccines.The health outcomes were quantified as quality-adjusted life years(QALYs)and compared across the vaccination and no vaccination strategies.In scenario analyses,incidence and vaccination rates were changed semi-continuously over spectrums,the results of which were presented as contour lines informing the efficiency frontiers of vaccination strategies.Oneway and probabilistic sensitivity analyses were also conducted.Results:The vaccination strategy was dominant in all jurisdictions in the base case by producing 105.18,98.15,99.70,60.48,112.00,and 103.47 QALYs while saving US$40.26 million,US$5.26 million,US$7.60 million,US$5.91 million,US$21.33 million,and US$7.18 million in Hong Kong SAR,Indonesia,China's Mainland,Philippines,Singapore,and Thailand per every 100,000 vaccinated individuals,respectively.Results were robust in alternative model specifications.Conclusions:Inactivated COVID-19 vaccines may be cost-saving options in Hong Kong SAR,Indonesia,China's Mainland,Philippines,Singapore,and Thailand.Mass vaccination programs using inactivated COVID-19 vaccines should be considered in these jurisdictions.展开更多
BACKGROUND The outbreak of the coronavirus disease 2019(COVID-19)caused by the severe acute respiratory syndrome coronavirus 2 has been the most important clinical challenge worldwide since January 2020.COVID-19 inact...BACKGROUND The outbreak of the coronavirus disease 2019(COVID-19)caused by the severe acute respiratory syndrome coronavirus 2 has been the most important clinical challenge worldwide since January 2020.COVID-19 inactivated vaccines play a crucial role in reducing the rates of morbidity and mortality.CASE SUMMARY We presented a 48-year-old woman from Haidian District,Beijing,China who developed ischemic colitis after receiving the second dose of COVID-19 inactivated vaccine.Computed tomography of the abdomen showed edema and bowel wall thickening with hypodensity in the sigmoid colon and descending colon.Colonoscopy revealed hyperemia,edema and erosion of the mucosa with superficial ulceration and a yellow-white coating at the descending colon and sigmoid colon.The symptoms were relieved after 1 wk of receiving pinaverium bromide(50 mg,tid)and aspirin enteric-coated tablets(0.1 g,qd).CONCLUSION The possible occurrence of ischemic colitis should be considered after administration of the COVID-19 inactivated vaccines.展开更多
文摘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.
基金supported by the National Science and Technology Major Project of China(No.2017ZX10202203-007,No.2017ZX10202203-008,and No.2018ZX10302206-003)a pilot project of clinical cooperation between traditional Chinese and western medicine for significant and complicated diseases of National Administration of Traditional Chinese Medicine:hepatic fibrosis.We also acknowledge the support of the National Natural Science Foundation of China(No.81772198)+1 种基金the Natural Science Foundation of Chongqing,China(No.cstc2020jcyj-msxmX0389)General Project of Chongqing Natural Science Foundation(No.cstc2020jcyj-msxmX0015).
文摘Inactivated COVID-19 vaccines have been widely used to vaccinate the Chinese population.However,limited literature exists to explore the effect of obesity on the humoral and cellular immune response to these vaccines.In this study,132 high BMI(Body mass index)(obesity and overweight,BMI≥24 kg/m^(2))and 82 normal BMI(BMI<24 kg/m^(2))participants were enrolled.Adverse events(AEs),Spike receptor-binding domain IgG antibody(anti-RBD-IgG),neutralizing antibodies(NAbs),and specific B-cell and T-cell responses were evaluated 21–105 days after full-course inactivated COVID-19 vaccination.The overall incidence of AEs was similar in individuals with and without obesity/overweight.No serious vaccine-related AEs occurred.Individuals with obesity/overweight had a reduced seropositivity rate of NAbs compared to those with normal BMI.Anti-RBD-IgG and NAbs titers in the high BMI group were significantly lower than those in the normal BMI group.The frequencies of RBD-specific memory B cells(MBCs)and the numbers of spike-specific TNF-α+spot-forming cells(SFCs)in individuals with obesity/overweight were reduced compared with those noted in individuals without obesity/overweight.A similar trend of weakened humoral responses was also observed in individuals with central obesity.Our study results suggested that inactivated COVID-19 vaccines were safe and well tolerated but induced poor humoral and cellular immune responses in Chinese individuals with obesity/overweight.
基金National Natural Science Foundation of China,Grant/Award Numbers:82271784,81974251,82071816National Key Research and Development Program of China,Grant/Award Number:2017YFC0909002。
文摘Background:Immunosuppressive medication reduces the immunogenicity of the coronavirus disease 2019(COVID-19)vaccines in patients with rheumatic and musculoskeletal diseases(RMDs).However,the underlying mechanism remains unclear.The primary aim of our study was to dissect the impact of immunosuppressive medication on cellular and humoral immune responses in RMD patients receiving the inactivated COVID-19 vaccine.Methods:A total of 28 RMD patients and five healthy controls(HCs)receiving two doses of the inactivated COVID-19 vaccine(Sinovac-CoronaVac)were prospectively enrolled.Blood samples were collected before the primary vaccination(Week 0)and one week after the second vaccination(Week 5).Neutralizing antibody(nAb)titers and autoantibody titers were measured by a pseudovirus-based neutralization assay and enzyme-linked immunosorbent assay,respectively.CD4^(+)T-cell and CD19^(+)B-cell subsets and serum cytokines were analyzed by flow cytometry.Results:The inactivated COVID-19 vaccine was immunogenic in RMD patients and HCs after the second vaccination,but the nAb titers were lower in RMD patients than those in HCs.Only patients with systemic lupus erythematosus(SLE)had notably increased nAb titers.Remarkably,IgG^(+)CD27^(+),IgG^(+)IgG1^(+),and IgG^(+)IgG1^(−)B cells were reduced,whereas IgG−IgG1^(+)B cells,and total IgA and IgG titers were markedly increased.However,Tfh cell and Tfr cell subsets and cytokines produced by Tfh cells were not increased.The flare rate was low in RMD patients with comparable autoantibody titers,unchanged CD4^(+)T cell subsets and serum proinflammatory cytokines(interleukin[IL]-6,IL-17,interferon-γ,and tumor necrosis factor-α)after the second vaccination.Conclusions:Immunosuppressive therapy decreased the immunogenicity of the vaccine and maintained a low flare rate by selectively modulating B cell but not CD4^(+)T cell responses in RMD patients receiving the inactivated COVID-19 vaccine.Optimization of the treatment regimen might ensure a durable and robust COVID-19 vaccination response.
基金the National Natural Science Foundation of China(82103662).
文摘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.
文摘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.
文摘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.
文摘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.
文摘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.
文摘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.
文摘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.
文摘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.
文摘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.
文摘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.
文摘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.
文摘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.
基金Supported by Scientific Research Foundation of Shanghai Municipal Health Commission of Changning District,No.20234Y038.
文摘Routine pediatric vaccination is one of the most effective public health inter-ventions for the control of a number of fatal diseases.However,during the coronavirus disease 2019 pandemic,routine pediatric vaccination rates were severely affected by disruptions of health services and vaccine confidence issues.Governments and the United Nations have taken measures to re-establish routine pediatric vaccination,while additional efforts are needed to catch up and develop plans to ensure routine vaccination services for the future pandemics.
文摘Introduction: Almost a year after the start of the COVID-19 pandemic, Senegal embarked on a vaccination campaign to protect its population. The objective of this study was to identify the factors influencing the COVID-19 vaccination practices within a health training university in Dakar. Methodology: This was a cross-sectional, descriptive and analytical study carried out from October 21 2021 to February 21 2022 among students at the Elhadj Ibrahima Niass private University in Dakar, Senegal. A 28-question online questionnaire was sent to all students enrolled at the university during this period. Results: Of the 576 students who responded, the average age was 22.60 years, with females predominating (57.81%). Medical students accounted for 66.14% of participants, pharmacy 22.40% and dental surgery 11.46%. Of these, 42.01% were bachelor’s students, 29.51% master’s students and 28.47% doctoral students. Vaccination coverage was 50.35%. Students who considered COVID-19 to be very dangerous were more likely to be vaccinated (OR = 5.05 [2.24-11.9]). Those with poor knowledge of vaccines were less likely to be vaccinated (OR = 0.07 [0.03-0.18]), as were those with poor knowledge of contraindications to vaccination (OR = 0.49 [0.28-0.86]). No association was found between vaccination status and socio-demographic or educational characteristics. Conclusion: In view of the importance of knowledge about COVID-19 vaccination, our results suggest that it is important to involve health students in the Ministry of Health’s awareness-raising strategies, because their support is necessary for better public awareness.
文摘Introduction: Vaccination against COVID-19 has proven highly effective in preventing severe forms of the disease. However, the literature reports several cases associating renal damage and the anti-COVID vaccine. The aim of our work was to report a case series of patients who developed glomerulopathy after anti-COVID-19 vaccine. We evaluated the type of vaccine, the clinico-biological profile, and the anatomopathological, therapeutic and evolutionary aspects. Material and Methods: Prospective descriptive study conducted at the Nephrology Department of CHU IbnSina in Rabat between December 2021 and June 2022 including 9 patients who presented with glomerulopathy after the 1st dose of anti-COVID-19 vaccine. We excluded patients followed for nephropathy. Results: The mean age of our patients was 33 ± 16 years with a sex ratio of 0.8. Six patients received an inactivated vaccine, 2 patients received a mRNA vaccine and 1 patient received a viral vector vaccine. The mean delay between the onset of signs and the date of the first vaccine dose was 3.1 +/? 0.65 months (1 - 6 months). All patients had a nephrotic syndrome, 2 pure and 7 impure: 3 patients had acute renal failure and microscopic hematuria, 2 patients had microscopic hematuria and 2 patients had acute renal failure. Histologically, focal segmental glomerulosclerosis (FSGS) was noted in 4 patients, lupus nephropathy in 3, and membranous nephropathy (MN) in 2. Specific treatment was administered to each patient, depending on the histological type of renal involvement and the context. After 6 months, complete remission was achieved in 5 patients, with no improvement in 2, and one patient was placed on hemodialysis. One patient died of another cause. Conclusion: The causal link between anti-COVID 19 vaccination and renal disease is highly probable, but remains to be confirmed.
文摘Objective:The present study aimed to document the economic profiles of inactivated COVID-19 vaccines in Hong Kong SAR,Indonesia,China's Mainland,Philippines,Singapore,and Thailand,the evidence on which is currently absent.Methods:Decision tree models were developed to assess the cost-effectiveness of two doses of inactivated COVID-19 vaccines at a population vaccination rate of 50%in the base case,which was an estimate of feasible vaccination coverage according to previous studies.Epidemiological,mortality,cost,and health state utility information were sourced from the literature.Vaccine efficacy against COVID-19 cases by severity were estimated using metaanalyses of publicly accessible phase 3 trial results of inactivated vaccines.The health outcomes were quantified as quality-adjusted life years(QALYs)and compared across the vaccination and no vaccination strategies.In scenario analyses,incidence and vaccination rates were changed semi-continuously over spectrums,the results of which were presented as contour lines informing the efficiency frontiers of vaccination strategies.Oneway and probabilistic sensitivity analyses were also conducted.Results:The vaccination strategy was dominant in all jurisdictions in the base case by producing 105.18,98.15,99.70,60.48,112.00,and 103.47 QALYs while saving US$40.26 million,US$5.26 million,US$7.60 million,US$5.91 million,US$21.33 million,and US$7.18 million in Hong Kong SAR,Indonesia,China's Mainland,Philippines,Singapore,and Thailand per every 100,000 vaccinated individuals,respectively.Results were robust in alternative model specifications.Conclusions:Inactivated COVID-19 vaccines may be cost-saving options in Hong Kong SAR,Indonesia,China's Mainland,Philippines,Singapore,and Thailand.Mass vaccination programs using inactivated COVID-19 vaccines should be considered in these jurisdictions.
文摘BACKGROUND The outbreak of the coronavirus disease 2019(COVID-19)caused by the severe acute respiratory syndrome coronavirus 2 has been the most important clinical challenge worldwide since January 2020.COVID-19 inactivated vaccines play a crucial role in reducing the rates of morbidity and mortality.CASE SUMMARY We presented a 48-year-old woman from Haidian District,Beijing,China who developed ischemic colitis after receiving the second dose of COVID-19 inactivated vaccine.Computed tomography of the abdomen showed edema and bowel wall thickening with hypodensity in the sigmoid colon and descending colon.Colonoscopy revealed hyperemia,edema and erosion of the mucosa with superficial ulceration and a yellow-white coating at the descending colon and sigmoid colon.The symptoms were relieved after 1 wk of receiving pinaverium bromide(50 mg,tid)and aspirin enteric-coated tablets(0.1 g,qd).CONCLUSION The possible occurrence of ischemic colitis should be considered after administration of the COVID-19 inactivated vaccines.