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Nevin Manimala Statistics

SARS-CoV-2 and Its Variants in Thrice-Infected Health Workers: A Case Series from an Italian University Hospital

Viruses. 2022 Nov 16;14(11):2536. doi: 10.3390/v14112536.

ABSTRACT

BACKGROUND: We described a SARS-CoV-2 thrice-infected case series in health workers (HW) to evaluate patient and virus variants and lineages and collect information on variables associated with multiple infections.

METHODS: A retrospective analysis of clinical and laboratory characteristics of SARS-CoV-2 thrice-infected individuals was carried out in Verona University Hospital, concurrent with the ORCHESTRA project. Variant analysis was conducted on a subset of available specimens.

RESULTS: Twelve HW out of 7368 were thrice infected (0.16%). Symptomatic infections were reported in 63.6%, 54.5% and 72.7% of the first, second and third infections, respectively. Nine subjects were fully vaccinated at the time of the third infection, and five had an additional booster dose. The mean time to second infection was 349.6 days (95% CI, 138-443); the mean interval between the second and third infection was 223.5 days (95% CI, 108-530) (p = 0.032). In three cases, the second and third infections were caused by the Omicron variant, but different lineages were detected when the second vs third infections were sequenced.

CONCLUSIONS: This case series confirms evidence of multiple reinfections with SARS-CoV-2, even from the same variant, in vaccinated HW. These results reinforce the need for continued infection-specific prevention measures in previously infected and reinfected HW.

PMID:36423145 | DOI:10.3390/v14112536

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Nevin Manimala Statistics

Early Access to Oral Antivirals in High-Risk Outpatients: Good Weapons to Fight COVID-19

Viruses. 2022 Nov 14;14(11):2514. doi: 10.3390/v14112514.

ABSTRACT

INTRODUCTION: Molnupiravir and Nirmatrelvir/r (NMV-r) have been proven to reduce severe Coronavirus Disease 2019 (COVID-19) in unvaccinated high-risk individuals. Data regarding their impact in fully vaccinated vulnerable subjects with mild-to-moderate COVID-19 are still limited, particularly in the era of Omicron and sub-variants.

METHODS: Our retrospective study aimed to compare the safety profile and effectiveness of the two antivirals in all consecutive high-risk outpatients between 11 January and 10 July 2022. A logistic regression model was carried out to assess factors associated with the composite outcome defined as all-cause hospitalization and/or death at 30 days.

RESULTS: A total of 719 individuals were included: 554 (77%) received Molnupiravir, whereas 165 (23%) were NMV-r users. Overall, 43 all-cause hospitalizations (5.9%) and 13 (1.8%) deaths were observed at 30 days. A composite outcome occurred in 47 (6.5%) individuals. At multivariate analysis, male sex [OR 3.785; p = 0.0021], age ≥ 75 [OR 2.647; p = 0.0124], moderate illness [OR 16.75; p < 0.001], and treatment discontinuation after medical decision [OR 8.148; p = 0.0123] remained independently associated with the composite outcome.

CONCLUSIONS: No differences between the two antivirals were observed. In this real-life setting, the early use of both of the oral antivirals helped limit composite outcome at 30 days among subjects who were at high risk of disease progression.

PMID:36423123 | DOI:10.3390/v14112514

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Nevin Manimala Statistics

Epidemiology and Transmission Dynamics of Infectious Diseases and Control Measures

Viruses. 2022 Nov 12;14(11):2510. doi: 10.3390/v14112510.

ABSTRACT

The epidemiology and transmission dynamics of infectious diseases must be understood at the individual and community levels to improve public health decision-making for real-time and integrated community-based control strategies. Herein, we explore the epidemiological characteristics for assessing the impact of public health interventions in the community setting and their applications. Computational statistical methods could advance research on infectious disease epidemiology and accumulate scientific evidence of the potential impacts of pharmaceutical/nonpharmaceutical measures to mitigate or control infectious diseases in the community. Novel public health threats from emerging zoonotic infectious diseases are urgent issues. Given these direct and indirect mitigating impacts at various levels to different infectious diseases and their burdens, we must consider an integrated assessment approach, ‘One Health’, to understand the dynamics and control of infectious diseases.

PMID:36423119 | DOI:10.3390/v14112510

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Nevin Manimala Statistics

Impact of COVID-19 Vaccination on Seroprevalence of SARS-CoV-2 among the Health Care Workers in a Tertiary Care Centre, South India

Vaccines (Basel). 2022 Nov 19;10(11):1967. doi: 10.3390/vaccines10111967.

ABSTRACT

Global vaccine development efforts have been accelerated in response to the devastating COVID-19 pandemic. The study aims to determine the seroprevalence of SARS-CoV-2 IgG antibodies among vaccine-naïve healthcare workers and to describe the impact of vaccination roll-out on COVID-19 antibody prevalence among the health care centers in tertiary care centers in South India. Serum samples collected from vaccinated and unvaccinated health care workers between January 2021 and April 2021were subjected to COVID-19 IgG ELISA, and adverse effects after the first and second dose of receiving the Covishield vaccine were recorded. The vaccinated group was followed for a COVID-19 breakthrough infection for a period of 6 months. Among the recruited HCW, 156 and 157 participants were from the vaccinated and unvaccinated group, respectively. The seroprevalence (COVID-19 IgG ELISA) among the vaccinated and unvaccinated Health Care Workers (HCW) was 91.7% and 38.2%, respectively, which is statistically significant. Systemic and local side-effects after Covishield vaccination occur at lower frequencies than reported in phase 3 trials. Since the COVID-19 vaccine rollout has commenced in our tertiary care hospital, seropositivity for COVID-19 IgG has risen dramatically and clearly shows trends in vaccine-induced antibodies among the health care workers.

PMID:36423062 | DOI:10.3390/vaccines10111967

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Nevin Manimala Statistics

Subnational Gender Inequality and Childhood Immunization: An Ecological Analysis of the Subnational Gender Development Index and DTP Coverage Outcomes across 57 Countries

Vaccines (Basel). 2022 Nov 18;10(11):1951. doi: 10.3390/vaccines10111951.

ABSTRACT

The role of gender inequality in childhood immunization is an emerging area of focus for global efforts to improve immunization coverage and equity. Recent studies have examined the relationship between gender inequality and childhood immunization at national as well as individual levels; we hypothesize that the demonstrated relationship between greater gender equality and higher immunization coverage will also be evident when examining subnational-level data. We thus conducted an ecological analysis examining the association between the Subnational Gender Development Index (SGDI) and two measures of immunization-zero-dose diphtheria-tetanus-pertussis (DTP) prevalence and 3-dose DTP coverage. Using data from 2010-2019 across 702 subnational regions within 57 countries, we assessed these relationships using fractional logistic regression models, as well as a series of analyses to account for the nested geographies of subnational regions within countries. Subnational regions were dichotomized to higher gender inequality (top quintile of SGDI) and lower gender inequality (lower four quintiles of SGDI). In adjusted models, we find that subnational regions with higher gender inequality (favoring men) are expected to have 5.8 percentage points greater zero-dose prevalence than regions with lower inequality [16.4% (95% confidence interval (CI) 14.5-18.4%) in higher-inequality regions versus 10.6% (95% CI 9.5-11.7%) in lower-inequality regions], and 8.2 percentage points lower DTP3 immunization coverage [71.0% (95% CI 68.3-73.7%) in higher-inequality regions versus 79.2% (95% CI 77.7-80.7%) in lower-inequality regions]. In models accounting for country-level clustering of gender inequality, the magnitude and strength of associations are reduced somewhat, but remain statistically significant in the hypothesized direction. In conjunction with published work demonstrating meaningful associations between greater gender equality and better childhood immunization outcomes in individual- and country-level analyses, these findings lend further strength to calls for efforts towards greater gender equality to improve childhood immunization and child health outcomes broadly.

PMID:36423046 | DOI:10.3390/vaccines10111951

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Nevin Manimala Statistics

Vaccinating Meat Chickens against Campylobacter and Salmonella: A Systematic Review and Meta-Analysis

Vaccines (Basel). 2022 Nov 15;10(11):1936. doi: 10.3390/vaccines10111936.

ABSTRACT

Foodborne enteritis is a major disease burden globally. Two of the most common causative bacterial enteropathogens in humans are Campylobacter and Salmonella species which are strongly associated with the consumption of raw or contaminated chicken. The poultry industry has approached this issue by use of a multi-hurdle method across the production chain to reduce or eliminate this risk. The use of poultry vaccines is one of these control methods. A systematic review and meta-analysis of vaccination effects against caecal Campylobacter and Salmonella were performed on primary research published between 2009 and 2022. Screening was conducted by three reviewers with one reviewer performing subsequent data extraction and one reviewer performing the risk of bias assessment. The confidence in cumulative evidence was evaluated based on the GRADE method. Meta-analyses were performed using standardised mean differences (SMDs) with additional analyses and random effects regression models on intervention effects grouped by the vaccine type. A total of 13 Campylobacter and 19 Salmonella studies satisfied the eligibility criteria for this review. Many studies included multi-arm interventions, resulting in a total of 25 Campylobacter and 34 Salmonella comparators which were synthesised. The analyses revealed a large reduction in pathogen levels; however, many effects required statistical adjustment due to unit of analysis errors. There was a moderate level of confidence in the reduction of Campylobacter by 0.93 SMD units (95% CI: -1.275 to -0.585; p value < 0.001) and a very low level of confidence in the reduction of Salmonella by 1.10 SMD units (95% CI: -1.419 to -0.776; p value < 0.001). The Chi2 test for heterogeneity (p value 0.001 and <0.001 for Campylobacter and Salmonella, respectively) and the I2 statistic (52.4% and 77.5% for Campylobacter and Salmonella, respectively) indicated high levels of heterogeneity in the SMDs across the comparators. The certainty of gathered evidence was also affected by a high risk of study bias mostly due to a lack of detailed reporting and, additionally for Salmonella, the presence of publication bias. Further research is recommended to source areas of heterogeneity, and a conscious effort to follow reporting guidelines and consider units of analysis can improve the strength of evidence gathered to provide recommendations to the industry.

PMID:36423031 | DOI:10.3390/vaccines10111936

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Nevin Manimala Statistics

Low Uptake of the Second Dose of Human Papillomavirus Vaccine in Dar es Salaam, Tanzania

Vaccines (Basel). 2022 Nov 13;10(11):1919. doi: 10.3390/vaccines10111919.

ABSTRACT

Cervical cancer represents the most common neoplastic pathology among women, with a high burden of morbidity and mortality globally. Tanzania is no exception. The human papillomavirus (HPV) vaccine remains the most effective intervention to address such a burden. However, the uptake of the second dose to confer full immunity remains a challenge. This study aimed to assess the uptake and factors associated with the second dose of the HPV (HPV-2) vaccine uptake among adolescents in the Ilala municipality of Dar es Salaam, Tanzania. Using a quantitative cross-sectional study, data of 389 adolescent girls was collected using a self-administered structured questionnaire. Analyses were conducted using Statistical Package for the Social Sciences (SPSS) software through descriptive and multivariate logistic regression methods to determine uptake, characteristics, and factors associated with the uptake of the second dose of the HPV vaccine. Among the 389 adolescents, the uptake of the HPV-2 vaccine dose was only 21.3%, a lower level compared with the first dose of HPV vaccine (35.2%). Factors associated with the uptake of the HPV-2 vaccine were age (AOR 0.14, p = 0.008), positive attitude towards the HPV-2 vaccine (AOR 2.04, p = 0.023), and awareness of the HPV-2 vaccine (AOR: 9.16, p = 0.003). In conclusion, only one in five adolescents in the Ilala municipality received a second dose of HPV vaccine. Such low uptake was associated with attitude towards the HPV vaccine and low awareness of HPV-2 vaccines. Regular community sensitization and awareness campaigns by relevant authorities and implementers may help to increase the HPV vaccine uptake.

PMID:36423015 | DOI:10.3390/vaccines10111919

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Nevin Manimala Statistics

Assessment of COVID-19 Anxiety Levels and Attitudes to COVID-19 Vaccine among Older Adults in Poland: A Pilot Study

Vaccines (Basel). 2022 Nov 13;10(11):1918. doi: 10.3390/vaccines10111918.

ABSTRACT

BACKGROUND: The fear of being infected with the SARS-CoV-2 has become widespread, especially among older adults. Information campaigns to promote mass vaccination against COVID-19 are a key element in controlling and preventing the spread of the COVID-19 pandemic. However, their success primarily depends on vaccination coverage in a given population. The aim of this study was to assess the severity of COVID-19 anxiety and attitudes towards COVID-19 vaccines among older adults in Poland.

METHODS: This pilot study was conducted among a total of 127 older participants, including 108 students (85%) of Third Age Universities in Bialystok and 19 patients (15%) of the Department and Clinic of Geriatrics of the Hospital of the Ministry of Internal Affairs and Administration in Bialystok. The study used a diagnostic survey based on an author-designed questionnaire and four standardized psychometric tools: The Fear of COVID-19 Scale (FCV-19S), Coronavirus Anxiety Scale (CAS), The Drivers of COVID-19 Vaccination Acceptance Scale (DrVac-COVID19S), and Scale to Measure the Perception of SARS-CoV-2 Vaccines Acceptance (The VAC-COVID-19 Scale).

RESULTS: COVID-19 vaccination coverage in the study group was 88.2%, with three doses in most cases. We found a negative vaccination status only in women taking part in the study. Men scored significantly higher on DrVac-COVID19S and its Value subscale, and markedly lower on FCV-19S. We did not observe significant differences in the scales’ scores between age groups. Respondents recruited from the Third Age Universities had significantly higher scores than geriatric clinic patients in the Knowledge subscale of DrVac-COVID19S. In the case of FCV-19S, no correlation with the results obtained in other scales used in the study was found. Additionally, no correlation was found between CAS scores and the following scales: DrVac-COVID19S (total), DrVac-COVID19S Knowledge (K) subscale, DrVac-COVID19S Autonomy (A) subscale and VAC-COVID-19-Scale-positive subscale. The other scales were strongly correlated with each other-the correlations were statistically significant.

CONCLUSIONS: Subjective COVID-19 anxiety in the study group was moderate. Seniors were more likely to show positive vaccine attitudes, as confirmed by the percentage of respondents vaccinated against COVID-19 with at least one dose. However, there is still a percentage of unvaccinated individuals in the population of seniors; therefore, measures should be taken to motivate this age group and encourage preventive vaccination against COVID-19. Furthermore, representative studies on COVID-19 anxiety and attitudes towards the COVID-19 vaccine among Polish seniors are needed to determine a more precise prevalence of these phenomena and potential correlations on a national level.

PMID:36423014 | DOI:10.3390/vaccines10111918

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Nevin Manimala Statistics

Antigen Coverage Presented by MHC Class I Has a Negative Correlation with SARS-CoV-2-Induced Mortality

Vaccines (Basel). 2022 Nov 13;10(11):1917. doi: 10.3390/vaccines10111917.

ABSTRACT

The COVID-19 pandemic has caused a health crisis worldwide; therefore, it is necessary to understand the factors related to its prognosis. In this study, we hypothesized that SARS-CoV-2-derived antigens presented by MHC class I may correlate with mortality in COVID-19 because they induce adaptive immune responses. Antigen coverage at the national level was inferred using country-specific HLA allele frequencies and relative predictions of binding antigens. We performed regression analysis between antigen coverage and the death rate due to COVID-19 across countries and found a negative correlation, although it was statistically significant only in HLA-B. This negative correlation was corroborated in multiple regression analysis with known risk factors, such as the prevalence of underlying disease. Furthermore, we analyzed antigen coverage in accordance with SARS-CoV-2 domains and identified a significant negative correlation when it was derived from the spike domain, which is reported to be favorable for COVID-19 prognosis. Taken together, the results indicate that the antigen coverage of SARS-CoV-2 specifically presented by HLA-B may act as a favorable factor when explaining COVID-19-induced mortality.

PMID:36423013 | DOI:10.3390/vaccines10111917

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Nevin Manimala Statistics

Assessment of Crosslinkers between Peptide Antigen and Carrier Protein for Fusion Peptide-Directed Vaccines against HIV-1

Vaccines (Basel). 2022 Nov 12;10(11):1916. doi: 10.3390/vaccines10111916.

ABSTRACT

Conjugate-vaccine immunogens require three components: a carrier protein, an antigen, and a crosslinker, capable of coupling antigen to carrier protein, while preserving both T-cell responses from carrier protein and B-cell responses from antigen. We previously showed that the N-terminal eight residues of the HIV-1 fusion peptide (FP8) as an antigen could prime for broad cross-clade neutralizing responses, that recombinant heavy chain of tetanus toxin (rTTHC) as a carrier protein provided optimal responses, and that choice of crosslinker could impact both antigenicity and immunogenicity. Here, we delve more deeply into the impact of varying the linker between FP8 and rTTHC. In specific, we assessed the physical properties, the antigenicity, and the immunogenicity of conjugates for crosslinkers ranging in spacer-arm length from 1.5 to 95.2 Å, with varying hydrophobicity and crosslinking-functional groups. Conjugates coupled with different degrees of multimerization and peptide-to-rTTHC stoichiometry, but all were well recognized by HIV-fusion-peptide-directed antibodies VRC34.01, VRC34.05, PGT151, and ACS202 except for the conjugate with the longest linker (24-PEGylated SMCC; SM(PEG)24), which had lower affinity for ACS202, as did the conjugate with the shortest linker (succinimidyl iodoacetate; SIA), which also had the lowest peptide-to-rTTHC stoichiometry. Murine immunizations testing seven FP8-rTTHC conjugates elicited fusion-peptide-directed antibody responses, with SIA- and SM(PEG)24-linked conjugates eliciting lower responses than the other five conjugates. After boosting with prefusion-closed envelope trimers from strains BG505 clade A and consensus clade C, trimer-directed antibody-binding responses were lower for the SIA-linked conjugate; elicited neutralizing responses were similar, however, though statistically lower for the SM(PEG)24-linked conjugate, when tested against a strain especially sensitive to fusion-peptide-directed responses. Overall, correlation analyses revealed the immunogenicity of FP8-rTTHC conjugates to be negatively impacted by hydrophilicity and extremes of length or low peptide-carrier stoichiometry, but robust to other linker parameters, with several commonly used crosslinkers yielding statistically indistinguishable serological results.

PMID:36423012 | DOI:10.3390/vaccines10111916