scholarly journals Immunogenicity of the COVID-19 Two-Vaccination Series Among Hematologic Malignancies: Report of Three Cases of Breakthrough Infection

2022 ◽  
Vol 29 ◽  
pp. 107327482110707
Author(s):  
Yanina Pasikhova ◽  
Austin R. Morrison ◽  
Ju Hee Katzman ◽  
Misbahuddin Syed
Keyword(s):  
Hematologic Malignancies ◽  
Immunocompromised Patients ◽  
Breakthrough Infection ◽  
Routine Testing ◽  
Post Vaccination ◽  
Routine Monitoring ◽  
Current Guidelines

Data is limited on the immunogenicity of the COVID-19 two-vaccination series among patients with hematologic malignancies and current guidelines do not recommend routine monitoring for post-vaccine antibodies. However, we describe three patients who developed severe or critical COVID-19 infections six months after vaccination. This highlights the importance of routine testing of COVID-19 IgG Spike, semi-quantitative antibodies post-vaccination, particularly among immunocompromised patients.

scholarly journals Viral loads of Delta-variant SARS-CoV2 breakthrough infections following vaccination and booster with the BNT162b2 vaccine

2021 ◽  
Author(s):  
Matan Levine-Tiefenbrun ◽  
Idan Yelin ◽  
Hillel Alapi ◽  
Rachel Katz ◽  
Esma Herzel ◽  
...  
Keyword(s):  
Viral Load ◽  
Real Life ◽  
Load Reduction ◽  
Protective Effects ◽  
Breakthrough Infection ◽  
Life Effectiveness ◽  
Post Vaccination ◽  
Viral Loads ◽  
Booster Vaccine ◽  
Viral Load Reduction

The BNT162b2 vaccine showed high real-life effectiveness both at preventing disease and in reducing viral loads of breakthrough infections, but coincidental with the rise of the Delta-variant SARS-CoV2, these protective effects have been decreasing, prompting a third, booster, vaccine inoculation. Here, analyzing viral loads of over 11,000 infections during the current wave in Israel, we find that even though this wave is dominated by the Delta-variant, breakthrough infections in recently vaccinated patients, still within 2 months post their second vaccine inoculation, do have lower viral loads compared to unvaccinated patients, with the extent of viral load reduction similar to pre-Delta breakthrough observations. Yet, this infectiousness protection starts diminishing for patients two months post vaccination and ultimately vanishes for patients 6 months or longer post vaccination. Encouragingly, we find that this diminishing vaccine effectiveness on breakthrough infection viral loads is restored following the booster vaccine. These results suggest that the vaccine is initially effective in reducing infectiousness of breakthrough infections even with the Delta variant, and that while this protectiveness effect declines with time it can be restored, at least temporarily, with a booster vaccine.

scholarly journals SARS-CoV-2 vaccine antibody response and breakthrough infections in patients receiving dialysis

2021 ◽  
Author(s):  
Shuchi Anand ◽  
Maria E Montez-Rath ◽  
Jialin Han ◽  
Pablo Garcia ◽  
LinaCel Cadden ◽  
...  
Keyword(s):  
Antibody Response ◽  
Mitigation Strategies ◽  
Breakthrough Infection ◽  
Post Vaccination ◽  
Correlates Of Protection ◽  
Igg Index ◽  
Nested Case Control ◽  
High Throughput Assay ◽  
Prior Infection ◽  
Sentinel Population

Background: Patients receiving dialysis are a sentinel population for groups at high risk for death and disability from COVID-19. Understanding correlates of protection post-vaccination can inform immunization and mitigation strategies. Methods: Monthly since January 2021, we tested plasma from 4791 patients receiving dialysis for antibodies to the receptor-binding domain (RBD) of SARS-CoV-2 using a high-throughput assay. We qualitatively assessed the proportion without a detectable RBD response and among those with a response, semiquantitative median IgG index values. Using a nested case-control design, we matched each breakthrough case to five controls by age, sex, and vaccination-month to determine whether peak and pre-breakthrough RBD IgG index values were associated with risk for infection post-vaccination. Results: Among 2563 vaccinated patients, the proportion without a detectable RBD response increased from 6.6% [95% CI 5.5-8.1] in 14-30 days post-vaccination to 20.2% [95% CI 17.1-23.8], and median index values declined from 92.7 (95% CI 77.8-107.5) to 3.7 (95% CI 3.1-4.3) after 5 months. Persons with SARS-CoV-2 infection prior-to-vaccination had higher peak index values than persons without prior infection, but values equalized by 5 months (p=0.230). Breakthrough infections occurred in 56 patients, with samples collected a median of 21 days pre-breakthrough. Peak and pre-breakthrough RBD values <23 (equivalent to <506 WHO BAU/mL) were associated with higher odds for breakthrough infection (OR: 3.7 [95% CI 2.0-6.8] and 9.8 [95% CI 2.9-32.8], respectively). Conclusions: The antibody response to SARS-CoV-2 vaccination wanes rapidly, and in persons receiving dialysis, the persisting antibody response is associated with risk for breakthrough infection.

scholarly journals Safety Monitoring of COVID Vaccines and Perception of Post-vaccination Side-Effects: Preliminary Findings From The First Month of Routine Monitoring in a Hospital Vaccination Setting of China

2021 ◽  
Author(s):  
Aihua Feng ◽  
Ruoyan Gai Tobe ◽  
Yongqiang Wang ◽  
Ting Yang ◽  
Xiuting Mo ◽  
...  
Keyword(s):  
Immune Deficiency ◽  
Side Effects ◽  
Side Effect ◽  
Safety Monitoring ◽  
Affecting Factors ◽  
Post Vaccination ◽  
Perceived Safety ◽  
Vaccination Uptake ◽  
Routine Monitoring ◽  
History Of

Abstract Objectives: This study aims to explore the occurrence of post-vaccination side-effects from COVID-19 vaccines and its affecting factors in a hospital vaccination setting of China.Results: A total of 811 vaccinees aged 17 to 58 years, who finished the full package of two doses in February 2021, have been recruited at the second vaccination uptake. Among all, there have been 66 participants who reported one or more mild side effects, while none of them developed severe cases. Those with history of immune deficiency were more likely to report side effect(s). Although with several concerns, most participants showed willingness to get vaccinated (98.8%) with relevant high proportions of perceived safety (99.5%) and effectiveness (97.3%).

scholarly journals SARS-CoV-2 Vaccine Responses in Individuals with Antibody Deficiency: Findings From The COV-AD Study

2022 ◽  
Author(s):  
Adrian M Shields ◽  
Sian E. Faustini ◽  
Harriet J. Hill ◽  
Saly Al-Taei ◽  
Chloe Tanner ◽  
...  
Keyword(s):  
Recurrent Infection ◽  
Cellular Responses ◽  
Antibody Deficiency ◽  
Breakthrough Infection ◽  
Live Virus ◽  
Post Vaccination ◽  
Vaccine Responses ◽  
Cell Responses ◽  
Interferon Gamma Release Assays ◽  
Antibody Levels

Abstract Background Vaccination prevents severe morbidity and mortality from COVID-19 in the general population. The immunogenicity and efficacy of SARS-CoV-2 vaccines in patients with antibody deficiency is poorly understood. Objectives COVID in patients with antibody deficiency (COV-AD) is a multi-site United Kingdom study that aims to determine the immune response to SARS-CoV-2 infection and vaccination in patients with primary or secondary antibody deficiency, a population that suffers from severe and recurrent infection and does not respond well to vaccination. Methods Individuals on immunoglobulin replacement therapy or with an IgG less than 4g/L receiving antibiotic prophylaxis were recruited from April 2021. Serological and cellular responses were determined using ELISA, live-virus neutralisation and interferon gamma release assays. SARS-CoV-2 infection and clearance were determined by PCR from serial nasopharyngeal swabs. Results 5.6% (n=320) of the cohort reported prior SARS-CoV-2 infection, but only 0.3% remained PCR positive on study entry. Seropositivity, following two doses of SARS-CoV-2 vaccination, was 54.8% (n=168) compared with 100% of healthy controls (n=205). The magnitude of the antibody response and its neutralising capacity were both significantly reduced compared to controls. Participants vaccinated with the Pfizer/BioNTech vaccine were more likely to be seropositive (65.7% vs 48.0%, p=0.03) and have higher antibody levels compared with the AstraZeneca vaccine (IgGAM ratio 3.73 vs 2.39, p=0.0003). T cell responses post vaccination were demonstrable in 46.2% of participants, were associated with better antibody responses but there was no difference between the two vaccines. Eleven vaccine-breakthrough infections have occurred to date, 10 of them in recipients of the AstraZeneca vaccine. Conclusion SARS-CoV-2 vaccines demonstrate reduced immunogenicity in patients with antibody deficiency with evidence of vaccine breakthrough infection.

scholarly journals Breakthrough COVID-19 infection rate with Indian strain in Single-center Healthcare Workers: A real world data.

2021 ◽  
Author(s):  
RAVINDRA SABNIS ◽  
Abhijit Patil ◽  
Nitiraj Shete ◽  
Arun Kumar Rastogi
Keyword(s):  
Side Effects ◽  
Infection Rate ◽  
Healthcare Workers ◽  
Breakthrough Infection ◽  
Real World Data ◽  
Post Vaccination ◽  
Hospital Employees ◽  
Indian Strain ◽  
Care Workers ◽  
Nih Classification

Abstract: Introduction: It is observed that many healthcare workers got COVID19 infection despite of completing both doses of Covishield vaccine. This study aimed to find real incidence of vaccine breakthrough infection. Material and methods: All hospital employees, who were fully vaccinated were included in study. Details about their vaccine side effects, infection prior to vaccination, post vaccination infection, severity of infection, hospital and ICU admission were noted. Results: None encountered any significant side effects of vaccine. Of the 461 participants, 86 (18.65%) got infection average 38 days (range 14 to 70days) after vaccination. As per the NIH classification, out of 86, disease was mild in 69(80.2%), moderate in 10(11.62%), severe in 6(6.97%) and critical in 1(1.16%). Of these, 10(11.62%) required hospital admission. Of these 10, 2 were shifted to ICU. Of the 2, One recovered while one died. Thus mortality was 1/86(1.6%). Conclusion: Breakthrough infection rate in health care workers was 18.65%. Moderate, severe or critical disease occurred in 19.7% participants even after two doses of vaccine. Mortality due to disease cannot be completely obviated due to vaccine. The vaccine was safe without any significant adverse events.

scholarly journals Tracheobronchial Manifestations ofAspergillusInfections

2011 ◽  
Vol 11 ◽  
pp. 2310-2329 ◽  
Author(s):  
Rafal Krenke ◽  
Elzbieta M. Grabczak
Keyword(s):  
Ambient Air ◽  
Hematologic Malignancies ◽  
Immunocompromised Patients ◽  
Transplant Recipients ◽  
Hematopoietic Stem ◽  
Symptomatic Disease ◽  
Airway Diseases ◽  
Human Lungs ◽  
Lung Transplant Recipients ◽  
Trachea And Bronchi

Human lungs are constantly exposed to a large number ofAspergillusspores which are present in ambient air. These spores are usually harmless to immunocompetent subjects but can produce a symptomatic disease in patients with impaired antifungal defense. In a small percentage of patients, the trachea and bronchi may be the main or even the sole site ofAspergillusinfection. The clinical entities that may develop in tracheobronchial location include saprophytic, allergic and invasive diseases. Although this review is focused on invasiveAspergillustracheobronchial infections, some aspects of allergic and saprophytic tracheobronchial diseases are also discussed in order to present the whole spectrum of tracheobronchial aspergillosis. To be consistent with clinical practice, an approach basing on specific conditions predisposing to invasiveAspergillustracheobronchial infections is used to present the differences in the clinical course and prognosis of these infections. Thus, invasive or potentially invasiveAspergillusairway diseases are discussed separately in three groups of patients: (1) lung transplant recipients, (2) highly immunocompromised patients with hematologic malignancies and/or patients undergoing hematopoietic stem cell transplantation, and (3) the remaining, less severely immunocompromised patients or even immunocompetent subjects.

scholarly journals Clinical outcome and economic impact of aminoglycoside peak concentrations in febrile immunocompromised patients with hematologic malignancies

1998 ◽  
Vol 44 (2) ◽  
pp. 408-414 ◽  
Author(s):  
Lutz Binder ◽  
Xaver Schiel ◽  
Claudia Binder ◽  
Cristina Fernandes Almeida Menke ◽  
Silke Schüttrumpf ◽  
...  
Keyword(s):  
Clinical Outcome ◽  
Cost Saving ◽  
Economic Impact ◽  
Hematologic Malignancies ◽  
Initial Therapy ◽  
Immunocompromised Patients ◽  
Economic Significance ◽  
Initial Application ◽  
Neutropenic Patients ◽  
Paul Ehrlich

Abstract The aim of this study was to investigate the clinical and economic significance of aminoglycoside peak concentrations in febrile neutropenic patients with hematologic malignancies. Sixty-one patients were treated according to protocol II of the Paul-Ehrlich-Gesellschaft: initial application of gentamicin or tobramycin in combination with a cephalosporin or ureidopenicillin and, after 3 days, a potential change of antibiosis to be decided in case of nonresponse. At the same time, samples were collected by an independent controller. We found a significant dependence of clinical outcome on aminoglycoside peak concentrations (P = 0.004). Twelve of 17 patients with peak concentrations &gt;4.8 mg/L, but only 13 of 44 patients with concentrations ≤4.8 mg/L, responded to initial therapy. Average infection-related costs per patient with peak values &gt;4.8 mg/L were US$1429, $1790, and $1701 for nursing, diagnostics, and therapeutics, respectively (total $4920). Expenses for patients with peak concentrations ≤4.8 mg/L were ∼1.8-fold higher (average total $8718). If all 61 patients had achieved peaks &gt;4.8 mg/L, the potential savings would have totalled $167 112. We conclude that neutropenic patients form a target group for successful pharmacokinetic intervention and cost saving.

scholarly journals Isolated Anti-HBc: Significance and Management

2020 ◽  
Vol 9 (1) ◽  
pp. 202 ◽  
Author(s):  
Florian MORETTO ◽  
François-Xavier CATHERINE ◽  
Clémentine ESTEVE ◽  
Mathieu BLOT ◽  
Lionel PIROTH
Keyword(s):  
Host Factors ◽  
Hbv Reactivation ◽  
Immunocompromised Patients ◽  
Moderate Risk ◽  
Ongoing Debate ◽  
Hbv Vaccination ◽  
Persons Living With Hiv ◽  
B Virus ◽  
Living With Hiv ◽  
Current Guidelines

Hepatitis B virus (HBV) infection is prevalent worldwide and is associated with dramatic levels of morbidity and mortality. Isolated anti-HBc (IAHBc) is a particular serological pattern that is commonly found in immunocompromised patients. There is ongoing debate regarding the management of patients with IAHBc. Herein, we summarize the current guidelines and the newest evidence. The frequency of IAHBc is variable, with a higher prevalence in some populations, such as persons living with HIV and others immunocompromised patients. The risk of HBV reactivation depends on host factors (including immunosuppression) and viral factors. It is now well established that immunocompromised patients can be classified into three groups for risk according to the type of immunosuppression and/or treatment. In patients at high risk, HBV therapy has to be considered systematically. In patients at moderate risk, the decision is based on the level of HBV DNA (preemptive treatment or monitoring and vaccination). In patients with low risk, HBV vaccination is another possible approach, although further studies are needed to assess the type of preemptive strategy.

scholarly journals Brain Abscess and Esophageal Dilatation: Where is the Link? - Case Report

2020 ◽  
Vol 39 (02) ◽  
pp. 146-148
Author(s):  
Leonardo C. Welling ◽  
Fabricio Stewan Feltrin ◽  
Mariana S. Welling ◽  
João Afonso Caldeira Brino ◽  
Victor Feferbaum Zyto ◽  
...  
Keyword(s):  
Case Report ◽  
Esophageal Stricture ◽  
Throat Swab ◽  
Primary Treatment ◽  
High Rate ◽  
Esophageal Dilatation ◽  
Intravenous Antibiotic ◽  
Routine Testing ◽  
Current Guidelines ◽  
Neurosurgical Intervention

Abstract Introduction Caustic substance ingestion is a common cause of esophageal stricture in children. The primary treatment is esophageal dilatation. Although it is known that endoscopic esophageal dilatation is a procedure associated with a high rate of bacteremia, current guidelines do not recommend routine throat swab cultures or antibiotic prophylaxis for the general children population. Case Report We describe a case of a 7-year-old boy presenting with refractory headaches who was diagnosed with cranial abscess after multiple esophageal dilatations due to stenosis caused by caustic soda ingestion. The patient was subjected to neurosurgical intervention and intravenous antibiotic treatment for 6 weeks. Streptococcus viridans culture was positive in purulent abscess content. Conclusion We highlight this condition that, although rare, needs immediate diagnosis and proper treatment. We also recommend routine testing of throat swabs and antibiotics prophylaxis to children undergoing esophageal dilatation.

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