scholarly journals The Effects of Heterologous Immunization with Prime-Boost COVID-19 Vaccination against SARS-CoV-2

Vaccines ◽  
2021 ◽  
Vol 9 (10) ◽  
pp. 1163
Author(s):  
Tzu-Chuan Ho ◽  
Yi-Ming Arthur Chen ◽  
Hung-Pin Chan ◽  
Chin-Chuan Chang ◽  
Kuo-Pin Chuang ◽  
...  
Keyword(s):  
Systematic Review ◽  
Immune Responses ◽  
Herd Immunity ◽  
Vaccine Hesitancy ◽  
Search Term ◽  
Serious Adverse Events ◽  
Global Challenge ◽  
Race Ethnicity ◽  
Study Sites ◽  
Vaccine Shortage

Coronavirus Disease 2019 (COVID-19) pandemic, which is caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has become the global challenge. Reaching global herd immunity will help end the COVID-19 pandemic. However, vaccine shortage and vaccine hesitancy are the obstacles to achieve global herd immunity against SARS-CoV-2. The current homologous vaccine regimen is experimentally switching to heterologous vaccination at several study sites. However, the reactogenicity of heterologous ChAdOx1-S and mRNA vaccination against SARS-CoV-2 is still unclear. We have conducted a systematic review to summarize the current findings on the safety and immunogenicity of this heterologous vaccination and elucidate their implications against SARS-CoV-2. This systematic review was conducted by the guidelines of PRISMA. Articles were searched from PubMed and other sources (MedRixv and Google scholar) starting from 1 January to 5 September 2021. The search term was heterologous ChAdOx1-S and BNT162b2 or mRNA-1273 vaccination. Our review found that participants with ChAdOx1/BNT162b2, ChAdOx1-S/mRNA-1273 or BNT162b2/ChAdOx1-S did not have the serious adverse events seen with homologous vaccination. Participants with the heterologous regimen (ChAdOx1/BNT162b2, ChAdOx1-S/mRNA-1273 or BNT162b2/ChAdOx1-S), compared with those with two doses of ChAdOx1-S, have shown a more robust immune responses against SARS-CoV-2, such as higher levels of responsive antibodies or increased numbers of spike-specific T-cells. Nevertheless, these immune responses were slightly diminished in the recipients of BNT162b2/ChAdOx1-S. Also, the safety study of heterologous ChAdOx1-S/mRNA vaccination was based on small populations. Further studies to enclose diverse categories, such as race/ethnicity or geography, may be necessary. Overall, the heterologous immunization with ChAdOX1-S and the mRNA vaccine may improve the vaccine shortage related slow pace of reaching herd immunity, especially using the heterologous immunization with ChAdOx1-S/BNT162b2.

scholarly journals COVID 19 Vaccine Hesitancy: A Protocol for Systematic Review and Meta-Analysis

2021 ◽  
Author(s):  
Emmanuel Okechukwu Nna ◽  
Michael Abel Alao ◽  
Babatunde Ogunbosi ◽  
Uchenna Okeke ◽  
Canice Anyachukwu
Keyword(s):  
Systematic Review ◽  
Quality Assessment ◽  
Observational Studies ◽  
Meta Analysis ◽  
Herd Immunity ◽  
Risk Of Bias ◽  
Vaccine Uptake ◽  
Vaccine Hesitancy ◽  
Cochrane Library ◽  
Geographical Regions

Abstract Background The unprecedented development of COVID 19 vaccine within a few months and its introduction into the population brought a sigh of relief with the promise of preventing primary infections, halting spread, reducing hospitalization of infected people, and ultimately inducing herd immunity. However, public perception in many communities leaves a lot to worry about as the so much sort-after vaccine has been met with safety concerns, scepticism and hesitancy. We seek to produce a protocol for a reliable and accurate systematic review and meta-analysis on the hesitancy of COVID 19 vaccine uptake in the mist of a global pandemic.MethodsWe developed a search strategy using MeSH terms, text words and entry terms. Nine databases will be searched: PubMed, Embase, CINAHL, AJOL, Google Scholar, Web of Science, Cochrane Library, Research gate and Scopus. Only observational studies retrievable in the English Language will be included. The primary measurable outcome is the prevalence of COVID 19 vaccine hesitancy globally. The secondary outcomes are factors that influence COVID 19 vaccine hesitancy including race, age, gender, occupation, socioeconomic class, level of education, geographic location, misinformation, social media influence and vaccine safety. Identified studies will be screened, deduplicated, selected and data items extracted using DistillerSR software. All studies will be assessed for methodological, clinical and statistical heterogeneity. Assessment of risk of bias in the selected studies will be performed using the NIH Quality assessment tool for observational studies and the Cochrane tool of risk of bias. Publication bias will be assessed using the funnel plot as well as Egger’s regression intercept. The pooled prevalence, standard error and 95% CI will be reported. The strength of evidence from this analysis will be assessed by using NIH Quality Assessment for Systematic Reviews and Meta-analysis.DiscussionThe outcome of this analysis will give insight into the level of COVID 19 vaccine hesitancy and its correlates across geographical regions globally. It will examine if herd immunity via vaccination is attainable at the pooled rate of hesitancy. This will help Governments to redesign their public messages and sensitization. Systematic Review RegistrationThis protocol has been registered with PROSPERO, registration number CRD42021231165.

scholarly journals Healthcare workers’ (HCWs) attitudes and related factors towards COVID-19 vaccination: a rapid systematic review

2021 ◽  
pp. postgradmedj-2021-140195
Author(s):  
Mei Li ◽  
Yue Luo ◽  
Roger Watson ◽  
Yu Zheng ◽  
Jianlan Ren ◽  
...  
Keyword(s):  
Systematic Review ◽  
Perceived Risk ◽  
Policy Development ◽  
Healthcare Workers ◽  
Herd Immunity ◽  
Vaccine Hesitancy ◽  
Related Factors ◽  
Positive Attitudes ◽  
Tailored Communication ◽  
The Government

Herd immunity through vaccination is a key measure to control COVID-19 pandemic. However, vaccine hesitancy remains a public health threat, which is still common among healthcare workers (HCWs). This systematic review aimed to synthesise evidence on HCWs’ attitudes towards COVID-19 vaccination and analyse associated factors to provide information for vaccine policy development and practice. We searched PubMed, Embase, ScienceDirect, Web of Science and three Chinese databases for literature published on 12 February 2021. Two researchers screened the literature independently, and 13 studies were included in the systematic review. Vaccine acceptance varied widely and ranged from 27.7% to 77.3%. HCWs had positive attitudes towards future COVID-19 vaccines, while vaccine hesitancy was still common. Demographic variables such as men, older age and physicians were positive predictive factors. Women and nurses had more vaccine hesitancy. Previous influenza vaccination and self-perceived risk were facilitators. Concerns for safety, efficacy and effectiveness and distrust of the government were barriers. Influences of direct (COVID-19) patient care towards vaccination intention were less conclusive. Tailored communication strategies were needed to increase the uptake rate of COVID-19 vaccines among HCWs. More importantly, more data and information on the safety and efficacy of vaccines should be provided with transparency.

Attitudes and Opinions of Medical Students and Health Care Professionals about the Covid-19 Vaccine (A Quantitative Study from a Medical School and Its Affiliated Hospitals)

2021 ◽  
Vol 66 (Special Issue) ◽  
pp. 97-98
Author(s):  
Yesim Isil Ulman ◽  
◽  
Arshiya Abbaszadeh ◽  
Beril Ay ◽  
Diyar Dogrucam ◽  
...  
Keyword(s):  
Medical Students ◽  
Quantitative Study ◽  
Health Care Professionals ◽  
Cultural Context ◽  
Healthcare Professionals ◽  
Herd Immunity ◽  
Vaccine Hesitancy ◽  
Chi Square ◽  
Cross Sectional ◽  
Global Challenge

"Objectives: Vaccination is one of the most effective scientific inventions to prevent infectious diseases worldwide. Despite the evidence on the efficacy of vaccinations, vaccine refusal still poses a threat for human health. This study aims, firstly, to detect the underlying reasons of vaccine hesitancy concerning the COVID-19 among medical students and healthcare professionals; and, secondly, to compare the results between the two groups. Methods: This is an online, ongoing cross-sectional quantitative study based on a scale validated in the socio-cultural context in Turkey. The sample consists of students of medicine at six years of education including preparatory class at a foundation university in Istanbul, as well as the healthcare professionals at the affiliated hospitals of the same university. Data will mainly be collected through the Scale of Vaccine Hesitancy (1) annexed with demographic and open-ended questions detecting opinions about vaccination. T-test and chi-square tests will be used for the analysis of scale scores and demographic questions respectively. The open-ended questions will provide deeper findings on the issue. Discussion and Conclusion: While COVID-19 pandemic remains a global challenge, vaccine roll-out seems to be the best response to combat the disease. However, reluctance in acceptance of vaccines among diverse populations creates a risk for herd immunity. Comparatively investigating the motives of vaccine hesitancy among health-related populations may help proposing social, ethical guidance for medical education and health policies. Source: Kilincarslan, M. et al (2020). Development of Valid and Reliable Scale of Vaccine Hesitancy in Turkish Language. Konuralp Tıp Dergisi, 12(3), 420-429 . "

ADDRESSING THE ISSUE OF СOVID-19, SARS-COV-2 VIRUS AND THE DISEASE

2020 ◽  
Vol 99 (6) ◽  
pp. 15-31
Author(s):  
A.A. Korenkova ◽  
◽  
E.M. Mayorova ◽  
V.V. Bahmetjev ◽  
M.V. Tretyak ◽  
...  
Keyword(s):  
Public Health ◽  
Immune Responses ◽  
Molecular Mechanisms ◽  
Herd Immunity ◽  
Significant Problem ◽  
Prevention Measures ◽  
Optimal Therapy ◽  
The World ◽  
Public Health Challenge ◽  
Coronavirus Infection

The new coronavirus infection has posed a major public health challenge around the world, but new data on the disease raises more questions than answers. The lack of optimal therapy is a significant problem. The article examines the molecular mechanisms of SARS-CoV-2 infection and the pathogenesis of COVID-19, special attention is paid to features of pathological processes and immune responses in children. COVID-19 leads to a wide diversity of negative outcomes, many of which can persist for at least months. Many of the consequences have yet to be identified. SARS-CoV-2 may provoke autoimmune reactions. Reinfection, herd immunity, vaccines and other prevention measures are also discussed in this review.

scholarly journals Duloxetine versus ‘active’ placebo, placebo or no intervention for major depressive disorder; a protocol for a systematic review of randomised clinical trials with meta-analysis and trial sequential analysis

2021 ◽  
Vol 10 (1) ◽  
Author(s):  
Faiza Siddiqui ◽  
Marija Barbateskovic ◽  
Sophie Juul ◽  
Kiran Kumar Katakam ◽  
Klaus Munkholm ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Systematic Review ◽  
Sequential Analysis ◽  
Citation Index ◽  
Trial Sequential Analysis ◽  
Random Errors ◽  
Major Depressive ◽  
Serious Adverse Events ◽  
Meta Analyses

Abstract Background Major depression significantly impairs quality of life, increases the risk of suicide, and poses tremendous economic burden on individuals and societies. Duloxetine, a serotonin norepinephrine reuptake inhibitor, is a widely prescribed antidepressant. The effects of duloxetine have, however, not been sufficiently assessed in earlier systematic reviews and meta-analyses. Methods/design A systematic review will be performed including randomised clinical trials comparing duloxetine with ‘active’ placebo, placebo or no intervention for adults with major depressive disorder. Bias domains will be assessed, an eight-step procedure will be used to assess if the thresholds for clinical significance are crossed. We will conduct meta-analyses. Trial sequential analysis will be conducted to control random errors, and the certainty of the evidence will be assessed using GRADE. To identify relevant trials, we will search Cochrane Central Register of Controlled Trials, Medical Literature Analysis and Retrieval System Online, Excerpta Medica database, PsycINFO, Science Citation Index Expanded, Social Sciences Citation Index, Conference Proceedings Citation Index—Science and Conference Proceedings Citation Index—Social Science & Humanities. We will also search Chinese databases and Google Scholar. We will search all databases from their inception to the present. Two review authors will independently extract data and perform risk of bias assessment. Primary outcomes will be the difference in mean depression scores on Hamilton Depression Rating Scale between the intervention and control groups and serious adverse events. Secondary outcomes will be suicide, suicide-attempts, suicidal ideation, quality of life and non-serious adverse events. Discussion No former systematic review has systematically assessed the beneficial and harmful effects of duloxetine taking into account both the risks of random errors and the risks of systematic errors. Our review will help clinicians weigh the benefits of prescribing duloxetine against its adverse effects and make informed decisions. Systematic review registration PROSPERO 2016 CRD42016053931

scholarly journals Efficacy and safety of intravenous immunoglobulins for the treatment of viral encephalitis: a systematic literature review

2021 ◽  
Author(s):  
Judith N. Wagner ◽  
Annette Leibetseder ◽  
Anna Troescher ◽  
Juergen Panholzer ◽  
Tim J. von Oertzen
Keyword(s):  
Systematic Review ◽  
Viral Encephalitis ◽  
Viral Infections ◽  
Case Reports ◽  
Ivig Therapy ◽  
Intravenous Immunoglobulins ◽  
Efficacy And Safety ◽  
Serious Adverse Events ◽  
Optimal Dosing ◽  
Cochrane Database

Abstract Background For most viral encephalitides, therapy is merely supportive. Intravenous immunoglobulins (IVIG) have been used as a prophylactic and therapeutic approach. We conduct a systematic review on the safety and efficacy of IVIG in viral encephalitis. Methods We conducted a systematic review assessing PubMed, Cochrane Database, Biosis Previews and the ClinicalTrials.gov website to identify all reports on patients with viral encephalitis treated with IVIG as of May 31, 2019. The main outcomes assessed were therapeutic efficacy and safety. For an increased homogeneity of the population, atypical viral infections were excluded, as were reports on prophylactic IVIG use, intrathecal application of immunoglobulins, or use of antibody-enriched IVIG-preparations. Data were extracted from published studies. Descriptive statistics were used. Results We included a total of 44 studies (39 case reports). The case reports cover a total of 53 patients. Our search retrieved two prospective and three retrospective studies. These show heterogeneous results as to the efficacy of IVIG therapy. Only one study reports a significant association between IVIG-use and death (odds ratio 0.032; 95% confidence interval 0.0033–0.3024; p = 0.0027). None of the studies report significant differences in the number of serious adverse events. Conclusion Data on the efficacy of IVIG-therapy is heterogeneous. While it seems generally safe, evident superiority compared to supportive treatment has not been demonstrated so far. Future trials should also investigate the optimal dosing and timing of IVIG and their benefit in the immunosuppressed.

231 Breast Lymphedema After Breast Conservative Surgery; An Up-To-Date Systematic Review

2021 ◽  
Vol 108 (Supplement_2) ◽  
Author(s):  
M Abouelazayem ◽  
M Elkorety ◽  
S Monib
Keyword(s):  
Risk Factors ◽  
Systematic Review ◽  
Breast Surgery ◽  
Treatment Options ◽  
Conservative Surgery ◽  
Breast Size ◽  
Search Term ◽  
Common Complication ◽  
Breast Conservative Surgery ◽  
Conservative Breast Surgery

Abstract Background While arm lymphedema following breast cancer treatment is a common complication; breast lymphedema following treatment is not uncommon. Several risk factors were found to contribute to breast lymphedema, Aim: We aimed to provide a systematic review to help avoiding or management of breast lymphoedema Method The search term 'breast lymphedema' was combined with 'breast conservative surgery' and was used to conduct literature research in PubMed and Medline. The term lymphedema was combined with breast, conservative and surgery to search Embase database. All papers published in English were included with no exclusion date limits Results A total of 2155 female patients were included in this review; age ranged from 26 to 90. Mean BMI was 28.4, most of the studies included patients who underwent conservative breast surgery. Incidence of breast lymphedema ranged from 24.8% to 90.4%. Several risk factors were linked to breast lymphedema after conservative breast surgery, such as body mass index (BMI), breast size, tumour size, tumour site, type of surgery and adjuvant therapy. Treatment options focused on decongestive lymphatic therapy, including Manual lymphatic drainage (MLD), self-massaging, compression bras or Kinesio taping. Conclusions Breast lymphedema is a relatively common complication, yet there is no clear consensus on the definition or treatment options.

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