Distinct Vaccine Efficacy Rates Among Health Care Workers During a COVID-19 Outbreak in Jordan

BACKGROUND: We aimed to assess the efficacy of 3 COVID-19 vaccines in a population of health care workers at a tertiary cancer center in Amman, Jordan. METHODS: We evaluated the records of 2855 employees who were fully vaccinated with 1 of 3 different vaccines and those of 140 employees who were not vaccinated. We measured the number of SARS-CoV-2 infections that occurred at least 14 days after the second vaccine dose. RESULTS The 100-day cumulative incidence of PCR-confirmed SARS-CoV-2 infections was 19.3% +/- 3.3% for unvaccinated employees and 1.7% +/- 0.27% for fully vaccinated employees. The 100-day cumulative infection rates were 0.7% +/- 0.22% in BNT162b2 vaccine recipients (n = 1714), 3.6% +/- 0.77% in BBIBP-CorV recipients (n = 680), and 2.3% +/- 0.73% in ChAdOx1 recipients (n = 456). We used Cox regression analyses to compare the risks of SARS-CoV-2 infection among the different vaccine recipient groups and found a significantly higher infection risk in BBIBP-CorV (hazard ratio [HR] = 2.9 +/- 0.31) and ChAdOx1 recipients (HR = 3.0 +/- 0.41) compared to BNT162b2 recipients (P = .00039 and .0074, respectively). Vaccinated employees who had no previously confirmed SARS-CoV-2 infections were at a markedly higher risk for breakthrough infections than those who experienced prior infections (HR = 5.7 +/- 0.73, P = .0178). CONCLUSIONS: Our study offers a real-world example of differential vaccine efficacy among a high-risk population during a national outbreak. We also show the important synergism between a previous SARS-CoV-2 infection and vaccination.

The Chimeric Binjari-Zika Vaccine Provides Long-Term Protection against ZIKA Virus Challenge

We recently developed a chimeric flavivirus vaccine technology based on the novel insect-specific Binjari virus (BinJV) and used this to generate a chimeric ZIKV vaccine (BinJ/ZIKA-prME) that protected IFNAR-/- dams and fetuses from infection. Herein, we show that a single vaccination of IFNAR-/- mice with unadjuvanted BinJ/ZIKA-prME generated neutralizing antibody responses that were retained for 14 months. At 15 months post vaccination, mice were also completely protected against detectable viremia and substantial body weight loss after challenge with ZIKVPRVABC59. BinJ/ZIKA-prME vaccination thus provided long-term protective immunity without the need for adjuvant or replication of the vaccine in the vaccine recipient, both attractive features for a ZIKV vaccine.

Current COVID-19 vaccine epidemiology and dentistry

The coronavirus disease 2019 (COVID-19) vaccine story is continuously unfolding. Since our previous COVID-19 commentaries, much new information has transpired on the subject, and here we revisit this topic, which has practical implications for all stakeholders in dentistry, as well as the public. This article, on current vaccine epidemiology, provides an account of why vaccines fail in general, and the particular concerns in relation to the new Delta variant of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and related ‘variants of concern’. Issues related to vaccine failure are fundamentally dichotomous in nature, appertaining either to the vaccine strain (type) per se, and/or the numerous endogenous factors of the vaccine recipient/vaccinee. Societal factors such as vaccine hesitancy and its impact on herd immunity appear to overarch the long-term goal of total or partial global suppression of SARS-CoV-2, and its eventual endemicity. CPD/Clinical Relevance: To describe the reasons for the failure of currently administered COVID-19 vaccines, particularly in relation to the advent of the SARS-CoV-2 ‘variants of concern’, and discuss implications for clinical dental practice.

Adverse events following Sinopharm (Vero Cell), the inactivated COVID-19

Introduction: Various types of COVID 19 vaccine are being used globally to control the current pandemic. Post-licensure surveillance of vaccine is essential to ensure the safety. This study aimed to determine Adverse Events Following Immunization (AEFIs) of China Sinopharm (Vero cell), the inactivated COVID-19 vaccine. Method: This is a cross sectional observational study conducted at Patan hospital, Patan Academy of Health Sciences (PAHS) after the approval from IRC. Vaccine recipient between April 7 to April 13 and May 16 to May 25 were contacted through a phone call after 72 h of vaccination to record the AEFIs. Pattern and distribution of AEFIs were analyzed. Ethical approval was taken from PAHS IRC. Result: A total of 6142 individual got the first dose of the vaccine and out of them we were able to contact 4574 through phone calls. Of the 4574, only 941 were included for the follow up phone call after the second dose of the vaccine. A total of 1336 AEFIs were reported in 868(19%) first dose vaccine recipients while 147 AFEIs were reported in 105(11.2%) second dose vaccine recipients. The frequently reported AEFIs were pain at injection site, lethargy, headache, muscle ache and fever. All the AEFIs were mild to moderate in severity. Most of the AEFIs started within 24 h and resolved within 72 h. Conclusion: The Sinopharm (Vero cell) vaccine was found to have mild to moderate AEFIs in our study cohort and no case of severe AEFI was identified.

Comparative profiles of SARS-CoV-2 Spike-specific milk antibodies elicited by COVID-19 vaccines currently authorized in the USA

Three COVID-19 vaccines are licensed for emergency use in the USA: the Pfizer/BioNTech and Moderna/NIH mRNA-based vaccines, and the Johnson & Johnson (J&J)/Janssen human adenovirus (Ad26) vaccine. These vaccines have immunized ~160 million people nationwide, comprising ~53% Pfizer, 39% Moderna, and 8% J&J recipients [1]. Although at varying stages of clinical investigation for use in children, no COVID-19 vaccines are yet available for this population, posing a significant public health concern. One method to protect infants and young children may be passive immunization via antibodies (Abs) provided in the milk of a lactating vaccinated person. Our early work [2] and other recent reports [3-5] examining the milk Ab response to mRNA-based COVID-19 vaccination have demonstrated that unlike the post-SARS-CoV-2 infection milk Ab profile, which is rich in specific secretory (s)IgA, the vaccine response is highly IgG-dominant. In this report, we present a comparative assessment of the milk Ab response elicited by not only the Pfizer and Moderna vaccines, but importantly, the J&J vaccine as well. This analysis revealed that compared to mRNA vaccine recipients, 49% - 63% fewer J&J vaccine recipient milk samples were positive for Spike-specific IgG, with positive samples exhibiting significantly lower mean IgG titers. J&J recipient milk samples contained significantly less specific IgA than Moderna recipient milk samples, which exhibited significantly greater relative IgA increases compared to both Pfizer and J&J recipients. Absolute and relative vaccine-induced secretory Ab titers were similarly low for all groups, though ~25% more Moderna recipients exhibited a relative increase compared to Pfizer and J&J recipients. These data indicate that J&J vaccine poorly elicits Spike-specific Ab in milk compared to mRNA-based vaccines and that this vaccine should be considered a last choice for immunizing those intending to elicit a strong Ab response in their milk. These data also suggest that Moderna vaccine elicits a superior, albeit moderate, milk (s)IgA response, and highlight the need to design vaccines with optimal protection of the breastfeeding infant in mind.

Assessment of adverse event following immunization and its co-relates among COVID-19 vaccine recipient in Bundelkhand region of Uttar Pradesh: A cross-sectional study

Background: The COVID-19 pandemic is a global emergency. AEFIs reporting and assessment should be done with high priority as they could change the benefit-risk profile of the vaccine. Objective: To assess adverse effects after COVID-19 vaccination. Methods: This cross-sectional study conducted among 605 heath functionaries taken part from January 2021 to March 2021. Results: The most common AEFI reported was pain at injection site (51.9%). Gender, previous COVID status and perception before vaccination were significantly associated with AEFI. Conclusion: There was no serious adverse event after vaccination. COVID vaccine has a good safety profile.

Allergy to Polyethilenglicole of Anti-SARS CoV2 Vaccine Recipient: A Case Report of Young Adult Recipient and the Management of Future Exposure to SARS-CoV2

The main contraindication to the anti-SARS CoV2 vaccine is an anaphylactic reaction to a vaccine component. The need to vaccinate allergic people who are at higher risk can be of public health interest and this report shows a case of an allergic reaction to PEG of a HCW who had received the first dose of anti-SARS CoV2 vaccine. For 5 h after the administration of the vaccine, she had the appearance of erythematous spots on the face and neck, and a feeling of a slurred mouth and hoarseness. In order to treat the event, she was administered 8 mg intravenous dexamethasone, 1 vial intravenous chlorphenamine maleate, 250 mL intravenous 0.9% NaCl, and conventional oxygen therapy (2 L/min) with complete resolution of the suspected adverse drug reaction. According to the contraindication to the cutaneous test for this patient, BAT was used for further investigations. The patient who suffered the adverse reaction to the COVID-19 vaccine and other five allergic patients who did not report any adverse reaction after the vaccination were tested. There was a significant activation of the vaccine-reactive patient’s basophils with 14.79 CD203chigh% at the concentration of 0.2 mg/mL, while other patients were negative. People who have a confirmed reaction to a vaccine component should undergo further investigation to discover other possible cross-reactions and select the right vaccine to immunize them.

Self-Reported Real-World Safety and Reactogenicity of COVID-19 Vaccines: A Vaccine Recipient Survey

An online survey was conducted to compare the safety, tolerability and reactogenicity of available COVID-19 vaccines in different recipient groups. This survey was launched in February 2021 and ran for 11 days. Recipients of a first COVID-19 vaccine dose ≥ 7 days prior to survey completion were eligible. The incidence and severity of vaccination side effects were assessed. The survey was completed by 2002 respondents of whom 26.6% had a prior COVID-19 infection. A prior COVID-19 infection was associated with an increased risk of any side effect (risk ratio 1.08, 95% confidence intervals (1.05–1.11)), fever (2.24 (1.86–2.70)), breathlessness (2.05 (1.28–3.29)), flu-like illness (1.78 (1.51–2.10)), fatigue (1.34 (1.20–1.49)) and local reactions (1.10 (1.06–1.15)). It was also associated with an increased risk of severe side effects leading to hospital care (1.56 (1.14–2.12)). While mRNA vaccines were associated with a higher incidence of any side effect (1.06 (1.01–1.11)) compared with viral vector-based vaccines, these were generally milder (p < 0.001), mostly local reactions. Importantly, mRNA vaccine recipients reported a considerably lower incidence of systemic reactions (RR < 0.6) including anaphylaxis, swelling, flu-like illness, breathlessness and fatigue and of side effects requiring hospital care (0.42 (0.31–0.58)). Our study confirms the findings of recent randomised controlled trials (RCTs) demonstrating that COVID-19 vaccines are generally safe with limited severe side effects. For the first time, our study links prior COVID-19 illness with an increased incidence of vaccination side effects and demonstrates that mRNA vaccines cause milder, less frequent systemic side effects but more local reactions.

Survey of symptoms following COVID-19 vaccination in India

BackgroundCOVID-19 vaccines have been rolled out recently in several parts of the world. Although the protective efficacy is frequently discussed, little is known about the real-world post-vaccination experience outside of clinical trial conditions. Knowledge about what to expect after vaccination will help educate the public, dispel misinformation and reduce vaccine hesitancy.AimTo assess the immediate response to the first dose of COVID-19 vaccine.To study the spectrum of post-vaccination symptom profile for individual vaccines.MethodsA cross-sectional online survey was done which included questions pertaining to the immediate post vaccination experience in India.ResultsA total of 5396 people responded to the survey over a one-week period from 29 January to 4 February. Overall, 65.9 % of respondents reported at least one post-vaccination symptom. Tiredness (45%), myalgia (44%), fever (34%), headache (28%), local pain at injection site (27%), joint pain (12%), nausea (8%) and diarrhea (3%) were the most prevalent symptoms. The chance of having symptoms decreased with advancing age. The frequency of symptoms was 81% (3rd decade or 20-29 years), 80% (4th decade or 30-39 years), 68% (5th decade), 58% (6th decade), 45% (7th decade), 34% (8th decade) and 7% (9th decade, 80-90 years). Post-vaccination symptoms were more likely to be reported by women (74.7%) compared to men (58.6%) (p < 0.001). Among those who reported symptoms, 79% noticed them within the first 12 hours. 472 out of 5396 (8.7%) reported past history of COVID-19. Their symptom profile was not different to those who did not have a past history.ConclusionsTwo-thirds of healthcare professionals who completed the survey reported mild and short-lived post-vaccination symptoms. Tiredness, myalgia and fever were most commonly reported. These symptoms were consistent with an immune response commonly associated with vaccines, and correlated with the findings from previously published phase 2/3 trials. In 90% cases, the symptoms were either milder than expected or meeting the expectation of the vaccine recipient. No serious events were reported. Symptoms were more common among younger individuals. There was no difference in symptoms among those who had a past history of COVID-19.