The number of COVID-19 clusters in healthcare and elderly care facilities averted by vaccination of healthcare workers in Japan, February–June 2021

<abstract> <p>In Japan, a prioritized COVID-19 vaccination program using Pfizer/BioNTech messenger RNA (mRNA) vaccine among healthcare workers commenced on February 17, 2021. As vaccination coverage increases, clusters in healthcare and elderly care facilities including hospitals and nursing homes are expected to be reduced. The present study aimed to explicitly estimate the protective effect of vaccination in reducing cluster incidence in those facilities. A mathematical model was formulated using three pieces of information: (1) the incidence of clusters in facilities from October 26, 2020 to June 27, 2021; (2) the incidence of confirmed COVID-19 cases during the same period; and (3) vaccine doses among healthcare workers from February 17 to June 27, 2021, extracted from the national Vaccination System database. We found that the estimated proportion at risk in healthcare and elderly care facilities declined substantially as the vaccination coverage among healthcare workers increased; the greater risk reduction was observed in healthcare facilities, at 0.10 (95% confidence interval (CI): 0.04–0.16) times that in the pre-vaccination period, while that in elderly care facilities was 0.34 (95% CI: 0.24–0.43) times that in the earlier period. The averted numbers of clusters in healthcare facilities and elderly care facilities were estimated to be 247 (95% CI: 210–301) and 279 (95% CI: 218–354), respectively. Prioritized vaccination among healthcare workers had a marked impact on preventing the incidence of clusters in facilities.</p> </abstract>

Teleworking—An Economic and Social Impact during COVID-19 Pandemic: A Data Mining Analysis

The health crisis generated by the COVID-19 pandemic has induced, among other things, an increase in the importance of remote work or teleworking (TL) in the current period. The objective of this research is to identify the economic and social impact of telework in changing the behavior of employees in Romania. The research was conducted approximately one year after the onset of the pandemic until the beginning of the vaccination period in Romania. The research proposed includes three main directions of analysis of the extracted data, which are related to telework efficiency, this being considered one of the most important indicators for a company. In order to obtain conclusive results, we used a mixed methodology, combining results obtained through a survey based on a self-administered electronic questionnaire, with a data mining analysis. Detailed analysis of the groups identified based on work efficiency allowed us to highlight the most common employee profiles. This analysis was doubled by a second classification experiment, which provided us a more detailed analysis of the groups identified based on job satisfaction and highlighted the most common employee profiles. The expansion of telework in various economic areas is a result of adaptation to the new economic and social conditions caused by the COVID-19 pandemic.

Improvements and limits of anti SARS-CoV-2 antibodies assays by WHO (NIBSC 20/136) standardization

Objectives A few CLIA automated immunoassays for the recognition of anti S1-RBD SARS-CoV-2 antibodies have recently been placed on the market. Preliminary data demonstrate a high correlation between methods but wide differences in absolute concentrations. A new WHO international standard for anti-SARS-CoV-2 immunoglobulin, NIBSC code 20/136, has been recently introduced to reduce the differences. The aim of this study is thus to verify the harmonization made by NIBSC 20/136 on Ab anti S1-RBD measurement on real samples. Methods The following assays were studied: LIAISON® SARS-CoV-2 TrimericS IgG (DiaSorin); Elecsys® anti-SARS-CoV-2 S (ROCHE); Atellica IM SARS-CoV-2 IgG (sCOVG) (Siemens); MAGLUMI® SARS-CoV-2 S-RBD IgG (Snibe), measuring 210 samples from 70 health workers with no previous SARS-CoV2 infection, during their Pfizer-BioNTech’s BNT162b2 vaccination period. Results The recalculation of concentrations based on the NIBSC 20/136 standardization improve the analytical and diagnostic comparability but do not cancel this variability between methods: recalibrated results remain different across methods, both in terms of tendency and single data. Conclusions The recalculation of concentrations based on the NIBSC 20/136 standardization improves the analytical and diagnostic comparability but does not cancel the differences between methods: recalibrated results remain different across methods, both in terms of tendency and single data.

Influenza virus vaccination in pediatric nephrotic syndrome significantly reduces rate of relapse and influenza virus infection as assessed in a nationwide survey

Although vaccination may precipitate relapses of nephrotic syndrome (NS) in children with idiopathic NS, no data are available regarding NS activity regarding influenza (flu) virus infections and NS relapses after receiving inactivated flu vaccines. We conducted a nationwide study of children aged 6 months to 15 years with idiopathic NS to assess the relationship between NS relapse, flu vaccination, and flu infections. We used a multivariate Poisson regression model (MPRM) to calculate the risk ratio (RR) for flu infection and for NS relapse in children with and without flu vaccination. Data of 306 children were assessed. The MPRM in all 306 children showed a significantly lower RR for flu infection (RR: 0.21, 95% confidence interval CI 0.11–0.38) and for NS relapse (RR: 0.22, 95% CI 0.14–0.35) in children receiving flu vaccination compared with unvaccinated children. In an additional MPRM only among 102 children receiving flu vaccination, they had a significantly lower risk for NS relapse during the post-vaccination period (RR: 0.31. 95% CI 017–0.56) compared with the pre-vaccination period. Although our study was observational, based on the favorable results of flu vaccinations regarding flu infections and NS relapse, the vaccine may be recommended for children with NS.

Effect of COVID-19 Vaccination on Seizures in Patients With Epilepsy: a Multicenter, Retrospective Study

Background: Previous study have shown that seizures may occur as a result of vaccination. This study aimed to evaluate the risk and correlative factors of seizures in patients with epilepsy (PWE) after being vaccinated with COVID-19 and to provide reference opinions for PWE to receive COVID-19 vaccine.Methods: We retrospectively enrolled PWE patients who were vaccinated against COVID-19 in the epilepsy centers of nine hospitals in China. The binary logistic regression analysis included variables with a P-value less than 0.1 in the univariate analysis.Results: The study included 290 patients, of which 40 (13.8%) developed seizures within 14 days after vaccination, whereas 250 (86.2%) remained seizure-free. The binary logistic regression analysis revealed statistical significance in seizures within three months before vaccination (P<0.001, OR=10.121, 95% CI: 4.301-23.816) and withdrawal or reduction of anti-seizures medications (ASM) during the peri-vaccination period (P=0.027, OR=4.452, 95% CI: 1.182-16.768). In addition, 32 of 33 patients (97.0%) who were seizure-free within three months before vaccination and had normal EEG results before vaccination did not have any seizures within 14 days following vaccination.Conclusions: SARS-CoV-2 may induce epilepsy through an inflammatory cascade. It is recommended to provide the COVID-19 vaccine to seizure-free patients for at least three months before vaccination, and the vaccination is safer if EEG result is normal. During peri-vaccination period, all PWE should be prohibited from reducing ASM dosage. PWE with well-controlled seizures who have discontinued ASM might consider resuming ASM during the peri-vaccination period if their EEG results are aberrant.

Immunogenicity of The BNT162b2 mRNA COVID-19 Vaccine in Patients With Primary Brain Tumors: A Prospective Cohort Study

Purpose Immunogenicity of Covid-19 vaccines may be negatively impacted by anti-cancer treatment. The management of primary brain tumor (PBT) patients routinely includes temozolomide and steroids, which are immune-suppressive. In this study, we aimed to determine the rate of seropositivity in PBT patients following receipt of two doses of the BNT162b2 vaccine. Methods We prospectively evaluated IgG antibody levels against SARS-CoV-2 spike protein in 17 PBT patients following two doses of the BNT162b2 mRNA vaccine. IgG levels were collected at two time points: T1 - after a median of 44 days from the second vaccine dose and T2 - after a median of 130 days from the second dose. Titers were compared against a group of healthy controls (HC) comprised of patients’ family members/caregivers. Results At T1, 88.2% (15/17) of PBT patients achieved seroconversion, compared with 100% (12/12) of HCs. Median IgG titer was significantly lower in the PBT group compared to the HC group (1,908 AU/mL vs 8,198 AU/mL, respectively; p=0.002). At T2, 80% (12/15) of PBT achieved seroconversion, compared to 100% (10/10) of the HCs. Median IgG titer remained significantly lower in the PBT group (410 vs 1687; p=0.002). All three PBT patients who failed to seroconvert at T2 had been treated with corticosteroids during vaccination. In a univariate analysis, steroid use was negatively associated with antibody titer. Conclusion Most PBT patients achieve seroconversion after receiving the BNT162b2 vaccine, but with lower IgG titer compared to HCs. Steroid use during the vaccination period is associated with lower titer.

IMPROVEMENT OF SPECIFIC CHOLERA PREVENTION USING IMMUNOMODULATORS

It is known that the combined use of vaccines, cytokines and various immunomodulatory drugs contributes to the development of a full-fledged immune response. This approach makes it possible to enhance the immunogenicity of modern vaccines and to direct the development of immune responses according to the humoral or cellular type, depending on the properties of the pathogen of a particular disease. The improvement of preventive drugs due to their combined use with cytokines and immunomodulators increases the intensity of immunity, increases the level of production of specific immunoglobulins, the protectivity of antigens, and also reduces the manifestation of adverse reactions leading to post-vaccination complications.Immunomodulators are already successfully used in drugs intended for the treatment and prevention of chronic herpes infections and influenza vaccines. Numerous experimental and clinical data indicate a positive effect of the use of immunomodulatory drugs in the vaccination of various viral and bacterial infections, including particularly dangerous ones.Improving the specific prevention of cholera can be achieved through immunomodulatory agents that can stimulate the formation of a local and systemic immune response.We conducted a comparative assessment of the feasibility of the combined use of the cholera bivalent chemical vaccine (the Federal Government Health Institution Antiplague Research Institute “Microbe”) and immunomodulators in order to increase the effectiveness of cholera vaccination.Since the cholera vaccine causes the activation of the humoral immune response, the production of specific immunoglobulins in the body of vaccinated experimental animals and the effect of immunomodulators on this process at different times of the post-vaccination period were evaluated.The ability of immunomodulators to increase the protective activity of the cholera vaccine was studied by infecting animals with a virulent strain of cholera one month and seven months after vaccination.It was found that immunomodulators increase the immunogenicity and protectivity of antigens that are part of the anti-cholera vaccine. The use of all immunopreparations increases the production of specific immunoglobulins in the serum of vaccinated experimental animals. It was shown that in the first month after vaccination, polyoxidonium most effectively stimulated the formation of antibodies, but lycopide contributed to a longer retention of anti-cholera immunoglobulins in the serum of vaccinated rabbits. The combined use of the vaccine and lycopide prevented the development of cholera in all animals taken in the experiment, including those vaccinated with a reduced dose. In the long-term post-vaccination period, this immunomodulator increased the protectiveness of the anti-cholera vaccine by three times. Polyoxidonium and derinate also increased the protective effect of the cholera vaccine, but were slightly inferior to lycopide. The combined use of cholera vaccine and immunomodulators, especially lycopide, can be used to improve specific cholera prevention.

Course and Lethality of SARS-CoV2 Epidemic in Nursing Homes after Vaccination in Florence, Italy

Evidence on the effectiveness of SARS-CoV2 vaccines in nursing home (NHs) residents is limited. We examined the impact of the BNT162b2 mRNA SARS-CoV2 vaccine on the course of the epidemic in NHs in the Florence Health District, Italy, before and after vaccination. Moreover, we assessed survival and hospitalization by vaccination status in SARS-CoV2-positive cases occurring during the post-vaccination period. We calculated the weekly infection rates during the pre-vaccination (1 October–26 December 2020) and post-vaccination period (27 December 2020–31 March 2021). Cox analysis was used to analyze survival by vaccination status. The study involved 3730 residents (mean age 84, 69% female). Weekly infection rates fluctuated during the pre-vaccination period (1.8%–6.5%) and dropped to zero during the post-vaccination period. Nine unvaccinated (UN), 56 partially vaccinated (PV) and 35 fully vaccinated (FV) residents tested SARS-CoV2+ during the post-vaccination period. FV showed significantly lower hospitalization and mortality rates than PV and UV (hospitalization: FV 3%, PV 14%, UV 33%; mortality: FV 6%, PV 18%, UV 56%). The death risk was 84% and 96% lower in PV (HR 0.157, 95%CI 0.049–0.491) and FV (HR 0.037, 95%CI 0.006–0.223) versus UV. SARS-CoV2 vaccination was followed by a marked decline in infection rates and was associated with lower morbidity and mortality among infected NH residents.