COVID-19 Vaccine Research Articles

Early Efficacy and Safety of the Third Dose Inactivated COVID-19 Vaccine Among People Living With HIV: Erratum

Early Efficacy and Safety of the Third Dose Inactivated COVID-19 Vaccine Among People Living With HIV: Erratum

Parental experience with childhood COVID-19 vaccines and factors associated with parental hesitancy despite being vaccinated: findings of a cross-sectional analysis from Pakistan and implications for the future

ObjectivesThis study examined parental experiences with COVID-19 vaccination and factors contributing to COVID-19 vaccine hesitancy (CVH) among them to help guide future policy initiatives.DesignCross-sectional study.SettingLahore, the second largest metropolis in...

Improving uptake of COVID-19 testing and vaccination in a homeless population: mixed-methods evaluation of community health worker-led education in a shelter

ObjectivesAccess to healthcare and accurate health information is a persistent issue for people experiencing homelessness (PEH), one heightened by the COVID-19 pandemic and exacerbated by issues of health literacy and...

Uptake of COVID-19 Vaccination and Related Factors Among People who Inject Drugs, San Francisco, 2022.

We assessed the uptake of COVID-19 vaccination in a community-recruited sample of people who inject drugs (PWID) in San Francisco in 2022. Overall, 72.4% (95% CI 64.6-80.3) were vaccinated for COVID-19. Independent predictors of vaccination were age 65 years and older (adjusted odds ratio [AOR] 9.7, 95% CI 2.2-28.7) and ever testing positive for COVID-19 (AOR 2.0, 95% CI 1.2-3.5). Homelessness was associated with lower COVID-19 vaccination (AOR 0.5, 95% CI 0.3-0.8). Our study underscores the urgent need for targeted interventions to address unique challenges faced by PWID in accessing COVID-19 vaccination, particularly for those experiencing homelessness and who are younger.

Clinical phenotype of COVID-19 vaccine-associated myocarditis in Victoria, 2021-22: a cross-sectional study.

To describe myocarditis as an adverse event after coronavirus disease 2019 (COVID-19) vaccination, including a detailed description of clinical phenotypes and diagnostic test results and differences by age, sex, and degree of troponin level elevation. Retrospective cross-sectional study. Cases of suspected myocarditis following the administration of a COVID-19 vaccine in Victoria during 22February 2021 - 30 September 2022 reported to Surveillance of Adverse Events Following Vaccination In the Community (SAEFVIC), with symptom onset within 14 days of vaccination, and deemed to be confirmed myocarditis according to the Brighton Collaboration Criteria. Demographic (sex, broad age group), vaccine, and clinical presentation characteristics; cardiac investigation results (troponin levels, electrocardiography, echocardiography, cardiac magnetic resonance imaging [cMRI]). Of 454 SAEFVIC reports of suspected COVID-19 vaccine-associated myocarditis, 206 were deemed confirmed cases. The median age of people with confirmed myocarditis was 21 years (interquartile range [IQR], 16-32 years; range, 10-76 years); 129 were aged 24 years or younger (63%), 155 were male (75%). The median time from vaccination to symptom onset was two days (IQR, 1-4 days); 201 cases (98%) followed the administration of mRNA vaccines; five cases followed vaccination with AZD122. Forty-six cases followed first vaccine doses (22%), 138 second doses (67%), and 22 cases third vaccine doses (11.0%). In 201 cases, people initially presented to emergency departments; 129 people were admitted to hospital (63%; median length of stay, two days; IQR, 1-3 days). Five people were admitted to intensive care. Echocardiographic abnormalities were identified in 26 of 200 patients (13%); electrocardiographic abnormalities were identified in 105 of 206 patients (51%; less frequently in female than male patients: adjusted odds ratio, 0.75; 95% confidence interval, 0.64-0.89). Troponin levels were elevated in 205 of 206 patients; the median increase was greater in male (95.3-fold; IQR, 5.8-273-fold) than female patients (9.9-fold; IQR, 4.7-50-fold). No cMRI abnormalities were found in patients for whom the troponin increase was threefold or less. The clinical severity of COVID-19 vaccine-associated myocarditis in Victoria was generally mild. Markers of a more severe phenotype were more frequently recorded for male patients and people aged 24 years or younger. A threefold troponin increase could be used as a threshold for risk stratification of people with COVID-19 vaccine-associated myocarditis, especially in hospitals with limited access to cMRI facilities.

Calculating Apparent pKa Values of Ionizable Lipids in Lipid Nanoparticles.

Creating new ionizable lipids for use in lipid nanoparticles (LNPs) is an active field of research. One of the critical properties for selecting suitable ionizable lipids is the apparent pKa value of the lipid as formulated in an LNP. We have developed a structure-based, computational methodology for the prediction of the apparent pKa value of ionizable lipids within LNPs and have tested it using the lipid formulations in the mRNA LNP COVID-19 vaccines COMIRNATY and Spikevax, and the siRNA LNP therapeutic Onpattro. The calculation was also applied to Lipid A, a variant of the ionizable lipid used in COMIRNATY.

Vaccination Coverage for Medically Indicated Vaccines in a Convenience Sample of Severely Immunocompromised Patients with COVID-19: An Observational Cohort Study

Background: In recent decades, the number of immunocompromised patients (ICPs) has increased significantly. ICPs have an impaired immune system, making them susceptible to complicated infections. To protect them from infections, ICPs are eligible to receive several medically indicated vaccines. To obtain insight into the uptake of these medically indicated vaccines, we determined the coverage of these vaccines in ICPs. Methods: This observational cohort study was conducted at the University Medical Centre Utrecht, the Netherlands, from September 2021 to April 2022. All adult ICPs admitted for COVID-19 were asked to complete a questionnaire on their vaccination history (pneumococcal, herpes zoster, human papillomavirus vaccination, influenza, and COVID-19 vaccines) and history of vaccine-preventable infections. In addition, patients’ vaccination history was reviewed in medical files. Results: A total of 115 patients completed the questionnaire and were included. Although all patients had an indication for pneumococcal vaccination, only 22 received it (19%). Coverage for herpes zoster was low (1%, 1/106 eligible patients). Coverage for human papillomavirus vaccination (HPV) was also low (40%, two out of five eligible patients). In contrast, 92% of patients received vaccination against SARS-CoV-2, and 77% of patients received seasonal influenza vaccination. Conclusions: Although coverage for influenza and COVID-19 vaccination was high in ICPs, coverage for other medically indicated vaccines was low. Identifying which factors contributed to high COVID-19 and influenza vaccine uptake can help to improve vaccination rates for the other recommended vaccines. Clear guidelines for clinicians and the removal of organizational obstacles are needed to improve vaccination coverage.

Pemphigus and Bullous Pemphigoid Following COVID-19 Vaccination: A Systematic Review

The COVID-19 pandemic has encouraged the rapid development and licensing of vaccines against SARS-CoV-2. Currently, numerous vaccines are available on a global scale and are based on different mechanisms of action, including mRNA technology, viral vectors, inactive viruses, and subunit particles. Mass vaccination conducted worldwide has highlighted the potential development of side effects, including ones with skin involvement. This review synthesizes data from 62 manuscripts, reporting a total of 142 cases of autoimmune blistering skin diseases (AIBDs) following COVID-19 vaccination, comprising 59 cases of pemphigus and 83 cases of bullous pemphigoid. Among the 83 bullous pemphigoid cases, 78 were BP, with additional cases including 2 oral mucous membrane pemphigoid, 1 pemphigoid gestationis, 1 anti-p200 BP, and 1 dyshidrosiform BP. The mean age of affected individuals was 72 ± 12.7 years, with an average symptom onset of 11 ± 10.8 days post-vaccination. Notably, 59% of cases followed vaccination with BNT162b2 (Pfizer-BioNTech), 51.8% were new diagnoses, and 45.8% occurred after the second dose. The purpose of our review is to analyze the cases of pemphigus and bullous pemphigoid associated with COVID-19 vaccination and to investigate the pathogenetic mechanisms underlying the new development or flare-up of these diseases in association with vaccination. Our results show that the association between COVID-19 vaccines and AIBDs is a possible event.

Informing Vaccine Messaging and Community Outreach: Experience in Chicago with a Community-Based Participatory Approach.

In response to disparities in COVID-19 vaccine uptake in urban environments, we ascertained whether a community-engaged evaluation could rapidly determine why unvaccinated Chicago residents were hesitant to receive the COVID-19 vaccine. The assessment used a mixed-methods approach, grounded in community-based participatory research (CBPR) principles. Interviews were conducted by community partners between April and May 2022 in Chicago, in-person and via phone. A purposive sample of Chicagoans (n = 456), who were: (1) adults (≥18years); (2) living in priority areas in Chicago heavily impacted by COVID-19; (3) who spoke English or Spanish; and (4) had not received the COVID-19 vaccine. A transdisciplinary academic-community team co-developed an assessment tool. Members of Chicago's Community Health Response Corps (CHRC) (N = 115) interviewed participants, using a 46-item survey in Qualtrics. Interviews were analyzed using qualitative and quantitative software, including Dedoose for coding and SAS for descriptive statistics. Over half of all respondents were not concerned about getting COVID-19. Respondents voiced concerns about side effects (36%), vaccine safety (27%), and trust in governmental institutions, given historical events involving unethical research. Participants also reported other social needs (e.g., food or housing insecurity) that made COVID-19 a lower priority. The collaborative research approach highlighted issues of trust, concerns about side effects and vaccine safety, issues that have informed vaccine messaging.

Predictors of vaccine uptake during a pandemic: The interplay of lifetime discrimination, educational attainment, and family support.

The experience of discrimination can have significant health implications, especially during a global pandemic. This study examines how lifetime discrimination, educational attainment (measured in years of education), and family support individually and interactively predict COVID-19 vaccine uptake. Low educational attainment may amplify the impact of discrimination due to increased vulnerability to misinformation. Conversely, family support can buffer the negative effects of discrimination on health behaviors by mitigating how stressors adversely influence health decisions. We utilized national data from the Midlife in the United States (N = 2004; aged 25-74). The results showed that although lifetime discrimination did not predict vaccine uptake, interaction analyses revealed that lifetime discrimination, in combination with higher educational attainment predicted lower vaccine uptake. In addition, family support moderated the relationship between lifetime discrimination and vaccine uptake, buffering its negative impact. These findings highlight the complex interplay of factors influencing COVID-19 vaccination decisions.

Enhancing COVID-19 Vaccine Efficacy: Dual Adjuvant Strategies with TLR7/8 Agonists and Glycolipids.

The controlled release of immunostimulatory agents represents a promising strategy to enhance vaccine efficacy while minimizing side effects. This study aimed to improve the efficacy of the RBD-Fc-based COVID-19 vaccine through combining of an iNKT cell agonist and a TLR7/8 agonist using covalent conjugation and temporal delivery. We hypothesized that these combinations would yield a more balanced Th1/Th2 immune response. For covalent conjugation, we employed an uncleavable linker and a self-immolative disulfide linker to conjugate α-galactosylceramide (αGC) to imidazoquinoline (IMDQ). The αGC-SS-IMDQ-Ac conjugate, designed with a prodrug strategy for controlled TLR7/8 agonist release, elicited a higher IFN-γ/IL-4 T cell response ratio than individual adjuvants or their admixture. In the temporal delivery approach, administering IMDQ followed by αGC after 2 h resulted in the highest IgG2a/IgG1 ratio, significantly surpassing other groups. A 6 h delay between glycolipid and IMDQ injections yielded balanced IgG responses, enhancing IgG, IgG1, and IgG2a levels synergistically.

Development of a prediction nomogram for IgG levels among asymptomatic or mild patients with COVID-19

ObjectiveCOVID-19 has evolved into a seasonal coronavirus disease, characterized by prolonged infection duration and repeated infections, significantly increasing the risk of patients developing long COVID. Our research focused on the immune responses in asymptomatic and mild cases, particularly the critical factors influencing serum immunoglobulin G (IgG) levels and their predictive value.MethodsWe conducted a retrospective analysis on data from 1939 asymptomatic or mildly symptomatic COVID-19 patients hospitalized between September 2022 and June 2023. Spearman methods were used to test the correlation between serum IgG and age, immunoglobulin M (IgM), procalcitonin (PCT), interleukin-6 (IL-6), nucleic acid conversion time, and BMI. Univariate and multivariate logistic regression analyses identified independent key factors influencing serum IgG levels, which were integrated and visualized in a nomogram. Finally, receiver operating characteristic (ROC) curves were plotted to predict the model’s diagnostic performance by calculating the AUC.ResultsMild patients showed higher levels of IgG, IgM, and longer nucleic acid conversion times than asymptomatic patients, and a lower proportion of them had received ≥ 3 COVID-19 vaccine doses. Serum IgG was positively correlated with serum IgM and negatively correlated with age, PCT, IL-6, and BMI. Notably, it showed a moderate negative correlation with nucleic acid conversion time (r = -0.578, P < 0.001). Logistic regression results showed that younger age, lower IL-6 levels, ≥ 3 doses of vaccine, and no comorbidities were independent predictors of serum IgG levels ≥ 21.08 g/L. We used age, IL-6 levels, vaccine doses, and comorbidities to create a nomogram for predicting serum IgG levels, with the area under the ROC curve reaching 0.772.ConclusionAge, IL-6 levels, vaccination status, and comorbidities were independent predictors of serum IgG levels in asymptomatic or mild COVID-19 patients, facilitating risk stratification and clinical decision-making. Notably, receiving ≥3 doses of the COVID-19 vaccine was the most beneficial factor for elevated serum IgG levels.

Tackling the Burden of Substandard and Falsified Medicines and Health Technologies in Somaliland and Somalia

Background: The problem posed by the substandard and falsified (SF) medicines is a rising global challenge. WHO estimates that sales of SF medical products in low- and middle-income countries is around US$ 30 billion whereby 1 in 10 medical is substandard or falsified. Objectives: The purpose of this article was to enlighten the actions by the Somali NRA to tackle the scourge of SF medicines in Somalia. Methods: The literature was reviewed on the topic and evidence from other sources were incorporated including reports of post-marketing surveillance surveys, assessments at national and regional levels, as well as author’s experiences. Findings: The medicines regulatory capacity is weak in Somaliland and Somalia, where only 16% of total indicators for the regulatory system was in place as per WHO/IGAD rapid benchmarking of the National Regulatory Authority (NRA) in 2017, increasing the risk of circulation of SF medicines in the local private sector dominated and exclusively import relied pharmaceutical supply chain. Key actions by the NRA to address this problem include: regulatory reliance mechanisms such as using the WHO PQ/EUL for emergency authorization of vaccines, i.e. COVID-19 vaccines, enhanced licensing procedures, information exchange with NRAs in the region as well as technical collaboration with WHO. Conclusion & Recommendation: However, a lot has to be done and considering the weak laboratory capacity and the porous national borders, the risk of local circulation of SF medicines is high and swift actions are needed to ensure access to safe and quality medicines and health technologies in Somaliland and Somalia.

Using framing and nudging to increase COVID-19 vaccine willingness: An experimental study

Many people are hesitant or unwilling to take advantage of potentially life-saving vaccines; this is true even in a global pandemic and even when vaccines are readily available and/or free. Apart from general unwillingness to be vaccinated, fear of side effects is a frequently named reason for vaccine hesitation. This survey-based study, carried out online in Austria in March of 2021, examines the efficacy of two different approaches – framing and nudging – in promoting a fictional COVID-19 vaccine program. While nudging had no visible effects, either positive or negative, framing was associated with more positive feelings toward the campaign and a greater intention to be vaccinated, though only among those already pre-disposed to get the vaccine. Governments and healthcare organizations are eager to find low-cost measures to increase vaccination rates for COVID-19 and other diseases. This study’s results suggest that addressing and positively framing the high likelihood of problem-free vaccinations should form an integral part of public messages, but that this approach may be ineffective among those who are strongly hesitant or unwilling. AcknowledgementSupported by funds from the province of Tyrol.

A Comprehensive Review of COVID-19 Transmission and Vaccine Development: Past, Present, and Future Prospects

Corona virusis a large group of viruses that cause respiratory and gastrointestinal illnesses. Originating in Wuhan, China, in December 2019, the 2019-novel Corona virus pandemic has spread around the globe and raised concerns. Due to the large number of individuals affected worldwide, the illness has rendered isolated areas uninhabitable, forcing residents to stay inside their homes in an effort to contain its spread. The 2019 corona virus, the severe acute respiratory syndrome corona virus, and the first human pandemic of the twenty-first century have identical human cellular receptors. Nevertheless, compared to the severe acute respiratory syndrome corona virus, the 2019-novel corona virus is more powerful, highly infectious, and changeable. The spike glycoprotein is the best place to create a 2019 corona virus vaccine. Where would be best to develop a vaccine against the 2019 novel Numerous mechanisms, including receptor binding, membrane fusion via conformational changes, viral internalization, host tissue tropism, and spike deactivation due to antibody-induced instability, depend on the spike glycoprotein known as corona virus. After the first breakout in December 2019, everyone in the world felt momentarily comforted when the death ratio began to decline around the end of 2020. People believed that the summer was one of the best seasons to combat illness and prevent its spread. However, in recent months, a global outcry over new 2019 Corona virus infection variations has garnered attention, putting people's lives, regardless of age or community, at risk. Scholars must concentrate on the findings and advancements. In addition, we have worked to increase awareness of the need for the creation of an international virtual community in order to enable smooth communication across all parts of the world and support mankind in the case of a category 5 coronavirus outbreak.

Understanding Risk Communication Through a Postcolonial Theory Perspective: Lessons from Three Studies on COVID-19 Vaccine Hesitancy

AbstractThis article uses postcolonial theory to examine optimal risk communication practices of new risks and scientific information to non-indigenous communities. The article calls on risk communication scholars and health practitioners to embrace postcolonial theory as it provides a critical and reflective framework to examine ontological beliefs and methodological and structural aspects in the communication of public health messages. The article draws on insight from three studies on COVID-19 vaccine hesitancy within Scotland’s African, Caribbean, and Black communities between March 2021 and April 2022. The article offers new insight into why some communities hesitate to respond to public health messages such as vaccine uptake advice. Therefore, risk communication scholars should use the postcolonial lens to examine their assumptions, thinking, and perspectives on communicating new science and risk information in emergencies. Postcolonial theory enables risk communication scholars to address power imbalances, representation, and inclusion challenges in public health communication and trust-building efforts.

Modeling the potential public health and economic impact of different COVID-19 vaccination strategies with an adapted vaccine in the Kingdom of Saudi Arabia

ABSTRACT Background The dynamic evolution of the virus causing COVID-19 necessitates the development of adapted vaccines to protect against emerging variants. Research design and methods A combined Markov-decision tree model estimated the outcomes of alternative vaccination strategies. The Saudi Arabian population was stratified into standard-risk and high-risk subpopulations, defined as either the population comprising individuals aged ≥65 years and individuals with at least one comorbidity. The model estimated the health and economic outcomes of vaccination based on age-specific inputs taken from published sources and national surveillance data. Results The vaccination strategy targeting the elderly and high-risk subpopulation (was estimated to prevent 156,694 cases 12,800 hospitalizations, and 2,919 deaths and result in cost savings of SAR 1,239 million in direct costs and SAR 4,145 million in indirect costs. These gains increased with the vaccination strategies additionally targeting other subpopulations. Compared to the base case (aged ≥65 and those at high-risk), expanding vaccination coverage to 75% of the standard-risk population prevented more cases (323%), hospitalizations (154%), and deaths (60%) and increased the direct (232%) and indirect (270%) cost savings. Conclusions The adoption of broad vaccination strategies using a vaccine adapted to the dominant variant in circulation would yield substantial benefits in Saudi Arabia.

Retraction notice: Investigating sustainable development for the COVID-19 vaccine supply chain: a structural equation modelling approach

Retraction notice: Investigating sustainable development for the COVID-19 vaccine supply chain: a structural equation modelling approach

Rethinking prosocial vaccination: Nuancing altruism, solidarity, and reciprocity appeals to encourage flu shot uptake

ABSTRACT Prosocial persuasion has emerged as a significant focus in health communication, particularly regarding the promotion of vaccination. Recent studies on COVID-19 vaccination suggest that emphasizing the well-being of social others encourages vaccination behaviors. However, few studies have considered the theoretical nuances among prosocial motives. Drawing upon literature on prosociality, we investigate how three nuanced prosocial appeals (altruism, solidarity, and reciprocity) exhibit different levels of persuasiveness in influenza vaccine uptake. We employ psychological reactance theory to explain the varying persuasiveness of these appeals. Results suggest that the three appeals did not outperform a conventional message emphasizing individual benefits. However, prosocial messages provoked differing levels of psychological reactance (threat to freedom), which were negatively associated with flu shot uptake intention. State empathy had a substantial direct effect on behavior adoption in prosocial persuasion, although mere prosocial requests did not increase empathy among readers. We discuss theoretical and practical implications.

Estimating Causal Effect of Two-Dose COVID-19 Vaccination on Hospitalization: A Propensity Score Matching Approach

Introduction: To estimate the effectiveness of two-dose COVID-19 vaccination in reducing hospitalization, accounting for complex confounding factors in observational studies. Methods: Researchers applied propensity score methods to adjust for confounding variables, comparing their performance to traditional covariate adjustment methods. Multiple Logistic Regression and Propensity Score Matching were employed to analyze the data, ensuring a balanced comparison between vaccinated and unvaccinated groups. Results: Both analytical methods demonstrated a significant reduction in the likelihood of hospitalization among vaccinated individuals. The adjusted odds ratios (OR) were 0.29 (95% CI: 0.26, 0.31) via logistic regression and 0.32 (95% CI: 0.30, 0.34) using propensity score matching. Conclusion: The study confirms the effectiveness of two-dose COVID-19 vaccination in decreasing hospitalization. It highlights the importance of using meticulous approaches like propensity score methods to assess real-world impacts in complex observational data settings