Prevent Coronavirus Disease Research Articles

Long-term safety and effectiveness of mRNA-1273 vaccine in adults: COVE trial open-label and booster phases

Primary vaccination with mRNA-1273 (100-µg) was safe and efficacious at preventing coronavirus disease 2019 (COVID-19) in the previously reported, blinded Part A of the phase 3 Coronavirus Efficacy (COVE; NCT04470427) trial in adults (≥18 years) across 99 U.S. sites. The open-label (Parts B and C) primary objectives were evaluation of long-term safety and effectiveness of primary vaccination plus a 50-µg booster dose; immunogenicity was a secondary objective. Of 29,035 open-label participants, 19,609 received boosters (mRNA-1273 [n = 9647]; placebo-mRNA-1273 [n = 9952]; placebo [n = 10] groups). Booster safety was consistent with that reported for primary vaccination. Incidences of COVID-19 and severe COVID-19 were higher during the Omicron BA.1 than Delta variant waves and boosting versus non-boosting was associated with a significant, 47.0% (95% CI : 39.0-53.9%) reduction of Omicron BA.1 incidence (24.6 [23.4 − 25.8] vs 46.4 [40.6 − 52.7]/1000 person-months). In an exploratory Cox regression model adjusted for time-varying covariates, a longer median interval between primary vaccination and boosting (mRNA-1273 [13 months] vs placebo-mRNA-1273 [8 months]) was associated with significantly lower, COVID-19 risk (24.0% [16.0% − 32.0%]) during Omicron BA.1 predominance. Boosting elicited greater immune responses against SARS-CoV-2 than primary vaccination, irrespective of prior SARS-CoV-2 infection. Primary vaccination and boosting with mRNA-1273 demonstrated acceptable safety, effectiveness and immunogenicity against COVID-19, including emergent variants.

Clinical characteristics and risk factors for ZF2001 fully vaccinated inpatients with COVID-19: A retrospective cohort study

ABSTRACT The ZF2001 vaccine has demonstrated high efficacy in preventing coronavirus disease 2019 (COVID-19). However, the clinical characteristics of breakthrough infections in vaccinated individuals and the risk factors for adverse outcomes in COVID-19 patients remain unclear. We conducted a retrospective single-center cohort study at Xiangya Hospital of Central South University, including 210 fully vaccinated COVID-19 inpatients from December 5, 2022, to January 31, 2023. Data on clinical characteristics, laboratory findings, disease severity, treatment, and prognosis were collected and analyzed. Our findings revealed that COVID-19 inpatients still experienced common symptoms at the onset of illness, but most laboratory findings were within the normal range, except for white blood cell count (WBC), lymphocyte count, and lactate dehydrogenase (LDH) levels. Following standard treatment, 95.7% of patients were discharged from the hospital. We identified seven variables significantly associated with a higher risk of adverse outcomes, including age over 65, elevated WBC count, reduced lymphocyte count, higher levels of blood urea nitrogen (BUN), LDH, troponin, D-dimer, and procalcitonin. This study supports the substantial clinical benefits of the ZF2001 vaccine for COVID-19 patients. Additionally, age over 65, elevated WBC count, reduced lymphocyte count, and higher blood levels of BUN, LDH, D-dimer, and procalcitonin may be used as predictive factors for disease progression in fully vaccinated COVID-19 inpatients.

Perindopril decreases angiotensin-converting enzyme 2 (ACE2) expression in human adipocytes exposed to SARS-CoV-2 S1 spike protein.

The expression of angiotensin-converting enzyme 2 (ACE2) in the adipose tissues of obese patients needs further study, as it may aid infection and serve as a viral reservoir. There has been controversy over whether to use ACE inhibitors to prevent coronavirus disease 2019 (COVID-19) severity. Perindopril, an ACE2 inhibitor, has been proposed; however, its relationship with COVID-19 has not yet been clear. The aim of this study was to investigate the effect of perindopril to reduce the expression of ACE2 and pro-inflammatory cytokine in adipocytes exposed to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Enzymatic isolation of adipose tissues was performed from obese male donor patients aged 30-50 years, then exposed it with SARS-CoV-2 S1 spike protein. This study also included human recombinant ACE2 (hrsACE2) as a comparison to perindopril. The expression of ACE2 was evaluated using ELISA. Our data indicated that SARS-CoV-2 Spike protein exposure increased ACE2 expression significantly. Administration of perindopril decreased ACE2 expression (43.37 μg/mL) significantly compared to the positive group (80.31 μg/mL) (p<0.001). Perindopril administration also decreased IL-6 levels significantly compared to positive group (p<0.001). This study highlights that perindopril could reduce the ACE2 expression and pro-inflammatory cytokine levels in adipocytes exposed to SARS-CoV-2 S1 spike protein.

The Utility and Limitations of Universal Polymerase Chain Reaction Screening for SARS-CoV-2 During Hospital Admission.

Universal polymerase chain reaction (PCR) screening for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on hospital admission is an effective approach to preventing coronavirus disease 2019 (COVID-19) outbreaks in medical facilities. However, false-positive test results due to a recent infection are a concern. We investigated the usefulness and limitations of universal PCR screening for SARS-CoV-2 on hospital admission in a real-world setting. We retrospectively analyzed 1320 attempted hospital admissions for 775 patients at the Department of Respiratory Medicine, Kyushu University Hospital, between January 1, 2022, and May 2, 2023. Thirty-nine out of 1201 PCR tests (3.2%) yielded a positive result, with 22 of these results being considered false positives on the basis of a recent infection. We found that 39% of cases showed a positive PCR result between 31 and 60 days after the onset of COVID-19, although the threshold cycle (Ct) for target 1 (ORF1ab gene) of the Cobas SARS-CoV-2 test (Roche Diagnostics, Basel, Switzerland) was >30 in most instances. Hospital admission based on the results of PCR screening for SARS-CoV-2 should take into account not only PCR positivity but also the Ct value and recent COVID-19 history.

Relationship between oral health literacy and changes in self-assessment of oral health during COVID-19

Background/purposeHealth literacy is thought to play a major role in implementing health behaviors, such as preventing coronavirus disease 2019 (COVID-19). In this study, we aimed to examine the relationship between oral health literacy (OHL), dietary literacy (DL), and changes in oral health and eating habits during the COVID-19 pandemic. Materials and methodsThe self-assessment questionnaire, including questions on oral and dietary conditions for each period of the COVID-19 pandemic, sources of information, OHL, DL, and frequency of COVID-19 prevention measures, was administered using a web research company. All participants were divided into low- and high-literacy groups based on the median scores: those who scored above the median in the high group and those who scored at or below the median in the low group. Comparisons were conducted between the two groups. ResultsThe median OHL and DL scores were 16 and 17 for the 344 participants included in the study (168 males and 176 females); 160 (46.5%) participants had high OHL scores, and 157 (45.6%) had high DL scores. The group with high OHL or DL tended to collect information sent by medical professionals compared to the group with low OHL or DL, had significantly higher scores on self-assessment of oral and dietary conditions, and tended to implement infection control actions more frequently in eating situations. ConclusionThe high OHL and DL groups gathered information from professionals to have attain oral and dietary conditions regardless of COVID-19 and tended to implement infection prevention measures in oral health and diet.

Mycobacterium welchii Vaccine Granuloma – A Cautionary Tale

Background: Mycobacterium welchii (Mycobacterium w) vaccine was one of the many strategies used to both treat and prevent coronavirus disease 2019 (COVID-19) infection. We report the results of a retrospective analysis of 15 cases with vaccine-site granulomas after administration of prophylactic Mycobacterium w vaccine as part of a trial for COVID-19 and our experience in managing those cases. Methods: This was a retrospective analysis of 15 patients with vaccine-site granulomas who were given the vaccine as a prophylactic measure as part of a trial with informed consent. Results: The mean average age of cases was 37 and the male-to-female ratio was 1:0.87. All of the patients developed erythematous tender nodules over the injection sites within a month of receiving the inoculations. Mycobacterial cultures and cartridge-based nucleic acid amplification tests yielded negative results. Skin biopsy revealed granulomatous dermatitis with acid-fast bacilli positivity. A diagnosis of noninfective granulomatous dermatitis was made. Treatment started with analgesics and anti-inflammatory agents. Systemic antibiotics were required in 9/15 patients. Patients are being followed up with no reported recurrence till date. Conclusion: The possibility of injection-site granuloma should be taken into the risk–benefit analysis for the administration of Mycobacterium w vaccine and the patients should be counseled as such. Patients with persistent ulceration respond to combinations of doxycycline, ofloxacin, and clarithromycin.

Behavior to Prevent Coronavirus Disease 2019 (COVID-19) among the Elderly with Non-Communicable Disease in Rural Northeastern Thailand

Objective: This study aimed to investigate the preventive behaviors against coronavirus disease 2019 (COVID-19) and to identify factors influencing these behaviors. Material and Methods: We conducted a cross-sectional study from September 2021 to January 2022 during the COVID-19 outbreak. The study population comprised 320 early-onset elderly individuals with non-communicable diseases residing in rural northeastern Thailand. A simple random sampling technique was utilized to select participants. Data collection was facilitated through a self-administered questionnaire. Results: The analysis indicated that 69.1% of participants were female, with a mean age of 63.7 years. Diabetes mellitus represented 43.1% of the underlying conditions. A significant majority (54.4%) exhibited a high level of preventive behavior against COVID-19. Notably, 76.3% of the participants consistently engaged in hand hygiene with alcohol gel in public settings. Age and educational background were significant personal factors correlated with preventive behaviors (p-value&lt;0.05). Participants with very high preventive behaviors were predominantly in the 60-65 age bracket (62.3% vs. 37.7%, p-value=0.027) and had completed late elementary education (46.0% vs. 30.1%, p-value=0.018). Conclusion: Elderly individuals with underlying diseases in rural areas of northeastern Thailand displayed commendable preventive behaviors against COVID-19. These findings suggest a heightened awareness and proactive engagement in mitigating the transmission of this infectious disease.

Dealing with the coronavirus disease through a social knowledge management approach: The case of Iranian coronavirus patients in Tehran

Managing social crises requires collective wisdom and social knowledge. Social Knowledge Management (SKM) plays a key role in dealing with social crises such as the coronavirus disease. This research aims to describe the practices of SKM from the perspective of recovered coronavirus patients in Tehran, Iran, in response to the coronavirus disease, through semi-structured interviews. The findings revealed that various elements (such as social capital, networks, media, learning, benefits, and social systems), factors (including knowledge providers and recipients, social actors, knowledge capital, and skill capital), processes (such as acquisition, application, sharing, transferring, creation, storage, and knowledge organization), and roles of SKM (internalization, socialization, externalization, and the combination of social knowledge) are effective in preventing the spread of coronavirus disease on a large scale. This research concludes that the utilization of SKM by health policymakers effectively prevents social crises and can help increase public awareness and utilization of the elements, factors, processes, and roles of social knowledge in health to prevent coronavirus disease.

Macular perfusion changes in people administered two types of COVID-19 vaccines: optical coherence tomography angiography study.

To evaluate macular chorioretinal flow changes on optical coherence tomography angiography, in participants who received inactivated and messenger RNA (mRNA) vaccines to prevent Coronavirus disease 2019 (COVID-19). In this prospective cohort study, healthy participants who received two doses of an inactivated COVID-19 vaccine (CoronaVac) and then one dose of an mRNA vaccine (BNT162b2) were examined before and after each vaccination. Ophthalmologic examination and imaging with optical coherence tomography angiography were performed during each visit. We evaluated vascular densities in the superficial and deep capillary plexuses in foveal, parafoveal, and perifoveal areas; the foveal avascular zone; and choriocapillaris flows (in 1- and 6-mm-diameter areas). One eye in each of the 24 participants was assessed. Superficial capillary plexus vascular densities in the parafoveal area were significantly lower after the second dose of the CoronaVac vaccine than after the first dose. In the deep capillary plexus, vascular attenuation was observed only in the parafoveal region after the first CoronaVac dose. However, in all regions, the deep capillary plexus vascular densities and subfoveal choriocapillaris flow were significantly decreased after the second CoronaVac dose. After the BNT162b2 dose, the superficial capillary plexus vascular densities, the deep capillary plexus vascular densities, and subfoveal choriocapillaris flow of most regions were significantly lower than those before vaccinations. Vascular attenuation, observed particularly after the second dose of the CoronaVac vaccine, may explain the pathogenesis of postvaccine ocular ischemic disorders reported in the literature. However, these disorders are extremely rare, and the incidence of thrombotic events caused by COVID-19 itself is higher.

Negative impact of immunoparesis in response to anti-SARS-CoV-2 mRNA vaccination of patients with multiple myeloma.

Multiple myeloma reduces cellular and humoral immunity. Optimal prediction of antibody response to anti-severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccine in patients with MM and related disorders is essential to prevent coronavirus disease 2019 (COVID-19) during the SARS-CoV-2 pandemic. This study analyzed the humoral response to the anti-SARS-CoV-2 messenger ribonucleic acid (mRNA) vaccine and its associated factor in 83 patients from June to November 2021 at seven member institutions of the Kyoto Clinical Hematology Study Group. SARS-CoV-2 neutralizing antibody (nAb) was measured from 12 to 210days. The result revealed that 40 (48.2%) patients with MM and 59 (100%) healthy controls became seropositive after vaccination. Receiver operating characteristic curve analysis identified serum immunoglobulin (Ig) M of > 18mg/dL at vaccination as the optimal threshold level associated with seropositivity in the whole cohort. Moreover, the multivariate analysis identified serum IgM of > 18mg/dL as the independent predictor for a favorable response. Serum IgA level was positively associated with vaccine response in a sub-cohort. Our findings indicate a significant association between immunoparesis and impaired humoral response against mRNA vaccination, including that against SARS-CoV-2, and that serum non-M-protein Ig levels can serve as surrogate biomarkers of nAb production ability.

Effectiveness of Sotrovimab in Preventing COVID-19-Related Hospitalizations or Deaths Among US Veterans During Omicron BA.1.

The real-world clinical effectiveness of sotrovimab in preventing coronavirus disease 2019 (COVID-19)-related hospitalization or mortality among high-risk patients diagnosed with COVID-19, particularly after the emergence of the Omicron variant, needs further research. Using data from the US Department of Veterans Affairs (VA) health care system, we adopted a target trial emulation design in our study. Veterans aged ≥18 years, diagnosed with COVID-19 between December 1, 2021, and April 4, 2022, were included. Patients treated with sotrovimab (n = 2816) as part of routine clinical care were compared with all eligible but untreated patients (n = 11,250). Cox proportional hazards modeling estimated the hazard ratios (HRs) and 95% CIs for the association between receipt of sotrovimab and outcomes. Most (90%) sotrovimab recipients were ≥50 years old, and 64% had ≥2 mRNA vaccine doses or ≥1 dose of Ad26.COV2. During the period that BA.1 was dominant, compared with patients not treated, sotrovimab-treated patients had a 70% lower risk of hospitalization or mortality within 30 days (HR, 0.30; 95% CI, 0.23-0.40). During BA.2 dominance, sotrovimab-treated patients had a 71% (HR, 0.29; 95% CI, 0.08-0.98) lower risk of 30-day COVID-19-related hospitalization, emergency room visits, or urgent care visits (defined as severe COVID-19) compared with patients not treated. Using national real-world data from high-risk and predominantly vaccinated veterans, administration of sotrovimab, compared with contemporary standard treatment regimens, was associated with reduced risk of 30-day COVID-19-related hospitalization or all-cause mortality during the Omicron BA.1 period.

Clinicopathological characteristics of cutaneous complications following COVID-19 vaccination: A case series.

Several vaccine-related cutaneous adverse events occurred following the widespread use of vaccines to prevent coronavirus disease 2019 (COVID-19). This case series reports 25 patients with de novo or accentuated dermatologic conditions after receiving the Sinopharm, Sputnik V, AstraZeneca, or BIV1-CovIran vaccine in Iran. Twenty-five eligible patients with a mean age of 46.80 years were investigated. The cutaneous adverse events included pityriasis rosea, zoster, viral exanthema, urticaria, bullous pemphigoid, pemphigus vulgaris, and acute generalized exanthematous pustulosis. The manifestations appeared 14.45 ± 6.98 and 20.79 ± 22.18 days following injection of the first and second doses of COVID-19 vaccines, respectively. All patients experienced new cases of cutaneous disease other than two who developed flare-ups of lichen planus and psoriasis. Several cutaneous reactions, ranging from allergic events to skin diseases, have been reported following the injection of COVID-19 vaccines. Focal injection-site reactions are the most common cutaneous adverse events; however, de-novo skin diseases and a flare-up of preexisting cutaneous disorders have also been described. Although many cases of COVID-19 vaccine-related cutaneous diseases have been published, our zoster/lichen planus and AGEP cases after vaccination are interesting. A more detailed understanding of cutaneous adverse events following COVID-19 vaccination will facilitate better diagnosis and management.

Co-infection dynamics of COVID-19 and HIV/AIDS

Although there are many results that can be used to treat and prevent Coronavirus Disease 2019 (COVID-19) and Human Immunodeficiency Virus (HIV), these diseases continue to be public health concerns and cause socioeconomic consequences. Following compromised immunity, COVID-19 is considered to be a challenge for people with HIV. People with advanced HIV are considered a vulnerable population at high risk in several case studies that discuss COVID-19 and HIV co-infection. As there is no cure for HIV and there is a chance of contracting COVID-19 again, co-infection continues to pose a problem. The purpose of this study is to investigate the impact of intervention strategies and identify the role of different parameters in risking people living with HIV to death when they get infected with COVID-19. This is achieved through the development and rigorous analysis of a mathematical model that considers a population at risk of death due to COVID-19 and HIV. The model formulation provides a detailed explanation of the transmission dynamics of COVID-19 and HIV co-infection. The solution’s invariant region, positivity, and boundedness were established. The reproduction numbers of the sub-models and the co-infection model were determined. The existence and stability of equilibria, including backward bifurcation for the COVID-19 sub-model, were examined. The epidemiological significance of backward bifurcation is that the condition {mathscr {R}}_0 less than 1 for eliminating COVID-19, though necessary, is no longer sufficient. Parametric estimation and curve fitting were performed based on data from Ethiopia. Numerical simulations were employed to support and clarify the analytical findings and to show some parameter effects on COVID-19 and HIV co-infection. Accordingly, the simulations indicated that parameters gamma _c, gamma _h, epsilon, and kappa, related to HIV patients’ exposure to other diseases and the increase in infectiousness, have a positive role in increasing the number of co-infections. On the other hand, an increase in COVID-19 vaccination (xi) shows the suppression of co-infection cases. In addition, treating co-infected individuals for COVID-19, increasing treatment rates alpha and varphi, reduces the death risk of HIV-infected individuals due to the co-infection burden. It was implied that improving vaccine delivery programs and other medical interventions have important contributions to lowering the risk of COVID-19 infection-related fatalities in HIV patients.

The prevalence and pattern of mask use and its association with COVID-19-related morbidity and mortality in Tabriz, Iran

Background. Using personal protective equipment, including masks, is one of the most important ways to prevent coronavirus disease 2019 (COVID-19). The aim of this study was to estimate the prevalence and pattern of mask use and its association with COVID-19-related morbidity and mortality in different areas of Tabriz, Iran. Methods. In this population-based study, 6,600 pedestrians were selected by multi-stage proportional sampling method in nine areas of Tabriz in 2021. The data was collected using the observation method. For each participant, we recorded gender, approximate age, mask usage, type of mask, and correct or incorrect use. The data of COVID-19-related morbidity and mortality for six months (from 21 March 2021 to 22 September 2021) were obtained from the Integrated Syndromic Surveillance System (ISSS). Results. The overall prevalence of facial mask use was 56.8% (95% CI: 55.56 – 57.95). Out of 3,421 men, 1,599 (46.7%; 95% CI: 45.1-48.4) and out of 3,179 women, 2,147 (67.5%; 95% CI: 65.9-69.2) were used face mask (P&lt;0.001). The correlations between mask use and morbidity (r=0.375, P=0.320) and mortality (r=0.219, P=0.571) rates were not statistically significant. Conclusion. The percentage of using face masks in Tabriz was relatively low, especially among males and young people. Also, there was no significant relationship between COVID-19 morbidity and mortality and mask use. Practical Implications. The results of the present study showed that the percentage of mask use in men and the youth was relatively low. In times of disease epidemics, it is necessary to create the necessary sensitivity in these groups and to carry out the necessary training and interventions to increase the use of masks and protective measures.

Comparison between estimation and measurement of inhalation exposure to active substances for disinfection workers

As disinfection has been strongly recommended to prevent coronavirus disease 2019 (COVID-19) infection, potential health risks from exposure to active substances in disinfectants for disinfection workers have increased. Estimated exposure of disinfection workers to active substances using the exposure algorithm may differ from actual exposure in indoor environments. Therefore, it is necessary to compare and validate the actual exposure of disinfection workers to active substances through measurement. The target active substances were quaternary ammonium compounds (QACs), benzalkonium chloride (BKC), and isopropyl alcohol (IPA), which are commonly used in Korea. The measured personal exposure concentration of disinfection workers simulated by the researcher for QACs in the indoor environment was 0.10 ± 0.05 mg/m3, which was approximately twice lower than the estimated concentration using exposure algorithm (0.22 ± 0.02 mg/m3). The measured BKC personal exposure concentration was six times lower than the estimated exposure. Whereas the measured IPA personal exposure concentration was 11 times higher than the estimated exposure. From the risk assessment conducted, QACs had a potential health risk, whereas BKC and IPA did not. Evaluating the exposure to active substances using the exposure algorithm could be over or under-estimated depending on the physicochemical properties of the active substance such as vapor pressure and volatility. Therefore, risk assessment for disinfection workers using exposure algorithms could be inaccurate. Although risk assessment using an exposure algorithm has been widely used to manage the exposure and health risks of general population as well as disinfection workers, validation and supplementation through measurement are required for efficient risk assessment.

Model of protective behavior during the COVID-19 pandemic in Indonesia

To prevent coronavirus disease 2019 (COVID-19) from spreading extensively and rapidly during the pandemic, protective behaviors are crucial. This study aimed to determine the influence of risk perceptions, health care, social influences, and intentions on the improvement of protective behaviors during the COVID-19 pandemic. There were 325 participants consisting of 74 men and 251 women (mean age (M)=21.47, SD=6.8). Based on previous studies, measurements were conducted using a variety of questionnaires. The hypotheses were examined by data analysis using structural equation modeling (SEM). The results show that the proposed model met the established criteria. It is interesting to note that risk perceptions influence how protective behaviors are improved through health care and intentions. The social influences on protective behaviors, meanwhile, are both directly and partially mediated by intentions. In conclusion, health care and intentions serve as mediators between risk perceptions and protective behaviors rather than being directly associated. Health care, however, is unrelated to intentions. Furthermore, social influences are the most dominant factor in improving protective behaviors during COVID-19 pandemic. Therefore, it may serve as a preliminary justification for the government to promote for a policy that addresses social influences in order to improve protective behaviors.

Safety and Immunogenicity of the BNT162b2 Vaccine Coadministered with Seasonal Inactivated Influenza Vaccine in Adults.

Vaccination is a critical tool for preventing coronavirus disease 2019 (COVID-19) and influenza illnesses. Coadministration of the COVID-19 vaccine, BNT162b2, with seasonal inactivated influenza vaccine (SIIV) can provide substantial benefits, including streamlining vaccine delivery. In this phase 3 study, healthy 18- to 64-year-olds who had received three previous doses of BNT162b2 were randomized (1:1) to the coadministration group (month0, BNT162b2 + SIIV; month1, placebo) or the separate-administration group (month0, placebo + SIIV; month1, BNT162b2). The primary immunogenicity objective was to demonstrate that the immune responses elicited by BNT162b2 and SIIV [measured by full-length S-binding immunoglobulin G (IgG) levels and strain-specific hemagglutination inhibition assay (HAI) titers against four influenza strains 1month post-vaccination, respectively] when coadministered were noninferior to those elicited by either vaccine administered alone, based on a prespecified 1.5-fold noninferiority margin [lower bound 95% CI for geometric mean ratio (GMR) > 0.67]. Reactogenicity and adverse event (AE) rates were evaluated. Randomized participants who received study vaccination (N = 1128; coadministration group, n = 564; separate-administration group, n = 564) had a median age of 39years. Model-adjusted GMRs for coadministration to separate administration were 0.83 (95% CI 0.77, 0.89) for full-length S-binding IgG levels and 0.89-1.00 (lower bound of all 95% CIs > 0.67) for the four influenza strain-specific HAI titers, with all endpoints achieving the prespecified noninferiority criterion. Reactogenicity events were mostly mild or moderate when BNT162b2 was coadministered with SIIV. Serious AEs were reported in < 1% of participants within 1month after any vaccination; none were considered vaccine-related. BNT162b2 coadministered with SIIV elicited immune responses that were noninferior to those elicited by BNT162b2 alone and SIIV alone, and BNT162b2 had an acceptable safety profile when coadministered with SIIV. The results of this study support the coadministration of BNT162b2 and SIIV in adults. ClinicalTrials.gov registration: NCT05310084.

The Parenting Styles on Handwashing Behavior for Preventing Coronavirus Disease 19 Spread on Children with Mental Retardation

The increasing number of Coronavirus Disease 19 (Covid 19) in Indonesia has made the government implement health protocols, one of which is washing hands. Children with mental retardation who have intellectual abilities below the average and have difficulty implementing it. The parenting style applied to children will affect the child's behavior, one of which is handwashing behavior. This study aimed to determine the relationship of parenting on handwashing behavior for spread preventing Coronavirus Disease 19 in children with mental retardation. This study utilized a quantitative correlation with a cross-sectional approach. A total of 33 parents who have children with mild mental retardation in Special School 2 Banjarmasin. The research instrument is the parenting style questionnaire and the handwashing behavior observation sheet. The results showed from 33 parents who applied democratic parenting were 21 people (63%), as many as 19 children (57%) with good handwashing behavior. Chi-Square test obtained p-value = 0.000 &lt; ?= 0.05. There is the relationship between parenting on handwashing behavior for Preventing Coronavirus Disease 19 Spread on Children with Mental Retardation. The right parenting pattern for children with mental retardation can help children grow and develop properly.

Impaired Seroconversion After Severe Acute Respiratory Syndrome Coronavirus 2 mRNA Vaccine in Patients With Thymic Epithelial Tumors

IntroductionThymic epithelial tumors (TETs) are rare malignancies associated with dysregulation of the immune system and humoral- and cell-mediated immunity abnormalities. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) mRNA vaccine is effective in preventing coronavirus disease 2019 morbidity and mortality. The aim of this study was to evaluate the seroconversion in patients with TET after two doses of mRNA vaccine. MethodsThis is a prospective study in which consecutive patients with TET were enrolled before receiving the first dose of SARS-CoV-2 mRNA vaccine (BNT162b2 by Pfizer-BioNTech). SARS-CoV-2 spike-binding immunoglobulin (Ig)G antibody serologic levels were analyzed at different time points, including before first vaccine dose (T0), 1 month after the second dose (T2), and 3 months after the second dose (T3). ResultsOverall, 39 patients were included in the analysis. All patients had negative antibody titer results at T0. There were 19 patients (48.7%) in the follow-up with no residual tumor lesion/s (referred as no evidence of disease), and 20 (51.3%) had evidence of disease (ED) and were receiving systemic treatment. Dysregulations of the immune system were diagnosed in 29 patients (74.4%) with Good syndrome (GS) being the most frequent immune disorder (48.7%). At univariate analysis, lack of seroconversion at T2 was significantly associated with ED (p < 0.001) and with GS (p = 0.043). A significant association with impaired seroconversion was confirmed at multivariate analysis for ED (p = 0.00101) but not for GS (p = 0.625). ConclusionsOur data revealed that patients with TET with ED had substantially higher probability of impaired seroconversion after SARS-CoV-2 mRNA vaccine as compared with patients with no evidence of disease.

Health care workers' self-perceived infection risk and COVID-19 vaccine uptake: A mixed methods study.

Vaccination is the most cost-effective way of preventing Coronavirus Disease 2019 (COVID-19) although there was a considerable delay in its institution in Tanzania. This study assessed health care workers' (HCWs) self-perceived infection risk and uptake of COVID-19 vaccines. A concurrent embedded, mixed methods design was utilized to collect data among HCWs in seven Tanzanian regions. Quantitative data was collected using a validated, pre-piloted, interviewer administered questionnaire whereas in-depth interviews (IDIs) and focus group discussions (FGDs) gathered qualitative data. Descriptive analyses were performed while chi-square test and logistic regression were used to test for associations across categories. Thematic analysis was used to analyze the qualitative data. A total of 1,368 HCWs responded to the quantitative tool, 26 participated in the IDIs and 74 in FGDs. About half of the HCW (53.6%) reported to have been vaccinated and three quarters (75.5%) self-perceived to be at a high risk of acquiring COVID-19 infection. High perceived infection risk was associated with increased COVID-19 vaccine uptake (OR 1.535). Participants perceived that the nature of their work and the working environment in the health facilities increased their infection risk. Limited availability and use of personal protective equipment (PPE) was reported to elevate the perceived infection risks. Participants in the oldest age group and from low and mid-level health care facilities had higher proportions with a high-risk perception of acquiring COVID-19 infection. Only about half of the HCWs reported to be vaccinated albeit the majority recounted higher perception of risk to contracting COVID-19 due to their working environment, including limited availability and use of PPE. Efforts to address heightened perceived-risks should include improving the working environment, availability of PPE and continue updating HCWs on the benefits of COVID-19 vaccine to limit their infection risks and consequent transmission to their patients and public.