Vaccine Titers Research Articles

DYNAMIC cohort study evaluating metabolic predictors of influenza vaccine immune response in older adults

Immunosenescence (age-related immune dysfunction) and inflamm-aging contribute to suboptimal immune responses in older adults to standard-dose influenza vaccines, which may be exacerbated in those with metabolic co-morbidities. We sought to investigate metabolic factors/predictors of influenza vaccine immune response in an older adult (age ≥65 years) cohort in Singapore, where influenza typically circulates year-round. The primary outcome for the DYNAMIC prospective cohort study was haemagglutination-inhibition titer (HAI) response to each of the trivalent inactivated influenza vaccine strains at day 28 (D28) compared to baseline (D0), as assessed by seroconversion and D28/D0 log2 HAI fold rise. Baseline blood samples were tested for total Vitamin D (25-(OH) D) levels. We enrolled 234 participants in June–Dec 2017. Two hundred twenty completed all study visits. The median age was 71 [IQR 68–75] years, 67 (30.5%) had diabetes mellitus (DM), and the median BMI was 24.9 [IQR 22.2–27.8] kg/m2. Median baseline totals 25-(OH) D was 29 [IQR: 21–29] ng/ml. Age, DM, obesity, and baseline 25-(OH) D were not associated with HAI fold rise in multivariable analysis. More recent prior influenza vaccination and higher baseline HAI titers were associated with lower HAI fold rise for influenza A/HK/H3N2. Physical activity was associated with a higher HAI fold rise for influenza A/HK/H3N2 in a dose-response relationship (p-test for trend = 0.015). Older adults with well-controlled metabolic co-morbidities retain HAI response to the influenza vaccine, and physical activity had a beneficial effect on immune response, particularly for influenza A/HK/H3N2.

HYPEREOSINOPHILIA LEADS TO PRIMARY IMMUNODEFICIENCY DIAGNOSIS

<h3>Introduction</h3> In the absence of prior infections, idiopathic hypereosinophilia should prompt consideration of a primary immunodeficiency (PID). <h3>Case Description</h3> We present an 8-month-old previously healthy male admitted for persistent hypoxia and suspected bronchiolitis. This patient did not present with fever, weight loss, adenopathy, chronic rash, GI symptoms, or medication use. There was no travel history, sick contacts, or pertinent family history. Laboratory results were significant for negative viral panel and absolute eosinophil count > 34,000. Chest CT showed scattered ground glass opacities without cavitation or bronchiectasis. Bone marrow biopsy was negative for malignancy. T cell (beta) and B cell gene rearrangement studies were negative, as well as FIP1L1-PDFGFRA, FISH studies, and myelodysplastic panels. Cardiac workup, infectious/parasitic tests, tryptase, and B12 levels were normal. The patient was started on systemic steroids with dramatically improved hypereosinophilia. Workup revealed low IgG/IgA levels, with normal IgM. Vaccine titers to tetanus, diphtheria and Hib were absent, despite up-to-date immunizations. Genetic testing revealed a pathogenic mutation in the CD40L gene, indicating X-linked hyper IgM syndrome (HIGM). Pneumocystic jirovecii was confirmed with bronchoscopy. TMP-SMX treatment allowed for weaning off steroids. The patient was started on IVIG and is awaiting bone marrow transplant. <h3>Discussion</h3> HIGM often presents in infancy with increased susceptibility to sinopulmonary infections. Unlike other PIDs with clinical manifestations of atopy, HIGM does not often present with eosinophilia. Opportunistic infections, including PJP, may drive eosinophil production through antigenic stimulation of TH2 cells. This case illustrates the importance of immunologic considerations in patients with unexplained hypereosinophilia, even without a significant infectious history.

Characterizing Longitudinal Antibody Responses in Recovered Individuals Following COVID-19 Infection and Single-Dose Vaccination: A Prospective Cohort Study.

Investigating antibody titers in individuals who have been both naturally infected with SARS-CoV-2 and vaccinated can provide insight into antibody dynamics and correlates of protection over time. Human coronavirus (HCoV) IgG antibodies were measured longitudinally in a prospective cohort of qPCR-confirmed, COVID-19 recovered individuals (k = 57) in British Columbia pre- and post-vaccination. SARS-CoV-2 and endemic HCoV antibodies were measured in serum collected between Nov. 2020 and Sept. 2021 (n = 341). Primary analysis used a linear mixed-effects model to understand the effect of single dose vaccination on antibody concentrations adjusting for biological sex, age, time from infection and vaccination. Secondary analysis investigated the cumulative incidence of high SARS-CoV-2 anti-spike IgG seroreactivity equal to or greater than 5.5 log10 AU/mL up to 105 days post-vaccination. No re-infections were detected in vaccinated participants, post-vaccination by qPCR performed on self-collected nasopharyngeal specimens. Bivariate analysis (complete data for 42 participants, 270 samples over 472 days) found SARS-CoV-2 spike and RBD antibodies increased 14-56 days post-vaccination (p < 0.001) and vaccination prevented waning (regression coefficient, B = 1.66 [95%CI: 1.45-3.46]); while decline of nucleocapsid antibodies over time was observed (regression coefficient, B = -0.24 [95%CI: -1.2-(-0.12)]). A positive association was found between COVID-19 vaccination and endemic human β-coronavirus IgG titer 14-56 days post vaccination (OC43, p = 0.02 & HKU1, p = 0.02). On average, SARS-CoV-2 anti-spike IgG concentration increased in participants who received one vaccine dose by 2.06 log10 AU/mL (95%CI: 1.45-3.46) adjusting for age, biological sex, and time since infection. Cumulative incidence of high SARS-CoV-2 spike antibodies (>5.5 log10 AU/mL) was 83% greater in vaccinated compared to unvaccinated individuals. Our study confirms that vaccination post-SARS-CoV-2 infection provides multiple benefits, such as increasing anti-spike IgG titers and preventing decay up to 85 days post-vaccination.

113 Immunological Effects of Ganoderma Lucidum Supplementation in Canine Nutrition

Abstract Ganoderma lucidum (GL) is a mushroom that has been widely used in Asia for its immunomodulatory, anti-inflammatory and anti-tumor capacity in humans. However, the nutraceutical properties of GL have not been tested in dogs. Forty adult beagles were used in a completely randomized design and were fed a commercial dry extruded complete and balanced diet plus GL top-dressed daily upon feeding time. Four experimental treatments were used: 0% GL supplementation (control), 5 mg/ kg BW of GL, 10 mg/ kg BW of GL, or 15 mg/kg BW of GL. Following a 7 d adaptation to the control diet, dogs were fed their respective treatment diets for consecutive 28 d. They were challenged with vaccination of a modified live virus Canine Distemper, Adenovirus Type 1 (Hepatitis), Adenovirus Type 2, Parainfluenza, and Parvovirus and killed Rabies Virus on d 7 with blood collections on d 0, 14, and 28. The objective of the present study was to evaluate the effects of dietary inclusion of GL on peripheral blood mononuclear cells (PBMC; T-cells, B-cells, monocytes, and natural killers) and vaccine titers response of adult dogs. The inclusion of GL in all dosages was well-accepted by all dogs. There was a trend that the percentage of MHC-II from B-cells was greater in dogs fed 15 mg/kg of GL (41.91%) compared with the control group (34.63%). The phagocytosis response tended to have treatment by time interaction among treatments; dogs fed 15mg/kg of GL tended to have greater phagocytosis activity on d 28 than dogs from the control group and dogs fed 5mg/kg of GL. These data suggest that the inclusion of GL had no detrimental effects on analyzed PBMC. Based on our findings, GL may also exert beneficial immunomodulatory effects in healthy adult dogs when provided at a daily dose of 15 mg/ kg BW.

Expression and Immunogenicity of SARS-CoV-2 Virus-Like Particles based on Recombinant Truncated HEV-3 ORF2 Capsid Protein.

COVID-19 is an emerging disease that poses a severe threat to global public health. As such, there is an urgent demand for vaccines against SARS-CoV-2, the virus that causes COVID-19. Here, we describe a virus-like nanoparticle candidate vaccine against SARS-CoV-2 produced by an E. coli expression system. The fusion protein of a truncated ORF2-encoded protein of aa 439~608 (p170) from hepatitis E virus CCJD-517 and the receptor-binding domain of the spike protein from SARS-CoV-2 were expressed, purified and characterized. The antigenicity and immunogenicity of p170-RBD were evaluated in vitro and in Kunming mice. Our investigation revealed that p170-RBD self-assembled into approximately 24 nm virus-like particles, which could bind to serum from vaccinated people (p < 0.001) and receptors on cells. Immunization with p170-RBD induced the titer of IgG antibody vaccine increased from 14 days post-immunization and was significantly enhanced after a booster immunization at 28 dpi, ultimately reaching a peak level on 42 dpi with a titer of 4.97 log10. Pseudovirus neutralization tests showed that the candidate vaccine induced a strong neutralizing antibody response in mice. In this research, we demonstrated that p170-RBD possesses strong antigenicity and immunogenicity and could be a potential candidate for use in future SARS-CoV-2 vaccine development.

Inhaled corticosteroids do not affect the antibody titer against the SARS-CoV-2 spike protein in BNT162b2 mRNA vaccinated patients

ObjectivesOral corticosteroids reduce the antibody titer of the BNT162b2 mRNA vaccine against SARS-CoV-2. To date, the effect of inhaled corticosteroids on antibody titers is unknown.Study designThe design of this study is retrospective study.MethodsWe analyzed the relationship between the clinical features and total antibody titers against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) spike protein in 320 subjects who had never been infected with Coronavirus disease 2019 (COVID-19) and were vaccinated the second time with the BNT162b2 mRNA vaccine between October 1 to December 28, 2021.ResultsOf the 320 subjects, 205 were treated with inhaled corticosteroids. The median antibody titer of patients treated with inhaled corticosteroids was 572 U/mL, which was significantly higher than that of patients treated without inhaled corticosteroids (454U/mL, P = 0.00258). The median antibody titers of smokers, men, and patients aged 65 years and over, were 315.5 U/mL, 385 U/mL, and 425.5 U/mL, respectively. These results are significantly lower than those of patients who never smoked, women, and patients aged less than 64 years (582 U/mL [P < 0.0001], 682.5 U/mL [P < 0.0001], and 717 U/mL [P < 0.0001], respectively). The multivariate analysis revealed that females and age were independent antibody titer-reducing factors (P = 0.0001 and P < 0.0001, respectively).ConclusionsThe use of inhaled corticosteroids did not reduce the antibody titer against SARS-CoV-2 spike protein. Clinicians should continue treatment with inhaled corticosteroids if indicated.

Evaluation of Superficial Well Water on the performance and Immune-response of Broiler Chickens Against Avian Influenza and Newcastle Diseases Vaccination in New Valley Governorate.

A total of 200 unsexed 1-day old broiler chickens (Masr poultry) were used in this study in El-Dakhla City in the New Valley Governorate. They were randomly allocated into two groups of 100 birds in each. Groups were classified according to water source, (G1) received superficial well water (S) and (G2) received filtered water (F), that have been physically and chemically analyzed. The two groups received balanced formulated diet free from any additives and vaccinated with AI (H9) and ND vaccines. Weekly, five chicks were randomly collected and weighted (FI, BWG and FCR were estimated), At (1, 7, 15, 25, 35 days) 5 serum samples were examined for the antibody titers of AI (H9) and ND vaccines using HI test. The results of physicochemical water analyses recorded higher numerical values in superficial well group than filtered group which exceeded the permissible limits. There are significant differences among groups at (p>0.05) for most of the performance and immune parameters. (G2) showed a significant higher response for body weight (BWT), BWT gain (BWG), feed conversion ratio and antibody response to ND and AI (H9) virus vaccine. Our study showed that concentration of heavy metals residues in different tissues of broilers received Superficial well as (Fe, Mn, Pb and CD) recorded higher result as compared with filter group. In conclusion, In El Dakhla City the superficial well water affect negatively on performance and immune parameters of broiler chickens.

Bimodal antibody-titer decline following BNT162b2 mRNA anti-SARS-CoV-2 vaccination in healthcare workers of the INT – IRCCS “Fondazione Pascale” Cancer Center (Naples, Italy)

BackgroundBoth SARS-CoV-2 mRNA-based vaccines [BNT162b2 (Pfizer-BioNTech) and mRNA-1273 (Moderna)] have shown high efficacy, with very modest side effects in limiting transmission of SARS-CoV-2 and in preventing the severe COVID-19 disease, characterized by a worrying high occupation of intensive care units (ICU), high frequency of intubation and ultimately high mortality rate. At the INT, in Naples, only the BNT162b2/Pfizer vaccine has been administered to cancer patients and healthcare professionals aged 16 and over. In the present study, the antibody response levels and their decline were monitored in an interval of 6–9 months after vaccine administration in the two different cohorts of workers of the INT – IRCCS "Fondazione Pascale" Cancer Center (Naples, Italy): the group of individuals previously infected with SARS-CoV-2 and vaccinated with a single dose; and that of individuals negative for previous exposure to SARS-CoV-2 vaccinated with two doses 21 days apart.MethodsSpecific anti-RBD (receptor-binding domain) titers against trimeric spike glycoprotein (S) of SARS-CoV-2 by Roche Elecsys Anti-SARS-CoV-2 S ECLIA immunoassay were determined in serum samples of 27 healthcare workers with a previously documented history of SARS-CoV-2 infection and 123 healthcare workers without, during antibody titers’ monitoring. Moreover, geometric mean titers (GMT) and relative fold changes (FC) were calculated.ResultsBimodal titer decline was observed in both previously infected and uninfected SARS-CoV-2 subjects. A first rapid decline was followed by a progressive slow decline in the 6/9 month-period before the further vaccine boost. The trend was explained by 2 different mathematical models, exponential and power function, the latter revealing as predictive of antibody titer decline either in infected or in not previously infected ones. The value of the prolonged lower vaccine titer was about 1 log below in the 6/9-month interval after the single dose for previously infected individuals with SARS-CoV-2 and the two doses for those not previously infected. The titer change, after the boost dose administration, on the other hand, was ≥ 1.5 FC higher than the titers at the 6/9-month time-points in both cohorts. A similar quantitative immune titer was observed in both cohorts 8 days after the last boost dose. The subsequent immunoresponse trend remains to be verified.DiscussionThe results show that a very rapid first decline, from the highest antibody peak, was followed by a very slow decline which ensured immune protection lasting more than 6 months. The apparent absence of adverse effects of the rapid decline on the vaccine's immune protective role has been related to a large majority of low avidity antibodies induced by current vaccines. High avidity antibodies with prolonged anti-transmission efficacy show a longer half-life and are lost over a longer interval period. The cellular immunity, capable of preventing severe clinical diseases, lasts much longer. The unbalanced dual activity (cellular vs humoral) while effective in limiting ICU pressure and overall mortality, does not protect against transmission of SARS-CoV-2, resulting in high circulation of the virus among unvaccinated subjects, including the younger population, and the continuous production of variants characterized by changes in transmissibility and pathogenicity. The high mutation rate, peculiar to the RNA virus, can however lead to a dual opposite results: selection of defective and less efficient viruses up to extinction; risk of more efficiently transmitted variants as the current omicron pandemic.ConclusionsIn conclusion the current bimodal antibody-titer decline, following BNT162b2 mRNA anti-SARS-CoV-2 vaccination, needs a further extended analysis to verify the protective borderline levels of immunity and the optimal administration schedule of vaccine boosters. Our current results can contribute to such goal, besides a direct comparison of other FDA-approved and candidate vaccines.

Seroconversion among healthcare workers vaccinated with hepatitis B vaccine of RIMS Hospital, Imphal, Manipur

Hepatitis B, caused by hepatitis B virus (HBV) is a vaccine preventable disease. Health care workers are at high risk of HBV infection due to their exposure to infectious materials. Anti-hepatitis B surface antigen antibody (Anti HBs) titre of 10 IU/mL indicates protection.Aims: To determine the antibody titre among health care workers of RIMS Hospital, Imphal.Settings and Design: Cross-sectional studyMethods and Material: Blood samples were collected from 164 health care workers vaccinated with hepatitis B vaccine and anti HBs titre was estimated by ELISA.Statistical analysis used: Descriptive and inferential statistics. The quantitative variables were expressed as mean and standard deviation while categorical variables were expressed as percentage. Odds ratio was used for calculation of protective antibody titre. Association between antibody titres and time since vaccination was analysed using Pearson correlation.Results: Protective titre seen in 130(79.26%) participants while on-protective titre is seen in 34(20.73%) participants. While only 15.57% of fully vaccinated individuals have non-protective anti HBs titre, 40% of partially vaccinated HCWs do not have protective titre.Conclusions: Completion of a three-dose series of hepatitis B vaccine is important to achieve seroconversion. A second series of vaccine may be recommended for seroconversion failure after the first series of vaccine followed by re-testing of anti Hbs titre. Booster dose is not recommended for seroconverted individuals with low antibody titre.

Immune responses to Vibrio vulnificus formalin-killed vaccine and ghost vaccine in Scophthalmus maximus.

In this research, Vibrio vulnificus formalin-killed (FKCs) vaccine and ghost (VVGs) vaccine were successfully developed, and shown to prevent vibriosis of Scophthalmus maximus resulting from V. vulnificus. The antibody titre of FKCs and VVGs vaccine was 1: 28 and 1: 211 . The RPS of FKCs and VVGs vaccine was 60% and 80%. In order to improve the understanding of vaccine protection mechanism, transcriptome data was used to analyse the immune response of S. maximus infected with V. vulnificus after vaccination with FKCs and VVGs vaccine. In the SmCon and SmIV groups, a series of innate immune-related genes were upregulated (such as, TLR5, Tp12, AP-1 and IL-1β) or downregulated (such as, CASP6 and CASP8), which suggested that the immune protection mechanism induced by inactivated vaccine was similar to that of autoimmune response. In the SmIV and SmGho group, a number of innate and adaptive immune-related genes (such as, STAT1, IFN-γ and MHC Ia) were activated, in which the expression of these genes was higher in SmGho, and VVGs vaccine induced stronger innate and acquired immune responses. In conclusion, the results lay a foundation for further study on the molecular mechanisms of immune protection induced by VVGs vaccine and FKCs vaccine.

Impacts of a post-transport/pre-processing rest period on the growth performance, anthelmintic efficacy, and serum metabolite changes in cattle entering a feed yard.

A total of 80 crossbred, high-risk heifers (initially 250 ± 4.2 kg BW), were transported from an Oklahoma City, Oklahoma sale barn to the Kansas State University Beef Cattle Research Center. Cattle were unloaded and randomly placed into one of four receiving pens and provided ad libitum hay and water. Each pen was randomly assigned to one of the four rest times before processing: (1) immediately upon arrival (0); (2) after a 6-h rest period (6); (3) after a 24-h rest period (24); and (4) after a 48-h rest period (48). After all cattle were processed, heifers were allotted into individual pens with ad libitum access to a receiving ration and water. Heifers were weighed individually on d 0, 7, 14, 21, 28, and 35 to calculate average daily gain (ADG). Feed added and refusals were measured daily to determine dry matter intake (DMI). A fecal egg count reduction test and analysis of blood serum metabolites were also conducted. All data were analyzed using the GLIMMIX procedure of SAS (v. 9.4, Cary, NC) with individual animal as the experimental unit. Processing time did not impact (P > 0.05) heifer BW or ADG. From d 0 to 35, DMI decreased linearly (P = 0.027) as rest time increased. The number of days for heifers to reach a DMI of 2.5% BW was linearly increased (P = 0.023) as rest time increased. There was no evidence of differences (P ≥ 0.703) among rest times for feed efficiency. While morbidity did not differ between treatments (P > 0.10), mortality increased linearly (P = 0.026) as the time of rest increased. A significant processing time × day interaction (P < 0.0001) was observed for the prevalence of fecal parasites, where the percentage of positive samples was significantly lower 14-d after anthelmintic treatment, regardless of the processing time. Serum IBR titer for heifers processed at either 0 or 6-h upon arrival was significantly higher (P < 0.01) on d 35 compared to d 0. Heifers processed after a 48-h rest period had significantly higher glucose values (P < 0.01) on d 0 compared to heifers processed at 0, 6, or 24-h. In summary, rest time prior to processing did not impact receiving calf growth performance. A 6-h rest period upon arrival appeared to be most beneficial to DMI. Anthelmintic treatment at processing reduced the parasitic load in heifers processed at all times. Vaccine titer did not increase after initial processing in heifers processed 24- or 48-h after arrival, indicating the seroconversion of IBR antibodies during the longer rest period.

Retrospective analysis of vaccine antibody titers in patients with different stages of monoclonal plasma cell disorders.

e20031 Background: Infections occur with up to twofold increased risk in patients with monoclonal gammopathy of undetermined significance (MGUS) and tenfold increased risk in multiple myeloma (MM). To reduce risk, revaccination following autologous hematopoietic cell transplantation (AHCT) is recommended to restore humoral immunity. We have previously shown that vaccine titers after AHCT have prognostic significance. In the COVID era, reliable clinical data about antibody titers is relevant yet scarce. We investigated the significance of different vaccine titers in newly diagnosed patients in different stages of the disease. Methods: The study population comprised of 77 patients with MGUS, smoldering multiple myeloma (SMM) and MM who were seen at a tertiary cancer center from 2018-2022. All patients had antibody titers (B. pertussis, Diptheria, H. Influenzae B, Hepatitis, Influenza, Meningitis, Mumps, Rubeola, Rubella, Poliovirus, S. pneumoniae, Varicella Zoster and Tetanus) tested at the time of diagnosis, prior to start of treatment if indicated. Titers were interpreted in accordance with the manufacturers’ recommendations. Patient characteristics were compared using the Kruskal-Wallis and Fisher’s exact tests. Associations with % titer positivity were evaluated using the Kruskal-Wallis test. Results: There was significant difference in antibody titer positivity between the different patient groups (51.4% in MGUS, 40.5% in SMM and 34.2% in MM) (p &lt; 0.001). There was no difference in antibody titer positivity depending on age, sex or race. Among individual pathogens, there was a significant difference between the three groups in regards to titers for Diphtheria, Mumps, Poliovirus 3, Strep pneumoniae 19, Strep pneumoniae 56 and Varicella Zoster. Conclusions: Antibody titers for vaccine preventable diseases are significantly different between patients with MGUS, SMM and MM at the time of diagnosis, with MGUS having the highest and MM having the lowest positivity. Patient related factors such as age, sex or race were not associated with antibody titer positivity. Current guidelines for revaccination are not extended to patients with MGUS and SMM and can be considered in prospective trials.[Table: see text]

MO896: Association Between Immune System Function as Determined by Hepatitis B Infection/Vaccination Status and Risk of COVID-19 Infection

Abstract BACKGROUND AND AIMS Since the beginning of the COVID-19 pandemic in early 2020, &amp;gt;290 million people were infected by SARS-CoV-2 and &amp;gt;5.4 million have died from or with COVID-19 (https://coronavirus.jhu.edu/). Patients with chronic health conditions such as end-stage kidney disease (ESKD) experience particularly high morbidity and mortality because of COVID-19. ESKD patients on hemodialysis are widely vaccinated for hepatitis B (HBV) and seroconversion is routinely measured. This practice presents a rare opportunity to study immune function on a wide scale. It can be reasonably assumed that patients who are able to produce a vaccinal or post-HBV antibodies titers have a better immune function than those who are unable to mount such a serological response. We aim to jointly analyze results of SARS-CoV-2 RT-PCR and hepatitis B serology to determine if presence of vaccinal or post-HBV antibodies is associated with likelihood of developing COVID-19 infection. METHOD Patients who were tested for COVID-19 at Fresenius Medical Care North America dialysis clinics from May 2020 to September 2020 were included in this analysis. HBV infection/vaccination status, demographic parameters and clinical parameters were obtained from the medical record. Nasopharyngeal swab specimen was tested via RT-PCR to detect presence of SARS-CoV-2. Patients were categorized as having good immune function or poor immune function based on vaccinal and post-HBV sero-status. Patients who were vaccinated against HBV but did not seroconvert were considered to have poor immune function. On the other hand, patients who mounted vaccinal or post-HBV antibodies were considered to have good immune function. Univariate and multivariate logistic regression were utilized to study the association between immune function and other demographic, anthropometric and clinical parameters on the likelihood of not being diagnosed with COVID-19. Four models were constructed: Model 1: unadjusted; Model 2: adjusted for age. Model 3: adjusted for age, gender, race, ethnicity, body mass index (BMI). Model 4: adjusted for parameters in model 3 and dialysis vintage (in years), diabetes and congestive heart failure (CHF). RESULTS 11 870 patients were included in this analysis. 54% patients were male, 33% were Black, 24% of the patients were Hispanic, 69% had diabetes and 22% had CHF. Patients were 61.2 ± 14.4 years old with dialysis vintage of 3.9 ± 3.9 years, BMI of 29.6 ± 9.7 kg/m2 and eKt/V 1.5 ± 0.3. Of these patients, 21% had poor immune function and 79% had good immune function. Results of the logistic regression models are shown in Table 1. In the unadjusted model, poor immune function was associated with an increased likelihood of being diagnosed with COVID-19. In models, 2, 3 and 4 age, vintage and presence of diabetes were all significantly associated with a higher likelihood of being diagnosed with COVID-19. However, poor immune function was not a significant predictor of COVID-19 diagnosis in the adjusted models. CONCLUSION Patients who have vaccinal or post-HBV antibodies did not have a lower likelihood of COVID-19 compared with patients who were unable to mount an adequate vaccinal or post-HBV antibody response. Response to HBV vaccination or infection may not be adequate to characterize a patient as having good immune response. Other factors that are routinely measured in hemodialysis patients, which may allow us to make inferences about a patient's immune function should be explored.

Effect of gluten-free diet and antibiotics on murine gut microbiota and immune response to tetanus vaccination.

The purpose of this study was to compare the effect of a gluten-free diet and/or antibiotics on tetanus vaccine induced immunoglobulin G titers and immune cell levels in BALB/c mice. The gluten-free diet was associated with a reduced anti-tetanus IgG response, and it increased the relative abundance of the anti-inflammatory Bifidobacterium significantly in some of the mice. Antibiotics also led to gut microbiota changes and lower initial vaccine titer. After a second vaccination, neither gluten-free diet nor antibiotics reduced the titers. In the spleen, the gluten-free diet significantly increased regulatory T cell (Treg) fractions, CD4+ T cell activation, and tolerogenic dendritic cell fractions and activation, which extend the downregulating effect of the Treg. Therefore, the systemic effect of the gluten-free diet seems mainly tolerogenic. Antibiotics reduced the fractions of CD4+ T and B cells in the mesenteric lymph nodes. These results suggest that vaccine response in mice is under influence of their diet, the gut microbiota and the interplay between them. However, a gluten-free diet seems to work through mechanisms different from those induced by antibiotics. Therefore, diet should be considered when testing vaccines in mice and developing vaccines for humans.

Associations of Enteric Protein Loss, Vaccine Response, Micronutrient Deficiency, and Maternal Depressive Symptoms with Deviance in Childhood Linear Growth: Results from a Multicountry Birth Cohort Study.

ABSTRACT.We identified the determinants of positive (children who had a birth weight < 2.5 kg and/or maternal height < 145 cm but were nonstunted at 24 months of age) and negative (children who had a birth weight ≥ 2.5 kg and maternal height ≥ 145 cm but were stunted at 24 months of age) deviance in childhood linear growth. We found that socioeconomic status (β = 1.54, P < 0.01), serum retinol (β = 0.05, P < 0.01), hemoglobin (β = 0.36, P < 0.01), length-for-age Z-score (LAZ) at birth (β = 0.47, P < 0.01), and tetanus vaccine titer (β = 0.182, P < 0.05) were positively and maternal depressive symptom (β = –0.05, P < 0.01), serum ferritin (β = –0.03, P < 0.01), male sex (β = –1.08, P < 0.01), and α1-antitrypsin (β = –0.81, P < 0.01) were negatively associated with positive deviance. Further, diarrhea episodes (β = 0.02, P < 0.01), male sex (β = 0.72, P < 0.01), and α1-antitrypsin (β = 0.67, P < 0.01) were positively and hemoglobin (β= –0.28, P < 0.01), soluble transferrin receptor level (β = –0.15, P < 0.01), and LAZ score at birth (β = –0.90, P < 0.01) were negatively associated with negative deviance. To summarize, enteric protein loss, micronutrient deficiency, vaccine responses and maternal depressive symptoms were associated with linear growth deviance in early childhood. In such a background, public health approaches aimed at reducing the risk of intestinal inflammation and altered gut permeability could prove fruitful in ensuring desired linear growth in children. In addition, maternal mental health issue should also be considered, especially for promoting better nutritional status in children in the context of linear growth deviance.

COVID-19: Comparison of immunogenicity response between natural and post-vaccination infections

Background: The COVID-19 pandemic in Indonesia has been ongoing for a year as at time of writing, since March 2020. Vaccination interventions are public health efforts that are arguably the most effective in the current pandemic situation, in addition to routine health protocols. Until now, there have been few reports of the effectiveness of vaccination and antibody titers formed after vaccination is carried out. This study aims to find out the difference in antibody titers after vaccination in confirmed COVID-19 cases. Methods: This observational study investigated the difference in SARS-Cov-2 quantitative antibody titers between two cohorts: unvaccinated COVID patients who were confirmed -with COVID-19 and individuals undergoing vaccination at the hospital Prof. dr. R. D. Kandou Manado. Inclusion and exclusion criteria, statistical analysis, and research ethics were applied in the study. Results: Antibody titers in survivor groups were relatively lower at 56 days and 84 days after COVID-19 diagnosis, while the antibody titer in the elderly group undergoing vaccination relatively increased at 56 days and 84 days after the first vaccination. There was a significant difference in antibody titers between a group of survivors and those who underwent vaccination on the first (28 days) and third (84 days). Conclusions: From this study, it was found that in the naturally COVID-19-infected group, antibody titers were still found for 84 days after COVID-19 diagnosis. In the group undergoing vaccination, it was found that antibody titers increased significantly at 56 days after vaccination.

Management of hepatitis B virus prophylaxis in patients treated with disease-modifying therapies for multiple sclerosis: a multicentric Italian retrospective study

BackgroundPatients with multiple sclerosis (MS) often receive disease-modifying therapies (DMTs) that can expose them to reactivation of potential occult hepatitis B virus (HBV) infection (pOBI). We aimed to evaluate the MS Centers behavior regarding HBV screening and prophylaxis in a large cohort of MS patients receiving anti-CD20 or cladribine.MethodsRetrospective, multicentric study recruiting Italian MS patients treated with rituximab, ocrelizumab and cladribine.ResultsWe included 931 MS patients from 15 centers. All but 38 patients performed a complete HBV screening. Patients’ age > 50 years was significantly associated with no history of vaccination and HBsAb titres < 100 mIU at baseline (p < 0.001). No significant correlation was found between post-vaccination HBsAb titres and type of treatment (p = 0.5), pre-or post-therapy vaccination (p = 0.2) and number of previous DMTs (p = 0.2). Among pOBI patients (n = 53), 21 received antiviral prophylaxis, while only 13 had HBV DNA monitoring and 19 patients neither monitored HBV DNA nor received prophylaxis.ConclusionsBaseline HBV screening in patients receiving anti-CD20 and cladribine is a consolidated practice. Nonetheless, HBV vaccination coverage is still lacking in such population and age is a significant factor associated with low HBV protection. Rituximab, ocrelizumab and cladribine did not impair HBV vaccine response. Almost 35% of pOBI patients fail to receive HBVr prevention. Management of HBV prophylaxis could be improved in MS patients and further prospective studies are needed to assess the effectiveness of prophylactic strategies in such patients.

Heterologous AD5-nCOV plus CoronaVac versus homologous CoronaVac vaccination: a randomized phase 4 trial

The emergence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variants and the waning of vaccine-elicited neutralizing antibodies suggests that additional coronavirus disease 2019 (COVID-19) vaccine doses may be needed for individuals who initially received CoronaVac. We evaluated the safety and immunogenicity of the recombinant adenovirus type 5 (AD5)-vectored COVID-19 vaccine Convidecia as a heterologous booster versus those of CoronaVac as homologous booster in adults previously vaccinated with CoronaVac in an ongoing, randomized, observer-blinded, parallel-controlled phase 4 trial (NCT04892459). Adults who had received two doses of CoronaVac in the past 3–6 months were vaccinated with Convidecia (n = 96) or CoronaVac (n = 102). Adults who had received one dose of CoronaVac in the past 1–3 months were also vaccinated with Convidecia (n = 51) or CoronaVac (n = 50). The co-primary endpoints were the occurrence of adverse reactions within 28 d after vaccination and geometric mean titers (GMTs) of neutralizing antibodies against live wild-type SARS-CoV-2 virus at 14 d after booster vaccination. Adverse reactions after vaccination were significantly more frequent in Convidecia recipients but were generally mild to moderate in all treatment groups. Heterologous boosting with Convidecia elicited significantly increased GMTs of neutralizing antibody against SARS-CoV-2 than homologous boosting with CoronaVac in participants who had previously received one or two doses of CoronaVac. These data suggest that heterologous boosting with Convidecia following initial vaccination with CoronaVac is safe and more immunogenic than homologous boosting.

Assessment of COVID-19 mRNA vaccination titer and side effects in healthy volunteers

Abstract Objectives An effective vaccine against SARS-CoV-2 is essential to mitigate the COVID-19 pandemic. In these several months, a number of groups have started to report humoral responses and side effects after BNT162b2 vaccinations. Although these reports demonstrate the safety and efficacy, further studies are warranted to verify these findings. Here we examined the levels of SARS-CoV-2 antibodies in Japanese healthy volunteers who underwent BNT162b2 vaccine, to assess the humoral responses and side effects. Methods Forty-one healthy volunteers’ samples were used for the measurement of SARS-CoV-2 antibodies with chemiluminescent assays against the Receptor Binding Domain (RBD) of the virus. We also measured the side effects of the vaccination. Results Although the levels of IgM varied, all participants were seronegative for IgM and IgG before vaccination, and both IgM and IgG were significantly increased after the vaccinations. We further analyzed the humoral responses in relation to age, and found that the IgG levels for 14 days and 35 days, and IgM levels for 14 days after vaccination showed clear declining trends with age. Commonly reported side effects in the participants were sore arm/pain (90.0%) after the first dose, and generalized weakness/fatigue (70.0%), fever (57.5%), and sore arm/pain (90.0%) after the second dose. Conclusions BNT162b2 vaccination generates sufficient production of IgG especially after the second dose, though the response decreases age-dependently. The high frequencies of generalized weakness/fatigue, fever, and sore arm/pain were not negligible, especially after the second dose. This may be associated with the age characteristics of the population.

Response to hepatitis B vaccination in adult patients with cirrhosis of liver- A real world scenario

Background and Aim: We aimed to determine response rates to hepatitis B vaccination and its determinants in adult patients with cirrhosis of liver. Methods: This prospective study was done over a period of three years from 2019-2021. All adult patients (>18 years) with cirrhosis of liver were screened for HBsAg, anti HBc and anti HBs. Those who were negative for all were advised vaccination. For vaccine naïve patients, dose of 20 mcg intramuscular in deltoid region was administered at 0, 1 and 6 months. For those with prior history of vaccination but negative anti HBs titres, dose of 40 mcg was used at 0, 1 and 6 months. We excluded patients who were known HBs Ag positive, on oral antiviral drugs and who did not complete the recommended vaccination. Anti HBs titres were measured 2 months after completion of vaccination. Patients with anti HBs titres >10 were considered responders and those with titres <10 were labelled as non-responders. Baseline demographic parameters, anthropometry, Model of End stage liver disease (MELD) score and history of prior vaccination were compared between the two groups. Results: A total of 678 patients with cirrhosis were seen over the study period. Seventy-two were newly found to be HBs Ag +/ anti HBc + and 165 were detected to be anti HBs +. A total of 277 cases did not complete vaccination or were lost to follow up. The study cohort included 164 patients- median age 43 (18-68) years and 67% males. On follow up at 2 months after last dose of vaccination, 103 (62.8%) had anti HBs titre >10 IU/L. Non responders were significantly older than responders (48 vs 41 years, p 0.01). Conclusions: The response rate to hepatitis B vaccination in cirrhotics is 62.8%. Older patients are more likely to be non-responders.