Category: Covid-19 Vaccine

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Post-COVID-19 Vaccine Thromboembolic Complication in the Setting of Newly Diagnosed May-Thurner Syndrome – Cureus

March 8, 2024

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Post-COVID-19 Vaccine Thromboembolic Complication in the Setting of Newly Diagnosed May-Thurner Syndrome - Cureus

What happened to the guy who had 217 COVID vaccinations – New Atlas

March 8, 2024

A man that police caught taking 217 doses of COVID vaccine has offered himself up to researchers for a study looking into what happens to the immune system after so many doses. The results offer surprising insight into these new mRNA vaccines.

In March 2022 a 62-year-old man in Germany was caught by police getting multiple COVID vaccine shots. It was suspected he had personally received more than 90 doses as a way of accumulating vaccination cards to sell to people that were avoiding the jab.

An investigation ultimately led to no criminal charges, however, a team of researchers from Friedrich-Alexander-Universitt Erlangen-Nrnberg were fascinated by the case. What exactly did this many COVID vaccinations do to a human immune system?

We learned about his case via newspaper articles, said Kilian Schober, an author on the newly published case study. We then contacted him and invited him to undergo various tests in Erlangen. He was very interested in doing so.

In chronicling his case, the man claimed to have received 217 COVID vaccinations, of which more than half could be verified by clinical records. The vast majority were mRNA doses, with a small amount of AstraZeneca, Johnson & Johnson, and Sanofi also in the mix. All the doses spanned a total period of 29 months but most were clustered in a nine-month stretch from mid-2021.

One of the key things the researchers set out to look at was whether the man was suffering from what has been informally referred to as immune exhaustion'. As people around the world began to receive their third, fourth or fifth COVID vaccine dose, some researchers emerged to suggest hitting the immune system with the same antigen over short periods of time could actually be harmful. According to Schober, this idea comes from observations in patients suffering from chronic viral infections such as HIV.

That may be the case in a chronic infection such as HIV or Hepatitis B, that has regular flare-ups, noted Schober. There is an indication that certain types of immune cells, known as T-cells, then become fatigued, leading to them releasing fewer pro-inflammatory messenger substances.

So if this held true for multiple COVID vaccine doses then someone who received dozens of doses over a short period of time would surely display molecular signs of immune impairment. But it turns out, at least for this man, that was not the case.

Looking at blood work conducted both recently and over the last couple of years, the man showed extraordinarily high levels of antibodies and T-cells targeting SARS-CoV-2. Investigating more general T-cell responses to other antigens, the mans immune cells were as effective as any of the control cells. This suggests his immune system was not fatigued or exhausted and could fight off pathogens as well as any average person.

Perhaps even more striking, the researchers report the man displayed no negative side effects from any of his multiple vaccine doses even when he was receiving them daily for weeks on end. On top of that the man reported no history of ever being infected with SARS-CoV-2.

During the study, the man even received another COVID vaccine dose, at his insistence, in order to examine his acute immune response following all of his previous shots. He had an effective antibody response indicating the vaccine was still doing its job.

Schober is cautious to stress this doesnt mean we should all go out and get extra vaccine doses whenever we want. This is just a single case study, and an incredibly strange one at that. But what this story does tell us is that COVID vaccines are generally pretty safe and it is unlikely issues of immune exhaustion will arise after just a handful of doses.

The observation that no noticeable side effects were triggered in spite of this extraordinary hypervaccination indicates that the drugs have a good degree of tolerability, said Schober. Current research indicates that a three dose vaccination, coupled with regular top-up vaccines for vulnerable groups, remains the favored approach.

The new study was published in the journal The Lancet Infectious Diseases.

Source: FAU

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What happened to the guy who had 217 COVID vaccinations - New Atlas

German Man Receives 217 Covid Vaccines – The Onion

March 8, 2024

A German man who voluntarily received 217 Covid 19 vaccines in the span of 29 months has experienced no negative health effects, according to researchers, although doctors still do not endorse hyper-vaccination to boost immunity. What do you think?

Looks like someone has Pfizer stock.

Sandra Bodnar, General Fireproofer

This Week's Most Viral News: March 8, 2024

Uh oh, now hes got to get 217 boosters!

Doug Rinaldo, Trivia Aggregator

Jeez, I cant imagine getting more than 150.

Cyrus Sprecher, unemployed

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German Man Receives 217 Covid Vaccines - The Onion

Extension of COVID-19 vaccine waiver uncertain after WTO conference – Life Sciences Intellectual Property Review

March 8, 2024

WTO members failed to reach consensus on whether to expand patent waiver agreed in 2022 | Extended proposal would include tests and treatments for COVID-19.

The World Trade Organizations (WTO) 13th Ministerial Conference (MC13) closed last week with members failing to reach an agreement on expanding the IP waiver on COVID-19 vaccines to include therapeutics and diagnostics.

MC13 took place in Abu Dhabi from February 26 to March 1, and its conclusion with a lack of consensus about extending the waiver of patent protection comes after years of discussion and heated debate surrounding the issue.

At a meeting of the TRIPS Council on February 13 ahead of the conference, members acknowledged that despite considerable efforts to support a fact- and evidence-based discussion on whether tests and treatments should be included in the waiver, no agreement had been reached.

Campaigners have been pushing for an extension of the agreement made at the 12th WTO Ministerial Conference (MC12) in June 2022, when members affirmed a partial waiver of patent protection for COVID-19 vaccines.

Before last months conference, the TRIPS Council said it would continue its work as directed by the ministerial declaration from MC12 to review and build on all the lessons learned and the challenges experienced during the COVID-19 pandemic, and to build effective solutions in case of future pandemics, in an expeditious manner.

Within this context, areas of interest were cited as the role of IP and, more specifically, voluntary licensing, technology transfer, the operation of the Medicines Patent Pool (MPP), geographical limitations of licences and the operation of Article 31(f) of the TRIPS Agreement.

Waiver expansion unnecessary and harmful

The Chartered Institute of Patent Attorneys (CIPA) and the Pharmaceutical Research and Manufacturers of America (PhRMA) have been vocal critics of the IP waiver, viewing it as undermining the value of innovation and competition.

In October last year, PhRMA issued a statement in response to a US International Trade Commission report on COVID-19 and the TRIPS Agreement, arguing that the pandemic was over and that there was an abundance of treatments.

TRIPS waiver expansion is unnecessary and would harm American workers, patients and innovation by handing over IP to foreign competitors. Its past time for the Biden administration and other world leaders to move beyond this ideological debate and focus on real global health challenges, PhRMA said.

Prank highlights double standard

On February 14, the Peoples Vaccine Alliancea coalition of organisations that supports equitable access to medical technologiesreleased a hoax statement, purportedly from US and EU delegations to the WTO, announcing that they had reversed their opposition to easing IP rules in future pandemics.

Brook Baker, professor at Northeastern University School of Law and senior policy analyst at Health GAP, criticised the blatant hypocrisy of the US and EU in failing to support expansion of the waiver.

We have pulled a prank to highlight this deadly double standard, he said.

If the Pandemic Accord doesnt include clear and comprehensive provisions allowing low- and middleincome countries to overcome Big Pharmas monopoly control over supply, price, and distribution of vaccines, medicines, and diagnostics, well see the savage inequity of COVID-19 and AIDS repeated in the next pandemic.

The deadline for deciding on extending the waiver was postponed indefinitely in December last year.

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Harvard FINALLY drops COVID-19 vaccine requirement for incoming students – Campus Reform

March 8, 2024

Harvard University dropped its COVID-19 vaccination requirement on Tuesday after previously requiring students to get the vaccine, plus boosters.

Harvard University Health Services announced on its website Tuesday that it wouldnt require students to receive the coronavirus vaccination to attend the school.

Harvard University Health Services (HUHS) will no longer require students to receive the COVID-19 vaccine, the university wrote in an update. We strongly recommend that all members of the Harvard community stay up-to-date on COVID-19 vaccines, including boosters if eligible. Additionally, we continue to emphasize the benefits of wearing a high-quality face mask in crowded indoor settings and remaining at home if unwell. HUHS considers state and federal guidance, along with advice from the Universitys public health experts, in responding to COVID-19. We will continue to monitor public health data and will periodically review requirements.

A FAQ page on the health services website further states that incoming students for the 2024-2025 academic year wont be required to get the COVID-19 vaccine.

[RELATED: Rep. Foxx says Harvard has absolutely failed to comply with subpoena, handed over useless documents]

Harvard University previously dropped its COVID-19 vaccine booster requirement in May 2023, according to the Harvard Crimson.

Campus Reform has reached out to Harvard University for comment.

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Harvard FINALLY drops COVID-19 vaccine requirement for incoming students - Campus Reform

Expect COVID-19 vaccine to operate like flu shot, with a new round in the fall – cleveland.com

March 5, 2024

CLEVELAND, Ohio You may be offered a reformulated one-shot COVID-19 vaccine this fall along with an updated flu shot, according to local health experts.

The updated COVID-19 vaccine will be reformulated months in advance, once researchers determine the most prevalent strain that will be circulating by fall, said Erika Sobolewski, medical director for Summit County Public Health.

While the public health emergency for COVID-19 has ended, the virus is still with us, Sobolewski said.

We are shifting from the pandemic phase to the endemic state of COVID-19, where it is found very commonly among the population, Sobolewski said. Getting vaccinated is still the best prevention from severe illness, hospitalization and death.

The COVID-19 vaccine is on peoples minds again because two recent moves by the U.S. Centers for Disease Control and Prevention regarding vaccine recommendations and isolation for those with the illness.

Vaccines: Americans 65 and older now are recommended to get an additional dose of the current one-shot COVID-19 vaccine, the CDC said Wednesday in updating its vaccine guidelines for the first time since the fall.

Older adults are at increased risk of severe disease from COVID-19, with more than half of COVID-19 hospitalizations from October to December 2023 occurring in adults 65 and older, the CDC said.

The one-shot COVID-19 vaccine first became available last fall, and was recommended for everyone age 5 and up to protect against serious illness.

Isolation: Then on Friday, the CDC issued new guidelines in isolation, saying Americans who test positive for the virus no longer need to stay away from others for at least five days.

The updated recommendations bring COVID-19 in line with the CDCs advice for other kinds of respiratory infections, including influenza and respiratory syncytial virus. Offering a single set of unified guidance will make people more likely to follow it, agency experts said in a news briefing Friday.

People who have the illness should stay home until theyve been fever-free without medication for at least 24 hours and their symptoms have been improving for 24 hours, the CDC said.

Most people under 65 can get a single COVID-19 vaccine yearly, according to current CDC recommendations, Sobolewski said. There are special allowances for additional doses for people who are moderately or severely immunocompromised, and initial vaccination in children 6 months to 4 years old.

People under 65 can get an additional vaccine shot two to three months after an infection, said Dr. Robert Salata, physician-in-chief at University Hospitals.

However, there are reasons to get a COVID-19 vaccine dose sooner, Sobolewski said. These include a persons risk of severe disease, risk of disease in a loved one or close contact, local COVID-19 hospital admission level, and the most common variant currently causing illness.

People who already had COVID-19 and do not get vaccinated after their recovery are more likely to get COVID-19 again, than those who get vaccinated after their recovery, Sobolewski said.

U.S. adult COVID-19 vaccination coverage

Here are facts about COVID-19 vaccine uptake among American adults from the CDC. Estimates of vaccination coverage are based on self reporting.

As of Feb. 17, 22.3% of adults reported having received an updated 2023-24 COVID-19 vaccine since Sept. 14, 2023.

An additional 11.1% reported that they definitely plan to get vaccinated.

Across states and the District of Columbia, vaccination coverage ranged from 10.1% in Mississippi to 45.5% in Vermont.

Vaccination coverage increased by age and was highest among adults 75 years and older.

White adults had higher vaccination coverage than adults in all other race and ethnicity groups. Coverage ranged from 14.5% among Hispanic adults to 26.0% among non-Hispanic White adults.

Vaccination coverage was lower among adults living in rural areas (17.8%) than among people in suburban (22.7%) and urban (23.5%) areas.

Vaccination coverage was higher among insured adults (24.4%) than uninsured adults (7.3%).

Julie Washington covers healthcare for cleveland.com. Read previous stories at this link.

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Expect COVID-19 vaccine to operate like flu shot, with a new round in the fall - cleveland.com

Severe COVID-19, death lowest by far among vaccinated Canadians – University of Minnesota Twin Cities

March 5, 2024

The incidence of COVID-19 infection and poor outcomes in the last half of 2021 was consistently lowest among Canadians who completed a primary vaccination series and highest among the unvaccinated, with the most severe consequences among those aged 80 and older of any vaccination status, the Public Health Agency of Canada (PHAC) reports.

The researchers mined the National COVID-19 Case Dataset and the Canadian COVID-19 Vaccination Coverage Surveillance System for data on people aged 12 years and older in 12 of 13provinces and territories by vaccination status, COVID-19 outcomes, and demographic factors from December 2020 to January 2022.

During the study period, 1,194,694COVID-19 infections in patients with complete vaccination history (73.6% of all cases) were reported to PHAC. Most infected patients were unvaccinated, and the lowest percentage of infections was among those who received a primary COVID-19 vaccination series and one booster dose.

During the emergence of the SARS-CoV-2 Delta variant (May to July 2021), compared with vaccinated people, the unvaccinated were 6.8 times more likely to be infected, 11.4 times more likely to be hospitalized, and 17.5 times more likely to die. Amid Delta predominance (July to December 2021), those figures were 6.2, 21.0, and 15.4, respectively.

After the emergence of the Omicron variant (December 2021 to January 2022), the increased likelihoods for unvaccinated participants were 0.9, 7.1, and 11.3 for infection, hospitalization, and death, respectively.

"Case incidence in 2021 was consistently highest in unvaccinated individuals, with younger age groups having the highest incidence rates," the authors wrote.

"Starting in spring2021, there was an increase in vaccine breakthrough cases, consistent with studies showing that, although completion of a primary vaccination series was highly effective in preventing infection against the wild-type virus and Alpha variant, it was slightly less effective against the Beta, Gamma, and Delta variants."

Vaccination remains one of the most important public health interventions, particularly among older adults, to protect against COVID-19 severe outcomes as the pandemic evolves.

Rates of poor outcomes were consistently highest among those aged 80years and older, followed by those aged 60 to 79 for all vaccination statuses. Infection incidence was highest among adults aged 18 to 39, followed by those aged 40 to 59, from mid-2021 to late August2021. Infection incidence rates of in these older age-groups fell after vaccine uptake rose, until Omicron emergence.

"Vaccination remains one of the most important public health interventions, particularly among older adults, to protect against COVID-19 severe outcomes as the pandemic evolves," the study authors wrote. "Routine monitoring of COVID-19 outcomes by vaccination status can identify changes in COVID-19 epidemiology and inform public health action and policy."

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Severe COVID-19, death lowest by far among vaccinated Canadians - University of Minnesota Twin Cities

COVID 19 vaccination as a trigger of acute genital ulcers in an immunocompromised adolescentcase study and … – BioMed Central

March 5, 2024

When diagnosing external genital ulcers in women, both endo- and exogenous causes should be considered. The specialists should pay attention to both infectious and non-infectious reasons [9].Numerous factors such as infectious, inflammatory, immunological, neoplastic, traumatic, or medication-induced causes need to be taken into account [10].In adolescents the most common causes of AGU are: herpes simplex virus (HSV), Epstein-Barr virus, cytomegalovirus, human immunodeficiency virus (HIV), Behcets disease, Crohns disease (CD), ulcerative colitis, celiac disease, cyclic neutropenia, periodic fever syndromes and leukemia [9].

A thorough physical examination should be performed following detailed history-taking, because a patients childhood diseases can have a significant impact on their current health problems. Our patient was diagnosed with PFAPA syndrome in the past. This disease is a complex auto-inflammatory disorder diagnosed on the basis of clinical symptoms such as periodic fever, aphthous stomatitis, pharyngitis, and cervical adenitis. The course of the disease is characterized by alternating periods of relapses and remissions, and the main symptoms are often accompanied by gastrointestinal disorders [11]. Beside the chief complaint, our patient presented abdominal pain, nausea and vomiting.

PFAPA syndrome is associated with a polygenic predisposition to impaired functioning of the innate immune system. The interaction of genetic susceptibility and environmental factors, including infections, predisposes individuals to the occurrence of the disease and its recurrence in the autoimmune mechanism [11, 12]. People suffering from PFAPA display increased activation of CD4Th1 and Th17 lymphocytes [13]. This molecular susceptibility results in the dysfunction of antigen-presenting cells, e.g. monocytes, and in dysregulation of T cells. Monocytes produce higher levels of pro-inflammatory cytokine IL-12, which stimulates CD4 and CD8 lymphocytes to produce excessive amounts of IFN- and lipopolysaccharides (LPS) [14].Moreover, the expression of the IL-10 gene decreases, resulting in a reduction of anti-inflammatory IL-10 cytokine [13]. In addition, down regulation of CCR1 (CC motif chemokine receptor 1) predisposes to a reduced migration of monocytes [15]. Depletion of these cells in inflammatory diseases may lead to increased migration of microorganisms through the permeable mucous membrane, which results in ulceration [14]. In PFAPA, the classical complement pathway is activated, while the alternative pathway remains unchanged. During PFAPA flare-ups, the levels of T-cell chemokines (IP-10/CXCL10, MIG/CXCL9), G-CSF (granulocyte colony-stimulating factor), and pro-inflammatory cytokines IL-1, IL-6, IL-12, IL-18 are all increased, and the complement system is activated [11, 12]. PFAPA is a consequence of excessive intracellular protein complexes response with the participation of pro-inflammatory factors such as caspase-1, IL-6, IP-10 (interferon gamma-induced protein 10) and interleukin 1 receptor antagonist (IL1Ra), but the levels of other pro-inflammatory factors, such as TNF (tumor necrosis factor) and MCP-1 (monocyte chemoattractant protein-1), remain relatively steady.

During PFAPA attacks, the complete blood count shows increased levels of neutrophils and monocytes, with low levels of lymphocytes and eosinophils [12, 16]. The disease usually responds to treatment with corticosteroids [11]. The administration of antibiotics is not justified due to the autoimmune basis of the disease. Tonsillectomy provides a 7097% long-term remission of the PFAPA syndrome [17].

PFAPA syndrome may predispose to the occurrence of AGU [13, 18]. However, AGUs are a very rare and atypical manifestation of PFAPA. The presence of vulvar ulcers in PFAPA patients is influenced by reduced IL-10 (anti-inflammatory cytokine) and CCR1 levels [13, 14]. According to Scattoni et al. this atypical symptom should be regarded as a potential and useful indicator of PFAPA [18].

In the present study, we took into consideration the influence of the PFAPA syndrome on the development of labial ulceration in our patient. The immune and genetic determinants that caused the PFAPA syndrome could also lead to the appearance of ulcers after the occurrence of provoking factors. The patient's leukocyte, neutrophil, and eosinophil levels resembled those typically found in PFAPA syndrome. The vulvar lesions were accompanied by fever episodes, abdominal pain, nausea, and vomiting. Additionally, our patient did not undergo a tonsillectomy, a procedure reducing the risk of the PFAPA syndrome recurrence.

Furthermore, as emphasized by researchers, the incidence of PFAPA syndrome rose during the COVID-19 pandemic [14].

An effective vaccination against SARS-CoV-2 was a vital tool to halt the spread of the pandemic; however, some predisposed people may have presented adverse reactions to the vaccination. Several cutaneous side effects were observed, e.g. delayed large local reactions and eruptions.

Recently, cases of AGU associated with COVID-19 vaccinations have been reported [2, 5, 19]. Of the 94 cases of vulvovaginal ulceration reported in the female adolescent age group, there was evidence that at least 37 were AGUs. In addition, up to December 2022, there were approximately 12 case reports published in scientific literature on genital ulceration after COVID-19 vaccine administration in non-sexually active adolescent patients. In majority, the events occurred after the second dose, usually within 1week. Common symptoms included pain-related difficulty in urination, defecation, sitting and walking. Fever, vulvar swelling and fatigue were also noted. Despite a different approach, the ulcers were usually self-limiting and healed between 2 to 6weeks [20].

The most frequently reported altered effects of vaccines are pain and swelling. Mucosal changes (bleeding gums, oral sores and ulcers) may occur after administration of diphtheria, tetanus, acellular pertussis and polio vaccines [19]. Incidences of lichen planus, a chronic inflammatory disease which affects the stratified squamous epithelium and frequently involves the oral and genital mucosa, have been reported after hepatitis B vaccination. In all likelihood, the immune system recognizes epitopes similar/identical to proteins of the virus on keratinocytes and induces immunological response and apoptosis of these cells [21].

Once an mRNA vaccine is administered,the spike protein, a viral receptor-binding protein, is produced by ribosomes in muscle cells. Subsequently, it binds to the host receptor angiotensin-converting enzyme 2 and triggers a robust CD8+and CD4+cell mediated response, inducing the production of neutralizing antibodies and memory of B and T-cells. COVID-19 vaccinations induce an autoimmune response by several pathways, including the development of specific autoantibodies, the effects of certain vaccine adjuvants, and molecular mimicry [22].

The SARS-CoV-2 spike protein and lung surfactant proteins share 13 out of 24 pentapeptides and the respiratory system is the most frequently attacked system in the case of COVID-19 infection. A similar mechanism of cross-reactions between the virus proteins and a variety of human antigens could possibly lead to autoimmunity against other organs, including the formation of mucosal and skin lesions induced by the coronavirus invasion as well as COVID-19 vaccines [22].The side effects of a vaccination might as well be due to transient bursts of IFN-I expression, effective antibody production, oxidative stress and DNA-damage, which may stimulate hyperinflammatory conditions. Another explanation indicates that in the case of mRNA vaccines, mRNA presents as both antigen and adjuvant, and might be so identified by Toll-like receptors, which trigger inflammation and immunity [22]. Nevertheless, the pathophysiology of AGUs after vaccination remains poorly understood.

A rare problem following COVID-19 vaccination described in the literature is Behcet's disease, and it is also possible that AGUs after vaccination are the first manifestation of this condition [23].

Behcets disease (BD) should also be evaluated in our patients history of aphthous lesions in the mouth and genital ulceration. Behcets disease is a rare inflammatory disorder diagnosed based on clinical symptoms and specific characteristics. According to the new criteria, a patient who scores4 points is classified as having BD. Characteristic signs and symptoms include ocular lesions (2), genital aphthosis (2), oral aphthosis (2), skin lesions (1), neurological manifestations (1), vascular manifestations (1) and, optionally, a positive pathergy test (1) [24]. In addition, BD is often associated with the neutrophil to lymphocyte ratio (NLR) being increased while the hemoglobin (HB) level is decreased. Additionally, there is an increase in the erythrocyte sedimentation rate (ESR) and CRP, and the human leukocyte antigens (HLA-B51) test shows positive results [25].

The pathomechanism of BD may depend on neutrophil-mediated mechanisms, that is, neutrophil hyperactivation via both a massive reactive oxygen species (ROS) production and neutrophil extracellular traps (NETs) release. BD patients have higher serum concentrations of sTNFR, leptin, sCD40L, and IL-6. Tumor necrosis factor alpha (TNF-alpha), leading neutrophils to disrupt the oral mucosa, is elevated in patients with recurrent aphthae, and affects endothelial cell adhesion and neutrophil chemotaxis. This is believed to be one of the molecular factors that are responsible for aphthous ulcers. As mentioned above in the present article, aphthous ulcers may occur both as a rare side effect of COVID-19 vaccination and as a consequence of high serum concentrations of sTNFR in BD [26].

,PFAPA syndrome and Behcets disease are characterized by similar pathomechanism. For this reason, they are often considered in the differential diagnosis [10, 13]. It is postulated that the same HLA type, specifically, HLA-B5 and HLA-B51, is involved in the development of both diseases [13, 14].Thus, ulceration in the vaginal area can be a symptom of PFAPA syndrome and Behcets disease.

The vulva can be affected by a variety of microorganisms including bacteria, viruses, fungi and parasites. Commonly, those infections are transmitted by sexual contact. However, in non-sexually active adolescents, genital infections might develop as well. AGU is commonly described as associated with a variety of infections including cytomegalovirus, herpes zoster virus (HZV), influenza type A and B, mumps virus, salmonella, mycoplasma and, most commonly, Epstein-Barr virus [4].

EBV causing infectious mononucleosis syndrome has been reported as a most common cause of AGU. Serologic testing for EBV in patients with vulvar ulcers demonstrated evidence of acute as well as prior infections [3]. Most patients develop systemic symptoms of IMS, and lymphadenopathy distant from the site of ulceration is also common; however, in the presented case the enlargement of lymph nodes has not been noted. Acute CMV infection has also been detected in patients with AGU and CMV inclusions found in cells of the vulva and cervix [3, 27]. As for the vulvar HZV infection, it is uncommon and often causes pain or a burning sensation. Lesions usually appear in a specific dermatomal distribution.

Herpes simplex virus, causing genital herpes, remains the most common factor of genital ulcers among sexually active females. However, it might also be responsible for ulcers in non-sexually active adolescents [4, 28]. There are two types of HSV. HSV-2 is considered to be the main cause of AGU, whilst HSV-1 is mostly linked to oral cavity lesions.

American pediatric and adolescent gynecology care providers suspect an 80% of HSV etiology at the onset of AGU diagnosis, therefore aggressive diagnosis of lesions should be delayed [29].

Since there is no single infectious agent identified as a cause of AGU, clinical examination and detection of viral genetic material or serologic tests play a pivotal role in the diagnostic process.

We also considered the possibility of vulvar cancer, although the incidence of genital cancers are rare in young females [30]. However, the macroscopic appearance of the vulvar lesion as an ulcer raised suspicions of oncological concern. There are two types of vulvar intraepithelial neoplasia (VIN). One of them, defined as differentiated (dVIN), is often associated with lichen sclerosus. The other refers to vulvar high-grade squamous intraepithelial lesions (vH-SIL) [31]. It is an HPV-related oncology condition that is specific to younger women and refers to intraepithelial neoplasia and squamous cell vulvar carcinoma (SVC) [32]. Moreover, given the increase in HPV infections and an early age of sexual initiation, there is a significant risk of vulvar cancer in younger age groups [33]. However, biopsy from vulvar lesions in children is debatable among many researchers unless there is a recurrence or a non-infectious etiology is suspected [29]. Most cases of vulvar ulceration in young women are self-limiting and respond to topical and systemic corticosteroid therapy. For these reasons, some authors recommend reducing extensive diagnostics [34].In our study, due to the extensive area of necrosis as well as the specificity of a hospital also providing oncological treatment, it was decided to collect material for histopathological examination. Biopsy excluded neoplastic invasion, therefore we ruled out vulvar cancer.

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COVID 19 vaccination as a trigger of acute genital ulcers in an immunocompromised adolescentcase study and ... - BioMed Central

A Case Study in Vaccine Sharing Across Nations | Northern Today – Northern Today

March 5, 2024

Immunizations are an essential component of public health against infectious diseases. A Northern Michigan University assistant professor co-authored a recent publication that contends the COVID-19 pandemic provides a case study for how social equity is a global issue. Dr. Jongeun You in the Department of Political Science and Public Administration examined vaccine sharing policies across nations and found a significant imbalance in the international distribution of COVID-19 vaccines to lower-income nations, leading to severe disparities in access and vaccination rates.

Dr. You at NMU and Dr. Juniper Katz at the University of Massachusetts Amherst published their research in the Journal of Social Equity and Public Administration. The authors focused on four cases: China, India, the European Union and the United States. The case selections were based on their association with vaccine production, their varying wealth levels, regime types and development statuses.

Using publicly available documents and online information, the researchers explored the unprecedentedly rapid adoption of COVID-19 vaccines, driven by technology breakthroughs, large investments and coordinated international cooperation.

The speedy international cooperation to develop COVID-19 vaccines did not adequately translate into an equitable global distribution process, they wrote. Historically marginalized nations, communities, and populations were disproportionately disadvantaged by the COVID-19 pandemic physically, economically, and educationally.

In reaction to the public outcry over vaccine inequity, political leaders stressed international solidarity to treat everyone equally and with dignity.

However, there is tension between the desire to be seen globally as a good-faith actor that facilitates global vaccine equity and the centrifugal forces in favor of the status quo, wrote Drs. You and Katz. While many COVID-19 vaccine-producing nations face international pressure to supply vaccines to other nations, they also face internal pressure to retain their domestic supply. This situation propels governments to balance globalism with protectionism in forestalling wicked transboundary problems caused by the pandemic.

Updated statistics show that, while 70.6% of the world population was administered at least one COVID-19 vaccine dose, only 32.7% of the population in low-income nations was administered at least one dose by February29, 2024.

The authors claim that major vaccine-producing nations can better promote social equity and justice by enabling other nations to produce their own vaccines, but add that much would need to change in order to prioritize global health security over financial gains.

They also wrote that outcomes might improve with the establishment of a global response roadmap (as opposed to sporadically announcing vague commitments); the strengthening of global leadership (as opposed to focusing inward); the sharing of resources (as opposed to stockpiling them); and the extension of national distribution and delivery capabilities (as opposed to taking part in ad-hoc charity).

Drs. You and Katz use vaccine distribution as a way to show how social equity is a global responsibility. Their article does an excellent job of taking a contemporary problem and showing its many implications, said the journal's editor and University of Colorado Distinguished Professor Dr. Mary E. Guy.

Read the full journal article here.

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A Case Study in Vaccine Sharing Across Nations | Northern Today - Northern Today

Disparities in Digital Health Portal Use Persist Beyond the COVID-19 Pandemic – Drug Topics

March 5, 2024

Although the COVID-19 pandemic led to an increase in electronic patient portal use, disparities in access due to health literacy persisted, according to research published in JAMA Network Open.1

As digital health continues to evolve and research continues regarding its overall use and efficacy, health care professionals are keen on understanding why and how certain demographics use specific resources.1 And at the height of the COVID-19 pandemic, digital health portals seemed to be more necessary than ever before.

The COVID-19 pandemic disrupted face-to-face health care delivery and accelerated the adoption and use of digital health modalities, like patient portals, according to the authors of a cohort study on the disparities of patient portal use during the most restrictive phase of the COVID-19 pandemic.1

Prior to the pandemic, ongoing research was conducted to identify which demographics have access, would benefit most, and are more likely to use digital health portals for primary care needs.

As part of the recently published study on patient portal use, the authors collected data from 2019 to 2022 on the frequency of portal logins. They identified how often specific demographics logged into their portals compared with others during and after the pandemic.

Analyzing the portal activities of 536 participants (mean age, 66.7 12.0 years; 62.7% women), researchers identified the number of days each patient logged into their portal in 2019, 2020, 2021, and 2022.

Despite researchers only observing login frequencies, it is important to note that patient portals are used for several health care activities, such as scheduling appointments, viewing post-visit summaries, patient-clinician communication, and more.

With a mean participant age of 66.7, the authors goal was to identify disparities in portal logins among older individuals who were at greater risk of long-term COVID-19 complications during the pandemic. They also separated participants by age, sex, health literacy, and socioeconomic status to attain a greater understanding of demographical disparities.

Populations with pre-existing risk factors, including those with low health literacy, may continue to be left behind in the shift toward digital health, wrote the authors.

Despite the immediate overall rise in portal use during the pandemic, login frequencies were still significantly lower for patients aged 70 years and older, patients with a low socioeconomic status, and patients with limited health literacy.

Conversely, participants aged 60 years or younger with an adequate health literacy status logged into their portals most frequently.

More frequent logins were also reported by individuals with more than 3 chronic health conditions and menalthough, the disparity between men and women was later deemed insignificant by 2022 login frequencies.

In 2016, the 21st Century Cures Act was signed into law,2 giving Americans much more transparent access to their medical files and data.2 But despite recent advancements in medical record-keeping, other hurdleslike access to the internet, new technology, and health care educationcontinue to leave low SES communities behind.

As telehealth and digital health tools continue to be an integral part of health care systems, future research would benefit from evaluating and optimizing digital literacy challenges as a potential barrier to portal adoption and use, as well as optimizing access to reliable internet or broadband services, particularly for communities that have historically had poor digital access due to limitations in neighborhood infrastructure, the authors concluded.

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Disparities in Digital Health Portal Use Persist Beyond the COVID-19 Pandemic - Drug Topics

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