Category: Covid-19

Adalja is a practicing infectious disease, critical care, and emergency physician.

News surfaced last week suggesting a potential shift in COVID-19 isolation guidance from the CDC. The planned guidance, which is expected to be released this spring for public comment, indicates a significant switch in how COVID-19 is conceptualized. The guidance would bring COVID-19 into line with how other common respiratory viruses are managed: with isolation recommended until the individual has mild and improving symptoms, and is fever-free (without pharmaceutical aid) for 24 hours.

With the news of the proposed guidance, many voices rose up to immediately attack the proposed guidance as a capitulation and not evidence-based. This was similar to the refrain from opponents when the federal or state governments dropped or loosened mask requirements or guidance.

I was not one of them.

Indeed, I welcome the proposed guidance change because it reflects the progress that has been made in the management of COVID-19. When evaluating this guidance, it is critical to understand that SARS-CoV-2, the cause of COVID-19, is situated among the myriad respiratory viruses that infect humans.

SARS-CoV-2, a virus unknown to humans before 2019, naturally began its foray into our species unopposed by diagnostic tests, antivirals, vaccinations, and knowledge. Today, in 2024, there are more tools for monitoring and managing COVID-19 than for any other respiratory virus: spanning from home tests, to wastewater monitoring, to potent antivirals, to highly effective vaccines, to a wealth of clinical guidance to manage cases and mitigate complications. All of these medical countermeasures are coupled with a high degree of immunity in the population from prior infections, vaccinations, and combinations of both. In short, the entire context of COVID-19 has changed for the better.

No longer are hospitals worried about capacity due to huge COVID surges -- cases may ebb and flow in the community and new variants appear, but no longer are these phenomena coupled to hospitals in crisis. While the raw numbers of hospital admissions and invasive mechanical ventilation or death were higher for COVID than for both respiratory syncytial virus (RSV) and the flu in 2022-2023, rates of ventilation or death were statistically no different for older adults hospitalized for either RSV or COVID (13.5% vs 10.2%), recent CDC data showed, both higher than for flu (7%). Furthermore, the highest rates of oxygen therapy and ICU admission in the study were among those with RSV (a virus for which no antiviral exists).

What is most baffling to me is that those who are critical of the proposed guidance change seemingly ignore the fact that most countries have already moved to this new paradigm without any evidence of major untoward impacts. Indeed, even California and Oregon -- two states not known for cavalier attitudes regarding COVID-19 mitigation -- have done the same. These states also advise that asymptomatic patients do not need to isolate at all; masking for 10 days is deemed sufficient. This is despite the fact that contagiousness remains in some individuals, even with improved clinical symptoms and a fever-free status.

What the new guidance reflects is that COVID-19, with the wealth of tools that were created to combat it, cannot be singled out from the pack of respiratory viruses (most of which we have zero countermeasures for) for special treatment in perpetuity.

When our ancestors chose to live among each other in cities and villages, it brought many advantages, but there was also the tradeoff of flourishing communicable diseases, as population density and attendant social interactions increased. Among these communicable diseases were respiratory virus infections, which I believe people implicitly consent to when they live among and interact with each other.

While certain respiratory viruses are above that consent threshold -- and COVID-19 was above that threshold for some time -- many are not. COVID no longer is. What that means is that it will remain important for those at high risk for severe COVID, severe RSV, and severe influenza -- or anyone who really wants to avoid infection to keep in mind that these viruses are ever-present where there are people. They must also remember that humans have the tools to minimize their impact via masks, tests, vaccines, and antivirals; these are readily available if an individual's risk calculation favors employing them. COVID-19 hospitalizations and deaths are preventable with prompt antiviral use coupled with high-risk individuals staying up-to-date on vaccination.

COVID-19 guidance has long needed to embrace the paradigm of harm reduction as it does for sexually transmitted infections, injection drug use, and many other endeavors humans choose to engage in that have a non-zero risk. COVID-19 was always destined to be an endemic respiratory virus for which repeated infection would become a fact of life for humans. This is not capitulation but an embracing of the biology of the virus. Abstinence-only guidance -- as reflected by current guidelines that do not reflect the almost science fiction-like progress made against COVID-19 -- no longer has any place.

Amesh Adalja, MD, is a senior scholar at the Johns Hopkins Center for Health Security, and a practicing infectious disease, critical care, and emergency physician in Pittsburgh.

Disclosures

Adalja is currently a consultant, speaker, and/or advisory board member for GSK, Shionogi, and BD.

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Opinion | When It Comes to Isolation, COVID Shouldn't Be Singled Out From the Pack - Medpage Today

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The Determinants of COVID-19-Related Stress Among Caregivers of Individuals at High Risk During the Pandemic - Cureus

An extensive, two-year review of COVID-19 in schools and daycares has revealed that these settings were not a significant source of transmission of the virus when infection prevention and control measures were used, researchers at McMaster University have found.

The review was published Thursday in The Lancet Child and Adolescent Health and examined more than 34,000 references, including databases, websites, and studies, related to transmission in child-care settings and schools across the globe.

The results of the review appear to cast doubt on the necessity of the repeated interruptions to in-person learning during the pandemic.

In Ontario schools were closed for a minimum of 135 days to prevent the spread of COVID-19, with disruptions in three successive school years.

We found that after that initial shutdown where everything was locked down, schools did not appear to have much impact on community level transmission when infection prevention control measures were in place, Sarah Neil-Sztramko, an assistant professor at the university and the lead author of the review, said in a written statement.

The review, which was updated 18 times over the past two years, was launched in response to a need for timely, up-to-date access to scientific evidence to guide decision making, the authors said.

The role of schools and daycares in COVID-19 transmission, from a growing number of studies, were reported in several reviews; the overall findings were mixed, and these reviews became quickly outdated as new and often higher-quality evidence emerged, the authors wrote.

The purpose of this living rapid review was to continually identify, appraise, and summarise emerging research evidence about the risk of transmission of COVID-19 among children and adults in schools and daycares, the effect of infection prevention and control (IPAC) measures on COVID-19 transmission within schools and daycares, and the effect of opening schools and daycares on community-level transmission.

The review found that masking, vaccinations and test-to-stay policies were the best methods to reduce COVID-19s spread in schools and daycares.

The effectiveness of strategies like mandatory quarantining, cohorting, and hybrid learning is uncertain and may have made little to no difference in transmission, the authors added.

It is important to understand which measures mitigate transmission so that schools can remain open as much as possible, given the negative impacts that were found during COVID-19 when they were closed, Neil-Sztramko said.

Remote learning, the review noted, was associated with increased educational disparities, especially for low-income families and those in remote areas with limited access to technology and resources.

School closures also reduced opportunities for students to interact with their peers, which has been shown to have an adverse effect on their social and emotional development, the review read.

Additionally, the fear, stress, and isolation caused by the pandemic contributed to a substantial increase in loneliness, anxiety, depression, and other mental health problems.

Decision-makers were faced with a difficult balancing act in their respective communities, the authors added.

Although the data consistently show that children can both contract and transmit COVID-19, based on published reports to date, following reopening, the risk of widespread transmission from child to child and child to adult is low, particularly when IPAC measures are in place and adhered to, the review read.

This trend appears to be consistent in the data collected with early variants of concern. Even when absolute case numbers were high, most infections originated from outside of school.

The researchers said the review provides a strong and factual foundation on how to handle significant outbreaks of other variants or infectious diseases in the future.

If there were to be another wave where community transmission was increasing and straining the health-care system, strategies such as masking, vaccination, and test-to-stay interventions are effective in fighting transmission, allowing schools to stay open, Neil-Sztramko said.

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Researchers at McMaster release review on COVID-19 in schools, daycares - CP24

A new study assessed lung impairment in Indians post-COVID-19 recovery and found that the prevalence of residual lung damage was much higher compared to the Europeans and Chinese. This might have been influenced by the higher rate of comorbidities in the Indian population, the researchers said.

The study published in the PLOS Global Public Health Journal by the Christian Medical College (CMC) in Vellore analysed lung impairment in patients that persisted 63 days after the onset of the disease during the first wave of the pandemic. The trial was conducted with 207 subjects by the Department of Pulmonary Medicine at CMC between August 11, 2020, to January 14, 2021.

In a large Indian cohort, we have reported the presence of post-COVID-19 residual lung damage, as assessed by lung function tests, exercise capacity, chest radiography, and quality of life measurement, the paper highlighted.

The doctors at CMC used a pulmonary function test to determine the working capacity of the lung called the diffusing capacity for carbon monoxide (DLCO). It measures the amount of oxygen that is transferred from the lungs to the bloodstream when a gas containing trace amounts of carbon monoxide is inhaled.

In the cohort, overall 44.4 per cent had diminished DLCO with less than 80 per cent diffusing capacity. Among the remaining subjects, 35 per cent had a restrictive lung defect and 8.3 per cent had an obstructive defect, both conditions also restrict the volume of air the lungs take in and out.

The research was led by Dr DJ Christopher, professor of pulmonary medicine at CMC. He told Down to Earth, In the long run, these patients might end up with a lung that functions less than optimally. Patients are immediately symptomatic if the impairment is severe. If the impairment is relatively smaller, they will carry on normal activities of life. But they might not be able to run or participate in sports. When the activities increase, they may not be able to perform. Also, their lungs would age faster and cause breathing difficulties much sooner than normal people.

Further, the study compared the rate of comorbidities in several countries. Our population reported relatively higher symptomatology and comorbidities and greater lung function impairment, compared to most published studies, the paper said.

Overall, 72.5 per cent of subjects had underlying comorbidities, of which 40.1 per cent had two or more comorbidities. Common comorbidities included diabetes mellitus (37.7 per cent), systemic hypertension (33.3 per cent), chronic respiratory diseases (29 per cent), ischemic heart disease (8.2 per cent), malignancy (4.3 per cent) and chronic kidney disease (1.9 per cent), the paper added.

Comparatively, the number of patients who reported comorbidities was much lower in a 2020 study published in the European Respiratory Journal. The study said that 40 per cent of the Chinese subjects had at least one underlying comorbidity, 23.6 per cent had hypertension and 8.2 per cent had diabetes. Only 2.7 per cent were reported as having chronic respiratory diseases.

Comorbidities may be a factor contributing to lung damage. If people had comorbidities, the impact of the disease could have been worse, Christopher told DTE.

The 207 subjects were categorised into the WHO disease severity groups: Mild 124 (59.9 per cent), moderate 41 (19.8 per cent), severe and critical 42 (20.3 per cent).

Overall, the Indian population also fared poorly when it came to lung function post COVID-19 infection. A study by the University Hospitals Birmingham in 2021 found that the DLCO was low in 152 patients (20.3 per cent) with mild disease, 435 patients (32 per cent) with moderate disease and 181 patients (59.5 per cent) with severe disease.

In contrast, in the Indian population, low DLCO results were observed denoting lung impairment in 31.5 per cent of mild patients, 54.8 per cent of moderate patients and 73.3 per cent in the severe group. It is equivalent to an average of 44 per cent of low DLCO across the board in all three categories, the study calculated, juxtaposing the higher rate of poor lung functioning among Indians.

Christopher added, Across every category of disease, our population had worse lung function. It is clear that the lung function is affected more in the Indian population compared to the international data.

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Indians have worse lung function post COVID-19 compared to other populations: CMC study - Down To Earth Magazine

Of the many who succumbed to the coronavirus pandemic worldwide, between 2020 to date, a section of Covid-19 survivors in India have reportedly developed long term lung impairment, a study found recently.

A genetical comparison between SARS-CoV-1 and SARS-CoV-2 showed interstitial abnormalities in 4.6 per cent of patients 15 years after they had contracted SARS-CoV-1, according to Dr D J Christopher, Professor, Department of Pulmonary Medicine at Christian Medical College, Vellore.

According to Dr Christopher who is also the lead author of the study, unlike the minimal percentage of lung infection in SARS-CoV-1 survivors, the same in those who contracted SARS-CoV-2 is severe. After conducting a series of tests on 207 Covid-19 or SARS-CoV-2 survivors from the first wave of the pandemic, the study found many of these were infected with acute respiratory distress syndrome (ARDS) that is likely to result in fibrotic interstitial lung disease.

The US' National Institutes of Health defines interstitial lung disease as diffused parenchymal diseases which are a heterogeneous group of disorders characterized by scarring of the lungs. These are classified on the basis of histopathological, radiologic and clinical parameters.

Dr Christopher and his team observed the clinical symptoms of the 207 individuals 2 months after they recovered from Covid. These patients also underwent pulmonary function tests and were subjected to a 6-minute walk test, along with St Georges Respiratory questionnaire (SGRQ) and chest radiography. The mean age of the individuals part of the tests was 48.7 years of whom 141 (68.1per cent) were males.

The 207 individuals were distributed to the WHO disease severity categories as follows: mild 124 (59.9 per cent), moderate 41 (19.8 per cent) and severe & critical 42 (20.3 per cent) categories. The tests showed that around 49.3 per cent subjects suffered shortness of breath and 27.1 per cent had cough.

Another category that Dr Christopher's team focused was patients who contracted pneumonia while being Covid positive. They found that the mean lowest oxygen saturation was lower for the "Covid-19 pneumonia" group compared to the "mild Covid-19" group i.e., 94.89 vs 97.73, respectively.

Overall, the tests revealed that 44.4% had impaired diffusing capacity for carbon monoxide (Dlco). ScienceDirect decribes Dlco as an integrative measurement that describes the transfer of oxygen from the alveolus into the red blood cell. The Dlco impairment was 31.5 per cent in mild, 54.8 per cent in moderate and 73.3 per cent in severe groups.

With conclusions derived after the above tests, Dr Christopher and his team discovered that even a small degree of fibrosis in elderly patients with Covid-19, who may also have underlying lung disorders could lead to considerable morbidity. The study that is published in PLOS Global Public Health journal further said that the team is yet to conduct follow ups on more samples from different patient groups, to understand the levels of lung damage in Covid-19 survivors.

The study also stresses on the quality of life that individuals follow, and stated that this is one of the major factors in either fueling the damage to the lungs, or reducing it through practicing effort tolerance activities.

(Published 19 February 2024, 11:28 IST)

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Indian survivors of Covid 1st wave prone to long-term lung damage: Study - Deccan Herald

A host of London market reinsurers including units of Axa XL, Brit, Liberty and Chaucer have hit back at a $90mn lawsuit brought by WR Berkley's Lloyd's arm, arguing that the carriers Covid-19 reinsurance recoveries total no more than the $26.6mn which has already been paid.

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Reinsurers fight back against WR Berkleys $90mn Covid-19 ri dispute - Re-Insurance.com

by Timothy McQuiston, Vermont Business Magazine The Vermont Department of Health reported last week that COVID-19 cases again fell to their lowest level since early November and hospitalizations also were down for nearly the same timeframe, as the early winter spike has subsided. However, there were again 6 fatalities, which has been about the average since mid-December. The pandemic death total now stands at 1,124 as of February 10, 2024 (the most recent data available). Total reported deaths in January were 28, which is the highest monthly total in nearly a year, and 7 so far in February.

The VDH reported February 14, 2024, that COVID-19 hospitalizations were down 10 last week to a statewide total of 28. COVID-19 activity remains in the "Low" range, according to the VDH. Reported cases last week were 210, down 44 for the week.

Of the total deaths to date, 906 have been of Vermonters 70 or older. There have been 3 deaths of Vermonters under 30 since the beginning of the pandemic.

CDC states that already an estimated 97% of Americans have some level of immunity, from either vaccination or infection or both, which they said will help keep down new transmission and lessen serious outcomes.

Report Timeframe: February 4 to February 10, 2024

(see data tables below)

The hospitalizations dataset contains day-level data reported from all Vermont hospitals each Tuesday. Reported numbers are subject to correction.

The number of reportable COVID-19 cases is still available in this report, below. Laboratory-confirmed and diagnosed COVID-19 cases and COVID-19 outbreaks must still be reported to the Vermont Department of Health.

There were 3 outbreaks last week, 0 at schools, and 3 at long-term care facilities (LTC). There were 10 outbreaks the week before.

Vermont Department of Health recommendations: Preventing COVID-19 (healthvermont.gov)

Vermont has the second lowest state fatality rate in the US (129.8 per 100K; Hawaii 102.8/100K). Mississippi (442.6/100K) and Oklahoma (440.2/100K) have the highest rates. The US average is 295.1/100K (CDC data).

There has been a total of 1,178,527 COVID-related deaths to date in the US (CDC) and 7,028,881 globally (WHO).

Following an analysis of COVID-19 data, the VDH reported in January 2023 a cumulative 86 additional COVID-associated deaths that occurred over the course of the pandemic but had not been previously reported. Most of those deaths occurred in 2022.

COVID-19 Update for the United States

Early Indicators

Test Positivity

% Test Positivity

9.3%

(February 4 to February 10, 2024)

Trend in % Test Positivity

-0.6% in most recent week

Emergency Department Visits

% Diagnosed as COVID-19

1.8%

(February 4 to February 10, 2024)

Trend in % Emergency Department Visits

-5.3% in most recent week

These early indicators represent a portion of national COVID-19 tests and emergency department visits. Wastewater information also provides early indicators of spread.

Severity Indicators

Hospitalizations

Hospital Admissions

21,373

(February 4 to February 10, 2024)

Trend in Hospital Admissions

+0.8% in most recent week

Deaths

% of All Deaths in U.S. Due to COVID-19

2.7%

(February 4 to February 10, 2024)

Trend in % COVID-19 Deaths

-6.9% in most recent week

Total Hospitalizations

6,816,249

CDC | Test Positivity data through: February 10, 2024; Emergency Department Visit data through: February 10, 2024; Hospitalization data through: February 10, 2024; Death data through: February 10, 2024. Posted: February 16, 2024 12:16 PM ET

The Delta variant took off in August 2021, which resulted in the heaviest number of deaths before vaccines and their boosters helped alleviate serious COVID cases. Multiple Omicron variants are now circulating and appear more virulent than previous variants, but perhaps not more dangerous, according to the CDC.

New COVID-19 variant JN.1: Experts explain symptoms, how to spot and treat the new strain

AP April 5, 2023: WHO downgrades COVID pandemic, says it's no longer a global health emergency

Walk-in vaccination clinics run by the state closed on January 31, 2023. Learn more

Vermonters are reminded that all state COVID testing sites were closed as of June 25, 2022. PCR and take-home tests are available through doctors' offices, pharmacies and via mail from the federal government. The federal government officially ended its pandemic response as of May 11, 2023. See more information BELOW or here: https://www.healthvermont.gov/covid-19/testing.

Starting May 11, 2023, the CDC and Vermont Department of Health will no longer use the COVID-19 Community Level to measure COVID-19 activity in the U.S. and Vermont. Instead, Vermont's statewide COVID-19 level will be measured by the rate of COVID-19 in people being admitted to the hospital, per 100,000 residents.

Focusing on hospitalization data is a better estimate of how COVID-19 is impacting the community now that reported COVID-19 cases represent a smaller proportion of actual infections. This also allows us to compare Vermonts hospitalization levels with other parts of the country.

The Delta variant caused a surge in COVID-related fatalities last fall and into the winter.

The highest concentration of deaths was from September 2021 through February 2022. Overall, December 2020 and January 2022 were the worst months with 72 fatalities each.

The US confirmed its first case of COVID-19 on January 20, 2020.

Vermonters ages 6 months and older are eligible for COVID-19 vaccines. Getting vaccinated against COVID-19 is the safer way to build protection from serious illnesseven for those who have already had COVID-19. Learn more about COVID-19 vaccines (CDC)

COVID-19 vaccines are free and widely available. Anyone can get vaccinated in Vermont, including those who live in another state, are non-U.S. citizens, or who have no insurance. See Vermont's current vaccine rates

Know your rights when getting free vaccines.

You are considered up-to-date if you are over the age of 6 years old and have received a bivalent (updated) COVID-19 vaccine.Learn more about kid vaccines

If you are unable or choose not to get a recommended bivalent mRNA vaccine, you will be up to date if you received the Novavax COVID-19 vaccine doses approved for your age group.

Find more on recommended doses from CDC

COVID Vaccine Information for Health Care Professionals

More on COVID-19 Vaccines (CDC)

Recommended COVID Vaccine Doses (CDC)

Find a COVID-19 vaccine near you.

Image

Use Vaccines.gov to find a location near you, then call or visit the location's website to make an appointment.

Vaccines.gov

Everyone 6 months of age and older is eligible to get a COVID-19 vaccination.Most children are also now eligible for a bivalent dose that offers increased protection against the original strain and omicron variants.

See more on recommended vaccine doses by age group (CDC)

Resources for parents and caregivers

Confident Care for Kids

Tips for Helping Kids Feel Ready for Any Vaccine (Vermont Family Network)

#factsheet

What Families with Children Should Know About COVID-19 Vaccines (translated)

https://www.youtube.com/watch?v=lWcqHOgQIVg&t=5s

Conversations About COVID-19 Vaccines for Children with Vermont Pediatricians (American Academy of Pediatrics)

If you cannot get vaccines through any of the options above, our local health offices

offer immunization clinics by appointment.

Need a ride? If you do not have transportation to get a free COVID-19 vaccine or booster, please contact your local public transportation provider or callVermont Public Transportation Association (VPTA)

at 833-387-7200.

English language learners, or immigrant or refugee community members, who would like to learn about more about vaccine clinics can contact theAssociation of Africans Living in Vermont

(AALV) at 802-985-3106.

If you lost your vaccine card or your information is wrong:

Recommendations for keeping your vaccination card and record up to date

Find more COVID-19 translations

COVID-19 resources for people who are deaf and hard of hearing

Report your COVID-19 test results

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VDH: COVID cases and hospitalizations keep falling, fatalities do not - Vermont Biz

The degree of severity to which someone experiences COVID-19 has a lot to do with the bodys immune response to the SARS-CoV-2 virus and the infection it causes. Our immune system tailors antibodies to fight infections, so they are often used as an indicator to determine what type of illness were up against or how sick its likely to make us. Looking closely at one of the antibodies produced to fight COVID-19, researchers at Drexel Universitys College of Medicine have uncovered a trait that could be used to predict the diseases severity.

The finding, which was reported recently in the journal Nature Communications, is tied to the presence of sugar structures, called glycans, that modify antibodies and affect how they function. Early COVID-19 research focused on this modification, called glycosylation, as it occurred in long-lasting immunoglobulin G antibodies. The Drexel teams discovery came from looking at an antibody produced earlier in the immune response known as immunoglobulin M (IgM).

IgM plays a major role in how the immune system responds to pathogens like bacteria and viruses, said co-senior author of the research Mary Ann Comunale, EdD. No one was looking at IgM glycans, so we made it the target of this work. Comunale is an associate professor and glycobiologist in the College of Medicine with over two decades of biomarker research experience focusing on glycobiology.

The Drexel research group, led by MD/PhD candidate Ben Haslund-Gourley, a student in the Comunale lab at Drexels College of Medicine, found that changes in the glycan structures attached to IgM were associated with the severity of a patients COVID-19 infection and these changes in glycans may influence how the antibodies combat infection.

What this paper tells us is the immune system is changing the glycans on IgM especially during severe disease, said co-senior author Elias El Haddad PhD, a professor of microbiology and immunology in the College of Medicine. Although there is no rapid test to look at these glycans in hospitalized patients, these findings may serve as a starting point for understanding the immune system's response.

Blood samples used in the study came from hospitalized COVID-19 patients participating in the Drexel cohort of the National Institute of Allergy and Infectious Diseases Immunophenotyping Assessment in a COVID-19 Cohort Study (IMPACC), of which El Haddad and study co-author and College of Medicine Dean Charles Cairns, MD, serve as principal investigators. Researchers kept tabs on the patients, tracking the first 28 days of their illness.

Once IgM binds to its target, it activates a cascade of proteins, known as complement, that attack cell walls, El Haddad said. While this activity can help fight infections, overactivation of complement can lead to organ failure.

Severe COVID-19 infections have higher complement activity, a mechanism the body uses to fight pathogens. The Drexel teams research suggests that the glycans on IgM could partly be responsible for this over-activation during severe disease.

These findings suggest that identifying IgM glycans could identify patients at risk for severe disease at an early stage of the infection and help guide management, Cairns said.

The glycosylation of an antibody is essential when developing therapeutics, Comunale said. Antibodies can have pro- or anti-inflammatory effects depending on the glycans present. Glycoengineering is a way to fine-tune an antibody to kill a pathogen more effectively and ensure you are not causing an increase in the patient's inflammatory response. Hence, these results inform the development of immunotherapy strategies for viral diseases.

The authors hope this study on 22 patients leads to larger patient studies that verify these results, and future research that looks at IgM and IgG in patients after they leave the hospital to see if those glycans can help predict long-covid symptoms.

The collaboration started when Ben, a student in my lab, learned of the IMPACC study from his peer Kyra Woloszczuk, a student in the Drexel lab of Elias El Haddad PhD, bringing together experts in glycobiology and in immunology, Comunale said. The results of this work highlight two key points required for translational research: the importance of collaboration and the patients willingness to engage with scientists.

Other authors on this paper include Kyra Woloszczuk, Jintong Hou, Jennifer Connors, Gina Cusimano, Mathew Bell, Bhavani Taramangalam, Nathan Mege, and Mariana Bernui from Drexel, Slim Fourati from Emory, Matthew C. Altman from Benaroya Research Institute, Florian Krammer and Harm van Bakel from Icahn School of Medicine at Mount Sinai, the IMPACC Network, Holden T. Maecker from Stanford, Nadine Rouphael from Emory, Joann Diray-Arce from the University of Texas at Austin, and Brian Wigdahl and Michele A. Kutzler from Drexel.

The National Institutes of Health-funded study, IgM N-glycosylation correlates with COVID-19 severity and rate of complement deposition, is available here.

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Drexel Researchers Find Possible Predictor of COVID-19 Severity - Drexel

The COVID-19 pandemic inflicted enormous economic, social, and health costs (Agrawal et al. 2023, Cutler and Summers 2020, Viscusi 2023, Qiu et al. 2020, Chetty et al. 2020, Levy Yeyati and Filippini 2021). As of January 2024, approximately 7 million COVID-19 deaths have been reported globally. Beyond the tremendous loss of life, the pandemic has affected many facets of life, including peoples jobs and incomes due to disruptions in economy, visits to healthcare providers, social life and outdoor activities, distress caused by social isolation, loss of loved ones, fear of job loss, risk of getting infected, learning loss due to school closures, and so on (Cantor et al. 2022, Whaley et al. 2020, Ziedan et al. 2020, Chetty et al. 2020, Breslau et al. 2021, Raviv et al. 2021, Ettman et al. 2020, Maisonneuve et al. 2023, Kenny et al. 2021, Guglielminetti et al. 2021).

In order to protect people from infection and avert pandemic catastrophe, the first COVID-19 vaccine was approved for use in the US by the Food and Drug Administration on 11 December 2020, which led to the launch of the global COVID-19 vaccination campaign. Prior studies have examined the impact of vaccines on COVID-19 deaths (Gupta et al. 2021, Steele et al. 2022, Haas et al. 2022, He et al. 2022, Watson et al. 2022). However, the impacts of the global COVID-19 vaccination campaign on worldwide all-cause mortality are not fully understood. While data from clinical trials suggest that vaccines are safe and effective (Polack et al. 2020, Baden et al. 2021, Voysey et al. 2021), they fail to capture the real-world effectiveness of COVID-19 vaccines in averting deaths for a variety of reasons. First, individuals in the real world might change protective behaviours in response to vaccinations compared to participants in clinical trials, as participants in clinical trials did not have evidence on the effectiveness of the vaccine and they were blind to whether they received the experimental vaccine or a placebo (Agrawal et al. 2022). Second, the effectiveness of vaccines might depend on the variant of infection. The dominant variants when vaccines underwent clinical trials were different than the variants that were widespread when vaccines were introduced (Katella 2023). Third, the effectiveness of the vaccines might depend on prior infection status, and most clinical trial participants did not have a prior infection. Fourth, the effectiveness of vaccines might reduce with time since vaccination due to wanning antibody levels (Tartof et al. 2021, Eyre et al. 2022, Menni et al. 2022, Ferdinands 2022). Fifth, COVID-19 vaccines might influence all-cause mortality by affecting mental health, social isolation, healthcare use, and economic activity (Agrawal et al. 2021, Daz et al. 2023, Deb et al. 2022, Kwok et al. 2021, Tawk et al. 2021); and clinical trials were underpowered to estimate the effects of vaccines on all-cause mortality. Sixth, clinical trials are not suitable for estimating general equilibrium effects, such as the effects of vaccination on reduced transmission of disease.

We examine the real-world effectiveness of the global COVID-19 vaccination campaign on all-cause mortality using observational data. We focus on all-cause mortality as it accounts for both direct and indirect effects of the vaccines. It also mitigates the problem of measurement errors and incorrect reporting of COVID-19 deaths.

To calculate the effect of the COVID-19 vaccination campaign on all-cause mortality, we require data on the actual number of deaths occurring after the rollout of COVID-19 vaccines, as well as the number of deaths that might have occurred in a counterfactual world in which vaccines were not available. The difference in mortality between these two scenarios the real and the counterfactual provides an estimate of the number of lives saved due to the COVID-19 vaccination campaign. Since we cannot observe deaths in the counterfactual world of no vaccines for countries that vaccinated their populations, we use two quasi-experimental approach to estimate the effect of the vaccination campaign on all-cause mortality across 141 countries.

First, at the onset of COVID-19 vaccination campaign, vaccine availability varied across countries, resulting in some countries vaccinating their population earlier than others (see Figure 1). This staggered rollout of vaccines allows us to use the countries that were slow to vaccinate their population (control group) to predict deaths in countries that vaccinated their populations (treatment group) in the counterfactual world of vaccines not being available. For example, if by a certain date, country A had vaccinated 50% of their population but country B was yet to start its vaccination campaign, we can use data from Country B to predict what would have happened in Country A in the counterfactual world where country A also did not launch its vaccination campaign. Comparing deaths in the real world where country A vaccinated its population to the counterfactual world in which it did not provides an estimate of the lives saved by country As vaccination campaign. Doing this exercise for all countries that provided COVID-19 vaccines to their residents yields the total lives saved from the global vaccination campaign.

Figure 1 Worldwide share of population fully vaccinated by August 2021

Because the countries that did not administer COVID-19 vaccines might not be the ideal counterfactual for countries that did vaccinate their population, we used a second empirical approach to estimate the lives saved by COVID-19 vaccines globally. To do so, we use trends in all-cause mortality from the period when vaccines werent available to extrapolate or forecast deaths in the post vaccination period. Since we are using data from pre-vaccine availability period for the forecast, they provide an estimate of deaths in the counterfactual world of post vaccination period, in which vaccines were not available.

Using both the quasi-experimental approaches, we find that the COVID-19 vaccination campaign across 141 countries averted 2.4 million deaths by August 2021. We also calculate the value of lives saved using country and region-specific estimates of the value of statistical life (VSL) (Sweis 2022). We find that the lives saved during the first eight months of the COVID-19 vaccination campaign were valued at $6.5 trillion, which is approximately equal to 9% of the combined GDP of these 141 countries.

Finally, because the global distribution of vaccines has been uneven, with higher-income countries having earlier access to vaccines (Deb et al. 2023), we examine the potential impact of a more equitable counterfactual distribution of vaccines across 141 countries, where vaccination in each country is proportional to its population.

We estimate that with equitable distribution of vaccines among the 141 countries, the global COVID-19 vaccination campaign would have averted 670,000 more lives but with a $1.8 trillion decrease in the value of deaths averted (see Figure 2).

Figure 2 Change in lives saved and the value of lives saved (from actual to equitable distribution scenario)

This naturally raises the question: why does the value of lives saved decrease despite the increase in the number of lives saved with more equitable distribution? This happens because with a fixed supply of vaccines, a more equitable vaccine distribution implies reduced vaccination in richer countries and increased vaccination in poorer countries. It thus implies fewer lives saved in richer countries and more lives saved in poorer countries. Since VSL is positively correlated with per capita GDP, it is higher in richer countries compared to poorer countries. Therefore, we get the result that a more equitable distribution leads to lower value of lives saved. However, this does not mean that a more equitable distribution of vaccines is less desirable. VSL is just one metric for valuing lives, and it is likely not the best metric for comparing the value of lives across different countries. Considering the ethical view that all lives are equally important, a more equitable distribution would be more desirable as it would save more lives.

Our study contributes to the existing literature on the benefits of the global COVID-19 vaccination campaign by solving the limitations of clinical trials, and considering both direct and indirect effects of COVID-19 vaccines. The findings suggest that pharmaceutical interventions in the form of vaccination and therapeutics have a much larger protective effect on mortality compared to non-pharmaceutical interventions (NPIs), such as, shelter-in-place policies (Agrawal et al. 2023). Furthermore, our study adds to the literature on the most effective distribution strategy for essential medicines during a global public health crisis. We find that the number of lives saved would have been much higher if vaccines were distributed more equitably.

Agrawal, V, J Cantor, N Sood, and C Whaley (2021), The Impact of the COVID-19 Vaccine Distribution on Mental Health Outcomes, NBER Working Paper w29593.

Agrawal, V, J Cantor, N Sood, and C Whaley (2023), The Impact of COVID19 Shelterinplace Policy Responses on Excess Mortality, Health Economics, July, hec.4737.

Agrawal, V, N Sood, and C Whaley (2022), The Ex-Ante Moral Hazard Effects of COVID-19 Vaccines, NBER Working Paper w30602.

Baden, L R, H M El Sahly, B Essink et al. (2021), Efficacy and Safety of the mRNA-1273 SARS-CoV-2 Vaccine, New England Journal of Medicine 384(5): 40316.

Breslau, J, M L Finucane, A R Locker, M D Baird, E A Roth, and R L Collins (2021), A Longitudinal Study of Psychological Distress in the United States before and during the COVID-19 Pandemic, Preventive Medicine 143: 106362.

Cantor, J, N Sood, D M Bravata, M Pera, and C Whaley (2022), The Impact of the COVID-19 Pandemic and Policy Response on Health Care Utilization: Evidence from County-Level Medical Claims and Cellphone Data, Journal of Health Economics 82: 102581.

Chetty, R, J Friedman, N Hendren, M Stepner, and The Opportunity Insights Team (2020), The Economic Impacts of COVID-19: Evidence from a New Public Database Built Using Private Sector Data, NBER Working Paper w27431.

Cutler, D M, and L H Summers (2020), The COVID-19 Pandemic and the $16 Trillion Virus, JAMA 324(15): 149596.

Deb, P, D Furceri, D Jimenez, S Kothari, J D Ostry, and N Tawk (2022), The Effects of COVID-19 Vaccines on Economic Activity, Swiss Journal of Economics and Statistics 158(1): 3.

Deb, P, D Furceri, D Jimenez, S Kothari, J D Ostry, and N Tawk (2023), Determinants of COVID-19 Vaccine Rollouts and Their Effects on Health Outcomes, Applied Health Economics and Health Policy 21(1): 7189.

de La Maisonneuve, C, B gert, and D Turner (2023), Quantifying the Macroeconomic Impact of COVID-19-Related School Closures on Human Capital, VoxEU.org, 24 January.

Daz, F, P A Henrquez, N Hardy, and D Ponce (2023), Population Well-Being and the COVID-19 Vaccination Program in Chile: Evidence from Google Trends, Public Health 219: 2230.

Ettman, C K, S M Abdalla, G H Cohen, L Sampson, P M Vivier, and S Galea (2020), Prevalence of Depression Symptoms in US Adults Before and During the COVID-19 Pandemic, JAMA Network Open 3(9): e2019686.

Eyre, D W, D Taylor, M Purver, D Chapman, T Fowler, K B Pouwels, A S Walker, and T E A Peto (2022), Effect of Covid-19 Vaccination on Transmission of Alpha and Delta Variants, New England Journal of Medicine 386(8): 74456.

Ferdinands, J M (2022), Waning 2-Dose and 3-Dose Effectiveness of mRNA Vaccines Against COVID-19Associated Emergency Department and Urgent Care Encounters and Hospitalizations Among Adults During Periods of Delta and Omicron Variant Predominance VISION Network, 10 States, August 2021January 2022, MMWR. Morbidity and Mortality Weekly Report 71.

Guglielminetti, E, C Rondinelli, and V Ercolani (2021), Fears for the Future: Saving Dynamics after the Covid-19 Outbreak, VoxEU.org, 26 June.

Gupta, S, J Cantor, K I Simon, A I Bento, C Wing, and C M Whaley (2021), Vaccinations Against COVID-19 May Have Averted Up To 140,000 Deaths In The United States, Health Affairs 40(9): 146572.

Haas, E J, J M McLaughlin, F Khan et al. (2022), Infections, Hospitalisations, and Deaths Averted via a Nationwide Vaccination Campaign Using the PfizerBioNTech BNT162b2 mRNA COVID-19 Vaccine in Israel: A Retrospective Surveillance Study, The Lancet Infectious Diseases 22(3): 35766.

He, D, S T Ali, G Fan, D Gao, H Song, Y Lou, S Zhao, B J Cowling, and L Stone (2022), Evaluation of Effectiveness of Global COVID-19 Vaccination Campaign, Emerging Infectious Diseases 28(9): 187376.

Katella, K (2023), Omicron, Delta, Alpha, and More: What To Know About the Coronavirus Variants, Yale Medicine, 3 February.

Kenny, G, D Georgarakos, T Jappelli, and D Christelis (2021), Heterogenous Effects of Covid-19 on Households Financial Situation and Consumption: Cross-Country Evidence from a New Survey, VoxEU.org, 8 June.

Kwok, K O, K-K Li, W I Wei, A Tang, S Y S Wong, and S S Lee (2021), Influenza Vaccine Uptake, COVID-19 Vaccination Intention and Vaccine Hesitancy among Nurses: A Survey, International Journal of Nursing Studies 114: 103854.

Levy Yeyati, E, and F Filippini (2021), Pandemic Divergence: The Social and Economic Costs of Covid-19, VoxEU.org, 12 May.

Menni, C, A May, L Polidori et al. (2022), COVID-19 Vaccine Waning and Effectiveness and Side-Effects of Boosters: A Prospective Community Study from the ZOE COVID Study, The Lancet Infectious Diseases 22(7): 100210.

Polack, F P, S J Thomas, N Kitchin et al. (2020), Safety and Efficacy of the BNT162b2 mRNA Covid-19 Vaccine, New England Journal of Medicine 383(27): 260315.

Qiu, R T R, J Park, S Li, and H Song (2020), Social Costs of Tourism during the COVID-19 Pandemic, Annals of Tourism Research 84: 102994.

Raviv, T, C M Warren, J J Washburn et al. (2021), Caregiver Perceptions of Childrens Psychological Well-Being During the COVID-19 Pandemic, JAMA Network Open 4(4): e2111103.

Steele, M K, A Couture, C Reed et al. (2022), Estimated Number of COVID-19 Infections, Hospitalizations, and Deaths Prevented Among Vaccinated Persons in the US, December 2020 to September 2021, JAMA Network Open 5(7): e2220385.

Sweis, N J (2022), Revisiting the Value of a Statistical Life: An International Approach during COVID-19, Risk Management 24(3): 25972.

Tartof, S Y, J M Slezak, H Fischer et al. (2021), Effectiveness of mRNA BNT162b2 COVID-19 Vaccine up to 6 Months in a Large Integrated Health System in the USA: A Retrospective Cohort Study, Lancet (London, England) 398(10309): 140716.

Tawk, N, J D Ostry, S Kothari, D Jimnez, D Furceri, and P Deb (2021), The Economic Effects of COVID-19 Vaccines, VoxEU.org, 16 December.

Viscusi, W K (2023), The Global COVID-19 Mortality Cost Report Card: 2020, 2021, and 2022, PloS One 18(5): e0284273.

Voysey, M, S A Costa Clemens, S A Madhi et al. (2021), Safety and Efficacy of the ChAdOx1 nCoV-19 Vaccine (AZD1222) against SARS-CoV-2: An Interim Analysis of Four Randomised Controlled Trials in Brazil, South Africa, and the UK, The Lancet 397(10269): 99111.

Watson, O J, G Barnsley, J Toor, A B Hogan, P Winskill, and A C Ghani (2022), Global Impact of the First Year of COVID-19 Vaccination: A Mathematical Modelling Study, The Lancet Infectious Diseases 22(9): 12931302.

Whaley, C M, M F Pera, J Cantor et al. (2020), Changes in Health Services Use Among Commercially Insured US Populations During the COVID-19 Pandemic, JAMA Network Open 3(11): e2024984.

Ziedan, E, K Simon, and C Wing (2020), Effects of State COVID-19 Closure Policy on NON-COVID-19 Health Care Utilization, NBER Working Paper w27621.

See the original post:

The impact of the global COVID-19 vaccination campaign on all-cause mortality - CEPR

Johns Hopkins Coronavirus Resource Center. https://coronavirus.jhu.edu/map.html. Accessed 28 Dec 2022.

Rodriguez-Morales AJ, Cardona-Ospina JA, Gutierrez-Ocampo E, Villamizar-Pena R, Holguin-Rivera Y, Escalera-Antezana JP, et al. Clinical, laboratory and imaging features of COVID-19: a systematic review and meta-analysis. Travel Med Infect Dis. 2020;34:101623.

PubMed PubMed Central Google Scholar

McIntosh JA, Benkovics T, Silverman SM, Huffman MA, Kong J, Maligres PE, et al. Engineered Ribosyl-1-kinase enables concise synthesis of molnupiravir, an antiviral for COVID-19. ACS Cent Sci. 2021;7(12):19805.

CAS PubMed PubMed Central Google Scholar

Abdulla ZA, Al-Bashir SM, Al-Salih NS, Aldamen AA, Abdulazeez MZ. A summary of the SARS-CoV-2 vaccines and technologies available or under development. Pathogens. 2021;10(7):788.

CAS PubMed PubMed Central Google Scholar

Francis MJ. Recent advances in vaccine technologies. Vet Clin North Am Small Anim Pract. 2018;48(2):23141.

PubMed Google Scholar

Khoshnood S, Ghanavati R, Shirani M, Ghahramanpour H, Sholeh M, Shariati A, et al. Viral vector and nucleic acid vaccines against COVID-19: a narrative review. Front Microbiol. 2022;13:984536.

PubMed PubMed Central Google Scholar

Pollet J, Chen WH, Strych U. Recombinant protein vaccines, a proven approach against coronavirus pandemics. Adv Drug Deliv Rev. 2021;170:7182.

CAS PubMed PubMed Central Google Scholar

Cheng H, Peng Z, Luo W, Si S, Mo M, Zhou H, et al. Efficacy and safety of COVID-19 vaccines in phase III trials: a meta-analysis. Vaccines (Basel). 2021;9(6):582.

CAS PubMed Google Scholar

Sathian B, Asim M, Banerjee I, Roy B, Pizarro AB, Mancha MA, et al. Development and implementation of a potential coronavirus Disease 2019 (COVID-19) vaccine: a systematic review and meta-analysis of vaccine clinical trials. Nepal J Epidemiol. 2021;11(1):95982.

PubMed PubMed Central Google Scholar

Pormohammad A, Zarei M, Ghorbani S, Mohammadi M, Razizadeh MH, Turner DL, et al. Efficacy and safety of COVID-19 vaccines: a systematic review and meta-analysis of randomized clinical trials. Vaccines (Basel). 2021;9(5):467.

CAS PubMed Google Scholar

Calzetta L, Ritondo BL, Coppola A, Matera MG, Di Daniele N, Rogliani P. Factors influencing the efficacy of COVID-19 vaccines: a quantitative synthesis of phase III trials. Vaccines (Basel). 2021;9(4):341.

CAS PubMed Google Scholar

Rotshild V, Hirsh-Raccah B, Miskin I, Muszkat M, Matok I. Comparing the clinical efficacy of COVID-19 vaccines: a systematic review and network meta-analysis. Sci Rep. 2021;11(1):22777.

ADS CAS PubMed PubMed Central Google Scholar

Kumar S, Saikia D, Bankar M, Saurabh MK, Singh H, Varikasuvu SR, et al. Efficacy of COVID-19 vaccines: a systematic review and network meta-analysis of phase 3 randomized controlled trials. Pharmacol Rep. 2022;74:110.

Google Scholar

Hutton B, Salanti G, Caldwell DM, Chaimani A, Schmid CH, Cameron C, et al. The PRISMA extension statement for reporting of systematic reviews incorporating network meta-analyses of health care interventions: checklist and explanations. Ann Intern Med. 2015;162(11):77784.

PubMed Google Scholar

Higgins JPT, Savovi J, Page MJ, Elbers RG. JAC S. Chapter 8: Assessing risk of bias in a randomized trial. (updated February 2020). Cochrane, 2021. Preprint at http://www.training.cochrane.org/handbook (2021).

Good Clinical Practice. : GLOSSARY. https://ichgcp.net/1-glossary. Accessed 28 Dec 2022.

Salanti G, Ades AE, Ioannidis JP. Graphical methods and numerical summaries for presenting results from multiple-treatment meta-analysis: an overview and tutorial. J Clin Epidemiol. 2011;64(2):16371.

PubMed Google Scholar

Shim SR, Kim SJ, Lee J, Rcker G. Network meta-analysis: application and practice using R software. Epidemiol Health. 2019;41:e2019013.

PubMed PubMed Central Google Scholar

Neupane B, Richer D, Bonner AJ, Kibret T, Beyene J. Network meta-analysis using R: a review of currently available automated packages. PLoS ONE. 2014;9(12):e115065.

ADS PubMed PubMed Central Google Scholar

Seide SE, Jensen K, Kieser M. A comparison of bayesian and frequentist methods in random-effects network meta-analysis of binary data. Res Synth Methods. 2020;11(3):36378.

PubMed Google Scholar

Ella R, Reddy S, Blackwelder W, Potdar V, Yadav P, Sarangi V, et al. Efficacy, safety, and lot-to-lot immunogenicity of an inactivated SARS-CoV-2 vaccine (BBV152): interim results of a randomised, double-blind, controlled, phase 3 trial. Lancet. 2021;398(10317):217384.

CAS PubMed PubMed Central Google Scholar

Al Kaabi N, Zhang Y, Xia S, Yang Y, Al Qahtani MM, Abdulrazzaq N, et al. Effect of 2 inactivated SARS-CoV-2 vaccines on symptomatic COVID-19 Infection in adults: a randomized clinical trial. JAMA. 2021;326(1):3545.

CAS PubMed Google Scholar

Tanriover MD, Doganay HL, Akova M, Guner HR, Azap A, Akhan S, et al. Efficacy and safety of an inactivated whole-virion SARS-CoV-2 vaccine (CoronaVac): interim results of a double-blind, randomised, placebo-controlled, phase 3 trial in Turkey. Lancet. 2021;398(10296):21322.

CAS PubMed PubMed Central Google Scholar

Palacios R, Batista AP, Albuquerque CSN, Patio EG, Santos JdP, Conde MTRP, et al. Efficacy and safety of a COVID-19 inactivated vaccine in healthcare professionals in Brazil: The PROFISCOV study. SSRN J. 2021. https://doi.org/10.2139/ssrn.3822780.

Fadlyana E, Rusmil K, Tarigan R, Rahmadi AR, Prodjosoewojo S, Sofiatin Y, et al. A phase III, observer-blind, randomized, placebo-controlled study of the efficacy, safety, and immunogenicity of SARS-CoV-2 inactivated vaccine in healthy adults aged 1859 years: an interim analysis in Indonesia. Vaccine. 2021;39(44):65208.

CAS PubMed PubMed Central Google Scholar

Khairullin B, Zakarya K, Orynbayev M, Abduraimov Y, Kassenov M, Sarsenbayeva G, et al. Efficacy and safety of an inactivated whole-virion vaccine against COVID-19, QazCovid-in, in healthy adults: a multicentre, randomised, single-blind, placebo-controlled phase 3 clinical trial with a 6-month follow-up. EClinicalMedicine. 2022;50:101526.

PubMed PubMed Central Google Scholar

Mohraz M, Vahdat K, Ghamari SH, Abbasi-Kangevari M, Ghasemi E, Ghabdian Y, et al. Efficacy and safety of an inactivated virus-particle vaccine for SARS-CoV-2, BIV1-CovIran: randomised, placebo controlled, double blind, multicentre, phase 3 clinical trial. BMJ. 2023;382:e070464.

PubMed PubMed Central Google Scholar

El Sahly HM, Baden LR, Essink B, Doblecki-Lewis S, Martin JM, Anderson EJ, et al. Efficacy of the mRNA-1273 SARS-CoV-2 vaccine at completion of blinded phase. N Engl J Med. 2021;385(19):177485.

PubMed Google Scholar

Polack FP, Thomas SJ, Kitchin N, Absalon J, Gurtman A, Lockhart S, et al. Safety and efficacy of the BNT162b2 mRNA Covid-19 vaccine. N Engl J Med. 2020;383(27):260315.

CAS PubMed Google Scholar

Kremsner PG, Ahuad Guerrero RA, Arana-Arri E, Aroca Martinez GJ, Bonten M, Chandler R, et al. Efficacy and safety of the CVnCoV SARS-CoV-2 mRNA vaccine candidate in ten countries in Europe and Latin America (HERALD): a randomised, observer-blinded, placebo-controlled, phase 2b/3 trial. Lancet Infect Dis. 2022;22(3):32940.

CAS PubMed Google Scholar

Khobragade A, Bhate S, Ramaiah V, Deshpande S, Giri K, Phophle H, et al. Efficacy, safety, and immunogenicity of the DNA SARS-CoV-2 vaccine (ZyCoV-D): the interim efficacy results of a phase 3, randomised, double-blind, placebo-controlled study in India. Lancet. 2022;399(10332):131321.

CAS PubMed PubMed Central Google Scholar

Logunov DY, Dolzhikova IV, Shcheblyakov DV, Tukhvatulin AI, Zubkova OV, Dzharullaeva AS, et al. Safety and efficacy of an rAd26 and rAd5 vector-based heterologous prime-boost COVID-19 vaccine: an interim analysis of a randomised controlled phase 3 trial in Russia. Lancet. 2021;397(10275):67181.

CAS PubMed PubMed Central Google Scholar

Sadoff J, Gray G, Vandebosch A, Crdenas V, Shukarev G, Grinsztejn B, et al. Final analysis of efficacy and safety of single-dose Ad26.COV2.S. N Engl J Med. 2022;386(9):84760.

CAS PubMed Google Scholar

Voysey M, Costa Clemens SA, Madhi SA, Weckx LY, Folegatti PM, Aley PK, et al. Single-dose administration and the influence of the timing of the booster dose on immunogenicity and efficacy of ChAdOx1 nCoV-19 (AZD1222) vaccine: a pooled analysis of four randomised trials. Lancet. 2021;397(10277):88191.

CAS PubMed PubMed Central Google Scholar

Falsey AR, Sobieszczyk ME, Hirsch I, Sproule S, Robb ML, Corey L, et al. Phase 3 safety and efficacy of AZD1222 (ChAdOx1 nCoV-19) Covid-19 vaccine. N Engl J Med. 2021;385(25):234860.

CAS PubMed Google Scholar

Halperin SA, Ye L, MacKinnon-Cameron D, Smith B, Cahn PE, Ruiz-Palacios GM, et al. Final efficacy analysis, interim safety analysis, and immunogenicity of a single dose of recombinant novel coronavirus vaccine (adenovirus type 5 vector) in adults 18 years and older: an international, multicentre, randomised, double-blinded, placebo-controlled phase 3 trial. Lancet. 2022;399(10321):23748.

CAS PubMed Google Scholar

Heath PT, Galiza EP, Baxter DN, Boffito M, Browne D, Burns F, et al. Safety and efficacy of NVX-CoV2373 Covid-19 vaccine. N Engl J Med. 2021;385(13):117283.

CAS PubMed Google Scholar

Dunkle LM, Kotloff KL, Gay CL, ez G, Adelglass JM, Barrat Hernndez AQ, et al. Efficacy and safety of NVX-CoV2373 in adults in the United States and Mexico. N Engl J Med. 2022;386(6):53143.

CAS PubMed Google Scholar

Bravo L, Smolenov I, Han HH, Li P, Hosain R, Rockhold F, et al. Efficacy of the adjuvanted subunit protein COVID-19 vaccine, SCB-2019: a phase 2 and 3 multicentre, double-blind, randomised, placebo-controlled trial. Lancet. 2022;399(10323):46172.

CAS PubMed PubMed Central Google Scholar

Dai L, Gao L, Tao L, Hadinegoro SR, Erkin M, Ying Z, et al. Efficacy and safety of the RBD-dimer-based Covid-19 vaccine ZF2001 in adults. N Engl J Med. 2022;386(22):2097111.

CAS PubMed Google Scholar

Tabarsi P, Anjidani N, Shahpari R, Mardani M, Sabzvari A, Yazdani B, et al. Evaluating the efficacy and safety of SpikoGen, an Advax-CpG55.2adjuvanted severe acute respiratory syndrome coronavirus 2 spike protein vaccine: a phase 3 randomized placebo-controlled trial. Clin Microbiol Infect. 2023;29(2):21520.

CAS PubMed Google Scholar

Hernndez-Bernal F, Ricardo-Cobas MC, Martn-Bauta Y, Rodrguez-Martnez E, Urrutia-Prez K, Urrutia-Prez K, et al. A phase 3, randomised, double-blind, placebo-controlled clinical trial evaluation of the efficacy and safety of a SARS-CoV-2 recombinant spike RBD protein vaccine in adults (ABDALA-3 study). Lancet Reg Health Am. 2023;21:100497.

PubMed PubMed Central Google Scholar

Ryzhikov AB, Ryzhikov EA, Bogryantseva MP, Usova SV, Nechaeva EA, Danilenko ED et al. Assessment of safety and prophylactic efficacy of the EpiVacCorona peptide vaccine for COVID-19 prevention (phase III). Vaccines. 2023;11(5).

Mostafavi E, Eybpoosh S, Karamouzian M, Khalili M, Haji-Maghsoudi S, Salehi-Vaziri M, et al. Efficacy and safety of a protein-based SARS-CoV-2 vaccine: a randomized clinical trial. JAMA Netw Open. 2023;6(5):e2310302.

PubMed PubMed Central Google Scholar

Hager KJ, Prez Marc G, Gobeil P, Diaz RS, Heizer G, Llapur C, et al. Efficacy and safety of a recombinant plant-based adjuvanted Covid-19 vaccine. N Engl J Med. 2022;386(22):208496.

CAS PubMed Google Scholar

Korang SK, von Rohden E, Veroniki AA, Ong G, Ngalamika O, Siddiqui F, et al. Vaccines to prevent COVID-19: a living systematic review with Trial Sequential Analysis and network meta-analysis of randomized clinical trials. PLoS ONE. 2022;17(1):e0260733.

CAS PubMed PubMed Central Google Scholar

Kouhpayeh H, Ansari H. Adverse events following COVID-19 vaccination: a systematic review and meta-analysis. Int Immunopharmacol. 2022;109:108906.

CAS PubMed PubMed Central Google Scholar

Park JW, Lagniton PNP, Liu Y, Xu RH. mRNA vaccines for COVID-19: what, why and how. Int J Biol Sci. 2021;17(6):144660.

CAS PubMed PubMed Central Google Scholar

Garcia-Beltran WF, Lam EC, St Denis K, Nitido AD, Garcia ZH, Hauser BM, et al. Multiple SARS-CoV-2 variants escape neutralization by vaccine-induced humoral immunity. Cell. 2021;184(9):237283e9.

CAS PubMed PubMed Central Google Scholar

Jara A, Undurraga EA, Gonzlez C, Paredes F, Fontecilla T, Jara G, et al. Effectiveness of an inactivated SARS-CoV-2 vaccine in Chile. N Engl J Med. 2021;385(10):87584.

CAS PubMed Google Scholar

Ali K, Berman G, Zhou H, Deng W, Faughnan V, Coronado-Voges M, et al. Evaluation of mRNA-1273 SARS-CoV-2 vaccine in adolescents. N Engl J Med. 2021;385(24):224151.

CAS PubMed Google Scholar

Anderson EJ, Creech CB, Berthaud V, Piramzadian A, Johnson KA, Zervos M, et al. Evaluation of mRNA-1273 vaccine in children 6 months to 5 years of age. N Engl J Med. 2022;387(18):167387.

CAS PubMed Google Scholar

Creech CB, Anderson E, Berthaud V, Yildirim I, Atz AM, Melendez Baez I, et al. Evaluation of mRNA-1273 Covid-19 vaccine in children 6 to 11 years of age. N Engl J Med. 2022;386(21):201123.

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