Vaccine最新文献

{"title":"\"But then that's another barrier\": A qualitative study of parent and provider perspectives on rural versus urban disparities in adolescent vaccination.","authors":"Sarah E Brewer, Jessica R Cataldi, Cathryn Perreira, Andrea Nederveld, Michael P Fisher, Anna Furniss, Charnetta Williams, Sean T O'Leary, Amanda F Dempsey","doi":"10.1016/j.vaccine.2024.126456","DOIUrl":"10.1016/j.vaccine.2024.126456","url":null,"abstract":"<p><strong>Purpose: </strong>Vaccination rates are significantly lower among adolescents living in rural areas compared to those living in urban areas. The objective of this study was to understand the factors contributing to disparities in vaccination between adolescents in rural compared to urban areas.</p><p><strong>Methods: </strong>Semi-structured qualitative interviews were conducted with parents and providers in 16 rural and 4 urban counties of Colorado. Interview questions followed the socioecological model of health and addressed personal, interpersonal, community, and environment/structural barriers and facilitators that impact adolescent vaccination rates. Qualitative content analysis with a directed content analysis approach was used. Urban and rural interviews were compared to identify barriers unique to rural communities.</p><p><strong>Findings: </strong>Reported barriers included lack of vaccine access at primary care, lack of routine preventive care utilization, the need to take off time from work and school, and misinformation about vaccines. Barriers that were unique to rural communities included structural barriers such as lack of evening and weekend appointments, providers not stocking vaccines, short provider tenures, and costs; logistical barriers such as the need for multiple visits to multiple locations and distance and travel time; and beliefs and behaviors such as an overreliance on sports physicals (in lieu of preventive visits) and natural lifestyle cultures.</p><p><strong>Conclusions: </strong>There are unique challenges to adolescent vaccination in rural areas that contribute to fewer adolescents receiving their recommended vaccines. Addressing structural barriers may address this disparity.</p>","PeriodicalId":94264,"journal":{"name":"Vaccine","volume":"42 26","pages":"126456"},"PeriodicalIF":0.0,"publicationDate":"2024-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142515708","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The recombinant feline herpesvirus 1 expressing feline Calicivirus VP1 protein is safe and effective in cats.","authors":"Aoxing Tang, Meng Zhu, Jie Zhu, Da Zhang, Shiqiang Zhu, Chunchun Meng, Chuanfeng Li, Guangqing Liu","doi":"10.1016/j.vaccine.2024.126468","DOIUrl":"10.1016/j.vaccine.2024.126468","url":null,"abstract":"<p><p>Feline herpesvirus type 1 (FHV) and feline calicivirus (FCV) are significant pathogens causing upper respiratory tract disease in cats. Existing inactivated or modified live vaccines against FCV and FHV face limitations in safety and efficacy. To overcome these challenges, a recombinant strain FHV ΔgI/gE-FCV VP1 was developed by deleting the gI/gE gene and concurrently expressing FCV VP1, using the FHV WX19 strain as the parental virus. Results indicated the presence of FCV VP1 in FHV ΔgI/gE-FCV VP1-infected CRFK cells, confirmed through protein blotting and immunofluorescence assays and virus-like particles (VLPs) of FCV were observed using transmission electron microscopy. For efficacy in cats, each animal received intranasal vaccination with 1 mL of FHV ΔgI/gE-FCV VP1 at 10⁶ TCID₅₀. Following completion of vaccination on day 28, animals were exposed to a potent FCV strain. Assessments included clinical signs, nasal shedding, virus neutralizing antibodies, cytokine expression and postmortem histological testing. All vaccinations with FHV ΔgI/gE-FCV VP1 were deemed safe, with significantly reduced clinical disease scores, pathological changes and viral nasal shedding following infection and robust immune responses were induced. These findings collectively suggest the effectiveness of FHV-based recombinant vaccines in preventing FCV infections.</p>","PeriodicalId":94264,"journal":{"name":"Vaccine","volume":"42 26","pages":"126468"},"PeriodicalIF":0.0,"publicationDate":"2024-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142524016","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"SARS-CoV-2 spike-based virus-like particles incorporate influenza H1/N1 antigens and induce dual immunity in mice.","authors":"Zalma V Sanchez-Martinez, Sergio P Alpuche-Lazcano, Matthew Stuible, Bassel Akache, Tyler M Renner, Lise Deschatelets, Renu Dudani, Blair A Harrison, Michael J McCluskie, Sabahudin Hrapovic, Julie Blouin, Xinyu Wang, Matthew Schuller, Kai Cui, Jae-Young Cho, Yves Durocher","doi":"10.1016/j.vaccine.2024.126463","DOIUrl":"10.1016/j.vaccine.2024.126463","url":null,"abstract":"<p><p>A vaccine effective against both SARS-CoV-2 and influenza A (IAV) viruses could represent a cost-effective strategy to reduce their combined public health burden as well as potential complications arising from co-infection. Based on previous findings that full-length SARS-CoV-2 spike (S) expression can induce high-level, enveloped VLP (eVLP) production in CHO cells, we tested whether IAV H1N1 hemagglutinin (H1) and neuraminidase (N1) could also be displayed on these particles. We found that co-incorporation of the IAV surface antigens in spike VLPs (S-VLPs) was highly efficient: upon transient co-expression of S + H1 or S + H1 + N1 in CHO cells, the resulting VLPs contained similar amounts of the SARS-CoV-2 S and IAV antigens. The self-assembled bivalent (S/H1) and trivalent (S/H1/N1) VLPs released into the culture media were purified by single-step chromatography using a S-VLP affinity resin. Western blot analysis and immuno‑gold labeling transmission electron microscopy (TEM) of purified VLPs confirmed the coexistence of S, H1 and N1 antigens in the same particles. Finally, we demonstrated that two doses of adjuvanted bivalent and trivalent VLPs elicit specific functional antibodies and cellular immunity in a mouse model, suggesting potential for combined SARS-CoV-2/IAV vaccine development.</p>","PeriodicalId":94264,"journal":{"name":"Vaccine","volume":"42 26","pages":"126463"},"PeriodicalIF":0.0,"publicationDate":"2024-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142559931","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Safety of mRNA COVID-19 vaccines among persons 15- years and above in Ghana: A cohort event monitoring study.","authors":"Delese Mimi Darko, Seth Kwaku Seaneke, Eric Karikari-Boateng, Edwin Nkansah, Kwame Amponsa-Achiano, Naziru Tanko Mohamed, Harriet Affran Bonful, Richard Osei Buabeng, Adela Ashie, Abena Asamoa-Amoakohene, Jeremiah Ewudzie-Sampson, Alexander Mwinteru Derizie, Adjabui D Neimatu, Agongo A Wilfred, Comfort Ogar, Aida Hagos, George Tsey Sabblah","doi":"10.1016/j.vaccine.2024.126460","DOIUrl":"10.1016/j.vaccine.2024.126460","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Introduction: &lt;/strong&gt;The development of COVID-19 vaccines during the pandemic occurred with an unprecedented speed, requiring extraordinary post-approval safety monitoring to facilitate ongoing evaluation of their benefit-risk profile. In Ghana, the Food and Drugs Authority granted emergency use authorization to six of these vaccines including the two mRNA COVID-19 vaccines, namely, Pfizer-BioNTech and Moderna COVID-19 vaccines. The objective of the study was to estimate the incidence of adverse events following immunization (AEFIs) and adverse events of special interest (AESIs) in persons vaccinated with mRNA COVID-19 vaccines, and to identify factors associated with the development of AEFIs.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;We conducted a prospective cohort event monitoring study in seven selected static vaccination center in six of Ghana's 16 regions. The choice of regions was based on their geographical locations and the incidence rate of COVID-19 at the time of the study. The study was conducted with people aged 15 years and older who were vaccinated with mRNA COVID-19 vaccines, including pregnant women. Study participants were recruited starting in November 2021, with the last participant followed up in August 2022. Persons vaccinated were followed up on days 1, 7, and 28 post-dose 1 and up to 91 days after dose 2. AEFIs were described with the most specific, or lowest-level, term using the Medical Dictionary for Regulatory Activities (MedDRA) version 26.1. Frequencies of AEFIs after each vaccine dose and vaccination center were determined. Cox-proportional hazard regression was used to assess the independent risk factors associated with the incidence of AEFI among the participants.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Overall, 4678 persons who received Pfizer-BioNTech or Moderna COVID-19 vaccines from the seven vaccination centers were enrolled in the study. The mean age of participants was 32.9 years (SD ± 14.4). A total of 17.4 % (95 % CI: 16.3 % to 18.5 %) of participants experienced AEFI, with a higher incidence among Moderna COVID-19 vaccine recipients (20.4 %) compared to Pfizer-BioNTech COVID-19 vaccine recipients (14.0 %). The top five common AEFIs included injection site pain, headache, dizziness, fatigue, and fever. No serious AEFIs were reported during the study. Factors such as vaccination center and history of chronic medical conditions influenced the risk of experiencing an AEFI. Cox-proportional hazard regression revealed a 37 % lower risk of AEFI with the Pfizer-BioNTech COVID-19 vaccine compared to the Moderna COVID-19 vaccine.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;The study on mRNA COVID-19 vaccines in Ghana showed that the vaccines are tolerated well with no significant safety concerns. Reports of systemic and local events were consistent with those reported in the summary of product characteristics of the two vaccines. The study's outcome showed that there were no safety issues with mRNA COVID-19 vaccines in Ghana. ","PeriodicalId":94264,"journal":{"name":"Vaccine","volume":"42 26","pages":"126460"},"PeriodicalIF":0.0,"publicationDate":"2024-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142515713","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Virtual reality for routine immunisations in needle phobic children with and without developmental disabilities: A pilot study.","authors":"Allya Makhijani, Narelle Jenkins, Jessica Kaufman, Monsurul Hoq, Sabine Priestley, Sonja Elia, Ian McKenzie, Andrew Davidson, Paul Leong, Teresa Lazzaro, Sarah McNab, Margie Danchin","doi":"10.1016/j.vaccine.2024.126481","DOIUrl":"10.1016/j.vaccine.2024.126481","url":null,"abstract":"<p><p>Virtual reality for routine immunisations in needle phobic children with and without developmental disabilities: a pilot study.</p><p><strong>Background: </strong>Virtual Reality (VR) headsets can improve needle procedure success and experiences for children, but they have not been evaluated to support immunisation in children with anxiety and behavioural challenges. This study assessed the feasibility and acceptability of VR for immunisation in children with needle phobia, including children with and without developmental disabilities.</p><p><strong>Methods: </strong>A mixed method pilot study was conducted at the Royal Children's Hospital, Melbourne. Children with needle phobia aged 4-14 years scheduled for immunisation with distraction and conscious sedation were eligible. VR was offered to children with needle anxiety and/or developmental disabilities before and during immunisation in addition to standard care. Children and caregivers completed electronic surveys pre- and post-immunisation, followed by qualitative interviews post-immunisation. Clinicians completed post-immunisation surveys. Primary outcomes were feasibility and acceptability of VR according to children, caregivers and clinicians.</p><p><strong>Results: </strong>Between May and December 2022, we screened 54 children and included 30; 15 with and 15 without developmental disability. Preparation to use VR took less than five minutes for most children (24/30; 80 %). Twenty nine (96 %) used VR immediately before immunisation, and 17 (57 %) continued using it during immunisation (7 with developmental disability, 10 without). Twenty seven (90 %) children were immunised successfully, with a small reduction in required sedation. Of those who used VR during immunisation, 16/17 (94 %) reported a more positive overall experience. Of those who only used VR before immunisation, 3/13 (23 %) still reported benefit. VR was therefore described as beneficial for 19/30 (63 %) participants (9 with developmental disability, 10 without). Caregivers reported willingness to use VR in future immunisation encounters for 23/30 (77 %) children (11 with developmental disability, 12 without).</p><p><strong>Discussion: </strong>This pilot study suggests VR was feasible and acceptable for many children with needle phobia, both with and without developmental disability. These findings will inform a randomised controlled trial to assess effectiveness.</p>","PeriodicalId":94264,"journal":{"name":"Vaccine","volume":"42 26","pages":"126481"},"PeriodicalIF":0.0,"publicationDate":"2024-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142565369","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A multivalent RSV vaccine based on the modified vaccinia Ankara vector shows moderate protection against disease caused by RSV in older adults in a phase 3 clinical study.","authors":"Elke Jordan, Victoria Jenkins, Günter Silbernagl, Maria Paulina Velasco Chávez, Darja Schmidt, Frauke Schnorfeil, Stephanie Schultz, Liddy Chen, Fernanda Salgado, Jeanne-Marie Jacquet, Tobias Welte, Laurence De Moerlooze","doi":"10.1016/j.vaccine.2024.126427","DOIUrl":"10.1016/j.vaccine.2024.126427","url":null,"abstract":"<p><p>Respiratory syncytial virus (RSV) causes a significant disease burden in older adults. The live recombinant vaccine based on a nonreplicating modified vaccinia Ankara (MVA-BN) poxvirus, MVA-BN-RSV, encoding for multiple proteins of RSV subtypes A and B, was assessed for efficacy against respiratory disease caused by RSV. Adults aged ≥60 years, with or without underlying chronic conditions, were enrolled and randomized in a 1:1 ratio to receive a single dose of vaccine or placebo and were followed for disease caused by RSV infection during the 2022-2023 season. The 2 primary endpoints were RSV-associated lower respiratory tract disease (LRTD) with ≥3 and ≥ 2 symptoms; acute respiratory disease (ARD) was a key secondary endpoint. The humoral RSV-specific immune response was assessed at baseline and 14 days post-vaccination. Safety was evaluated by collection of solicited adverse events (AEs) and unsolicited AEs for 7 and 28 days post-vaccination respectively, and SAEs for the entire study period. In total, 18,348 participants were included in the final efficacy and safety analyses. Vaccine efficacy was 42.9 % (95 % CI: -16.1; 71.9) against RSV-associated LRTD with ≥3 symptoms, 59.0 % (95 % CI: 34.7; 74.3) against LRTD with ≥2 symptoms, and 48.8 % (95 % CI: 25.8; 64.7) against ARD. The primary objective was not met for LRTD with ≥3 symptoms since the lower bound of the 95 % CI was below 20 %, the prespecified success criterion. The vaccine-elicited immune response showed mean fold-increases of 1.7 for RSV A and B neutralizing antibodies and 2.9 and 4.3 for RSV-specific IgG and IgA, respectively. The vaccine displayed mild to moderate reactogenicity, and no safety concerns were identified. MVA-BN-RSV induced suboptimal protection against RSV-associated LRTD, likely due to suboptimal neutralizing antibody response. The vaccine had an acceptable safety profile and confirmed immunogenicity, overall showing promise for MVA-BN-vectored constructs targeting other diseases. Trial Registration:Clinicaltrials.gov Identifier NCT05238025 (Registered February 14, 2022).</p>","PeriodicalId":94264,"journal":{"name":"Vaccine","volume":"42 26","pages":"126427"},"PeriodicalIF":0.0,"publicationDate":"2024-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142515709","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparable and sustained levels of S1-RBD-IgG and S1-RBD-IgA in BNT162b2 homologous and CoronaVac-BNT162b2 heterologous booster vaccination: A 22-month prospective study in Malaysia.","authors":"Anis Atifah Mohd Hisham, Aini Syahida Mat Yassim, Rapeah Suppian, Maryam Azlan, Amiratul Aifa Mohamad Asri, Nur Suhaila Idris, Rosediani Muhamad, Mohd Nor Norazmi","doi":"10.1016/j.vaccine.2024.126471","DOIUrl":"10.1016/j.vaccine.2024.126471","url":null,"abstract":"<p><p>This prospective cohort study examines the long-term humoral immune responses post-COVID-19 vaccination in 146 individuals who received either a homologous three-dose BNT162b2 vaccine regimen (PPP) or two primary doses of CoronaVac followed by BNT162b2 booster (SSP) in Malaysia. The study focuses on serum anti-S1-RBD-IgG, -IgA, and -IgM, using the ELISA method. The results show that BNT162b2 outperformed CoronaVac in the two dose primary vaccination series. BNT162b2 booster dose significantly raised serum anti-S1-RBD-IgG and -IgA levels, sustaining this increase from 26 to 52 weeks after administration, regardless of the vaccine regimen. This leads to equivalent levels of anti-S1-RBD-IgG and -IgA after boosting with BNT162b2 in both groups. Breakthrough infections, particularly with the emergence of the Omicron variant, did not result in increased anti-S1-RBD-IgG and -IgA levels. No significant induction of anti-S1-RBD-IgM was observed following multiple vaccine doses. The long-term investigation revealed that PPP and SSP groups had comparable humoral immune responses to SARS-CoV-2, highlighting the advantage of mRNA booster dose in our cohort.</p>","PeriodicalId":94264,"journal":{"name":"Vaccine","volume":"42 26","pages":"126471"},"PeriodicalIF":0.0,"publicationDate":"2024-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142570850","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Anti-RBD IgG dynamics following infection or vaccination.","authors":"Amira Harrache, Kahina Saker, Bouchra Mokdad, Laurence Generenaz, Carla Saade, Sylvie Pons, Jean-Baptiste Fassier, Antonin Bal, Mary-Anne Trabaud, Muriel Rabilloud, Amna Abichou-Klich, Sophie Trouillet-Assant","doi":"10.1016/j.vaccine.2024.126464","DOIUrl":"10.1016/j.vaccine.2024.126464","url":null,"abstract":"<p><p>Identifying parameters influencing SARS-CoV-2 antibody dynamics post infection or vaccination is crucial for refining vaccination strategies. In a longitudinal analysis of 1340 samples from 375 healthcare workers, we characterized peak serological response and IgG half-life. Peak antibody titers post 2 vaccine doses were ∼ 20 times higher than natural infection; conversely, infected individuals had extended antibody half-life. Clinical and demographical factors such as BMI, age and smoking shaped peak response without affecting anti-RBD IgG half-life. A third mRNA vaccine dose increased peak antibody titers and prolonged half-life compared to the second dose. These findings underscore the diverse kinetics of SARS-CoV-2 antibody responses, which is influenced by immunization type/number and clinical factors.</p>","PeriodicalId":94264,"journal":{"name":"Vaccine","volume":"42 26","pages":"126464"},"PeriodicalIF":0.0,"publicationDate":"2024-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142484726","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Documenting human papillomavirus vaccine refusal among adolescents in electronic health records: A mixed methods study.","authors":"Nadja A Vielot, Christine A P Ballard, Denise T St Jean, Sophie Page, Kelli Hammond, Peyton Thompson, Anne M Butler, Leah M Ranney","doi":"10.1016/j.vaccine.2024.126467","DOIUrl":"10.1016/j.vaccine.2024.126467","url":null,"abstract":"<p><strong>Background: </strong>Human papillomavirus (HPV) vaccination is often refused by patients or caregivers. We conducted a mixed-methods study to understand how health care providers document HPV vaccination refusal and use this information in subsequent encounters.</p><p><strong>Methods: </strong>Using electronic health records (EHR) in a public academic health system, we identified patients aged 9-17 years with documentation of refusal of a recommended vaccination in billing codes or clinic notes from October 15, 2015 and December 31, 2021. We summarized the number of encounters in which vaccination was refused; the incidence of HPV vaccination following an initial refusal; and the content of clinic notes describing HPV vaccination refusal. Next, we held focus groups with clinic personnel to understand strategies for documenting HPV vaccination refusal and holding future conversations about HPV vaccination.</p><p><strong>Results: </strong>Of 523 patients with a documented vaccination refusal, 351 (67 %) refused HPV. Of these, 88 (27 %) eventually received HPV vaccination; incidence of vaccination was not associated with the method used to document refusal in the EHR (ICD-10 code versus clinic note). From focus group discussions, we learned that providers usually make brief notes describing when HPV vaccination was offered and refused, and generally plan to recommend vaccination again at a subsequent encounter. Documenting specific reasons for refusal (e.g., patient age, a conflicting priority) was considered helpful to guide future conversations.</p><p><strong>Conclusions: </strong>Patients who refuse HPV vaccination might accept vaccination in the future if providers continue to recommend it. Documenting the refusal in EHR can provide meaningful context to guide subsequent recommendations.</p>","PeriodicalId":94264,"journal":{"name":"Vaccine","volume":"42 26","pages":"126467"},"PeriodicalIF":0.0,"publicationDate":"2024-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142524051","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk of major adverse cerebro-cardiovascular events following BNT162b2, CoronaVac, and ChAdOx1 vaccination and SARS-CoV-2 infection: A self-controlled case-series study.","authors":"Norazida Ab Rahman, Teck Long King, Kalaiarasu M Peariasamy, Sheamini Sivasampu","doi":"10.1016/j.vaccine.2024.126465","DOIUrl":"10.1016/j.vaccine.2024.126465","url":null,"abstract":"<p><strong>Objective: </strong>To assess the potential risk of major adverse cerebro-cardiovascular events (MACCE) associated with COVID-19 vaccination and SARS-CoV-2 infection.</p><p><strong>Methods: </strong>This self-controlled case series study used nationwide health database from Malaysia. The study included individuals aged ≥18 years who were hospitalised between 24 February 2021 and 30 June 2022. Outcomes were composite of MACCE: stroke, acute ischaemic heart disease, and cardiovascular death. Exposures were COVID-19 vaccination and SARS-CoV-2 infection. The risk period was day 1 to day 21 following exposure. Conditional Poisson regression model was used to estimate the incidence rate ratios (IRRs) and 95 % confidence interval (CI) comparing the outcomes in the risk and control periods.</p><p><strong>Results: </strong>The risk of MACCE within 21 days after vaccination per 100,000 doses administered were 12.0 (95% CI 11.9-12.1) (BNT162b2), 9.2 (95% CI 9.1-9.3) (CoronaVac), and 6.8 (95% CI 6.6-7.0) (ChAdOx1). The incidence rate ratios showed no increased risk of MACCE associated with the first, second, or third doses of BNT162b2, CoronaVac, and ChAdOx1 vaccines for individuals without prior cardiovascular disease (CVD). This finding was consistent for individuals with CVD. Vaccine booster dose, whether in a homologous or heterologous schedule, did not show increased risk of MACCE. Analysis by ethnic groups detected a slightly elevated risk of MACCE in Indian after the first dose of ChAdOx1 (IRR 1.64; 95% CI 1.08-2.48) in those without CVD. No significant association were observed in other subgroup analyses. SARS-CoV-2 infection was associated with significantly increased risk of MACCE in individuals without CVD (IRR 3.54; 95% CI 3.32-3.76) and with CVD (IRR 1.98; 95% CI 1.61-2.34).</p><p><strong>Conclusions: </strong>Our findings support the favourable safety profile of these COVID-19 vaccines and indicate that the overall benefit-risk ratio of the COVID-19 vaccines remains positive.</p>","PeriodicalId":94264,"journal":{"name":"Vaccine","volume":"42 26","pages":"126465"},"PeriodicalIF":0.0,"publicationDate":"2024-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142515712","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}