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Expert Review of Vaccines 2023Vaccines prevent disease and disability; save lives and represent a good assessment of health interventions. Several systematic reviews on the efficacy and effectiveness...
INTRODUCTION
Vaccines prevent disease and disability; save lives and represent a good assessment of health interventions. Several systematic reviews on the efficacy and effectiveness of COVID-19 vaccines have been published, but the immunogenicity and safety of these vaccines should also be addressed.
AREAS COVERED
This systemic investigation sought to explain the efficacy, immunogenicity, and safety of new vaccination technologies against SARS-CoV-2 in people over 18 years old. Original research studying the effectiveness on mRNA, protein subunit vaccines, and viral vector vaccines against SARS-CoV-2 in people over 18 years old was analyzed. Several databases (Web of Science, Scopus, MEDLINE and EMBASE) were searched between 2012 and November 2022 for English-language papers using text and MeSH terms related to SARS-CoV-2, mechanism, protein subunit vaccine, viral vector, and mRNA. The protocol was registered on PROSPERO, CRD42022341952. Study quality was assessed using the NICE methodology. We looked at a total of six original articles. All studies gathered and presented quantitative data.
EXPERT OPINION
Our results suggest that new vaccinations could have more than 90% efficacy against SARS-CoV-2, regardless of the technology used. Furthermore, adverse reactions go from mild to moderate, and good immunogenicity can be observed for all vaccine types.
Topics: Humans; Adolescent; Viral Vaccines; Protein Subunits; COVID-19 Vaccines; SARS-CoV-2; RNA, Messenger; COVID-19; Vaccines, Subunit; Antibodies, Viral; Immunogenicity, Vaccine
PubMed: 36484136
DOI: 10.1080/14760584.2023.2156861 -
JAMA Pediatrics Jan 2023Published data on COVID-19 mRNA vaccine-associated myopericarditis in adolescents and young adults have been derived from small case series, national population-based... (Meta-Analysis)
Meta-Analysis
IMPORTANCE
Published data on COVID-19 mRNA vaccine-associated myopericarditis in adolescents and young adults have been derived from small case series, national population-based studies, or passive reporting systems. Pooled evidence from a larger, international cohort is scarce.
OBJECTIVE
To investigate the clinical features and early outcomes associated with myopericarditis after COVID-19 mRNA vaccination in a heterogeneous population of adolescents and young adults.
DATA SOURCES
PubMed and EMBASE were searched through August 2022. Language restrictions were not applied.
STUDY SELECTION
Observational studies and case series describing COVID-19 vaccine-associated myopericarditis in adolescents and young adults aged 12 to 20 years and reporting clinical characteristics and early outcomes were included.
DATA EXTRACTION AND SYNTHESIS
Two independent investigators extracted relevant data from each study. One-group meta-analysis in a random effects model was performed. The Preferred Reporting Items for Systematic Reviews and Meta-analysis and Meta-analysis of Observational Studies in Epidemiology reporting guidelines were followed.
MAIN OUTCOMES AND MEASURES
The primary outcomes were clinical features and early outcomes for COVID-19 mRNA vaccine-associated myopericarditis, including incident rate, cardiac findings, hospitalization, intensive care unit (ICU) admission, and in-hospital mortality.
RESULTS
A total of 23 observational studies were identified, including 854 individuals (mean age, 15.9 [95% CI, 15.5-16.2] years) with COVID-19 vaccine-associated myopericarditis. Male sex was predominant, at 90.3% (95% CI, 87.3%-93.2%) of individuals. The incident rate was higher after the second dose than the first dose, with 74.4% (95% CI, 58.2%-90.5%) of events occurring after the second dose. Most patients (84.4% [95% CI, 80.5%-88.3%] of patients) had preserved left ventricular (LV) function. Of the 15.6% (95% CI, 11.7%-19.5%) of patients with LV systolic dysfunction (LV ejection fraction [LVEF] <55%), most (14.1% [95% CI, 10.2%-18.1%]) were mild (ie, LVEF 45%-54%), and only 1.3% (95% CI, 0%-2.6%) of patients had severe LV systolic dysfunction (ie, LVEF<35%). Interestingly, cardiac magnetic resonance imaging revealed late gadolinium enhancement in 87.2% (95% CI, 79.8%-94.7%) of patients. Although 92.6% (95% CI, 87.8%-97.3%) of patients were hospitalized and 23.2% (95% CI, 11.7%-34.7%) of patients required ICU admission, inotropes were used in only 1.3% (95% CI, 0%-2.7%) of patients, no patients died or required mechanical support, and the hospital length of stay was 2.8 (95% CI, 2.1-3.5) days.
CONCLUSIONS AND RELEVANCE
This systematic review and meta-analysis found low incidence rate and largely favorable early outcomes of COVID-19 mRNA vaccine-associated myopericarditis in adolescents and young adults from a wide range of populations. These findings are reassuring but continued follow-up is warranted.
Topics: Humans; Male; Adolescent; Young Adult; COVID-19 Vaccines; COVID-19; Contrast Media; Gadolinium; Ventricular Dysfunction, Left; Vaccination; RNA, Messenger
PubMed: 36469338
DOI: 10.1001/jamapediatrics.2022.4768 -
Transplantation Jan 2023High rates of nonresponse to 2 doses of mRNA severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccine have been reported in transplant recipients. Several... (Meta-Analysis)
Meta-Analysis
BACKGROUND
High rates of nonresponse to 2 doses of mRNA severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccine have been reported in transplant recipients. Several studies have investigated the efficacy of a third dose in this population. However, efficacy remains unclear, as response rates vary across studies. Therefore, we conducted a systematic review and meta-analysis to determine the efficacy of a third dose of any mRNA SARS-CoV-2 vaccine in transplant recipients.
METHODS
Preferred Reporting Items for Systematic Review and Meta-Analysis reporting guidelines (PROSPERO:CRD42021281498) were followed. Medline, Embase, and CENTRAL were searched from inception to December 2, 2021, without restrictions. All full-text studies reporting on the efficacy of a third dose of any mRNA SARS-CoV-2 vaccine in pediatric and adult transplant recipients were included. The National Institutes of Health quality assessment tool for case series and the Cochrane risk of bias tool determined study quality. Meta-analysis was performed via the DerSimonian-Laird random-effect model.
RESULTS
Of 84 records, 12 studies totaling 1257 patients met inclusion criteria. One study was a randomized controlled trial, whereas all other studies were observational. Across 7 studies (801 patients), humoral response after 3 doses was observed in 66.1% (95% confidence interval, 62.8%-69.4%; I2 = 0%) of transplant recipients. Triple immunosuppression, mycophenolate, antiproliferatives, and belatacept use were associated with reduced odds of humoral response in studies reporting multivariate analyses. Transplant recipients receiving a third dose displayed higher levels of neutralizing antibodies to SARS-CoV-2 variants (Alpha, Beta, and Delta) compared with placebo.
CONCLUSIONS
A third dose SARS-CoV-2 mRNA vaccine should be strongly considered in transplant recipients. Limitations included lack of controlled studies and clinically relevant thresholds to determine response to vaccination.
Topics: Adult; Humans; Child; COVID-19 Vaccines; RNA, Messenger; SARS-CoV-2; COVID-19; Transplant Recipients; Antibodies, Viral; Randomized Controlled Trials as Topic
PubMed: 36398334
DOI: 10.1097/TP.0000000000004386 -
Human Vaccines & Immunotherapeutics Nov 2022The COVID-19 pandemic has severely affected adolescents. Safe and effective vaccines are pivotal tools in controlling this pandemic. We reviewed the safety profile of... (Meta-Analysis)
Meta-Analysis
The COVID-19 pandemic has severely affected adolescents. Safe and effective vaccines are pivotal tools in controlling this pandemic. We reviewed the safety profile of the BNT162b2 COVID-19 vaccine in adolescents using mostly real-world data to assist decision-making. We used random-effects model meta-analysis to derive pooled rates of single or grouped adverse events following immunization (AEFI) after each primary and booster dose, as well as after combining all doses. Reporting on over one million participants with safety data were included. The most-reported local and systemic AEFIs were pain/swelling/erythema/redness and fatigue/headache/myalgia, respectively. AESIs were rarely reported but were more frequent after the second dose than they were after the first and the booster doses. Health impact was less common among adolescents after receiving BNT162b2 vaccine. Rare life-threatening AEFIs were reported across all doses in real-world studies. Our findings highlight the significance of enhancing national and regional vaccination programs to ensure public confidence.
Topics: Adolescent; Humans; COVID-19; BNT162 Vaccine; Pandemics; RNA, Messenger; COVID-19 Vaccines; Vaccination
PubMed: 36367429
DOI: 10.1080/21645515.2022.2144039 -
Human Vaccines & Immunotherapeutics Nov 2022The success of mRNA vaccines against SARS-CoV-2 implies that this technology can be applied to target any pathogen. However, the scientific production and research...
The success of mRNA vaccines against SARS-CoV-2 implies that this technology can be applied to target any pathogen. However, the scientific production and research trends using the bibliometric method are still unknown. The top 100 most cited articles on mRNA vaccine research were obtained from the Scopus database from 1995 to 2021. Bibliometrix, an -Package, and VOSviewer 1.6.11 were used for data analysis. There is a rapid growth in scientific outputs with a gradual increase in 2021. The United States produced 45 (45%) of the articles, followed by Germany with 15 (15%) and Israel with 10 (10%). The New England Journal of Medicine published the most papers in this field 13 (13%), followed by Nature 6(6%). Barney S. Graham was the most productive author among the top 100 most cited mRNA vaccine articles. University of Pennsylvania Perelman School of Medicine, US, was the top ranking institution, having 37 (37%). The visualization map clearly and spontaneously displayed the current state and research hot spots of mRNA research from a specific perspective. The most frequent keywords were COVID-19, vaccine, mRNA vaccine, mRNA, SARS-CoV-2, and immunogenicity, among others. A systematic review of the articles provided evidence that out of 100 articles, approximately 25 (25%) were focused on vaccine production and evaluation, followed by 26 (26%) in mRNA vaccine safety and efficacy, 23 (23%) were into mRNA vaccination, 23 (23%) considered risk factors associated with mRNA vaccination, while 8 (8%) of the articles covered the issue of mRNA vaccine delivery. In addition, 42% of the articles focused on COVID-19, 17% on cancer, 8% on influenza virus, 4% on COVID-19 and kidney disease, 3% COVID-19 and myocarditis, and 3% on rabies virus, among others. The findings of this systematic and thematic analysis provided the knowledge basis for further research on mRNA vaccines globally.
Topics: United States; Humans; COVID-19 Vaccines; COVID-19; SARS-CoV-2; mRNA Vaccines; Vaccines, Synthetic; RNA, Messenger
PubMed: 36328513
DOI: 10.1080/21645515.2022.2135927 -
International Journal of Molecular... Oct 2022The CTNNB1 Syndrome is a rare neurodevelopmental disorder associated with developmental delay, intellectual disability, and delayed or absent speech. The aim of the... (Review)
Review
The CTNNB1 Syndrome is a rare neurodevelopmental disorder associated with developmental delay, intellectual disability, and delayed or absent speech. The aim of the present study is to systematically review the available data on the prevalence of clinical manifestations and to evaluate the correlation between phenotype and genotype in published cases of patients with CTNNB1 Syndrome. Studies were identified by systematic searches of four major databases. Information was collected on patients' genetic mutations, prenatal and neonatal problems, head circumference, muscle tone, EEG and MRI results, dysmorphic features, eye abnormalities, early development, language and comprehension, behavioral characteristics, and additional clinical problems. In addition, the mutations were classified into five groups according to the severity of symptoms. The study showed wide genotypic and phenotypic variability in patients with CTNNB1 Syndrome. The most common moderate-severe phenotype manifested in facial dysmorphisms, microcephaly, various motor disabilities, language and cognitive impairments, and behavioral abnormalities (e.g., autistic-like or aggressive behavior). Nonsense and missense mutations occurring in exons 14 and 15 were classified in the normal clinical outcome category/group because they had presented an otherwise normal phenotype, except for eye abnormalities. A milder phenotype was also observed with missense and nonsense mutations in exon 13. The autosomal dominant CTNNB1 Syndrome encompasses a wide spectrum of clinical features, ranging from normal to severe. While mutations cannot be more generally categorized by location, it is generally observed that the C-terminal protein region (exons 13, 14, 15) correlates with a milder phenotype.
Topics: Pregnancy; Female; Humans; Codon, Nonsense; Phenotype; Intellectual Disability; Syndrome; Genotype; Mutation; Eye Abnormalities; beta Catenin
PubMed: 36293418
DOI: 10.3390/ijms232012564 -
BMC Medicine Oct 2022Dose fractionation of a coronavirus disease 2019 (COVID-19) vaccine could effectively accelerate global vaccine coverage, while supporting evidence of efficacy,... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Dose fractionation of a coronavirus disease 2019 (COVID-19) vaccine could effectively accelerate global vaccine coverage, while supporting evidence of efficacy, immunogenicity, and safety are unavailable, especially with emerging variants.
METHODS
We systematically reviewed clinical trials that reported dose-finding results and estimated the dose-response relationship of neutralizing antibodies (nAbs) of COVID-19 vaccines using a generalized additive model. We predicted the vaccine efficacy against both ancestral and variants, using previously reported correlates of protection and cross-reactivity. We also reviewed and compared seroconversion to nAbs, T cell responses, and safety profiles between fractional and standard dose groups.
RESULTS
We found that dose fractionation of mRNA and protein subunit vaccines could induce SARS-CoV-2-specific nAbs and T cells that confer a reasonable level of protection (i.e., vaccine efficacy > 50%) against ancestral strains and variants up to Omicron. Safety profiles of fractional doses were non-inferior to the standard dose.
CONCLUSIONS
Dose fractionation of mRNA and protein subunit vaccines may be safe and effective, which would also vary depending on the characteristics of emerging variants and updated vaccine formulations.
Topics: Humans; Antibodies, Neutralizing; Antibodies, Viral; COVID-19; COVID-19 Vaccines; Protein Subunits; RNA, Messenger; SARS-CoV-2; Viral Vaccines
PubMed: 36284331
DOI: 10.1186/s12916-022-02600-0 -
Discovery Medicine 2022Irritable bowel syndrome (IBS), a common gastrointestinal disorder, was reported to contribute to abdominal pain, decrease the quality of life and work productivity of...
Irritable bowel syndrome (IBS), a common gastrointestinal disorder, was reported to contribute to abdominal pain, decrease the quality of life and work productivity of affected individuals, and lead to cachexia and frailty. However, molecules that regulate irritable bowel syndrome have not been fully clarified. MicroRNAs (miRNAs) are small non-coding RNAs that inhibit the translation of target messenger RNAs. Previous studies have shown that miRNAs have critical roles in the regulation of the pathogenicity of irritable bowel syndrome. Therefore, this systematic review focused on miRNAs that regulate irritable bowel syndrome. PubMed and Web of Science were searched to retrieve reference lists of eligible articles and related reviews. Original articles and reviews that reported the utility of miRNAs as potential biomarkers or targets for specific therapies of IBS that were published in English from 2004 to 2021 were included. Among 78 identified studies, 22 eligible studies were included in this systematic review. These results suggest that miRNAs are potential biomarkers and targets of gene therapy for IBS. Further studies including clinical studies will be necessary to confirm the utility of miRNAs as biomarkers and targets for the gene therapy of IBS.
Topics: Humans; Irritable Bowel Syndrome; MicroRNAs; Quality of Life; RNA, Messenger
PubMed: 36274256
DOI: No ID Found -
International Journal of Infectious... Nov 2022Available data show that COVID-19 vaccines may be less effective in people living with HIV (PLWH) who are at increased risk for severe COVID-19. This meta-analysis aimed... (Meta-Analysis)
Meta-Analysis Review
OBJECTIVES
Available data show that COVID-19 vaccines may be less effective in people living with HIV (PLWH) who are at increased risk for severe COVID-19. This meta-analysis aimed to compare the immunogenicity and efficacy of COVID-19 vaccines in PLWH with healthy individuals.
METHODS
Pubmed/Medline, EMBASE, and the Cochrane Library were searched. Risk ratios of seroconversion were separately pooled using random-effects meta-analysis, and a systematic review without meta-analysis of SARS-CoV-2 antibody titer levels was performed after the first and second doses of a COVID-19 vaccine.
RESULTS
A total of 22 studies with 6522 subjects met the inclusion criteria. After the first vaccine dose, seroconversion in PLWH was comparable to that in healthy individuals. After a second dose, seroconversion was slightly lower in PLWH compared with healthy controls, and antibody titers did not seem to be significantly affected or reduced among participants of both groups.
CONCLUSION
COVID-19 vaccines show favorable immunogenicity and efficacy in PLWH. A second dose is associated with consistently improved seroconversion, although it is slightly lower in PLWH than in healthy individuals. Additional strategies, such as a booster vaccination with messenger RNA COVID-19 vaccines, might improve seroprotection for these patients.
Topics: Humans; COVID-19 Vaccines; COVID-19; SARS-CoV-2; Seroconversion; Antibodies, Viral; HIV Infections; Vaccination
PubMed: 36241168
DOI: 10.1016/j.ijid.2022.10.005 -
Saliva is suitable for SARS-CoV-2 antibodies detection after vaccination: A rapid systematic review.Frontiers in Immunology 2022Since the introduction of efficient vaccines anti-SARS-CoV-2, antibody quantification becomes increasingly useful for immunological monitoring and COVID-19 control. In...
UNLABELLED
Since the introduction of efficient vaccines anti-SARS-CoV-2, antibody quantification becomes increasingly useful for immunological monitoring and COVID-19 control. In several situations, saliva samples may be an alternative to the serological test. Thus, this rapid systematic review aimed to evaluate if saliva is suitable for SARS-CoV-2 detection after vaccination. For this purpose, search strategies were applied at EMBASE, PubMed, and Web of Science. Studies were selected by two reviewers in a two-phase process. After selection, 15 studies were eligible and included in data synthesis. In total, salivary samples of approximately 1,080 vaccinated and/or convalescent individuals were analyzed. The applied vaccines were mostly mRNA-based (BioNTech 162b2 mRNA/Pfizer and Spikevax mRNA-1273/Moderna), but recombinant viral-vectored vaccines (Ad26. COV2. S Janssen - Johnson & Johnson and Vaxzevria/Oxford AstraZeneca) were also included. Different techniques were applied for saliva evaluation, such as ELISA assay, Multiplex immunoassay, flow cytometry, neutralizing and electrochemical assays. Although antibody titers are lower in saliva than in serum, the results showed that saliva is suitable for antibody detection. The mean of reported correlations for titers in saliva and serum/plasma were moderate for IgG (0.55, 95% CI 0.38-9.73), and weak for IgA (0.28, 95% CI 0.12-0.44). Additionally, six out of nine studies reported numerical titers for immunoglobulins detection, from which the level in saliva reached their reference value in four (66%). IgG but not IgA are frequently presented in saliva from vaccinated anti-COVID-19. Four studies reported lower IgA salivary titers in vaccinated compared to previously infected individuals, otherwise, two reported higher titers of IgA in vaccinated. Concerning IgG, two studies reported high antibody titers in the saliva of vaccinated individuals compared to those previously infected and one presented similar results for vaccinated and infected. The detection of antibodies anti-SARS-CoV-2 in the saliva is available, which suggests this type of sample is a suitable alternative for monitoring the population. Thus, the results also pointed out the possible lack of mucosal immunity induction after anti-SARS-CoV-2 vaccination. It highlights the importance of new vaccination strategies also focused on mucosal alternatives directly on primary routes of SARS-CoV-2 entrance.
SYSTEMATIC REVIEW REGISTRATION
https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42022336968, identifier CRD42022336968.
Topics: Antibodies, Viral; COVID-19; Humans; Immunoglobulin G; RNA, Messenger; SARS-CoV-2; Saliva; Vaccination; Viral Vaccines
PubMed: 36203571
DOI: 10.3389/fimmu.2022.1006040