Special Issue "Vaccination Strategies for COVID-19"

A special issue of Vaccines (ISSN 2076-393X). This special issue belongs to the section "COVID-19 Vaccines and Vaccination".

Deadline for manuscript submissions: closed (31 December 2022) | Viewed by 100720

Special Issue Editor

Prof. Dr. Martin H. Bluth
E-Mail Website
Guest Editor
1. Blood Transfusion and Donor Services, Maimonides Medical Center, Brooklyn, NY, USA
2. Department of Pathology, Wayne State University School of Medicine, Detroit, MI, USA
Interests: biomarker discovery; inflammation; immunotherapeutics; IgE/IgG antibody regulation; ADCC
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Special Issue Information

Dear Colleagues,

We are at the precipice of unprecedented developments in the arena of vaccine development and application. In the wake of COVID-19, government, academia, medicine, science, and engineering have coordinated, matured, and promoted worldwide vaccination strategies, as part of the healthcare armamentarium, towards curtailing and hopefully eradicating this global pandemic. These include both "tried and true" as well as novel modalities to stimulate the immune system to provide appropriate and hopefully long-lasting protection against the COVID-19 wild-type virus as well as potential variants. In this Special Issue, we entreat those invested in the unique field of vaccine development, application, and the greater healthcare industry to share their understanding with their clinical, scientific, academic, medical, and healthcare colleagues. This will provide a platform to amalgamate efforts and understanding as well as synergize efforts for current and future vaccine initiatives.

Prof. Dr. Martin H. Bluth
Guest Editor

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Keywords

  • COVID
  • vaccine
  • coronavirus
  • pandemic
  • immunology
  • molecular
  • public health

Published Papers (36 papers)

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Article
Spatial Optimization to Improve COVID-19 Vaccine Allocation
Vaccines 2023, 11(1), 64; https://doi.org/10.3390/vaccines11010064 - 28 Dec 2022
Viewed by 1076
Abstract
Early distribution of COVID-19 vaccines was largely driven by population size and did not account for COVID-19 prevalence nor location characteristics. In this study, we applied an optimization framework to identify distribution strategies that would have lowered COVID-19 related morbidity and mortality. During [...] Read more.
Early distribution of COVID-19 vaccines was largely driven by population size and did not account for COVID-19 prevalence nor location characteristics. In this study, we applied an optimization framework to identify distribution strategies that would have lowered COVID-19 related morbidity and mortality. During the first half of 2021 in the state of Missouri, optimized vaccine allocation would have decreased case incidence by 8% with 5926 fewer COVID-19 cases, 106 fewer deaths, and 4.5 million dollars in healthcare cost saved. As COVID-19 variants continue to be identified, and the likelihood of future pandemics remains high, application of resource optimization should be a priority for policy makers. Full article
(This article belongs to the Special Issue Vaccination Strategies for COVID-19)
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Article
Combining Influenza and COVID-19 Booster Vaccination Strategy to Improve Vaccination Uptake Necessary for Managing the Health Pandemic: A Systematic Review and Meta-Analysis
Vaccines 2023, 11(1), 16; https://doi.org/10.3390/vaccines11010016 - 21 Dec 2022
Viewed by 1547
Abstract
Background: The uptake of COVID-19 booster vaccines has been significantly low. Therefore, it is questionable whether combining the COVID-19 booster vaccines with influenza vaccines can increase the population’s interest in taking such vaccines and manage the health pandemic effectively. Methodology: In this systematic [...] Read more.
Background: The uptake of COVID-19 booster vaccines has been significantly low. Therefore, it is questionable whether combining the COVID-19 booster vaccines with influenza vaccines can increase the population’s interest in taking such vaccines and manage the health pandemic effectively. Methodology: In this systematic review and meta-analysis, a synthesis of the findings and summary of a total of 30 research articles based on the topic, ‘combining influenza and COVID-19 booster vaccination strategy’ was undertaken. The research articles were identified from three databases, namely, PubMed, Cochran Library, and Google Scholar using specific keywords and inclusion criteria. However, research articles that were not peer-reviewed and not published in English were excluded from the systematic review and meta-analysis. The average risk ratio of the intervention group getting a combination of COVID-19 booster and influenza vaccines from the samples of the included studies was 0.78 with regard to a 95% CI. Such risk ratio is based on the null hypothesis of the current study that combining COVID-19 booster and influenza vaccines can increase the uptake of COVID-19 booster vaccines. On the other hand, the heterogeneity between such studies was I2 = 35%, while the statistical significance of their findings occurred at p < 0.05. The average p-value of the included research studies was p = 0.62 with the proportion of studies with significant p-values being 63.33% which is equivalent to 19 out of 30 studies. Therefore, the null hypothesis was not rejected in more than half of the studies. Results: A synthesis of the chosen research articles revealed that when influenza and COVID-19 booster vaccines are combined, there is potential for an increase in the uptake of the latter, mainly because many populations have already been accustomed to taking influenza vaccines on an annual basis. Conclusions: In this way, through such findings, medical health experts can make informed decisions to increase the population’s willingness to receive the COVID-19 booster vaccines. Full article
(This article belongs to the Special Issue Vaccination Strategies for COVID-19)
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Article
COVID-19 Vaccination Hesitancy in Mexico City among Healthy Adults and Adults with Chronic Diseases: A Survey of Complacency, Confidence, and Convenience Challenges in the Transition to Endemic Control
Vaccines 2022, 10(11), 1944; https://doi.org/10.3390/vaccines10111944 - 17 Nov 2022
Viewed by 535
Abstract
Background. Monitoring of SARS-COV-2 vaccine hesitancy is important for epidemic control. We measured vaccine hesitancy among healthy adults and adults with chronic diseases after they had been offered the first dose of the vaccine in Mexico City. Methods. An observational cross-sectional study was [...] Read more.
Background. Monitoring of SARS-COV-2 vaccine hesitancy is important for epidemic control. We measured vaccine hesitancy among healthy adults and adults with chronic diseases after they had been offered the first dose of the vaccine in Mexico City. Methods. An observational cross-sectional study was undertaken among 185 healthy adults and 175 adults living with chronic diseases. Differences in means of variables for confidence, complacency, and convenience were analyzed. Aggregate indicators were constructed and their association with socioeconomic and demographic conditions and vaccination acceptance analyzed using multivariate analysis of variance and multivariate logistic analysis. Results. Up to 16.8% of healthy adults and 10.3% of sick adults reported not having received the SARS-COV-2 vaccine. Healthy adults were more complacent about COVID-19 risks than adults with chronic diseases, while no differences were found between the two groups regarding other hesitancy aggregate indicators. Among adults with chronic diseases, those with more education and enrolled with a social insurance institution were less complacent of COVID-19, while education was positively associated with convenience across both groups. Less complacency with COVID-19 and more confidence in the vaccine were associated with higher vaccine acceptance across both groups. Among adults living with chronic diseases, the odds ratios of vaccine acceptance were higher for less complacency (OR = 2.4, p = 0.007) than for confidence (OR = 2.0, p = 0.001). Odds ratios of vaccine acceptance in these two hesitancy indicators were similar among healthy adults (OR = 3.3, p = <0.005) and higher than for adults with comorbidities. Conclusions. Confidence in the vaccine and complacency regarding COVID-19 risks play an important role for vaccine acceptance in Mexico City, particularly among healthy adults. The perception of risk regarding COVID-19 is more important than confidence in vaccine safety and effectiveness. Promotion of COVID-19 vaccines needs to focus on decreasing complacency with COVID-19 and increasing vaccine confidence, particularly among healthy adults. Full article
(This article belongs to the Special Issue Vaccination Strategies for COVID-19)
Article
Pharmacist and Pharmacy Technician Attitudes and Experiences with Technician-Administered Immunizations
Vaccines 2022, 10(8), 1354; https://doi.org/10.3390/vaccines10081354 - 19 Aug 2022
Viewed by 664
Abstract
In response to the increased demand for healthcare services during the COVID-19 pandemic, the Public Readiness and Emergency Preparedness (PREP) Act amendments and guidance authorized pharmacy technicians, who are not otherwise authorized in their state, to administer the Advisory Committee on Immunization Practices [...] Read more.
In response to the increased demand for healthcare services during the COVID-19 pandemic, the Public Readiness and Emergency Preparedness (PREP) Act amendments and guidance authorized pharmacy technicians, who are not otherwise authorized in their state, to administer the Advisory Committee on Immunization Practices (ACIP)-recommended immunizations and COVID-19 vaccines under pharmacist order. Subsequently, many pharmacies nationwide have expanded technician duties to include immunization administration. The primary objective of this study was to evaluate and compare the attitudes and experiences associated with technician-administered immunizations among community pharmacists and technicians. The cross-sectional study evaluated the primary endpoint through the completion of anonymous surveys containing peer-reviewed questionnaires. Pharmacy technicians and their supervising pharmacists were selected to complete the survey at a grocery chain’s pharmacies located in five states across the Northeast if they completed the immunization program and administered at least one immunization. Surveys were drafted using Microsoft Forms and results were analyzed using Microsoft Excel. Chi-squared tests were utilized for comparing categorical variables between groups. A total of 268 survey responses were obtained; 171 responses came from pharmacists and 97 responses came from immunization-certified technicians. Most pharmacists and pharmacy technicians responded that technicians could safely administer vaccines (87.1% and 96.9%, respectively) and competently process and bill vaccine services (90.6% and 99.0%, respectively). In addition, both participant populations responded that technician-administered vaccines improved the workflow of vaccine services (76.6% and 82.5%, respectively) without increasing the likelihood of vaccine errors (56.1% and 78.3%, respectively). When compared with technicians, fewer pharmacists were confident in a technician’s ability to competently prepare vaccines (63.7% vs. 91.8%; p < 0.001). A statistically significant association was observed between responses regarding an efficient process for immunizing patients and the likelihood of technician vaccination errors (χ2 = 14.36; p < 0.01). Pharmacists and pharmacy technicians responded that technicians competently administer immunizations and should participate in more patient-care duties. Multiple states are enacting legislation to include technician vaccine administration as a permanent component of their scope of practice. Full article
(This article belongs to the Special Issue Vaccination Strategies for COVID-19)
Article
Clinical and Virological Features of Patients Hospitalized with Different Types of COVID-19 Vaccination in Mexico City
Vaccines 2022, 10(8), 1181; https://doi.org/10.3390/vaccines10081181 - 26 Jul 2022
Cited by 1 | Viewed by 921
Abstract
Coronavirus disease 2019 (COVID-19) vaccines effectively protect against severe disease and death. However, the impact of the vaccine used, viral variants, and host factors on disease severity remain poorly understood. This work aimed to compare COVID-19 clinical presentations and outcomes in vaccinated and [...] Read more.
Coronavirus disease 2019 (COVID-19) vaccines effectively protect against severe disease and death. However, the impact of the vaccine used, viral variants, and host factors on disease severity remain poorly understood. This work aimed to compare COVID-19 clinical presentations and outcomes in vaccinated and unvaccinated patients in Mexico City. From March to September 2021, clinical, demographic characteristics, and viral variants were obtained from 1014 individuals with a documented SARS-CoV-2 infection. We compared unvaccinated, partially vaccinated, and fully vaccinated patients, stratifying by age groups. We also fitted multivariate statistical models to evaluate the impact of vaccination status, SARS-CoV-2 lineages, vaccine types, and clinical parameters. Most hospitalized patients were unvaccinated. In patients over 61 years old, mortality was significantly higher in unvaccinated compared to fully vaccinated individuals. In patients aged 31 to 60 years, vaccinated patients were more likely to be outpatients (46%) than unvaccinated individuals (6.1%). We found immune disease and age above 61 years old to be risk factors, while full vaccination was found to be the most protective factor against in-hospital death. This study suggests that vaccination is essential to reduce mortality in a comorbid population such as that of Mexico. Full article
(This article belongs to the Special Issue Vaccination Strategies for COVID-19)
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Article
Protectivity of COVID-19 Vaccines and Its Relationship with Humoral Immune Response and Vaccination Strategy: A One-Year Cohort Study
Vaccines 2022, 10(8), 1177; https://doi.org/10.3390/vaccines10081177 - 25 Jul 2022
Viewed by 1434
Abstract
This prospective cohort study aimed to evaluate the efficacy of COVID-19 vaccine schemes, homologous versus heterologous vaccine strategies, and vaccine-induced anti-S-RBD-IgG antibody response in preventing COVID-19 among 942 healthcare workers 1 year after vaccination with the inactivated and/or mRNA vaccines. All participants received [...] Read more.
This prospective cohort study aimed to evaluate the efficacy of COVID-19 vaccine schemes, homologous versus heterologous vaccine strategies, and vaccine-induced anti-S-RBD-IgG antibody response in preventing COVID-19 among 942 healthcare workers 1 year after vaccination with the inactivated and/or mRNA vaccines. All participants received the first two primary doses of vaccines, 13.6% of them lacked dose 3, 50.5% dose 4, and 90.3% dose 5. Antibody levels increased with the increase in number of vaccine doses and also in heterologous vaccine regimens. In both inactive, mRNA vaccines and mixed vaccination, infection rates were significantly higher in two-dose-receivers, but lower in four- or five-dose receivers and increasing the total number of vaccine doses resulted in more protection against infection: the three-dose regimen yielded 3.67 times more protection, the four-dose 8 times, and five-dose 27.77 times more protection from COVID-19 infection, compared to any two-dose vaccination regimens. Antibody levels at the end of the first year of four- or five-dose-receivers were significantly higher than two- or three-dose receivers. To conclude, an increased number of total vaccine doses and anti-S-RBD antibody levels increased the protection from COVID-19 infection. Therefore, four or more doses are recommended in 1 year for effective protection, especially in risk groups. Full article
(This article belongs to the Special Issue Vaccination Strategies for COVID-19)
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Communication
Reasons for the Intention to Refuse COVID-19 Vaccination and Their Association with Preferred Sources of Information in a Nationwide, Population-Based Sample in Italy, before COVID-19 Vaccines Roll Out
Vaccines 2022, 10(6), 913; https://doi.org/10.3390/vaccines10060913 - 08 Jun 2022
Cited by 6 | Viewed by 900
Abstract
Sources of information on health and vaccines such as social media, online forums, televisions, and newspapers contributed to the spread of information related to COVID-19 and, in some cases, misinformation and vaccine hesitancy. Understanding what can influence the intention to refuse COVID-19 vaccination [...] Read more.
Sources of information on health and vaccines such as social media, online forums, televisions, and newspapers contributed to the spread of information related to COVID-19 and, in some cases, misinformation and vaccine hesitancy. Understanding what can influence the intention to refuse COVID-19 vaccination may help to plan future public health strategies aimed at increasing vaccination coverage. This study aimed to assess the reasons for the intention to refuse the COVID-19 vaccines and the possible association between these reasons and the preferred sources of information on vaccines. An anonymous online survey was shared among the general adult population living in Italy. Only participants aged 18 or older and living in Italy were considered eligible. The questionnaires that reported the intention to refuse COVID-19 vaccination were analyzed. A total of 677 participants (from 7563 valid questionnaires) reported the intention to refuse to vaccinate against COVID-19. Most of them used search engines (n = 390, 57.6%) to seek information about vaccines, while the fear of adverse reactions to the COVID-19 vaccine was the most mentioned reason for being unwilling to get vaccinated (n = 402, 59.4%). These data may be important to build new knowledge on the impact that different sources of information can have on the willingness to get vaccinated against COVID-19. Full article
(This article belongs to the Special Issue Vaccination Strategies for COVID-19)
Article
COVID-19 Vaccines: Fear of Side Effects among German Health Care Workers
Vaccines 2022, 10(5), 689; https://doi.org/10.3390/vaccines10050689 - 28 Apr 2022
Cited by 5 | Viewed by 1442
Abstract
(1) Background: Health care workers (HCWs) play a key role in increasing anti-COVID vaccination rates. Fear of potential side effects is one of the main reasons for vaccine hesitancy. We investigated which side effects are of concern to HCWs and how these are [...] Read more.
(1) Background: Health care workers (HCWs) play a key role in increasing anti-COVID vaccination rates. Fear of potential side effects is one of the main reasons for vaccine hesitancy. We investigated which side effects are of concern to HCWs and how these are associated with vaccine hesitancy. (2) Methods: Data were collected in an online survey in February 2021 among HCWs from across Germany with 4500 included participants. Free-text comments on previously experienced vaccination side effects, and fear of short- and long-term side effects of the COVID-19 vaccination were categorized and analyzed. (3) Results: Most feared short-term side effects were vaccination reactions, allergic reactions, and limitations in daily life. Most feared long-term side effects were (auto-) immune reactions, neurological side effects, and currently unknown long-term consequences. Concerns about serious vaccination side effects were associated with vaccination refusal. There was a clear association between refusal of COVID-19 vaccination in one’s personal environment and fear of side effects. (4) Conclusions: Transparent information about vaccine side effects is needed, especially for HCW. Especially when the participants’ acquaintances advised against vaccination, they were significantly more likely to fear side effects. Thus, further education of HCW is necessary to achieve good information transfer in clusters as well. Full article
(This article belongs to the Special Issue Vaccination Strategies for COVID-19)
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Article
Shoulder Injury Related to COVID-19 Vaccine Administration: A Case Series
Vaccines 2022, 10(4), 588; https://doi.org/10.3390/vaccines10040588 - 12 Apr 2022
Cited by 3 | Viewed by 2182
Abstract
Background: A shoulder injury related to vaccine administration (SIRVA) is a vaccination complication that can affect daily life activities. To date, there have been no case series of patients diagnosed as SIRVA following a COVID-19 vaccination. We offer a series of seven SIRVA [...] Read more.
Background: A shoulder injury related to vaccine administration (SIRVA) is a vaccination complication that can affect daily life activities. To date, there have been no case series of patients diagnosed as SIRVA following a COVID-19 vaccination. We offer a series of seven SIRVA cases including clinical presentations, investigations and treatment outcomes. Methods: A retrospective chart review was performed for seven patients who developed SIRVA following a COVID-19 vaccination between April 2021 and October 2021. All patients had no prior shoulder pain before their vaccination and then developed shoulder pain within a few days following the vaccination, which did not spontaneously improve within 1 week. Results: Four of the seven patients were male, and the average age was 62.29 ± 7.76 years. The average body mass index was 25.1 ± 2.2 kg/m2. In all cases, the cause of the SIRVA was from an incorrect COVID-19 vaccine administration technique. Two patients developed shoulder pain immediately following the injection, one patient about 3 h after the injection, and the other four patients within the next few days. Two of the seven patients visited the orthopedic clinic after the persistent shoulder pain for 3 and 4 days and the other five patients 1–9 weeks following their injections. One of the seven patients was treated with combined intravenous antibiotic and oral non-steroidal anti-inflammatory drug (NSAID) because septic arthritis of the shoulder could not initially be ruled out, and recovered within 2 weeks. The other six patients had shoulder pain without acute fever, and five of them were treated with only oral prednisolone 30 mg/day for 5–10 days, following which the pain improved and they all could return to normal activities within 14 days, with no side effects from the prednisolone such as stomachache, nausea, vomiting, headache, or dizziness. Discussion and conclusion: In our series, the most common cause of SIRVA was an incorrect vaccination technique. Most patients responded well to oral NSAIDs or oral prednisolone. Clinical relevance: All SIRVAs were from an incorrect injection technique and not actually the vaccination, so our series highlights the importance of ensuring all vaccinators understand the importance of taking proper care with the injection technique. Additionally, most of our patients with SIRVA from a COVID-19 injection responded well to oral prednisolone (30 mg/day). If there are no contraindications, we suggest this as the first line treatment for COVID-19-related SIRVA. Full article
(This article belongs to the Special Issue Vaccination Strategies for COVID-19)
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Article
Detection of Neutralizing Antibodies against SARS-CoV-2 Post-Vaccination in Health Care Workers of a Large Tertiary Hospital in Spain by Using a Rapid Test LFIC and sVNT-ELISA
Vaccines 2022, 10(4), 510; https://doi.org/10.3390/vaccines10040510 - 25 Mar 2022
Cited by 1 | Viewed by 1556
Abstract
The presence of neutralizing antibodies (NAbs) against SARS-CoV-2 represent a surrogate marker of immunologic protection in populations at high risk of infection such as healthcare workers caring for hospitalized patients with COVID-19. As recommended by CDC and the European CDC, the use of [...] Read more.
The presence of neutralizing antibodies (NAbs) against SARS-CoV-2 represent a surrogate marker of immunologic protection in populations at high risk of infection such as healthcare workers caring for hospitalized patients with COVID-19. As recommended by CDC and the European CDC, the use of rapid diagnostic tests during population-based evaluations offers an opportunity to identify individuals with serologic evidence of natural infection or who have undergone vaccination. We carried out a cross-sectional study to assess the presence of neutralizing antibodies against SARS-CoV-2 among medical providers at an intensive care unit of a large referral hospital in Alicante, Spain. In addition, we tested for the presence of neutralizing antibodies compared to serum of uninfected individuals from a Biobank. We were also interested in evaluating the use of a rapid lateral flow immunochromatography (LFIC) test against a surrogate ELISA viral neutralization test (sVNT). This rapid test demonstrated a specificity of 1.000 95% CI (0.91–1.00) and the sensitivity of 0.987 95% CI (0.93–1.00). The negative predictive value was 95%. After six months, this rapid test demonstrated that those immunized with two doses of BioNTech/Pfizer vaccine, maintained optimal levels of neutralizing antibodies. We concluded that all Health Care Workers develop NAbs and the use of this rapid immunochromatographic test represents a potential tool to be used in population-based studies to detect serological antibody responses to vaccination. Vaccination policies could benefit from this tool to assess additional doses of vaccine or boosters among high-risk populations. Full article
(This article belongs to the Special Issue Vaccination Strategies for COVID-19)
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Article
Risk Stratification of SARS-CoV-2 Breakthrough Infections Based on an Outbreak at a Student Festive Event
Vaccines 2022, 10(3), 432; https://doi.org/10.3390/vaccines10030432 - 11 Mar 2022
Viewed by 1373
Abstract
In early 2022, the Coronavirus disease 2019 (COVID-19) remains a global challenge. COVID-19 is caused by an increasing number of variants of the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2). Here, we report an outbreak of SARS-CoV-2 breakthrough infections related to a student [...] Read more.
In early 2022, the Coronavirus disease 2019 (COVID-19) remains a global challenge. COVID-19 is caused by an increasing number of variants of the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2). Here, we report an outbreak of SARS-CoV-2 breakthrough infections related to a student festive event with 100 mostly vaccinated guests, which took place in Northern Bavaria, Germany, in October 2021. The data were obtained by retrospective guest interviews. In total, 95 students participated in the study, with 94 being fully vaccinated and 24 reporting infection by the delta variant. Correlation analyses among 15 examined variables revealed that time spent at the event, conversation with the supposed index person, and a homologous viral vector vaccination regime were significant risk factors for infection. Non-significant observations related to higher rates of infection included time since last vaccination, shared use of drinking vessels, and number of individual person-to-person contacts at the event. Our data suggest that a high rate of breakthrough infections with the delta variant occurs if no preventive measures are practiced. To limit infection risk, high-quality testing of participants should be considered a mandatory measure at gatherings, irrespective of the participants’ vaccination status. Full article
(This article belongs to the Special Issue Vaccination Strategies for COVID-19)
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Article
Factors Associated with COVID-19 Vaccine Hesitancy after Implementation of a Mass Vaccination Campaign
Vaccines 2022, 10(2), 281; https://doi.org/10.3390/vaccines10020281 - 12 Feb 2022
Cited by 1 | Viewed by 1388
Abstract
An online cross-sectional study on COVID-19 vaccination adhesion was conducted in Portugal nine months after vaccination rollout (September–November 2021). Logistic regression was used to identify factors associated with hesitancy to take the COVID-19 vaccine in the community-based survey, “COVID-19 Barometer: Social Opinion”. Hesitancy [...] Read more.
An online cross-sectional study on COVID-19 vaccination adhesion was conducted in Portugal nine months after vaccination rollout (September–November 2021). Logistic regression was used to identify factors associated with hesitancy to take the COVID-19 vaccine in the community-based survey, “COVID-19 Barometer: Social Opinion”. Hesitancy was 11%; however, of those, 60.5% stated that they intended to take the vaccine. Hesitancy was associated with factors such as lower monthly household income; no intention of taking the flu vaccine this year; perceived reasonable health status; having two or more diseases; low confidence in the health service response; worse perception of the adequacy of anti-COVID-19 government measures; low or no perceived risk of getting COVID-19; feeling agitated, anxious or sad some days; and lack of trust in the safety and efficacy of the vaccines. Confidence in vaccines, namely against COVID-19, is paramount for public health and should be monitored during vaccination rollout. Clear communication of the risks and benefits of vaccination needs improvement to increase adherence and public confidence. Full article
(This article belongs to the Special Issue Vaccination Strategies for COVID-19)
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Article
Vaccination Schedule under Conditions of Limited Vaccine Production Rate
Vaccines 2022, 10(1), 116; https://doi.org/10.3390/vaccines10010116 - 13 Jan 2022
Cited by 1 | Viewed by 991
Abstract
The paper is devoted to optimal vaccination scheduling during a pandemic to minimize the probability of infection. The recent COVID-19 pandemic showed that the international community is not properly prepared to manage a crisis of this scale. Just after the vaccines had been [...] Read more.
The paper is devoted to optimal vaccination scheduling during a pandemic to minimize the probability of infection. The recent COVID-19 pandemic showed that the international community is not properly prepared to manage a crisis of this scale. Just after the vaccines had been approved by medical agencies, the policymakers needed to decide on the distribution strategy. To successfully fight the pandemic, the key is to find the equilibrium between the vaccine distribution schedule and the available supplies caused by limited production capacity. This is why society needs to be divided into stratified groups whose access to vaccines is prioritized. Herein, we present the problem of distributing protective actions (i.e., vaccines) and formulate two mixed-integer programs to solve it. The problem of distributing protective actions (PDPA) aims at finding an optimal schedule for a given set of social groups with a constant probability of infection. The problem of distributing protective actions with a herd immunity threshold (PDPAHIT) also includes a variable probability of infection, i.e., the situation when herd immunity is obtained. The results of computational experiments are reported and the potential of the models is illustrated with examples. Full article
(This article belongs to the Special Issue Vaccination Strategies for COVID-19)
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Article
Efficacy and Safety of Third Dose of the COVID-19 Vaccine among Solid Organ Transplant Recipients: A Systemic Review and Meta-Analysis
Vaccines 2022, 10(1), 95; https://doi.org/10.3390/vaccines10010095 - 09 Jan 2022
Cited by 16 | Viewed by 1960
Abstract
Solid organ transplant recipients were demonstrated to have reduced antibody response to the first and second doses of the COVID-19 mRNA vaccine. This review evaluated published data on the efficacy and safety of the third dose among solid organ transplant recipients. We performed [...] Read more.
Solid organ transplant recipients were demonstrated to have reduced antibody response to the first and second doses of the COVID-19 mRNA vaccine. This review evaluated published data on the efficacy and safety of the third dose among solid organ transplant recipients. We performed a systematic search of PubMed, EMBASE, and Web of Science to retrieve studies evaluating the efficacy of the third dose of anti-SARS-CoV-2 vaccines in adult solid organ transplant recipients. Serologic response after the third vaccine was pooled using inverse variance and generalized linear mixed and random-effects models. Seven studies met our inclusion criteria. A total of 853 patients received the third dose. Except for one randomized controlled trial, all studies were retrospective in design. Following the third COVID-19 vaccine dose, antibody response occurred in 6.4–69.2% of patients. The pooled proportion of antibody response rate after the third vaccine was 50.3% (95% confidence interval (CI): 37.1–63.5, I2 = 90%). Five papers reported the safety profile. No severe adverse events were observed after the third vaccine dose. In conclusion, a third dose of the SARS-CoV-2 mRNA vaccine in solid organ transplant recipients is associated with improved immunogenicity and appears to be safe. Nevertheless, a significant portion of patients remain seronegative. Full article
(This article belongs to the Special Issue Vaccination Strategies for COVID-19)
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Article
Safety and Immunogenicity of the Third Booster Dose with Inactivated, Viral Vector, and mRNA COVID-19 Vaccines in Fully Immunized Healthy Adults with Inactivated Vaccine
Vaccines 2022, 10(1), 86; https://doi.org/10.3390/vaccines10010086 - 06 Jan 2022
Cited by 30 | Viewed by 6507
Abstract
The coronavirus disease 2019 (COVID-19) pandemic has become a severe healthcare problem worldwide since the first outbreak in late December 2019. Currently, the COVID-19 vaccine has been used in many countries, but it is still unable to control the spread of severe acute [...] Read more.
The coronavirus disease 2019 (COVID-19) pandemic has become a severe healthcare problem worldwide since the first outbreak in late December 2019. Currently, the COVID-19 vaccine has been used in many countries, but it is still unable to control the spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, despite patients receiving full vaccination doses. Therefore, we aimed to appraise the booster effect of the different platforms of vaccines, including inactivated vaccine (BBIBP), viral vector vaccine (AZD122), and mRNA vaccine (BNT162b2), in healthy adults who received the full dose of inactivated vaccine (CoronaVac). The booster dose was safe with no serious adverse events. Moreover, the immunogenicity indicated that the booster dose with viral vector and mRNA vaccine achieved a significant proportion of Ig anti-receptor binding domain (RBD), IgG anti-RBD, and IgA anti-S1 booster response. In contrast, inactivated vaccine achieved a lower booster response than others. Consequently, the neutralization activity of vaccinated serum had a high inhibition of over 90% against SARS-CoV-2 wild-type and their variants (B.1.1.7–alpha, B.1.351–beta, and B.1.617.2–delta). In addition, IgG anti-nucleocapsid was observed only among the group that received the BBIBP booster. Our study found a significant increase in levels of IFN-ɣ secreting T-cell response after the additional viral vector or mRNA booster vaccination. This study showed that administration with either viral vector (AZD1222) or mRNA (BNT162b2) boosters in individuals with a history of two doses of inactivated vaccine (CoronaVac) obtained great immunogenicity with acceptable adverse events. Full article
(This article belongs to the Special Issue Vaccination Strategies for COVID-19)
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Article
Immunogenicity of a Heterologous Prime-Boost COVID-19 Vaccination with mRNA and Inactivated Virus Vaccines Compared with Homologous Vaccination Strategy against SARS-CoV-2 Variants
Vaccines 2022, 10(1), 72; https://doi.org/10.3390/vaccines10010072 - 03 Jan 2022
Cited by 8 | Viewed by 2318
Abstract
The emergence of SARS-CoV-2 variants may impact the effectiveness of vaccines, while heterologous vaccine strategy is considered to provide better protection. The immunogenicity of an mRNA-inactivated virus vaccine against the SARS-CoV-2 wild-type (WT) and variants was evaluated in the study. SARS-CoV-2 naïve adults [...] Read more.
The emergence of SARS-CoV-2 variants may impact the effectiveness of vaccines, while heterologous vaccine strategy is considered to provide better protection. The immunogenicity of an mRNA-inactivated virus vaccine against the SARS-CoV-2 wild-type (WT) and variants was evaluated in the study. SARS-CoV-2 naïve adults (n = 123) were recruited and placed in the following groups: BNT162b2, CoronaVac or BNT162b2-CoronaVac (Combo) Group. Blood samples were collected to measure neutralization antibodies (NAb) by a live virus microneutralization assay (vMN) and surrogate NAb test. The day 56 vMN geometric mean titre (GMT) was 26.2 [95% confident interval (CI), [22.3–30.9] for Combo, 136.9 (95% CI, 104.2–179.7) for BNT162b2, and 14.7 (95% CI, 11.6–18.6) for CoronaVac groups. At 6 months post-first dose, the GMT declined to 8.0, 28.8 and 7.1 in the Combo, BNT162b2 and CoronaVac groups, respectively. Three groups showed reduced neutralizing activity against D614G, beta, theta and delta variants. At day 56 GMT (74.6) and month 6 GMT (22.7), the delta variant in the BNT162b2 group was higher than that in the Combo (day 56, 7.4; month 6, 5.5) and CoronaVac groups (day 56, 8.0; month 6, 5) (p < 0.0001). Furthermore, the mean surrogate NAb value on day 56 in the BNT162b2 group was 594.7 AU/mL and higher than 40.5 AU/mL in Combo and 38.8 AU/mL in CoronaVac groups (p < 0.0001). None of the participants developed severe adverse events, and all other adverse events were self-limiting. The Combo vaccination strategy was safe. The overall vaccine immunogenicity at day 56 and 6 months were comparable to the homologous CoronaVac group but inferior to the homologous BNT162b2 group, against both the WT and all variants. Furthermore, the antibody response of vaccines waned at 6 months and thereby, a third dose of the vaccine is needed for these vaccines. Full article
(This article belongs to the Special Issue Vaccination Strategies for COVID-19)
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Students’ Views on Vaccination against COVID-19 Virus and Trust in Media Information about the Vaccine: The Case of Serbia
Vaccines 2021, 9(12), 1430; https://doi.org/10.3390/vaccines9121430 - 03 Dec 2021
Cited by 6 | Viewed by 2870
Abstract
Mass immunization of the citizens of the Republic of Serbia began in January 2021. Information on the significance, manner, advantages and consequences of this process was intensively distributed through all communication channels, with the media playing a key role. According to the data [...] Read more.
Mass immunization of the citizens of the Republic of Serbia began in January 2021. Information on the significance, manner, advantages and consequences of this process was intensively distributed through all communication channels, with the media playing a key role. According to the data of the official institutions for the public health of Serbia, by July 2021 the lowest percentage of vaccinated population was among those between the ages of 18 and 24—only 15% of this demographic had received the vaccine by this point. Given the low turnout of young people for vaccination, in this paper we investigated the general attitude of students in Serbia, as a special category of young people, towards the vaccine against the COVID-19 virus, as well as their attitude regarding information about vaccination in the media. Research was conducted on a sample of 345 students at the University of Novi Sad. The results of the research showed that 42% of students had not been vaccinated and did not plan to do so, 37.4% had received at least one dose of vaccine and 20.6% had not been vaccinated even though they planned to do so. Students who were vaccinated had more confidence in information provided through media channels than those who were not vaccinated. Therefore, it can be concluded that encouraging students to decide in favor of vaccination against the COVID-19 virus should come from the universities where they study as well as the media. Full article
(This article belongs to the Special Issue Vaccination Strategies for COVID-19)
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Article
Evaluation of Treatment Outcome for Pneumonia among Pre-Vaccinated COVID-19 Patients with/without Comorbidity in a Public Hospital in Bengkulu, Indonesia
Vaccines 2021, 9(12), 1411; https://doi.org/10.3390/vaccines9121411 - 30 Nov 2021
Cited by 7 | Viewed by 1560
Abstract
Pneumonia is one of the common complications of SARS-CoV-2 infection where most patients have moderate to severe symptoms that pose a higher risk for death. This study aims to evaluate the treatment outcome of COVID-19-associated Pneumonia among patients with/without comorbidity in a public [...] Read more.
Pneumonia is one of the common complications of SARS-CoV-2 infection where most patients have moderate to severe symptoms that pose a higher risk for death. This study aims to evaluate the treatment outcome of COVID-19-associated Pneumonia among patients with/without comorbidity in a public hospital in Indonesia. This is a retrospective cohort study involving unvaccinated confirmed COVID-19 patients admitted to the hospital between March and December 2020. All confirmed COVID-19 patients with Pneumonia (n = 1522) treated at the hospital were included. The majority of patients (99%) had mild COVID-19 symptoms while the remaining had moderate symptoms. The median age was about 32 years old and the average treatment duration was 6.25 ± 1.83 days. Most patients (88.8%) received a combination of azithromycin and oseltamivir. There was a very significant relationship (p < 0.001) between comorbidities with treatment and duration of treatment of Pneumonia in COVID-19 patients. Although most patients had Pneumonia and comorbidities, they were successfully treated with azithromycin and oseltamivir combination following approximately five days of treatment. Full article
(This article belongs to the Special Issue Vaccination Strategies for COVID-19)
Article
A Data-Driven Digital Application to Enhance the Capacity Planning of the COVID-19 Vaccination Process
Vaccines 2021, 9(10), 1181; https://doi.org/10.3390/vaccines9101181 - 15 Oct 2021
Cited by 4 | Viewed by 1714
Abstract
In this paper, a decision support system (DSS) is presented that focuses on the capacity planning of the COVID-19 vaccination process in the Netherlands. With the Dutch national vaccination priority list as the starting point, the DSS aims to minimize the per-class waiting-time [...] Read more.
In this paper, a decision support system (DSS) is presented that focuses on the capacity planning of the COVID-19 vaccination process in the Netherlands. With the Dutch national vaccination priority list as the starting point, the DSS aims to minimize the per-class waiting-time with respect to (1) the locations of the medical hubs (i.e., the vaccination locations) and (2) the distribution of the available vaccines and healthcare professionals (over time). As the user is given the freedom to experiment with different starting positions and strategies, the DSS is ideally suited for providing support in the dynamic environment of the COVID-19 vaccination process. In addition to the DSS, a mathematical model to support the assignment of inhabitants to medical hubs is presented. This model has been satisfactorily implemented in practice in close collaboration with the Dutch Municipal and Regional Health Service (GGD GHOR Nederland). Full article
(This article belongs to the Special Issue Vaccination Strategies for COVID-19)
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Article
Longitudinal Humoral Responses after COVID-19 Vaccination in Peritoneal and Hemodialysis Patients over Twelve Weeks
Vaccines 2021, 9(10), 1130; https://doi.org/10.3390/vaccines9101130 - 04 Oct 2021
Cited by 23 | Viewed by 1494
Abstract
It has been demonstrated that patients on hemo- or peritoneal dialysis are particularly susceptible to SARS-CoV-2 infection and impaired seroconversion compared to healthy controls. Follow-up data on vaccination response in dialysis patients is limited but is greatly needed to individualize and guide (booster) [...] Read more.
It has been demonstrated that patients on hemo- or peritoneal dialysis are particularly susceptible to SARS-CoV-2 infection and impaired seroconversion compared to healthy controls. Follow-up data on vaccination response in dialysis patients is limited but is greatly needed to individualize and guide (booster) vaccination strategies. In this prospective, multicenter study we measured anti-spike S1 and neutralizing antibodies in 124 hemodialysis patients, 41 peritoneal dialysis patients, and 20 age- and sex-matched healthy controls over 12 weeks after homologous BNT162b2 vaccination. Compared to healthy controls, both hemodialysis and peritoneal dialysis patients had lower anti-S1 IgG antibodies (median (IQR) 7.0 (2.8–24.3) and 21.8 (5.8–103.9) versus 134.9 (23.8–283.6), respectively; p < 0.001 and p < 0.05) and a reduced SARS-CoV-2 spike protein–ACE2 binding inhibition caused by vaccine-induced antibodies (median (IQR) 56% (40–81) and 77% (52–89) versus 96% (90–98), respectively; p < 0.001 and p < 0.01) three weeks after the second vaccination. Twelve weeks after the second vaccination, the spike protein–ACE2 binding inhibition significantly decreased to a median (IQR) of 45% (31–60) in hemodialysis patients and 55% (36–78) in peritoneal dialysis patients, respectively (p < 0.001 and p < 0.05). Peritoneal dialysis patients mounted higher antibody levels compared with hemodialysis patients at all time points during the 12-week follow-up. Individual booster vaccinations in high-risk individuals without seroconversion or rapidly waning neutralizing antibody levels are required and further data on the neutralization of emerging variants of concern in these patients are urgently needed. Full article
(This article belongs to the Special Issue Vaccination Strategies for COVID-19)
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Article
COVID-19 Vaccination in Patients with Myasthenia Gravis: A Single-Center Case Series
Vaccines 2021, 9(10), 1112; https://doi.org/10.3390/vaccines9101112 - 29 Sep 2021
Cited by 23 | Viewed by 4323
Abstract
In this study, we report the safety of coronavirus disease 2019 (COVID-19) vaccine in patients with myasthenia gravis (MG). Patients who were vaccinated against COVID-19 were included. Demographics, clinical characteristics, medications, and vaccination information were collected. The main observation outcome is the worsening [...] Read more.
In this study, we report the safety of coronavirus disease 2019 (COVID-19) vaccine in patients with myasthenia gravis (MG). Patients who were vaccinated against COVID-19 were included. Demographics, clinical characteristics, medications, and vaccination information were collected. The main observation outcome is the worsening of MG symptoms within 4 weeks following COVID-19 vaccination. A total of 22 patients with MG vaccinated for COVID-19 were included. Ten (45.5%) patients had ocular MG (OMG), and 12 (55.5%) patients had generalized MG (GMG). Six (27.3%) patients were female, and the mean (SD) onset age was 45.4 (11.8) years. Nineteen (86.4%) patients were seropositive for acetylcholine receptors (AChR) antibody. Seven (31.8%) patients underwent thymectomy, and four of them confirmed thymoma pathologically. Twenty-one patients were administrated with inactivated vaccines, and the remaining one was administrated with recombinant subunit vaccine. Twenty (90.9%) patients did not present MG symptom worsening within 4 weeks of COVID-19 vaccination, and two (9.1%) patients reported slight symptom worsening but resolved quickly within a few days. Our findings suggest inactivated COVID-19 vaccines might be safe in MG patients with Myasthenia Gravis Foundation of America (MGFA) classification I to II, supporting the recommendation to promote vaccination for MG patients during the still expanding COVID-19 pandemic. Full article
(This article belongs to the Special Issue Vaccination Strategies for COVID-19)
Article
Waning of IgG, Total and Neutralizing Antibodies 6 Months Post-Vaccination with BNT162b2 in Healthcare Workers
Vaccines 2021, 9(10), 1092; https://doi.org/10.3390/vaccines9101092 - 28 Sep 2021
Cited by 66 | Viewed by 5987
Abstract
Data about the long-term duration of antibodies after SARS-CoV-2 vaccination are still scarce and are important to design vaccination strategies. In this study, 231 healthcare professionals received the two-dose regimen of BNT162b2. Of these, 158 were seronegative and 73 were seropositive at baseline. [...] Read more.
Data about the long-term duration of antibodies after SARS-CoV-2 vaccination are still scarce and are important to design vaccination strategies. In this study, 231 healthcare professionals received the two-dose regimen of BNT162b2. Of these, 158 were seronegative and 73 were seropositive at baseline. Samples were collected at several time points. The neutralizing antibodies (NAbs) and antibodies against the nucleocapsid and the spike protein of SARS-CoV-2 were measured. At day 180, a significant antibody decline was observed in seronegative (−55.4% with total antibody assay; −89.6% with IgG assay) and seropositive individuals (−74.8% with total antibody assay; −79.4% with IgG assay). The estimated half-life of IgG from the peak humoral response was 21 days (95% CI: 13–65) in seronegative and 53 days (95% CI: 40–79) in seropositive individuals. The estimated half-life of total antibodies was longer and ranged from 68 days (95% CI: 54–90) to 114 days (95% CI: 87–167) in seropositive and seronegative individuals, respectively. The decline of NAbs was more pronounced (−98.6%) and around 45% of the subjects tested were negative at day 180. Whether this decrease correlates with an equivalent drop in the clinical effectiveness against the virus would require appropriate clinical studies. Full article
(This article belongs to the Special Issue Vaccination Strategies for COVID-19)
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Article
Heterologous ChAdOx1 nCoV-19/BNT162b2 Prime-Boost Vaccination Induces Strong Humoral Responses among Health Care Workers
Vaccines 2021, 9(8), 857; https://doi.org/10.3390/vaccines9080857 - 04 Aug 2021
Cited by 32 | Viewed by 2807
Abstract
Despite limited data on safety and immunogenicity, heterologous prime-boost vaccination is currently recommended for individuals with ChAdOx1 nCoV-19 prime immunization in certain age groups. In this prospective, single-center study we included 166 health care workers from Heidelberg University Hospital who received either heterologous [...] Read more.
Despite limited data on safety and immunogenicity, heterologous prime-boost vaccination is currently recommended for individuals with ChAdOx1 nCoV-19 prime immunization in certain age groups. In this prospective, single-center study we included 166 health care workers from Heidelberg University Hospital who received either heterologous ChAdOx1 nCoV-19/BNT162b2, homologous BNT162b2 or homologous ChAdOx1 nCoV-19 vaccination between December 2020 and May 2021. We measured anti-S1 IgG, SARS-CoV-2 specific neutralizing antibodies, and antibodies against different SARS-CoV-2 fragments 0–3 days before and 19–21 days after boost vaccination. Before boost, 55/70 (79%) ChAdOx1 nCoV-19-primed compared with 44/45 (98%) BNT162b2-primed individuals showed positive anti-S1 IgG with a median (IQR) anti-S1 IgG index of 1.95 (1.05–2.99) compared to 9.38 (6.26–17.12). SARS-CoV-2 neutralizing antibodies exceeded the threshold in 24/70 (34%) of ChAdOx1 nCoV-19-primed and 43/45 (96%) of BNT162b2-primed individuals. After boosting dose, median (IQR) anti-S1 IgG index in heterologous ChAdOx1 nCoV-19/BNT162b2 vaccinees was 116.2 (61.84–170), compared to 13.09 (7.03–29.02) in homologous ChAdOx1 nCoV-19 and 145.5 (100–291.1) in homologous BNT162b2 vaccinees. All boosted vaccinees exceeded the threshold for neutralization, irrespective of their vaccination scheme. Vaccination was well-tolerated overall. We show that heterologous ChAdOx1 nCoV-19/BNT162b2 vaccination is safe and induces a strong and broad humoral response in healthy individuals. Full article
(This article belongs to the Special Issue Vaccination Strategies for COVID-19)
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Article
Cellular and Humoral Immunogenicity of a Candidate DNA Vaccine Expressing SARS-CoV-2 Spike Subunit 1
Vaccines 2021, 9(8), 852; https://doi.org/10.3390/vaccines9080852 - 04 Aug 2021
Cited by 3 | Viewed by 3887
Abstract
The urgent need for effective, safe and equitably accessible vaccines to tackle the ongoing spread of COVID-19 led researchers to generate vaccine candidates targeting varieties of immunogens of SARS-CoV-2. Because of its crucial role in mediating binding and entry to host cell and [...] Read more.
The urgent need for effective, safe and equitably accessible vaccines to tackle the ongoing spread of COVID-19 led researchers to generate vaccine candidates targeting varieties of immunogens of SARS-CoV-2. Because of its crucial role in mediating binding and entry to host cell and its proven safety profile, the subunit 1 (S1) of the spike protein represents an attractive immunogen for vaccine development. Here, we developed and assessed the immunogenicity of a DNA vaccine encoding the SARS-CoV-2 S1. Following in vitro confirmation and characterization, the humoral and cellular immune responses of our vaccine candidate (pVAX-S1) was evaluated in BALB/c mice using two different doses, 25 µg and 50 µg. Our data showed high levels of SARS-CoV-2 specific IgG and neutralizing antibodies in mice immunized with three doses of pVAX-S1. Analysis of the induced IgG subclasses showed a Th1-polarized immune response, as demonstrated by the significant elevation of spike-specific IgG2a and IgG2b, compared to IgG1. Furthermore, we found that the immunization of mice with three doses of 50 µg of pVAX-S1 could elicit significant memory CD4+ and CD8+ T cell responses. Taken together, our data indicate that pVAX-S1 is immunogenic and safe in mice and is worthy of further preclinical and clinical evaluation. Full article
(This article belongs to the Special Issue Vaccination Strategies for COVID-19)
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Article
Young Adults’ Intentions and Rationales for COVID-19 Vaccination Participation: Evidence from a Student Survey in Ho Chi Minh City, Vietnam
Vaccines 2021, 9(7), 794; https://doi.org/10.3390/vaccines9070794 - 16 Jul 2021
Cited by 13 | Viewed by 5880
Abstract
The COVID-19 pandemic, a source of fear and anxiety worldwide, has caused many adverse impacts. Collaborative efforts to end COVID-19 have included extensive research on vaccines. Many vaccination campaigns have been launched in many countries, including Vietnam, to create community immunization. However, citizens’ [...] Read more.
The COVID-19 pandemic, a source of fear and anxiety worldwide, has caused many adverse impacts. Collaborative efforts to end COVID-19 have included extensive research on vaccines. Many vaccination campaigns have been launched in many countries, including Vietnam, to create community immunization. However, citizens’ willingness to participate is a prerequisite for effective vaccination programs and other related policies. Among all demographic groups, participation rates among young adults are of interest because they are an important workforce and are a source of high infection risk in the community. In March 2021, a pool of approximately 6000 participants in Ho Chi Minh City were randomly polled using an email-based online survey. The exploratory results of 398 valid observations show that students’ perceptions of the dangers of COVID-19 and the importance of vaccination were both relatively high (4.62/5 and 4.74/5, respectively). Furthermore, 83.41 percent of students polled (n = 332) chose vaccination, while 16.59 percent chose hesitation (n = 64) and not to be vaccinated (n = 2). More importantly, our estimated results of the Bayesian regression model (BRM) show that the perceived importance of the vaccine, concerns about the vaccine’s side effects, and a lack of access to information are the top three reasons for their reluctance and/or refusal to get vaccinated. These findings are a valuable resource for politicians, researchers, and those interested in COVID-19 vaccinations to devise and execute campaigns to effectively combat this terrifying pandemic. Full article
(This article belongs to the Special Issue Vaccination Strategies for COVID-19)
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Communication
Purpuric Skin Rash in a Patient Undergoing Pfizer-BioNTech COVID-19 Vaccination: Histological Evaluation and Perspectives
Vaccines 2021, 9(7), 760; https://doi.org/10.3390/vaccines9070760 - 08 Jul 2021
Cited by 8 | Viewed by 14733
Abstract
The COVID-19 pandemic has affected the entire planet, and within about a year and a half, has led to 174,502,686 confirmed cases of COVID-19 worldwide, with 3,770,361 deaths. Although it is now clear that SARS-CoV-2 can affect various different organs, including the lungs, [...] Read more.
The COVID-19 pandemic has affected the entire planet, and within about a year and a half, has led to 174,502,686 confirmed cases of COVID-19 worldwide, with 3,770,361 deaths. Although it is now clear that SARS-CoV-2 can affect various different organs, including the lungs, brain, skin, vessels, placenta and others, less is yet known about adverse reactions from vaccines, although more and more reports are starting to emerge. Among the adverse events, we focused particularly on skin rashes. In this short report, we describe the case of a patient vaccinated with Comirnaty, who developed a purpuric rash resistant to oral steroid therapy after 2 weeks. To date, this is one of the very few cases in which skin biopsy was performed to better characterize the histopathological picture of this rash. Finally, we conduct a literature review of the cases of rashes from SARS-CoV-2 vaccines described in the literature, with the aim of laying foundations for future, larger case studies. Full article
(This article belongs to the Special Issue Vaccination Strategies for COVID-19)
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Article
Healthcare Workers’ Perspectives on the Upcoming COVID-19 Vaccine in Terms of Their Exposure to the Influenza Vaccine in Riyadh, Saudi Arabia: A Cross-Sectional Study
Vaccines 2021, 9(5), 465; https://doi.org/10.3390/vaccines9050465 - 06 May 2021
Cited by 10 | Viewed by 2485
Abstract
In 2019, a novel severe acute respiratory syndrome (SARS-CoV-2 (COVID-19)) caused a global pandemic. There was an urgent need to develop a vaccine against COVID-19 to reduce its spread and economic burden. The main objective of this study was to understand the attitudes [...] Read more.
In 2019, a novel severe acute respiratory syndrome (SARS-CoV-2 (COVID-19)) caused a global pandemic. There was an urgent need to develop a vaccine against COVID-19 to reduce its spread and economic burden. The main objective of this study was to understand the attitudes and concerns of healthcare workers (HCWs) towards the upcoming COVID-19 vaccine, whether their decision was influenced by their history of taking the seasonal influenza vaccine, and factors that influence the acceptance of the upcoming COVID-19 vaccine. This was a cross-sectional study conducted in Riyadh, Saudi Arabia. We selected and surveyed 356 HCWs via an electronic self-administered questionnaire. A total of 61.16% of HCWs were willing to receive the COVID-19 vaccine, and 55.9% of them had received the seasonal influenza vaccine in the preceding year (2019–2020). The strongest predictors for taking the COVID-19 vaccine were the HCWs’ belief that the COVID-19 vaccine would be safe, needed even for healthy people, that all HCWs should be vaccinated against COVID-19, and that HCWs will have time to take the vaccine. Being female, being middle aged, having <5 years of work experience, having no fear of injections, and being a non-smoker were predictive factors for taking the upcoming COVID-19 vaccine. No associations were found between the intention to take the COVID-19 vaccine and a history of taking the seasonal influenza vaccine. Full article
(This article belongs to the Special Issue Vaccination Strategies for COVID-19)
Article
Targeted Vaccine Allocation Could Increase the COVID-19 Vaccine Benefits Amidst Its Lack of Availability: A Mathematical Modeling Study in Indonesia
Vaccines 2021, 9(5), 462; https://doi.org/10.3390/vaccines9050462 - 06 May 2021
Cited by 19 | Viewed by 3257
Abstract
With a limited number of vaccines and healthcare capacity shortages, particularly in low- and middle-income countries, vaccination programs should seek the most efficient strategy to reduce the negative impact of the COVID-19 pandemics. This study aims at assessing several scenarios of delivering the [...] Read more.
With a limited number of vaccines and healthcare capacity shortages, particularly in low- and middle-income countries, vaccination programs should seek the most efficient strategy to reduce the negative impact of the COVID-19 pandemics. This study aims at assessing several scenarios of delivering the vaccine to people in Indonesia. We develop a model for several scenarios of delivering vaccines: without vaccination, fair distribution, and targeted distribution to five and eight districts with the highest COVID-19 incidence in West Java, one of the most COVID-19-affected regions in Indonesia. We calculate the needs of vaccines and healthcare staff for the program, then simulate the model for the initial 4-month and one-year scenarios. A one-year vaccination program would require 232,000 inoculations per day by 4833 vaccinators. Targeted vaccine allocation based on the burden of COVID-19 cases could benefit the COVID-19 vaccination program by lowering at least 5000 active cases. The benefits would increase by improving the number of vaccines and healthcare staff. Amidst lacking available vaccines, targeted vaccine allocation based on the burden of COVID-19 cases could increase the benefit of the COVID-19 vaccination program but still requires progressive efforts to improve healthcare capacity and vaccine availability for optimal protection for people. Full article
(This article belongs to the Special Issue Vaccination Strategies for COVID-19)
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Communication
Expanding COVID-19 Vaccine Availability: Role for Combined Orthogonal Serology Testing (COST)
Vaccines 2021, 9(4), 376; https://doi.org/10.3390/vaccines9040376 - 13 Apr 2021
Cited by 2 | Viewed by 1330
Abstract
Background: The persisting Coronavirus disease 2019 (COVID-19) pandemic and limited vaccine supply has led to a shift in global health priorities to expand vaccine coverage. Relying on severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) molecular testing alone cannot reveal the infection proportion, which [...] Read more.
Background: The persisting Coronavirus disease 2019 (COVID-19) pandemic and limited vaccine supply has led to a shift in global health priorities to expand vaccine coverage. Relying on severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) molecular testing alone cannot reveal the infection proportion, which could play a critical role in vaccination prioritization. We evaluated the utility of a combination orthogonal serological testing (COST) algorithm alongside RT-PCR to quantify prevalence with the aim of identifying candidate patient clusters to receive single and/or delayed vaccination. Methods: We utilized 108,505 patients with suspected COVID-19 in a retrospective analysis of SARS-CoV-2 RT-PCR vs. IgG-nucleocapsid (IgGNC) antibody testing coverage in routine practice for the estimation of prevalence. Prospectively, an independent cohort of 21,388 subjects was simultaneously tested by SARS-CoV-2 RT-PCR and IgGNC to determine the prevalence. We used 614 prospective study subjects to assess the utility of COST (IgGNC, IgM-spike (IgMSP), and IgG-spike (IgGSP)) in establishing the infection proportion to identify a single-dose vaccination cohort. Results: Retrospectively, we observed a 6.3% (6871/108,505) positivity for SARS-CoV-2 RT-PCR, and only 2.3% (2533/108,505) of cases had paired IgGNC serology performed. Prospectively, IgGNC serology identified twice the number of COVID-positive cases in relation to RT-PCR alone. COST further increased the number of detected positive cases: IgGNC+ or IgMSP+ (18.0%); IgGNC+ or IgGSP+ (23.5%); IgMSP+ or IgGSP+ (23.8%); and IgGNC+ or IgMSP+ or IgGSP+ (141/584 = 24.1%). Conclusion: COST may be an effective tool for the evaluation of infection proportion and thus could define a cohort for a single dose and/or delayed vaccination. Full article
(This article belongs to the Special Issue Vaccination Strategies for COVID-19)
Article
COVID-19 Vaccination Willingness among Chinese Adults under the Free Vaccination Policy
Vaccines 2021, 9(3), 292; https://doi.org/10.3390/vaccines9030292 - 21 Mar 2021
Cited by 40 | Viewed by 3748
Abstract
(1) Background: China will provide free coronavirus disease 2019 (COVID-19) vaccinations for the entire population. This study analyzed the COVID-19 vaccination willingness rate (VWR) and its determinants under China’s free vaccination policy compared to a paid vaccine. (2) Methods: Data on 2377 respondents [...] Read more.
(1) Background: China will provide free coronavirus disease 2019 (COVID-19) vaccinations for the entire population. This study analyzed the COVID-19 vaccination willingness rate (VWR) and its determinants under China’s free vaccination policy compared to a paid vaccine. (2) Methods: Data on 2377 respondents were collected through a nationwide questionnaire survey. Multivariate ordered logistic regression models were specified to explore the correlation between the VWR and its determinants. (3) Results: China’s free vaccination policy for COVID-19 increased the VWR from 73.62% to 82.25% of the respondents. Concerns about the safety and side-effects were the primary reason for participants’ unwillingness to be vaccinated against COVID-19. Age, medical insurance and vaccine safety were significant determinants of the COVID-19 VWR for both the paid and free vaccine. Income, occupation and vaccine effectiveness were significant determinants of the COVID-19 VWR for the free vaccine. (4) Conclusions: Free vaccinations increased the COVID-19 VWR significantly. People over the age of 58 and without medical insurance should be treated as the target intervention population for improving the COVID-19 VWR. Contrary to previous research, high-income groups and professional workers should be intervention targets to improve the COVID-19 VWR. Strengthening nationwide publicity and education on COVID-19 vaccine safety and effectiveness are recommended policies for decision-makers. Full article
(This article belongs to the Special Issue Vaccination Strategies for COVID-19)
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Review

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Review
Plant Molecular Pharming and Plant-Derived Compounds towards Generation of Vaccines and Therapeutics against Coronaviruses
Vaccines 2022, 10(11), 1805; https://doi.org/10.3390/vaccines10111805 - 26 Oct 2022
Viewed by 949
Abstract
The current century has witnessed infections of pandemic proportions caused by Coronaviruses (CoV) including severe acute respiratory syndrome-related CoV (SARS-CoV), Middle East respiratory syndrome-related CoV (MERS-CoV) and the recently identified SARS-CoV2. Significantly, the SARS-CoV2 outbreak, declared a pandemic in early 2020, has wreaked [...] Read more.
The current century has witnessed infections of pandemic proportions caused by Coronaviruses (CoV) including severe acute respiratory syndrome-related CoV (SARS-CoV), Middle East respiratory syndrome-related CoV (MERS-CoV) and the recently identified SARS-CoV2. Significantly, the SARS-CoV2 outbreak, declared a pandemic in early 2020, has wreaked devastation and imposed intense pressure on medical establishments world-wide in a short time period by spreading at a rapid pace, resulting in high morbidity and mortality. Therefore, there is a compelling need to combat and contain the CoV infections. The current review addresses the unique features of the molecular virology of major Coronaviruses that may be tractable towards antiviral targeting and design of novel preventative and therapeutic intervention strategies. Plant-derived vaccines, in particular oral vaccines, afford safer, effectual and low-cost avenues to develop antivirals and fast response vaccines, requiring minimal infrastructure and trained personnel for vaccine administration in developing countries. This review article discusses recent developments in the generation of plant-based vaccines, therapeutic/drug molecules, monoclonal antibodies and phytochemicals to preclude and combat infections caused by SARS-CoV, MERS-CoV and SARS-CoV-2 viruses. Efficacious plant-derived antivirals could contribute significantly to combating emerging and re-emerging pathogenic CoV infections and help stem the tide of any future pandemics. Full article
(This article belongs to the Special Issue Vaccination Strategies for COVID-19)
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Review
COVID-19 Vaccines: Current and Future Perspectives
Vaccines 2022, 10(4), 608; https://doi.org/10.3390/vaccines10040608 - 13 Apr 2022
Cited by 4 | Viewed by 3206
Abstract
Currently available vaccines against severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) are highly effective but not able to keep the coronavirus disease 2019 (COVID-19) pandemic completely under control. Alternative R&D strategies are required to induce a long-lasting immunological response and to reduce adverse events [...] Read more.
Currently available vaccines against severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) are highly effective but not able to keep the coronavirus disease 2019 (COVID-19) pandemic completely under control. Alternative R&D strategies are required to induce a long-lasting immunological response and to reduce adverse events as well as to favor rapid development and large-scale production. Several technological platforms have been used to develop COVID-19 vaccines, including inactivated viruses, recombinant proteins, DNA- and RNA-based vaccines, virus-vectored vaccines, and virus-like particles. In general, mRNA vaccines, protein-based vaccines, and vectored vaccines have shown a high level of protection against COVID-19. However, the mutation-prone nature of the spike (S) protein affects long-lasting vaccine protection and its effectiveness, and vaccinated people can become infected with new variants, also showing high virus levels. In addition, adverse effects may occur, some of them related to the interaction of the S protein with the angiotensin-converting enzyme 2 (ACE-2). Thus, there are some concerns that need to be addressed and challenges regarding logistic problems, such as strict storage at low temperatures for some vaccines. In this review, we discuss the limits of vaccines developed against COVID-19 and possible innovative approaches. Full article
(This article belongs to the Special Issue Vaccination Strategies for COVID-19)
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Review
Safety of Global SARS-CoV-2 Vaccines, a Meta-Analysis
Vaccines 2022, 10(4), 596; https://doi.org/10.3390/vaccines10040596 - 12 Apr 2022
Cited by 7 | Viewed by 2295
Abstract
(1) Background: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccines were developed in only a short amount of time and were widely distributed. We conducted this meta-analysis to understand the safety of SARS-CoV-2 vaccines. (2) Methods: We searched the corresponding literature published from [...] Read more.
(1) Background: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccines were developed in only a short amount of time and were widely distributed. We conducted this meta-analysis to understand the safety of SARS-CoV-2 vaccines. (2) Methods: We searched the corresponding literature published from 1 January 2020 to 20 October 2021. Information of adverse events (AEs) of each selected work was collected. The quality and bias of studies was evaluated, and meta-analysis was carried out by using Stata 17.0. (3) Results: Totally, 11,451 articles were retrieved, and 53 of them were included for analysis. The incidence rate of AEs was 20.05–94.48%. The incidence rate of vascular events increased after viral vector vaccination, while the incidence rate of vascular events decreased after mRNA vaccination. Viral vector vaccine had a higher AE rate compared to mRNA vaccines and inactivated vaccines. In most circumstances, the incidence of AEs was higher in older people, female and after the second dose. The sensitivity of meta-analysis was acceptable; however, the literature was subject to a certain publication bias. (4) Conclusions: The safety of SARS-CoV-2 vaccines was acceptable. The incidence of allergic symptoms and cardiovascular and cerebrovascular symptoms was low. Viral vector vaccine had a higher risk of leading to thrombosis events. The understanding of SARS-CoV-2 vaccine AEs should be enhanced, so as to promote the vaccination. Full article
(This article belongs to the Special Issue Vaccination Strategies for COVID-19)
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Review
COVID-19 in Low- and Middle-Income Countries (LMICs): A Narrative Review from Prevention to Vaccination Strategy
Vaccines 2021, 9(12), 1477; https://doi.org/10.3390/vaccines9121477 - 14 Dec 2021
Cited by 9 | Viewed by 1916
Abstract
The management of the COVID-19 pandemic represents a challenging process, especially for low- and middle-income countries (LMICs) due to the serious economic and health resource problems it generates. In this article, we assess COVID-19 situation in LMICs and outline emerging problems and possible [...] Read more.
The management of the COVID-19 pandemic represents a challenging process, especially for low- and middle-income countries (LMICs) due to the serious economic and health resource problems it generates. In this article, we assess COVID-19 situation in LMICs and outline emerging problems and possible solutions. The prevention and control of COVID-19 would be based on focused tests exploiting those systems (e.g., GeneXpert®) already used in other scenarios. This would be less stressful for the healthcare system in LMICs. Avoiding close contact with people suffering from acute respiratory infections, frequent handwashing, and avoiding unprotected contact with farm or wild animals are recommended infection control interventions. The appropriate use of personal protective equipment (PPE) is required, despite its procurement being especially difficult in LMICs. Patients’ triage should be based on a simple and rapid logarithm to decide who requires isolation and targeted testing for SARS-CoV-2. Being able to estimate which patients will develop severe disease would allow hospitals to better utilize the already limited resources more effectively. In LMICs, laboratories are often in the capital cities; therefore, early diagnosis and isolation become difficult. The number of ICU beds is often insufficient, and the equipment is often old and poorly serviced. LMICs will need access to COVID-19 treatments at minimal prices to ensure that all who need them can be treated. Year-to-date, different vaccines have been approved and are currently available. The main obstacle to accessing them is the limited ability of LMICs to purchase significant quantities of the vaccine. Full article
(This article belongs to the Special Issue Vaccination Strategies for COVID-19)
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Review
Factors Affecting the Antibody Immunogenicity of Vaccines against SARS-CoV-2: A Focused Review
Vaccines 2021, 9(8), 869; https://doi.org/10.3390/vaccines9080869 - 05 Aug 2021
Cited by 12 | Viewed by 5227
Abstract
Vaccines are a crucial part of the global anti-pandemic effort against COVID-19. The effects of vaccines, as well as their common influencing factors, are the most important issues that we should focus on at this time. To this end, we review statistics on [...] Read more.
Vaccines are a crucial part of the global anti-pandemic effort against COVID-19. The effects of vaccines, as well as their common influencing factors, are the most important issues that we should focus on at this time. To this end, we review statistics on immunogenicity after vaccination, using neutralizing antibodies as the main reference index. Age, infection history, and virus variants are compared, and vaccination program recommendations are made accordingly. Suggestions are made to address concerns raised by the vaccines’ shortened development cycle, as well as the emergence of immunity escape of viral variants. Finally, a brief description and future prospects are provided based on the principle of the ADE effect and previous experience with similar viruses. Full article
(This article belongs to the Special Issue Vaccination Strategies for COVID-19)

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Brief Report
Analysis of the Effectiveness of Measures on the COVID-19 Vaccination Rate in Hong Kong
Vaccines 2022, 10(5), 747; https://doi.org/10.3390/vaccines10050747 - 10 May 2022
Cited by 1 | Viewed by 1417
Abstract
Background: The World Health Organization has set a target of at least 70% of the global population being vaccinated by the middle of 2022. There are only 17 countries that achieved a 70% vaccination rate (VR). This study aims to analyze the effectiveness [...] Read more.
Background: The World Health Organization has set a target of at least 70% of the global population being vaccinated by the middle of 2022. There are only 17 countries that achieved a 70% vaccination rate (VR). This study aims to analyze the effectiveness of public policies to increase the COVID-19 VR. Methods: vaccination figures of all eligible population groups in Hong Kong from 22 February 2021 to 23 January 2022, were extracted for analysis. Weekly acceleration in the VR (AVR) was calculated as a measure of policy effectiveness. A total of 13 identified measures were classified into four policy categories: eligibility, accessibility, incentives, and restrictions. Age-weighted AVR (AWAVR) was compared by age group and policy presence vs. absence using Mann–Whitney U tests. Results: the AWAVR means across age groups ranged from −1.26% to +0.23% (p = 0.12) for eligibility; accessibility ranged from +0.18% to +1.51% (p < 0.0001); incentives ranged from +0.11% to +0.68% (p < 0.0001); and restrictions ranged from +0.02% to +1.25% (p < 0.0001). Conclusions: policies targeting accessibility, incentives, and restrictions are effective at increasing the VR. These results may serve as a policy reference. Full article
(This article belongs to the Special Issue Vaccination Strategies for COVID-19)
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