Special Issue:
Challenges and Opportunities in Vaccines
Enrique Chacon-Cruz
Think Vaccines LLC, Houston, Texas, USA.
Erika Zoe Lopatynsky-Reyes
Think Vaccines LLC, Houston, Texas, USA.
Kapil Maithal
Zydus Lifesciences Limited, Ahmedabad, Gujarat, India.
Sabrina Bakeera-Kitaka
Department of Paediatrics, Makerere College of Health Sciences, Kampala, Uganda.
Collins Ankunda
Department of Pharmacology and Therapeutics, Makerere College of Health Sciences, Kampala, Uganda.
Javier Casellas
Allergy, Respiratory, Infectious Diseases and Vaccines Team, IQVIA, Buenos Aires, Argentina.
Malook Vir Singh
IQVIA RDS (India) Private Limited, Noida, India.
Frederic Nikiema
Institut de Recherche en Sciences de la Santè, IRSS, Bobo Dioulasso, Burkina Faso.
Jessabelle E. Basa
Research Institute for Tropical Medicine, Department of Health, Philippines.
Mahmud Sheku
Department of Population Health Sciences, School of Public Health, Georgia State University, Atlanta, Georgia, USA.
Oscar E. Zazueta
Harvard T.H, Chan School of Public Health. Department of Epidemiology. Boston, MA, USA.
Abstract
Pertussis in a highly infectious respiratory disease, and even though vaccination has been globally implemented since the 1940s, we are far from elimination, and even still suffering from many outbreaks throughout the world.
This comprehensive review is tailored primarily for clinicians and healthcare practitioners, aiming to deepen their insights into the evolving dynamics of Pertussis over time since the first whole-cell Pertussis vaccine was started. It delves into the high reactogenicity and alleged severe neurologic effects, which were later conclusively disproven. The ensuing repercussions of these early challenges manifested in multiple outbreaks, compelling the scientific community to respond proactively. This led to the development and subsequent implementation of acellular Pertussis vaccines, marked by an improved safety profile.
Moreover, the exclusive adoption of acellular Pertussis vaccines for widespread immunization in certain countries resulted in a notable surge in Pertussis cases. Subsequent investigations, conducted through both animal models and epidemiological studies, elucidated that acellular Pertussis vaccines exhibited a considerably diminished mucosal immunity. Consequently, nasopharyngeal carriage showed minimal reduction, leading to a substantial decline in indirect or herd immunity when compared to whole-cell Pertussis vaccines. Conversely, numerous developing countries presently incorporate whole-cell Pertussis vaccines either independently or in conjunction with acellular formulations. In light of this, precise recommendations must be systematically addressed to cultivate a more unified and pragmatic landscape for immunization strategies. These recommendations should be rooted in the latest scientific data and aligned with the guidelines articulated by both the World Health Organization and the Global Pertussis Initiative.
This concerted approach aims to optimize immunization practices on a global scale, fostering a harmonized and evidence-based framework for combating Pertussis. Relevant and updated issues concerning maternal, adolescent and adult vaccination are addressed, as well as the ongoing pipeline of new intramuscular and mucosal vaccines, and finally emphasizing the continuous need for improved surveillance and pharmacovigilance systems.
Ayesha Anwar, MD
Allama Iqbal Medical College
Meryem Malik, MD
Harvard University, Cambridge MA
Vaneeza Raees
Undergraduate Student at University of Washington
Maryem Anwar, MBBS, MRCGP
NHS UK
Anjum Anwar, MD
University of Washington School of Medicine
Abstract
Vaccines offer life-saving protection against diseases and keep us safe from the harmful effects. The speedy development of vaccines during COVID-19 pandemic has reduced the coronavirus’s transmissibility and severity. COVID-19 vaccine development was challenging but the global scientific collaboration and use of resources including extensive funding made it possible. COVID-19 vaccines were deployed in controlled phases for general public use, initially offering them to the first responders and those vulnerable to life threatening effects of virus. However, it was observed that the general population has widespread vaccine hesitancy. Mass media plays a critical role in influencing people’s attitudes and practices. A common man cannot comprehend correlation from causation and jumps to conclusions. Media has the power to unite the world on one platform for a common cause. It is a source for the public to seek information, but like a double ended sword, this platform that provides information, also gives misinformation. On one hand, the public uses the media to seek information for vaccine safety and efficacy and on the other hand, to propagate unverified conspiracies against vaccines. In this review, we analyze the role of mass media and public health communications in COVID-19 vaccination from December 11, 2020, to September 15, 2021, and draw scientific inferences. We have discussed vaccine hesitancy and some prominent reasons that instil fear among the public, including the implausible claims of vaccines being the carriers of Radio Frequency Identification (RFID) microchips, impairing the reproductive systems, converting humans to hybrids, and the misconceptions about herd immunity. A consequential role of media was observed in keeping the world updated and motivated by tracking the vaccine number, distribution and deployment through live dashboards. We saw an upward trend in vaccination numbers with media campaigns, social media vaccination surveys, and socio-medico evidence. Thus, we have proposed a model for developing public awareness and health promotion using media as a tool for better distribution and administration of COVID-19 vaccines. With this, health organizations can gain widespread public trust, manage anti-vaccine movements, overcome threats faced due to vaccine conspiracy theories and eventually overcome the COVID-19 and future pandemics.
Larry L Mweetwa
DDT College of Medicine, Department for Pharmacy and Pharmaceutical Sciences, P.O. Box 70587, Gaborone Botswana, Africa, Tel: +267(0)3904924/5, Cell: +267(0) 77100000 Fax: +267(0)3904935.
Derrick D Tlhoiwe
DDT College of Medicine, Department for Pharmacy and Pharmaceutical Sciences, P.O. Box 70587, Gaborone Botswana, Africa, Tel: +267(0)3904924/5, Cell: +267(0) 77100000 Fax: +267(0)3904935.
Tumelo Tlhoiwe
DDT College of Medicine, Department for Pharmacy and Pharmaceutical Sciences, P.O. Box 70587, Gaborone Botswana, Africa, Tel: +267(0)3904924/5, Cell: +267(0) 77100000 Fax: +267(0)3904935.
Kabo Osmas Tshiamo
DDT College of Medicine, Department for Pharmacy and Pharmaceutical Sciences, P.O. Box 70587, Gaborone Botswana, Africa, Tel: +267(0)3904924/5, Cell: +267(0) 77100000 Fax: +267(0)3904935.
Sody Mweetwa Munsaka
University of Zambia, School of Health Sciences, P. O. Box 32379 Lusaka, Africa.
Thatoyaone J Kenaope
Department of Pharmacy, Boitekanelo College, Plot 5824 Masetlheng Rd, Gaborone 00000, Botswana.
Getrude Mothibe
Department of Pharmacy, Boitekanelo College, Plot 5824 Masetlheng Rd, Gaborone 00000, Botswana.
Ogorogile Mokate
DDT College of Medicine, Department for Pharmacy and Pharmaceutical Sciences, P.O. Box 70587, Gaborone Botswana, Africa, Tel: +267(0)3904924/5, Cell: +267(0) 77100000 Fax: +267(0)3904935.
Emmanuel T Oluwabusola
DDT College of Medicine, Department for Pharmacy and Pharmaceutical Sciences, P.O. Box 70587, Gaborone Botswana, Africa, Tel: +267(0)3904924/5, Cell: +267(0) 77100000 Fax: +267(0)3904935.
Abstract
Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) or Coronavirus was initially detected in Wuhan China in December 2019 and has subsequently resulted in the COVID-19 pandemic. The disease presents asymptomatically in some of individuals yet also causes symptoms ranging from those associated with influenza and pneumonia, acute respiratory distress syndrome (ARDS) and even death. The world is currently relying on physical (social) distancing, hygiene and repurposed medicines; however, it was predicted that an effective vaccine will be necessary to ensure comprehensive protection against COVID-19. There was a global effort to develop an effective vaccine against SARS-CoV-2 with approximately 300 vaccines in clinical trials, and over 200 more in different stages of development and anticipated that their success will change research clinical trials processes. Although every one of these vaccines comes with its own particular set of characteristics and difficulties, they were all developed as a direct result of research and development efforts that were carried out on a scale that had never been seen before. It is the first time in the history of vaccination that a worldwide immunization campaign has begun during a time of severe pandemic activity that is defined by high virus transmission. This achievement marks an important milestone in the history of vaccination. More than anything else, the most important aspect of the new game change in drug design is that the traditional drug discovery rules have been rewritten. This is especially significant for the development of vaccines, as it is possible for all clinical trials to be accelerated, which would bring a vaccine or drug molecule to market within a year rather than the traditional fifteen years for each phase of drug clinical trials. This review provides insight in respect to first generation COVID-19 vaccines, which were in clinical use as of December 2020 and focused on the Pfizer/ BioNTech/Fosun, Moderna mRNA-1273, Johnson and Johnson and AstraZeneca/Oxford AZD1222 vaccines.
Larry L Mweetwa
DDT College of Medicine, Department for Pharmacy and Pharmaceutical Sciences, P.O. Box 70587, Gaborone Botswana, Africa, Tel: +267(0)3904924/5, Cell: +267(0) 77100000 Fax: +267(0)3904935.
Derrick D Tlhoiwe
DDT College of Medicine, Department for Pharmacy and Pharmaceutical Sciences, P.O. Box 70587, Gaborone Botswana, Africa, Tel: +267(0)3904924/5, Cell: +267(0) 77100000 Fax: +267(0)3904935.
Tumelo Tlhoiwe
DDT College of Medicine, Department for Pharmacy and Pharmaceutical Sciences, P.O. Box 70587, Gaborone Botswana, Africa, Tel: +267(0)3904924/5, Cell: +267(0) 77100000 Fax: +267(0)3904935.
Kabo Osmas Tshiamo
DDT College of Medicine, Department for Pharmacy and Pharmaceutical Sciences, P.O. Box 70587, Gaborone Botswana, Africa, Tel: +267(0)3904924/5, Cell: +267(0) 77100000 Fax: +267(0)3904935.
Sody Mweetwa Munsaka
University of Zambia, School of Health Sciences, P. O. Box 32379 Lusaka, Africa.
Thatoyaone J Kenaope
Department of Pharmacy, Boitekanelo College, Plot 5824 Masetlheng Rd, Gaborone 00000, Botswana.
Getrude Mothibe
Department of Pharmacy, Boitekanelo College, Plot 5824 Masetlheng Rd, Gaborone 00000, Botswana.
Ogorogile Mokate
DDT College of Medicine, Department for Pharmacy and Pharmaceutical Sciences, P.O. Box 70587, Gaborone Botswana, Africa, Tel: +267(0)3904924/5, Cell: +267(0) 77100000 Fax: +267(0)3904935.
Emmanuel T Oluwabusola
DDT College of Medicine, Department for Pharmacy and Pharmaceutical Sciences, P.O. Box 70587, Gaborone Botswana, Africa, Tel: +267(0)3904924/5, Cell: +267(0) 77100000 Fax: +267(0)3904935.
Abstract
Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) or Coronavirus was initially detected in Wuhan China in December 2019 and has subsequently resulted in the COVID-19 pandemic. The disease presents asymptomatically in some of individuals yet also causes symptoms ranging from those associated with influenza and pneumonia, acute respiratory distress syndrome (ARDS) and even death. The world is currently relying on physical (social) distancing, hygiene and repurposed medicines; however, it was predicted that an effective vaccine will be necessary to ensure comprehensive protection against COVID-19. There was a global effort to develop an effective vaccine against SARS-CoV-2 with approximately 300 vaccines in clinical trials, and over 200 more in different stages of development and anticipated that their success will change research clinical trials processes. Although every one of these vaccines comes with its own particular set of characteristics and difficulties, they were all developed as a direct result of research and development efforts that were carried out on a scale that had never been seen before. It is the first time in the history of vaccination that a worldwide immunization campaign has begun during a time of severe pandemic activity that is defined by high virus transmission. This achievement marks an important milestone in the history of vaccination. More than anything else, the most important aspect of the new game change in drug design is that the traditional drug discovery rules have been rewritten. This is especially significant for the development of vaccines, as it is possible for all clinical trials to be accelerated, which would bring a vaccine or drug molecule to market within a year rather than the traditional fifteen years for each phase of drug clinical trials. This review provides insight in respect to first generation COVID-19 vaccines, which were in clinical use as of December 2020 and focused on the Pfizer/ BioNTech/Fosun, Moderna mRNA-1273, Johnson and Johnson and AstraZeneca/Oxford AZD1222 vaccines.
Malireddy S. Reddy, BVSC (DVM)., MS., Ph.D.
International Media And Cultures, INC. (IMAC) American Dairy Food And Consulting Labs, INC. (ADFAC Labs, Inc.) Denver, CO., USA.
Abstract
The US patent 11,077,052 B1, issued in August of the year 2021, has been granted relying on the research conducted until September 2020, using the multiple mixed strain probiotics and their immunomodulins to prevent or treat COVID-19 due to SARS-CoV-2 and its limited variants. Since then the SARS-CoV-
2 virus continuously generated multiple variants with different genomic configurations, almost to the point of overriding the vaccines and medications. The objective of this research article is to evaluate the effectiveness of the invention outlined in the U.S. patent 11,077,052 B1 on the variants of SARS- CoV-2 evolved in the later years of 2020, 2021 and 2022. This research has great significance because vaccines are not totally effective because of the high rate of mutations of SARS-CoV-2 virus resulting in antigenically different variants, which are overriding the immunity conferred by vaccines. Thus, there is a definite need for a reliable alternative or adjuvant therapy, which can be used either by itself or used as adjuvant therapy along with vaccines to combat COVID-19 infection due to SAR-CoV-2 virus and its continuously mutating variants of different antigenicity. The results of this investigation proved that the use of multiple mixed strain probiotics along with their immunomodulins are effective not only on novel SARS-CoV-2 coronavirus evolved in late 2019 and mid 2020 but also the mutated variants in the later part of the years 2020, 2021, and 2022. The COVID-19 pandemic is not yet contained as of August 2022. The SARS-CoV- 2 virus has been continuously mutating generating variants which are resisting vaccines and the treatments. The death’s due to SARS -COV- 2 viral infections are attributed predominantly to cytokine storm and thrombosis resulting in ARDS (Acute Respiratory Disease Syndrome} and multi organ failure. The earlier published article thoroughly discussed about the genesis and control of cytokine storm to protect the victims. This article mainly emphasizes the Pathophysiology of thrombosis, due to SARS-CoV-2 virus and its recent multiple variants, and the ways and means of controlling it to prevent or cure COVID-19, using the multiple mixed strain probiotics and their Immunomodulins. The hormonal and enzymatic system variations causing the disturbance in homeostasis of the vascular system resulting in thrombosis, due to SARS-CoV-2 virus and its continuously evolving variants is thoroughly discussed. In addition, the infection pattern and progression of the SARS-CoV-2 virus causing endothelial cell lysis of the vascular system resulting in thrombosis has been elucidated with molecular details. The specific role of immunomodulins of the multiple mixed strain probiotics to prevent or treat COVID-19 disease induced thrombosis has also been presented. The physiological functions of individual components of the probiotics and the immunomodulins produced by the multiple mixed strain probiotics, is presented for the first time with explicitly proven molecular details, showing how they contribute individually and cumulatively to prevent or treat COVID-19 infection, due to SARS-CoV-2 virus and its multiple variants, generated during the years 2020 through 2022, to induce thrombosis.
Oscar Cobar
School of Health Sciences, University of Isthmus, Guatemala; Pharmacogenomics and Nutrigenomics Research Group, School of Chemical Sciences and Pharmacy, University of San Carlos, Guatemala.
Stella Cobar
School of Chemical Sciences and Pharmacy, University of San Carlos, Guatemala.
Abstract
Background: The World Health Organization -WHO- declares the end of COVID-19 pandemic on May 5, 2023, and the contagious and pathogenic XBB.2.3 “Acrux” begins to spread worldwide. XBB.2.3 has a higher transmission rate and greater evasive capacity of immune-generated antibodies and vaccines than the XBB.1.16 strain, the potential to evade all forms of immunity, including those conferred by current booster vaccination or by previous infections, besides that current virus vaccines and their boosters may provide little or no protection against XBB.2.3*. Those infected with XBB.2.3*, are expected to acquire more opportunistic secondary infections that contribute to the severity of the disease and more long-term problems (Post-COVID Syndrome) and a possible increase in the mortality rate.
Aim: The purpose of the manuscript is to present a systematic review on the prevalence, structural, genomic, and pathogenic characteristics of XBB.2.3 and its descendants as of May 31, 2023, emphasizing the symptoms generated in children, adults, and the elderly.
Material and methods: Original scientific articles published in Medline, Pubmed, Science Direct, Web of Science, Scopus, EBSCO and BioMed Central databases, official health organizations (WHO, CDC, ECDEC, DOH Philippines) electronic publications, and specialized media in the subject, were electronically searched to accomplish the aim of the study. Articles published in any language were included from 2020 to present using a variety of keywords in combination. The studies relevant to our review were analysed and compared.
Results and discussion: XBB.2.3 probably originated in India, but is expanding, being detected as early as Europe in mid-January 2023 and as of May 31, 2023, in more than 47 countries, including the United States, India, Philippines and Thailand. XBB.2.3* has five defining mutations; S:D253G (previously found in Lambda and Iota variants), S:P521S (new since XBB family), S:S486P and the unprecedented ORF1a:G2091S, and ORF7a:A13V. S:S486P is probably the responsible of the superior transmissibility of XBB.2.3*, appears to have a 37% rate of infection and hospitalisation, which is 3-8% higher than other sub-variants.
Conclusions: XBB.2.3* SARS-CoV-2 strain has a higher transmission rate than XBB.1.16*, exhibits a greater evasive capacity of immune-generated antibodies and vaccines than XBB.1.16*, and even has the potential to evade all forms of immunity, including those conferred by current booster vaccination or by previous infections. Those infected with XBB.2.3*, are expected to acquire more opportunistic secondary infections that contribute to the severity of the disease and more long-term problems (Post-COVID Syndrome) and a possible increase in the mortality rate. Preliminary data from the study suggest that current virus vaccines and their current boosters may provide little or no protection against XBB.2.3*. The potential consequences of XBB.2.3* underscore the importance of coordinated, proactive and productive efforts to contain its spread.
Mairi C. Noverr
Department of Microbiology and Immunology, Tulane University School of Medicine
Junko Yano
Center of Excellence in Oral and Craniofacial Biology, LSU Health School of Dentistry
Michael E. Hagensee
Section of Infectious Diseases, Department of Medicine, LSU Health New Orleans
Hui-Yi Lin
Biostatistics Program, LSU Health School of Public Health
Mary C. Meyaski
Clinical and Translational Research Center, LSU Health New Orleans
Erin Meyaski
Clinical and Translational Research Center, LSU Health New Orleans
Jennifer Cameron
Department of Microbiology, Immunology, and Parasitology, LSU Health New Orleans
Judd Shellito
Section of Pulmonary Medicine, Department of Medicine, LSU Health New Orleans
Amber Trauth
Section of Infectious Diseases, Department of Medicine, LSU Health New Orleans
Paul L. Fidel, Jr.
Center of Excellence in Oral and Craniofacial Biology, LSU Health School of Dentistry
Abstract
Mortality in COVID-19 cases was strongly associated with progressive lung inflammation and eventual sepsis. There is mounting evidence that live attenuated vaccines commonly administered during childhood, also provide beneficial non-specific immune effects, including reduced mortality and hospitalization due to unrelated infections. It has been proposed that live attenuated vaccine-associated non-specific effects are a result of inducing trained innate immunity to function more effectively against broader infections. In support of this, our laboratory has reported that immunization with a live attenuated fungal strain induces a novel form of trained innate immunity which provides protection against various inducers of sepsis in mice via myeloid-derived suppressor cells. Accordingly, we initiated a randomized control clinical trial with the live attenuated Measles, Mumps, Rubella (MMR) vaccine in healthcare workers in the greater New Orleans area aimed at preventing/reducing severe lung inflammation/sepsis associated with COVID-19 (ClinicalTrials.gov Identifier: NCT04475081). Included was an outcome to evaluate the myeloid-derived suppressor cell populations in blood between those administered the MMR vaccine vs placebo. The unanticipated emergency approval of several COVID-19 vaccines in the midst of the MMR clinical trials eliminated the ability to examine effects of the MMR vaccine on COVID-19-related health status. Unfortunately, we were also unable to show any impact of the MMR vaccine on peripheral blood myeloid-derived suppressor cells due to several inherent limitations (low percentages of blood leukocytes, small sample size), that also included a collaboration with a similar trial (CROWN CORONATION; ClinicalTrials.gov Identifier: NCT04333732) in St. Louis, MO. In contrast, monitoring the COVID-19 vaccine response in trial participants revealed that high COVID-19 antibody titers occurred more often in those who received the MMR vaccine vs placebo. While the trial was largely inconclusive, lessons learned from addressing several trial-associated challenges may aid future studies that test the non-specific beneficial immune effects of live attenuated vaccines.
Oscar Cobar
Pharmacogenomics and Nutrigenomics Research Group, School of Chemical Sciences and Pharmacy, University of San Carlos, Guatemala; Biomedical Sciences Ph.D. Program, School of Medical Sciences, University of San Carlos, Guatemala.
Stella Co
Shool of Chemical Sciences and Pharmacy, University of San Carlos, Guatemala.
Abstract
Background: JN.1 (BA.2.86.1.1) has become the dominant strain in the U.S. at the end of 2023 according to the U.S. Centers for Disease Control and Prevention. The strain is a descendant of EG.5 family that was identified in China in February 2023 and was first detected in the United States in April 2023. JN.1* SARSCoV2 lineages: JN.1 (BA.2.86.1.1), JN.1.1, JN.1.1.1, JN.1.2, JN.1.3 and recombinants XDD (EG.5.1.1/JN.1), XDK (XBB*/JN.1.1.1). There is only a single change between JN.1 and BA.2.86 in the spike protein. JN.1 has inherited more than 30 mutations in its spike protein. It also acquired a new mutation,L455S, which further decreases the ability of antibodies to bind to the virus and prevent infection. A nonspike protein that is heavily mutated in JN.1 is the NSP3 protein. There are six mutations in NSP3 protein, namely T24I, V238L, G489S, K1155R, N1708S, and A1892T. NSP3 is one of the most active proteins in the virus, playing roles in viral RNA binding, polyprotein processing, and other functions. While the exact function of these mutations is unknown, they are likely to increase the efficiency of many of these mechanisms, creating a more functional and pathogenetic virus.The N protein is heavily mutated, R203K and G204R have been mutated in most virus variants throughout the pandemic and likely improve viral replication rate. The other mutations in N may also work to improve viral replication. While the Orf8 protein is truncated in the widespread XBB.1.5 variant, it is fully present in JN.1.
The symptoms of JN.1 appear to be similar to those caused by other strains, which include sore throat, congestion, runny nose, cough, fatigue, headache, muscle aches, fever or chills, loss of sense of taste or smell, shortness of breath or difficulty breathing, nausea or vomiting and diarrhea.
Some doctors have reported that upper respiratory symptoms seem to follow a pattern of starting with a sore throat, followed by congestion and a cough.
Aim: The purpose of the manuscript is to present a systematic review on the prevalence, structural, genomic, and pathogenic characteristics of JN.1 from January 1 to February 29, 2024, emphasizing on the variant genetic characteristics, contagiousness, and potential pathogenicity.
Material and Methods: Original scientific articles published in Medline, Pubmed, Science Direct, Web of Science, Scopus, EBSCO and BioMed Central databases, official health organizations (World Health Organization, U.S. Centers for Disease Control and Prevention, European Centre for Disease Prevention and Control) electronic publications, and specialized media in the subject, were electronically searched to accomplish the aim of the study. Articles published in any language were included from January 2024 to present using a variety of keywords in combination. The studies relevant to our review were analysed and compared.
Results and Discussion: The step-change evolution of BA.2.86, combined with the immune-evading features in JN.1, has given the virus a global growth advantage well beyond the XBB.1-based lineages the world faced in 2023. Evidence suggests the human adaptive immune system could still recognise and respond to BA.286 and JN.1 effectively. Updated monovalent vaccines, tests and treatments remain effective against JN.1. There are two elements to “severity”: first if it is more ‘intrinsically’ severe (worse illness with an infection in the absence of any immunity) and second if the virus has greater transmission, causing greater illness and deaths, simply because it infects more people. The latter is certainly the case with JN.1.
Conclusions: The latest data from US-CDC shows JN.1 as the prevalent SARS-CoV-2 variant in the United States. JN.1 in January 2024, quickly increase its prevalence and surpassed other variants, including HV.1 to become the most prevalent strain in The United States of América. JN.1 has a similar transmission rate, exhibits a greater evasive capacity of immune-generated antibodies than HV.1 family of SARS-CoV-2, produce similar symptoms that of other Omicron variants, are expected not to produce an increase in hospitalizations and mortality rate and the SARS-CoV-2 vaccines recently developed by Pfizer and Moderna, must be effective against this Omicron subvariant. For now, the dominant variant JN.1 does not seem harmful in terms of creating a deadly disease but is still contagious enough to not be ignored.
Chester Spatt, Ph.D.
Tepper School of Business, Carnegie Mellon University, 5000 Forbes Ave, Pittsburgh, PA 15213, USA.
Abstract
Several fundamental principles in economics help enhance our understanding of COVID-19, including opacity and externalities. COVID-19 is a contagious disease whose spread has been difficult to manage due to opacity, as the disease is contagious prior to the presence of symptoms and in some instances testing results for the disease require a considerable time lag before they become available. This highlights the importance of alternative testing strategies to limit the extent of opacity and to manage the costs associated with accurate testing. In addition to individual tests, such strategies would include testing employees in small groups and testing for concentration of the disease in wastewater. Diminishing returns to scale, depreciation, and shocks to the underlying disease also all play an important role in understanding the effectiveness of vaccines. Externalities are central to the mechanism for transmitting contagious diseases. The strength of the externality can be reduced potentially by various preventive measures such as social distancing and masking, though quantitative studies of the efficacy of such measures can be enhanced. Further, efforts to undertake randomized trial studies of various questions related to vaccines and prevention would be helpful, especially in light of the magnitude of economic costs that have been imposed by contagious disease, such as COVID-19.
COVID-19 and other contagious diseases also have had considerable effects on the structure of the economy. This has resulted in great development of technologies to support online meetings and work and the ability to work remotely, which in turn highlights dramatic challenges to the five-day work week, the potential for stay-at-home work, the relationship between residential and office real estate and the value of contractual flexibility in the face of dramatic shocks. Some of the effects arise during the period of acute societal disease, while other aspects reflect long-term learning. The nature of societal shocks to work and income generation also has led to important questions regarding the use of societal resources and potential shocks to the overall macroeconomy.
Babalola O.E.
Department of Surgery, Bingham University, New Karu, Nigeria
Ajayi A.A ., MD, PhD
Adjunct Professor, Keck Department of Medicine, Division of Hypertension and Clinical pharmacology, Baylor College, Houston TX 77030.
Abstract
Background and aims
The covid 19 pandemic necessitated the use of old, repurposed, and new drugs, in addition to vaccines and public health measures. There are still many controversies about the efficacy and impact of some of the medications used, which need further elucidation.
We review the pharmacological properties and the place of the repurposed drug, Ivermectin (IVM) in the prophylaxis and treatment of SARS – CoV- 2 (severe acute respiratory syndrome coronavirus 2.) infection or Covid 19 disease.
Major findings: in-vitro, in-vivo, and human studies
In vitro studies in Vero/hSlam cells caused a 99.98 % inhibition of SARS – Cov-2 (5000-fold) within 48 hours. The IC50 (half maximal inhibitory concentration) for this virucidal action was 2.8μM, which was thought unattainable in humans in-vivo. Thus, there was initial skepticism on pharmacokinetic grounds as to possible efficacy of IVM in humans with Covid 19. There are, however, a multiplicity of anti-covid 19 mechanisms, beyond mere anti-viral effects, such as blockade of ACE2 receptor viral entry, and the anti-cytokine and anti-inflammatory effects of IVM. IVM has a long half-life of 18 – 24 hours, Mean Residence Time (MRT) of 3.4 days and a preferential site of lung accumulation.
In-vivo studies in Syrian Golden hamsters confirmed the symptomatic, anti-inflammatory, anti-cytokine, histopathological and survival benefit of IVM, which was more manifest in female animals.
In a January 2023 meta-analysis of studies (s) in total number of patients (n) for various parameters (p), the reduction in risk relative to placebo or controls were as follows:
- Overall improvement (s= 95) (n= 134,554) was 62% [95%CI 54-69].
- Mortality (s=48) (n=120,000) there was 51% reduction [95%CI 37-62].
- Hospitalization (s=29) (n = 44, 784), there was 34% reduction [ 95% CI 20-45].
- Viral clearance (s=20) (n= 3945) there was 45% reduction [95%CI 31-55].
- Prophylaxis (s=17) (n=19,764) showed 82% reduction [95%CI 73-88]
6 Randomised Control Trial (RCT) studies (s= 45) (n=2173) showed a 54 % mortality reduction [95% CI 39-65]
In addition, IVM has been shown in studies to cause a rapid reversal of hypoxemia (SPO2 < 94%) and a rapid increase in SPO2, an effect exhibiting a gender dichotomy. (SPO2 is the percentage of the maximum carrying capacity of the blood). This effect on SPO2 has been attributed to IVM’s reversal and prevention of SARS-CoV-2 virus induced hemagglutination. The dosage used for treatment of covid 19 varied widely within studies, but doses of 200-400 μg/kg twice weekly or daily for 5 consecutive days, caused significant viral clearance and clinical improvement, with minimal safety concerns. For prophylaxis, a dose of 200μg/kg for two consecutive days every 15 days was found effective in studies.
Conclusion: This review provides powerful evidence that IVM is efficacious singly or as a part of a regimen for covid 19. IVM could potentially be combined with newer oral anti-covid 19 agents, such as Paxlovid, for effective and life-saving regimen in patients infected with covid-19. The anti-viral properties of these drugs can synergize with the anti-inflammatory and anti-cytokine properties of Ivermectin. Ivermectin is also useful prophylactically, especially where vaccines are unavailable or undesirable.
Daniel R. Lucey, MD, MPH
Professor of Medicine Geisel School of Medicine at Dartmouth and the Dartmouth Institute for Healthcare Policy and Clinical Research, Hanover, New Hampshire, USA
Abstract
Nipah virus is a bat-borne zoonotic RNA virus discovered in Malaysia during an 1998-1999 outbreak that involved pigs, fruit bats, and humans in Malaysia (1). Clinical manifestations are primarily encephalitis and pneumonia. The case fatality rate of symptomatic cases is 40%-70%. Survivors can have severe neurologic sequelae (2-5). There are no licensed vaccines, antiviral drugs, monoclonal antibodies, or point-of-care rapid diagnostic tests, although extensive work on vaccines and monoclonal antibodies is underway (6). Person-to-person transmission, including a small number of superspreading events, has occurred in Bangladesh and India (7-9).
From 1998-2023 all reported outbreaks have been in either southeast (SE) Asia (Malaysia, Singapore, the Philippines), or south Asia (Bangladesh, India) (2, 7-10). It is likely that a future Nipah outbreak, and possibly widespread epidemic, will occur outside south/SE Asia, whether elsewhere in Asia such as China, or on another continent. When it does, then as with the COVID-19 pandemic, multiple questions will be raised regarding the origin of the epidemic. Each of the following four (4) main scenarios could be anticipated to account for the origin of such a geographically-unprecedented Nipah epidemic during analysis on Day 1 of the event by national and international organizations.
Marco Villanueva Reza
Infectious Disease Physician, Instituto Nacional Enfermedades Respiratorias
Sebastián Rodríguez-Llamazares
Division of Respirology and Sleep Medicine, Queen’s University Department of Medicine
Alvaro López Iñiguez
HIV and Infectious Disease Physician, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán
Santiago Montiel Romero
Infectious Disease Physician, Centro Medico ABC (American British Cowdray Hospital)
Arturo Galindo Fraga
Deputy Director of Epidemiology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán
Abstract
In Latin America, the COVID-19 pandemic, which initially surged and is now a constant presence, has brought about significant health challenges due to disparities and differences in regional responses. Vaccination is not only a necessity but also a responsibility as the primary tool for prevention. However, its implementation has not been consistent across countries, leading to various challenges such as global demand, initial high costs, infrastructure limitations for distribution, public hesitance, and misinformation. Other issues, like vaccine efficacy in immunocompromised patients and the use of different vaccines, were initially questioned but are now regarded as strategies to protect patients. This region, with its unique traditions, also faces several risk factors including vaccine supply shortages, lack of vaccine manufacturing, overcrowded cities, and an increasing migrant population that adds to the vulnerability of the people, challenging countries to strive for equity in prevention strategies. It is important to address individual strategies in communities to increase vaccine uptake as part of public health policy, and collaboration between countries should be encouraged to reach more people. This review will provide information about the COVID-19 vaccines available in the region, their characteristics and composition, their use across countries, and the reported effectiveness in the general population and among those with weakened immune systems.
Maia G Campbell
Ball State University Honors College
Dr. Jayanthi Kandiah
Ball State University College of Health
Dr. James Jones
Ball State University
Abstract
Background. The global spread of COVID-19 prompted a need for widespread vaccination to slow the transmission of the virus. Despite global, national, and local efforts, many people in various nations hesitated to receive a COVID-19 vaccine.
Aims. The objective of this systematic review was to synthesize the existing literature addressing factors influencing COVID-19 vaccine acceptance and hesitancy.
Methods. A literature search was conducted between November 2021 and March 2022. Inclusion criteria were studies identifying causations of COVID-19 vaccine acceptance and/or hesitancy since March 2020 in six developed/developing countries, Australia, Brazil, India, Nigeria, Russia, and the United States. Studies that were not originally published in English were excluded.
Results. Patterns in the factors influencing both acceptance and hesitancy toward the COVID-19 vaccines emerged. Vaccination acceptance was largely related to individuals’ personal preferences and beliefs regarding immunity, while vaccination hesitancy was attributed to fears and distrust of vaccine safety, side effects, and efficacy.
Limitations. Lack of consistency in methodical procedures and text availability by country may limit the generalizability of the findings.
Conclusion. In developed/developing nations, emerging data suggest that skepticism surrounding COVID-19 vaccines was the most prevalent factor leading to vaccination hesitancy, while factors including personal protection were largely associated with higher acceptance rates of the COVID-19 vaccine. Because widespread immunization is necessary to slow the transmission of COVID-19, it is important that factors leading to hesitation are addressed in order to increase vaccination rates and achieve herd immunity.
Ronald Cárdenas Krenz
Universidad de Lima. Universidad Pública de Navarra
Abstract
What has been experienced during the COVID-19 pandemic, especially in the most vulnerable populations, has revealed the need for a new health model, much more fair, efficient and inclusive; However, defining and applying it is particularly a complex task.
When the pandemic arrived, health systems in different parts of the world revealed their precariousness and inequality, exacerbating the vulnerability of some groups. To make matters worse, the international response once the crisis arrived revealed limited solidarity in the most difficult moments of the crisis.
Although the arrival of vaccines months later offered hope, demonstrating the importance of collective work and not the fate of nations, many people, for reasons of the most diverse nature, were reluctant to get vaccinated. So, governments, faced with the urgency of confronting the virus in the most massive and rapid way, dictated different measures, sometimes correct, sometimes controversial, with the purpose of promoting vaccination.
This intervention, beyond its results, should raise questions about the scope and limits of state intervention in health, what are the terms that the relationship between the individual and the State should have, the need for subtle measures to motivate vaccination and the possibility of applying nudges as a strategy for the effect.
The experience of the pandemic, with its millions of victims, raises the need for a global and autonomous model, taking advantage of globalization to access knowledge, produce medicines and vaccines, as well as distribute them in the most efficient way.
In this purpose, science plays a crucial role, even when its postulates are provisional. States must rebuild lost trust in their governments, and know how to balance health and the economy. The pandemic has highlighted the importance of global public goods and the need to reconcile personal and collective interests instead of opposing them.
Lessons include the need for universal health systems, balanced measures by the State and the promotion of both a culture of responsibility and an ethic of care, with persuasion preferable to imposition.
This article certainly does not seek to propose what this system should be, which requires deeper and more interdisciplinary work, but it does seek to propose some guidelines that serve as guidance in this task, based on reflection on the experiences lived in the fateful days of the pandemic.
Eliana Zeballos
USDA Economic Research Service, Food Economic Division, Washington, D.C., USA
Wilson Sinclaira
USDA Economic Research Service, Food Economic Division, Washington, D.C., USA
Keenan Marchesia
USDA Economic Research Service, Food Economic Division, Washington, D.C., USA
Abstract
The U.S. government’s efforts in response to the pandemic included the development, manufacturing, and distribution of safe and effective COVID-19 vaccines. By the end of 2020, the Food and Drug Administration issued Emergency Use Authorizations for the Pfizer-BioNTech COVID-19 and the Moderna COVID-19 vaccine. Following this authorization, on December 14, 2020, each State received allocations of vaccines and devised individual distribution plans. This study investigates the impact of COVID-19 vaccination on U.S. food spending at home and away from home in 2021 employing fixed-effects regression analysis on quarterly State-level data. The results reveal that higher vaccination rates—measured by the share of the population that is fully vaccinated—are associated with a decrease in food-at-home sales and an increase in food-away-from-home sales. Further analysis reveals nuanced shifts between full-service and limited-service restaurants, indicating increased sales at full-service establishments and decreased sales at limited-service ones, suggesting a trade-off effect between the two restaurant types. The results of this study provide valuable insights for policymakers and industry stakeholders seeking to understand the heterogenous impacts of vaccinations on food spending.
Kashif Gulzar, Dr
Nephrology Department, Dubai Hospital, Dubai, UAE.
Fakhriya Alalawi, Dr
Nephrology Department, Dubai Hospital, Dubai, UAE.
Hind Hassan Alnour, Dr
Nephrology Department, Dubai Hospital, Dubai, UAE.
Amna Khalifa AlHadari, Dr
Nephrology Department, Dubai Hospital, Dubai, UAE.
Abstract
Background: Coronavirus disease 2019 (COVID-19) is associated with increased morbidity and mortality in chronic kidney disease patients, especially those on maintenance hemodialysis (HD). The comparison of immunogenicity of different COVID vaccines in the dialysis populations is lacking especially in the middle east region.
Methods: We conducted a retrospective observational study, that includes 164 hemodialysis patients (HD) and 54 health workers (HW), who received 2 doses of either Pfizer-BioNTech or Sinopharm vaccine. The primary endpoint was to report the rate of seroconversion and the factors affecting it.
Results: HD patients have a significantly low seroconversion rate than HW (HD vs HW: 76.54% and 100%, p=<0.05), also S1 IgG antibody level was significantly low in HD patients (HD vs HW: 183.5 and 400 BAU/ml, p=<0.05). The type of vaccine and hypo-response to the HBV vaccine were two statistically significant factors affecting the seropositivity rate in HD patients. As compared to Sinopharm, Pfizer-BioNTech vaccinated HD patients exhibit not only higher seroconversion rate (Pfizer-BioNTech vs Sinopharm: 90.80% and 60%, p=<0.05) but also express high S1 antibody titer (Pfizer-BioNTech vs Sinopharm: 425 and 162 BAU/ml (p=<0.05), however, there is no significant difference in post-vaccine COVID infection rate among the two vaccines (Pfizer-BioNTech vs Sinopharm: 39.24% and 42.22% (p= 0.176).
Conclusion: Lower Immune response to the COVID vaccine is observed in HD patients as compared to HW participants, also Pfizer-BioNTech vaccinated HD patients exhibit better seroconversion rates and higher antibody titer than Sinopharm vaccine in HD patients, so alternative vaccine strategies should be designed in dialysis patients.
Ankica Kosic
Sapienza University of Rome, Italy
Corine Stella Kana Kenfack
Sapienza University of Rome, Italy
Amy L. Ai
Florida State University, USA
Abstract
The COVID-19 pandemic has led to psychological stress caused by several threats such as concerns for health, economic problems, and several others. This study aims at exploring if inner resilience and belief in spiritual support may moderate the relationship between the concerns, on one side, and distress and the attitudes towards anti-COVID-19 vaccines, on the other side. We conducted a study involving 235 participants through an online survey from March to April 2021 in Italy, immediately after the last lockdown that took place in March 2021. Several scales were used to measure various difficulties and concerns, resilience, beliefs about spiritual support, conspiracy beliefs about COVID-19, psychological distress, and acceptance of the anti-COVID-19 vaccines. We found that resilience moderates the relationship between several concerns and psychological distress during the COVID-19 pandemic, especially among the participants who have strong beliefs in spiritual support.
Jose-Luis Sagripanti
US Food and Drug Administration and US Department of Defense (RETIRED). Maryland, United States.
Daniel R. Aquilano
Laboratorio de Análisis Bioquímicos, La Plata, Prov. Buenos Aires, Argentina
Abstract
COVID-19 seems to have progressed under two general assumptions: a) every new variant of SARS-Co V-2 should bear the worst consequences, thus justifying extension of government-mandated lock-downs, school and border closures, face mask wearing and other restrictive measures and b) that hastily developed experimental vaccines employing novel technologies would quickly and efficiently stop the pandemic by protecting from infection or, at the very least, by preventing complications and death. We tested these two hypotheses by analyzing the epidemiological data officially released by the governments of six countries in South America. We found that vaccination failed to prevent contagion by Omicron or by previous variants of SARS-Co V-2. Mortality has decreased with time since the start of global COVID-19 in early 2020 with Omicron showing the lowest mortality to date. This finding cursorily agreed with a beneficial effect of vaccination in each individual country but failed when countries with similar mortalities and different vaccination rates were analyzed. Thus, the slight but continued reduction in mortality through the duration of the pandemic and sharp decrease with Omicron do not correlate with the level of national vaccination among the countries studied. A more plausible explanation for the decrease in mortality through time is the natural attenuation of SARS-Co V-2 from successive passage through millions of susceptible and healthy hosts, as dictated by well-established principles of virology, immunology, and vaccinology dating at least from the mid 1950’s. The failure to prevent infection or to substantially reduce mortality as reported here should raise questions about the value of the massive vaccination campaigns in South America, particularly, considering the potential risks of adverse reactions (still to be fully determined) to experimental vaccines and the considerable cost to the stressed national economies of the region.
Abstract
Background: The administration of the COVID-19 vaccine at some points in the COVID-19 pandemic resulted in a significant reduction in the spread, risk of complications, and death from coronavirus infection. However, in the face of hesitancy against COVID-19 vaccination springing from the novelty of the vaccines and safety concerns, vulnerable population to COVID-19 infection such as people living with HIV/AIDS (PLWHA) were showing higher hesitancy to COVID-19 vaccines than the general population. This scoping review aims to identify factors COVID-19 vaccine hesitancy among PLWHA. Methods: A scoping review was conducted to identify and summarize studies from all over the world on COVID-19 vaccine uptake/hesitancy among people living with HIV/AIDS (PLWHA). The Preferred Reporting Items for Systematic Review and Meta-analysis (PRISMA) Extension for scoping reviews was used. Articles written in English, peer-reviewed, published within the years 2021-2023, and conducted in any part of the world with sample population being PLWHA, and with an outcome of uptake/hesitancy towards the COVID-19 vaccine were included. Results: Fourteen articles met the inclusion criteria and were included in this review. The primary study settings were clinic and hospital-based and online self-reported. The prevalence of COVID-19 vaccine hesitancy was as high as 90.8% in an online survey done in the US and as low as 27.5% in a facility-based survey in China. The most common factors mentioned associated with COVID-19 vaccination were the fear of side effects of the COVID-19 vaccine, concerns about the safety of the vaccine, medical mistrust, vaccine novelty, disclosure of HIV status, and perceived interference with highly active antiretroviral therapy (HAART). Male gender, race, good knowledge of COVID-19 prevention practice, having a CD4 count > 200 cells (p=0.032) and lower or undetectable viral load (p<0.001) were identified as predictors of COVID-19 uptake.
David J.A Goldsmith, FRCP
Retired physician
Eric J.W. Orlowski, MPhil
PhD Candidate
Abstract
It is the purpose of this narrative review to examine the impact of COVID-19 and the countermeasures deployed by central authorities on the health and wellbeing of children in the UK and in Sweden.
The COVID-19 pandemic of 2020-2023 was the most momentous and impactful public health event since the “Spanish Flu” pandemic of 1918-1920. Many fatalities ensued, largely but not completely confined to older subjects. However, taking a broader lens than just counting fatalities, it is clear that the pandemic exposed dramatic societal inequalities, whose impacts also were felt differently by different age groups. Health policy interventions were conceived in the main around the needs of adults, not children.
The special focus of this paper is the comparison between a full “lock down” country such as the UK, which had amongst the longest COVID-mandated school closures in the free world, and Sweden, which almost uniquely declined to impose distance learning on school children aged 15 and under. Similarly, the opportunity afforded by the immunisation of children against COVID-19 using novel vaccines was taken up to a very variable degree with some countries strongly advocating its routine use, while others only administered such vaccines to those at the highest risk of adverse outcomes (Sweden).
The authors searched (using Google Scholar and PubMed) for relevant pre-print/fully-published articles, periodicals, books, press reports, government policy pronouncements and publications for the period January 2020 to October 2023; in addition, the publicly-available outputs of the completed Swedish and ongoing UK COVID-19 enquiries were examined. Finally, a detailed in-person interview was undertaken in 2023 by one of the authors (DG) with the former State Epidemiologist of Sweden (Dr Anders Tegnell), who was in day-to-day charge of that country’s actions between 2020 and 2022.
Using these diverse lines of evidence, the authors have attempted to understand what measures were undertaken in the two countries which directly affected children’s health, why those policy choices were made, and any lessons learned which may be useful in the certain expectation of similar if not worse future pandemics.
Mahmood Dashti
Postgraduate Orthodontics Resident, Georgia School of Orthodontics, Atlanta, Georgia, USA.
Nozhan i Azim
Dental Student, Faculty of Dentistry, Tehran Islamic Azad University of Medical Sciences, Tehran, Iran.
Shohreh Ghasemi
Adjunct Assistant Professor, Department of Oral and Maxillofacial Surgery, The Dental College of Georgia at Augusta University, Augusta, Ga, USA.
Abstract
The B.1.1.529 (Omicron) variant of SARS-CoV-2 has rapidly spread with many variants like BA.1, BA.2, BA3., BA4., and BA5. With sublineages as well. It (Omicron) was first discovered in November 2021 and has become the predominant variant in several nations. Due to the sensitivity of infection and various other limitations like no particular real-time data for different age groups, there is a lack of information on the actual efficacy of vaccines against this variant. Limitations of data and reviews and the incidence of emergence rather than hospitalized people would result in an underestimation of the efficacy of vaccines against severe diseases. This systematic review was conducted by following PRISMA guidelines. Specific inclusion and exclusion parameters were strictly followed. Our studies show that a substantial number of people have received mRNA COVID-19 vaccine doses. The booster dose must be administered and obtained immediately before all efforts to stop the pandemic go to waste. Focusing on the primary vaccination is no longer sufficient.
James E. Galen
Center for Vaccine Development and Global Health, Baltimore MD 21201; University of Maryland School of Medicine, Baltimore MD 21201
Thanh Pham
Center for Vaccine Development and Global Health, Baltimore MD 21201; University of Maryland School of Medicine, Baltimore MD 21201
Abstract
Cancer remains a serious challenge to public health, with breast cancer, lung, and colorectal cancers predominating in both incidence and deaths worldwide. Significant advances have been made in the therapeutic treatment and resolution of non-solid tumors using immune checkpoint inhibitors (ICI) and chimeric antigen receptor (CAR) T cell therapy to break immune tolerance and initiate tumor clearance. However, these innovative strategies have enjoyed only limited success with solid tumors, especially in late-stage cancers in which tumor size is large. An immunosuppressive tumor microenvironment (TME) that surrounds and protects solid tumors significantly confounds the ability of the host immune system to target and eliminate tumor tissue. Novel technologies using nanomedicines have begun to yield promising results by penetrating into the microenvironment to stimulate innate immunity and induce trafficking of activated antigen presenting cells to regional lymph nodes, ultimately leading to tumor-specific adaptive immune responses. One type of nanomedicine that is generating increasing enthusiasm in the field of immunotherapy are bacterial outer membrane vesicles (OMVs) that can be genetically engineered to surface-express tumor-associated antigens; the resulting recombinant OMVs (rOMVs) can then be purified as immunotherapeutic vaccines. Recent data from experimental animal models have demonstrated remarkable efficacy in tumor challenge models. Such promising experiments suggest the possibility of translating these novel strategies into success with solid tumors in clinical trials. In this review, we will summarize current research using purified rOMVs as immunotherapeutic vaccines and further discuss potential obstacles that still need to be adequately addressed to ensure success in human trials.
Oscar Cobar
Pharmacogenomics and Nutrigenomics Research Laboratory, School of Chemical Sciences and Pharmacy, University of San Carlos, Guatemala.
Stella Cobar
School of Chemical Sciences and Pharmacy, University of San Carlos, Guatemala.
Abstract
Background: HV.1 (EG.5.1.6.1) was the dominant strain in the U.S. as of the end of second week of December 2023, according to the U.S. Centers for Disease Control and Prevention (CDC). The strain is a descendant of EG.5 family that was identified in China in February 2023 and was first detected in the United States in April 2023. 44 mutations in S-protein, 2 in Membrane and Envelope viral structures, 5 mutations in the Nucleocapsid, 21 mutations in Orf1a, 1 mutation in Orf3a, Orf6, Orf10, and 2 mutations in Orf8 virus genome open reading frames are reported. The symptoms of HV.1 are similar that of other Omicron variants, these include fever or chills, cough, shortness of breath or difficulty breathing, fatigue, muscle or body aches, headache, new loss of taste or smell, sore throat, congestion or runny nose, nausea or vomiting, and diarrhea, but congestion, sore throat and dry cough seem to be the three most prominent symptoms right now. Since HV.1 belongs to the same family as XBB, health experts assumethat updated vaccines are expected to be effective against this new dominant subvariant.The only way to distinguish (COVID-19) from RSV and flu, both of which are now gaining steam, is by testing.
Aim: The purpose of the manuscript is to present a systematic review on the prevalence, structural, genomic, and pathogenic characteristics of HV.1 from October 1, 2023, as of December 31, 2023, emphasizing on the variant genetic characteristics, contagiousness, and potential pathogenicity.
Material and Methods: Original scientific articles published in Medline, Pubmed, Science Direct, Web of Science, Scopus, EBSCO and BioMed Central databases, official health organizations electronic publications, and specialized media in the subject, were electronically searched to accomplish the aim of the study. Articles published in any language were included from October 2023 to present using a variety of keywords in combination. The studies relevant to our review were analysed and compared.
Results and Discussion: HV.1 showed significantly lower plasma neutralisation titers compared with their parental strains after acquiring L452R and A475V mutations, explaining their growth advantages. A475V mutation also resulted in decreased binding affinity, enhancing immune evasion compared to HK.3 (XBB.1.5+FLip). However, the L452R mutation of HV.1 did not affect binding affinity. 44 mutations in S-protein, 2 in Membrane and Envelope viral structures, 5 in the Nucleocapsid, 21 in Orf1a, 1 mutation in Orf3a, Orf6, Orf10, and 2 in Orf8 virus genome open reading frames mutations are reported. These mutations give to HV.1 improved ability to enter the human cell, although no greater pathogenicity or severity of the symptoms.
Conclusions: The latest data from US-CDC in 2023, shows HV.1 as the second prevalent SARS-CoV-2 variant in the United States. HV.1 (XBB.1.9.2.5.1.6.1 or EG.5.1.6.1) in October 2023, quickly increase its prevalence and surpassed other variants, includingEG.5 (Eris) to become the most prevalent strain in USA until week ending on December 9, 2023. HV.1 has a similar transmission rate, exhibits a greater evasive capacity of immune-generated antibodies than EG.5.1* family of SARS-CoV-2, produce similar symptoms that of other Omicron variants, are expected not to produce an increase in hospitalizations and mortality rate and the SARS-CoV-2 vaccines recently developed by Pfizer and Moderna, must be effective against this Omicron subvariant.For now HV.1 does not seem harmful in terms of creating a deadly disease but is still contagious enough to not be ignored.
Anushka Ashok
Final Mile Consulting, Mumbai, India
Sangiwe Moyo
Final Mile Consulting, Johannesburg, South Africa
Saransh Sharma
Final Mile Consulting, New York, USA
Laura Myers
Final Mile Consulting, Johannesburg, South Africa
Abstract
In addition to the direct health and economic impacts of the COVID-19 pandemic, routine immunization of children for vaccine-preventable diseases has also suffered. Quantitative studies have shown evidence of backsliding in routine immunization, i.e., children failing to receive their vaccinations on schedule. Pandemic restrictions were the cause for some of this behavior, and there are signs that subsequent campaigns and supply-side initiatives have influenced trends toward routine immunization catch-up. However, limited qualitative research indicates that the pandemic may have disrupted parents/caregivers’ decision-making processes around routine immunization, and their attitudes toward vaccination, in ways that could have long-term effects on rates of immunization. Further behavioral research can help elucidate this and provide guidance to policymakers to boost immunization uptake.
This policy article explores the decision dynamics leading to missed routine immunization doses during the pandemic, through an analysis of secondary literature, a summary of primary-research studies on COVID-19 vaccine hesitancy conducted during the pandemic across Côte d’Ivoire, Burkina Faso, Kenya and Pakistan, and a summary of a study on the impact of COVID-19 on routine immunization uptake in South Africa.
We found that the COVID-19 pandemic severely disrupted prior patterns of engagement with the health system, turning routine immunization from a default decision for parents/caregivers into an “active decision-making” moment. Restrictions on movement, limited routine immunization supplies and other practical impediments combined with fear of contracting COVID-19 at health facilities, misinformation, and fear of vaccine side-effects, creating an emergent behavior of missed immunization doses during the pandemic period. We also found that hesitancy about COVID-19 vaccines may be transferred onto previously accepted vaccines, impacting routine immunization.
We identified three decision-making pathways for routine immunization uptake among South African parents/caregivers once the lockdowns were lifted: the “path of procrastination,” the “path of doubt,” and the “path of persistence.” We highlight the policy implications of these, and suggest potential interventions to increase routine immunization uptake for parents/caregivers on each path, as well as for general communications, service delivery, and pandemic readiness.
Abstract
Annually, 59,000 people die of rabies, the world’s oldest known infectious disease, globally. In the United States, canine rabies has been virtually eliminated but the risk of rabies due to wildlife, especially raccoons, skunks, and bats, has required post exposure prophylaxis (PEP) be administered to more than 60,000 patients annually1. In 2021, 5 people in the United States2 died of rabies mostly due to misinformation or improper treatment. Rabies post exposure prophylaxis consists of three steps, wound washing, administration of human rabies immune globulin (HRIG) and a full course of vaccine3. In 2022, Whitehouse4 published that there were 122 breakthrough rabies infections when PEP was given due to four factors: 1) deviations from core practice 2) delays in seeking health care 3) errors in administration of HRIG 4) comorbidities or immunosuppression. It is estimated that over 40% of PEP administration is given inappropriately.
The publication,” Safety, and efficacy of rabies immunoglobulin in pediatric patients with suspected exposure”, Human Vaccines & Immunotherapeutics, 17:7, 2090–20965, was the first study that prospectively reviewed the use of human rabies immune globulin 150 IU/ml in 30 pediatric patients ages 0.5–14.9 years old.
Globally, 40% of people bitten by animals suspected of being infected with the rabies virus are children under the age of 15.6
This paper will look at risk reduction strategies that will include:
- Proper Identification of major rabies vectors
- Special risks associated with bat exposures in children
- Administration of human rabies immune globulin with volume considerations in children
- Special administration consideration for rabies vaccines
- “Just -in- time “Education for health care providers
Illustrative cases will be used to demonstrate each of these strategies of risk as well as the strategies for risk reduction.
Shaun Dennis Black
The University of Texas at Tyler
Abstract
COVID-19 disease is caused by the Betacoronavirus, SARS-CoV-2. This virus gave rise to 676 million confirmed cases with 6.9 million deaths worldwide by early 2023. After first appearing in Wuhan, China in late 2019, the virus has mutated into seven successive major forms with progressive increases in infectivity: Alpha, Beta, Delta, Omicron, and Omicron variants BA.4, BA.5, and XBB.1.5. Liposomal mRNA vaccines have been developed against SARS-CoV-2. Many of these received Emergency-use Authorization, and all have been highly promoted by civil authorities and the media. On the other hand, therapeutics against COVID-19 have been developed, but some of these have been severely suppressed, even by reliance on retracted papers. Our laboratory found that chlorpheniramine maleate, an over-the- counter antihistamine, was active against the Coronavirus through drug-database searches, molecular modeling, and a preliminary retrospective clinical-study. The manuscript that described this work was rejected by several journal editors without peer review, thus providing further direct evidence for suppression of small-molecule therapeutics. Epidemiologic study of death statistics in the VAERS database showed that 19,710 people lost their lives after COVID-19 vaccination; mortality from all other common vaccines does not sum to even 20% of this staggering value. The vaccine has also been responsible for significant morbidity. A consensus has begun to develop among physicians and scientists that COVID-19 disease and vaccination both result in chronic symptoms in many people, now called “Long COVID” or “Long-hauler’s syndrome”. Thus, vaccination does not appear to be a reasonable approach to combat COVID-19 disease. In view of this, development, testing, and approval or repurposing of therapeutics is imperative, especially as we observe recent increases in mortality due to COVID-19 Omicron XBB.1.5. Chlorpheniramine maleate, an over-the-counter medication, is uniquely positioned to serve as a broad-spectrum antiviral against SARS-CoV-2 and other viruses in this post- pandemic age.
Tom Boom
Department of Science and Engineering, University College Roosevelt, P.O. Box 94, 4330 AB Middelburg, The Netherlands.
Anna Budinská
Department of Science and Engineering, University College Roosevelt, P.O. Box 94, 4330 AB Middelburg, The Netherlands.
Júlia Šeligová
Department of Science and Engineering, University College Roosevelt, P.O. Box 94, 4330 AB Middelburg, The Netherlands.
Ger T. Rijkers
Department of Science and Engineering, University College Roosevelt, P.O. Box 94, 4330 AB Middelburg, The Netherlands.
Abstract
Streptococcus pneumoniae is a polysaccharide encapsulated bacterium responsible for the majority of cases of community acquired pneumonia. The upper respiratory tract of children becomes colonized with pneumococci early in life, from the first weeks of life up to 18 months. Factors which influence timing of colonization include geographical localization, socio-economic circumstances, and household conditions.
Pneumococcal pneumonia to a degree is a seasonal disease, peaking in the winter months. One of the epidemiological determinants is that viral infections (in particular influenza) predispose for pneumococcal pneumonia. The infectious nature of pneumococcal pneumonia was underscored during the COVID-19 pandemic. Due to societal restrictions imposed (face masks, social distancing) the incidence of invasive pneumococcal disease (IPD) dropped, and returned to pre-COVID-19 numbers after lifting of the restrictions.
There are 100 different S. pneumoniae serotypes, based on differences in the capsular polysaccharide. Introduction of protein conjugated polysaccharide vaccines (PCV) has reduced the incidence of IPD in children. Because children are the reservoir for other risk groups, in particular the elderly, introduction of PCV has indirectly also reduced the burden of IPD in latter risk group. The first generation of PCV consisted of the seven most prevalent pneumococcal serotypes. After implementation, replacement colonization of the upper respiratory tract with non-vaccine serotypes was observed and also replacement disease. Upcoming 24-valent PCVs will have a much broader coverage, but whether replacement disease now has been eliminated remains to be seen.
Dr. Sridevi Kulkarni
Senior Resident, Dept of Community Medicine, BGS Global Institute of Medical Sciences, Bangalore
Dr. Guruckeeran Nakkeeran
Non-Pg Registrar, Critical care Medicine, CMC Vellore, Bangalore
Mr. Narayana Swamy DM
Assistant Professor- statistician, Dept of Community Medicine, ESIC Medical College PGIMSR, Bangalore
Dr. Govind GS
Tutor, Department of Physiology, BGS GIMS, Bangalore
Dr. Rani HL
House- surgeon, BGS GIMS, Bangalore
Abstract
Introduction: The novel coronavirus disease (COVID-19) pandemic, is a newly emergent disease and its epidemiology was unknown. In absence of effective treatment and vaccines, prevention of spread was the only option to save mankind. Social distancing, diseased isolation, and face mask use were initiated across the globe as prevention strategies. Of these, using face masks has stood as time tested strategy. But the introduction of face masks in Indian settings, without prior education on appropriate methods of use (wear, storage, disposal) has made their effectiveness questionable. Hence, the present study intended to assess the knowledge, attitude, and practice of face mask use among rural adults and to address the gaps if any.
Objectives:
- To determine the prevalence of face mask usage
- To determine the prevalence of practicing appropriate method (WHO recommended) of face mask use.
- To assess knowledge, attitude, and practice of face mask use and factors influencing them.
Methodology: A community-based cross-sectional study was conducted in the rural field practice area of BGS Global Institute of Medical Sciences, Bangalore. Pretested questionnaire was administered to 120 participants through the face-to-face interview. There were 8,5 and 11 questions used to assess knowledge, attitude, and practice of face mask use respectively.
Results: The face mask acceptance rate was 98.6%. Only 1/3rd of the study population knew the appropriate method (WHO) of wearing a face mask. The majority of participants had good knowledge (76.6%) and positive attitude (74.9%) towards mask use, but poor practices (76.6%). Knowledge about face mask use was associated with age, education, and occupation. A positive attitude towards mask use was associated with the participants’ education level. Whereas the practices related to face mask use was poor and was not associated with any of the factors mentioned above.
Conclusion: The media (mass/social) has equipped people with good knowledge about face masks and the current pandemic has brought in a positive attitude. But people lack skills in appropriate mask use, storage, and disposal. Community activities directed towards Behavioural Change Communication are the need of the hour to ensure WHO-recommended practices for face mask use and disposal.
Ken Steven Rosenthal & Daniel H Zimmerman
CEL-SCI Corporation, 8229 Boone Blvd, Vienna, VA 22182, USA
Abstract
Autoimmune disease disrupts the normal immunological balance by promoting a perpetual cycle of innate/immune/inflammatory responses that continues due to the continued presence of antigen. The disease cycle is in turn amplified and regulated by cycles of antigen-specific T cell mediated immune responses. Removal of the stimuli or regulation of the disease drivers can stop the cycle to allow rebalancing and prevent the progression or chronicity of disease. As an alternative to the current treatments for autoimmune and inflammatory disease, which reduce, inhibit or eliminate the triggers, drivers or antigens, newer approaches stimulate regulatory responses, or inhibit or repurpose the effector/inflammatory responses to control the immune disease cycle. LEAPS (Ligand Epitope Antigen Presentation System) therapeutic vaccines for rheumatoid arthritis are presented as examples of therapies that elicit antigen-specific T cell modulation of autoimmune and inflammatory responses to treat disease.
Poy Theprungsirikul, MD
Clinical Fellow, Yale School of Medicine, Yale University, New Haven, CT, USA
Natalia Neparidze, MD
Associate Professor of Internal Medicine (Hematology); Research Leader, Myeloma Program, Hematology, Yale School of Medicine, Yale University, New Haven, CT, USA
Abstract
Cancer has been recognized as one of the major comorbidities associated with severe outcomes in the novel coronavirus disease 19 (COVID-19) patients. Compared to those with solid tumors and those without cancer, patients with hematologic malignancies appear to have more severe clinical outcomes and higher rate of mortality from COVID-19. This was particularly demonstrated during the early pandemic period. The COVID-19 pandemic has posed additional challenges in the management of hematologic malignancies, including establishing prompt diagnoses, providing optimal treatment while minimizing the risk and sequela of COVID-19 infection. Given these challenges, clinical practice guidelines and recommendations on management of hematologic malignancies during the COVID-19 pandemic were developed and proposed based on expert panels and individual expert opinions. Multiple myeloma is the second most common hematologic malignancy. The management of patients with multiple myeloma during the COVID-19 pandemic is extremely challenging as patients with multiple myeloma are particularly vulnerable to infections due to underlying humoral and cellular immune dysfunction, cytotoxic chemotherapy, immunotherapy, cellular therapy and steroid regimens, advanced age, and the presence of other comorbidities. In this paper, we attempt to provide a general review of clinical practice management patterns during and after the COVID-19 pandemic in patients with multiple myeloma and demonstrate how changes evolved as more knowledge was gained over time. Specifically, we review the impact of the pandemic on treatment approaches, supportive care, and vaccinations for patients with newly diagnosed multiple myeloma, relapsed/refractory multiple myeloma, patients with stable disease, and those with precursor states like monoclonal gammopathy and smoldering multiple myeloma. During early pandemic several changes were noted in myeloma care including minor delay in time to treatment initiation and tendency to defer autologous stem cell transplant. However, after 2022, with the advent of effective vaccines and treatment strategies the severity of COVID-19 infection decreased and care of myeloma returned to usual management, incorporating transplant, CART and multiple novel immune therapy approaches. Finally, we highlight the importance of meticulous vaccination schedule for patients with myeloma for all common viral, bacterial pathogens and vaccination against COVID-19.
Rohan S. Kulkarni, MBBS, MS
Dr. DY Patil Medical College, Hospital & Research Centre, Pimpri, Pune, India.
Salva G. Ahmed, MD
Brookville Family Care, Premier Health Family Medicine, Brookeville, Ohio, USA.
Sunil S. Kulkarni, PhD, MBA, CFA
Department of Engineering Management, Systems, and Technology, School of Engineering, University of Dayton, Ohio, USA.
Virendra K. Bhojwani, PhD
Department of Mechanical Engineering, MIT Art, Design and Technology University, Pune, India.
Abstract
Background: As of March 2024, the populations of the USA, India, and Brazil have suffered over 2.4M combined COVID-19 deaths and are ranked as the top three countries in the world with the most fatalities due to the virus. Their populations differ significantly regarding their races/ethnicities, population densities, urbanization proportions, GDPs (Gross Domestic Products), age profiles, and COVID vaccinations. However, surprisingly they are bunched up at the top when it comes to the world’s COVID-19 deaths.
Aims: This paper examines these populations, with a combined 194M infections and counting, to provide a comprehensive understanding and explore the social inferences of the virus.
The main objectives of this study are to comprehend similarities and differences of the three populations for race, age, income, population density, urbanization, and effectiveness of the COVID-19 vaccines.
Methods: To understand COVID-19’s underlying deaths in a country, its demographic and economic data were analyzed.
Results: For the US, in terms of population proportion of a race, the Whites saw a higher percentage of COVID-19 deaths, while the Blacks’ deaths were in line with this proportion but both the Hispanics and Asians saw lower COVID-caused deaths than their proportions. For the country, 90% of these deaths were for the ages of over 55 years. Surprisingly the 0-17 years age group saw only 0.15% of total 1.2M COVID-19 deaths.
Brazil did experience the second highest COVID-19 deaths in the world. 80% of these deaths occurred in 11 states out of the country’s 26. The same states have 70% of Brazil’s population creating 65% of the country’s GDP.
India, the world’s most populated country, experienced the third-highest COVID-19 deaths in the world. 87% of its COVID deaths came from 14 states out of the country’s 28. These states have 85% of India’s population produced 89% of the country’s GDP. India’s top five COVID-caused deaths producing states experienced 60% of these deaths.
Conclusions: The top five COVID-19 deaths-producing states for both the USA and Brazil were driven by population and GDP rankings. A blend of GDP, total population, urbanization, and median age were key drivers for India’s COVID-19 deaths.
Ali Zare Dehnavi
Department of Physiology and Biomedical Engineering, Mayo Clinic College of Medicine and Science, Rochester, USA; Research Center for Antibiotic Stewardship and Antimicrobial Resistance, Infectious diseases department, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
Seyed Ali Dehghan Manshadi
Iranian Research Center for HIV/AIDS, Iranian Institute for Reduction of High-Risk Behaviors, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
Seyed Ahmad Seyed Alinaghi
Iranian Research Center for HIV/AIDS, Iranian Institute for Reduction of High-Risk Behaviors, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
Behnam Amini
Research Center for Antibiotic Stewardship and Antimicrobial Resistance, Infectious diseases department, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
Fatemeh Rashidi
Research Center for Antibiotic Stewardship and Antimicrobial Resistance, Infectious diseases department, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
Masoumeh Farrokh Ashtiani
Iranian Research Center for HIV/AIDS, Iranian Institute for Reduction of High-Risk Behaviors, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
Hoda khoshnevis
Iranian Research Center for HIV/AIDS, Iranian Institute for Reduction of High-Risk Behaviors, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
Adel Tabrizi Tochaee
Iranian Research Center for HIV/AIDS, Iranian Institute for Reduction of High-Risk Behaviors, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
Mohammadreza Salehi
Research Center for Antibiotic Stewardship and Antimicrobial Resistance, Infectious diseases department, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
Cristina Mussini
University of Modena and Reggio Emilia, Modena, Italy
Abstract
There is limited information about COVID-19 vaccines in people living with HIV (PLWH). We aimed to compare the immunogenicity and effectiveness of the Sinopharm BIBP COVID-19 inactivated vaccine between PLWH and non-HIV individuals in the Omicron era. We evaluated the production of receptor-binding domain (RBD), spike, SARS-CoV-2 IgG, and neutralizing antibodies in both PLWH (case) and individuals without HIV (control) groups three months after they received the second dose of the vaccine. All participants were also followed during three months after the second dose for the COVID-19 infection and its outcomes (hospital admission, need to intensive care unit, and mortality). A total of 250 individuals comprising 150 PLWH and 100 people without HIV were recruited. The mean age was 42.2 years. The infection rate was significantly higher in non-HIV individuals than in PLWH (63% vs. 21.3%, p < 0.001). The hospitalization rate in the PLWH group was significantly hig1her than that in the non-HIV group (5.3% vs. 1%, p = 0.009). There were no significant differences in the mean levels of Spike antibody (84.4 ± 34.4 vs. 95 ± 109.5 RU/mL), RBD antibody (65.6 ± 42 vs. 69 ± 42.3 RU/mL), and SARS-CoV-2 IgG (2.9 ± 2.5 vs. 3 ± 2.3 Index) between the groups. The mean value of neutralizing antibodies was significantly higher in non-HIV individuals (34 ± 23.3 vs. 26.2 ± 20 µg/mL, p = 0.005). The Sinopharm BIBP COVID-19 inactivated vaccine can be as immunogenic in PLWH as in non-HIV individuals. This vaccine is likely more effective in preventing Omicron-associated hospitalization in non-HIV individuals.
Wen-Jan Tuan, DHA
Departments of Family and Community Medicine and Public Health Science, College of Medicine, Pennsylvania State University
Adriana Von Rago
College of Medicine, Pennsylvania State University, Pennsylvania, USA
Christopher Heron, MD
Department of Family and Community Medicine, College of Medicine, Pennsylvania State University, Pennsylvania, USA
Michael Partin, MD
Department of Family and Community Medicine, College of Medicine, Pennsylvania State University, Pennsylvania, USA
Kyle Burke, MD
Departments of Family and Community Medicine, Pennsylvania State University, Pennsylvania, USA
Grace Hwang
Aleksandra E. Zgierska, MD, PhD
Abstract
Despite advancements in vaccines and treatments for COVID-19 over time, many concerns remain about reinfection and waning immunity against COVID-19 and its variants, including among individuals treated with stimulants. The study aimed to evaluate the risk of COVID-19 reinfection and severe illness among adults prescribed stimulants compared to those not on stimulant therapy to elucidate the potential relationship of this therapy to the COVID-19 reinfection-related outcomes. A retrospective cohort study was conducted using the TriNetX database consisting of over 2,563,130 adults (age ≥18 years) with COVID-19 infection from January 1, 2020 to April 30, 2022. COVID-19 reinfection was defined as a new COVID-19 illness documented ≥ 30 days after the initial infection. Logistic regression was applied to assess the odds ratios (ORs) of COVID-19 reinfection and severe illness course (presence of emergence department (ED), hospitalization, and intensive care unit (ICU) care, mortality) within 30 days of reinfection, controlled for demographic and comorbid condition characteristics. Analysis revealed that adults who received at least three prescriptions for stimulants, compared to those without any stimulant prescriptions within six months prior to the initial COVID-19 illness, were more likely to be re-infected by COVID-19 (aOR=1.36, 95% confidence interval (CI): 1.32-1.41), but less likely to be treated in the ED (aOR=0.77, 95% CI: 0.72-0.82), hospital (aOR=0.72, 95% CI: 0.63-0.82), ICU (aOR=0.68, 95% CI: 0.53-0.89), or die (aOR=0.31, 95% CI: 0.15-0.64) within 30 days of reinfection (all p-values < 0.01). The study offers additional insights into the potential risks and benefits of prescription stimulants to aid in clinical decision making for treating COVID-19 reinfection in adults on stimulant therapy.
Dr. Úrsula Oswald-Spring, Prof
Regional Centre of Multidisciplinary Research at National Autonomous University of Mexico (CRIM-UNAM in Spanish)
Abstract
The objective of this article review the complex impacts of COVID-19 not only as a health problem, but also related to unemployment, poverty rise, gender violence, and climate disasters in Mexico. An open, dissipative, and self-regulating system methodology interlinks the complex socioeconomic, political, and sanitary feedback. Governmental and private corruption in the purchase of drugs, protective gear, badly equipped and unbuilt hospitals after the 2017 earthquakes, lack of trained personnel, and people with comorbidity produced excess mortality. Support from private hospitals, ventilators, medical specialists from Cuba, vaccines bought worldwide, and the immunization of 71.3% of the adult population in 2022, reduced dead and contagion. The socioeconomic and health impacts were wide, when in 2020 12.5 million people lost their jobs, mostly women and youth, poverty raised, and lockdown increased intrafamilial violence. Governance included direct money transfers to elderlies, students, youth in apprenticeship, single mothers, and peasants planting timber and fruit trees. The cash steered youth away from organised crime, granted food security, and the acquisition of protective gear. New public works created employment in the poorest southern regions highly affected by COVID-19 due to undernourishment, improving their livelihood. Further, 52 cyclones on both oceans, forced people to flee, while the Trump Administration declared Art. 42 and returned migrants from different countries to the Mexican border, increasing the contagion. The Biden Administration gave vaccine gifts against COVID-19 to stimulate export industries in the northern region. The Russian-Ukrainian war raised prices that affected the food security of poor people. Agreements with supermarkets and food providers, systematic increases in the minimum wage, and new public infrastructure enhanced jobs, improved livelihood, and alleviate poverty. A rigorous macroeconomic policy allowed free vaccination also for children over five years and the building of an alternative public health system, providing sanitary and preventive medical attention to the impoverished population in the indigenous southern regions.
Amofah George, MPH
President, Ghana Public Health Association
Badu Sarkodie
Sarkodie Badu (Former Director Public Health, Ghana Health Service)
Abstract
The Ghana Public Health Association organized a scientific seminar in April 2014 to examine the introduction of genetically modified organisms (GMOs) into public use, and their potential health consequences. The seminar was driven by the current public debate on the subject. Concerns have been raised about the use of GMOs, especially in developing countries, for a variety of reasons including ethical and biosafety considerations. The seminar identified some of their advantages such as the introduction of pest-resistant, disease-resistant, and drought-tolerant crops; the potential for reduced use of chemicals and pesticides; improvement the nutritional properties of crops, and huge potential for the production of pharmaceuticals and vaccines.
Potential health concerns raised included current efforts focusing primarily on a few crop/trait combinations of high commercial value; most trial designs are laboratory design and of short duration; increasing observation of trends in organ disease with the use of GMOs, and lack of labeling of GMO products that hinder post-marketing surveillance.
There is the need to enhance local capacity to research the introduction and use of GMOs; to put in place appropriate regulatory mechanisms including, particularly, the labeling of their products, and long-term post-marketing surveillance for possible negative health consequences.
Furthermore, the appropriate state agency should put in place advocacy and communication strategies to keep the public informed about the health and other consequences of GMOs, for informed public choices.
Willem van Aardt, BProc (Cum Laude), LLM (UP), LLD (NWU)
North-West University, Research Unit: Law, Justice and Sustainability, Potchefstroom Campus, South Africa
Abstract
The global fervor to develop and deliver a vaccine to protect people against COVID-19, the disease caused by SARS-CoV-2, has been extraordinary. COVID-19 vaccine development has been pursued at an unprecedented speed and scale; following the Emergency Use Authorization (EUA) of COVID-19 vaccines, rapid mass vaccination deployment efforts commenced in all earnest. This fervor to get a needle into every arm has now led to the European Commission president calling on the EU’s 27 member states to consider mandatory vaccination across Europe. With an intensification in COVID-19 vaccine hesitancy and many refusing to be vaccinated, an important question that arises is whether obligatory COVID-19 vaccination policies are ethical and legal in terms of international human rights norms and standards. Article 4(2) of the International Covenant on Civil and Political Rights which was ratified by 173 States Parties worldwide enumerates a specific list of human rights from which no derogation is allowed even in times of a public emergency. Included in this list of non-derogable rights is a sub-category of internationally recognized human rights known as “physical integrity rights” that includes the right to be free from medical or scientific experimentation. International human rights law is unambiguous that all people should be afforded their non-derogable fundamental human right to free and informed consent. Normative ethical perspectives and legal obligations erga omnes dictate that States Parties should not make COVID-19 vaccination mandatory in breach of International Human Rights Law relating to non-derogable rights that are regarded as core human rights, jus cogens. A bioethics perspective, rooted in fundamental human rights, should play a crucial role in the COVID-19 pandemic.
Shalom Onyinye Katas, MD
School of Medicine, International University of the Health Sciences (IUHS) Basseterre, St. Kitts & Nevis
Inelefo Roger Iyayi, MD
Department of Medicine and Surgery, University of Benin, Edo State, Nigeria
Princess Okoronkwo, PharmD
Department of Pharmacy, D’youville University, Buffalo, NY
Derek Olatunde Olagbemi, MBBS, LMCC
College of Medicine, University of Lagos, Lagos, Nigeria
Tinuade Oladayo Adeakin-Dada, MD, LMCC, PGCertCR
Department of Medicine, Windsor University School of Medicine, St Kitts and Nevis
Oluwadamilola Daniel Odutola, MD
Department of Internal Medicine Medical University of South Carolina, SC, USA
Paul Akhere Momodu
Department of Medicine, International University of the Health Sciences Basseterre, St Kitts and Nevis
Stephen N. Utulor, MD
Department of Medicine, International University of the Health Sciences (IUHS) School of Medicine, Basseterre, St Kitts and Nevis
Uzodinma Joseph Nwadinigwe, MBBS
Department of Medicine, University of Nigeria Teaching Hospital Ituku, Nigeria
Oluwabusayo Monsurat Osundiji, MD
Department of Medicine, St Martinus University, Curacao, Netherland Antilles
Okelue E. Okobi, MD
Department of Family Medicine, Larkin Community Hospital (PSC), Miami, FL, USA
Abstract
Background: Diabetes mellitus is a prevalent chronic disease that significantly increases the risk of complications from infections such as influenza and pneumococcal disease. Despite established recommendations for vaccination, coverage rates among adults with diabetes remain suboptimal. This study aims to analyze trends in influenza and pneumococcal vaccination rates among adults with diabetes using the United States Diabetes Surveillance System (USDSS) database.
Methods: This retrospective database study utilized data from the USDSS from 2000 to 2022, which provides comprehensive nationwide data on diabetes care. The study population included adults aged 18 and above with a documented diagnosis of diabetes. Data were extracted on demographic variables (age, sex, race/ethnicity), clinical characteristics (type of diabetes, duration of diabetes, comorbid conditions), and vaccination records. Descriptive statistics summarized demographic and clinical characteristics, while temporal trends in vaccination rates were analyzed using graphical representations.
Results: Over the past two decades, influenza vaccination rates among adults with diabetes increased from 41.4% in 2000 to 56.7% in 2019, reflecting improved awareness and healthcare practices, though slightly dipping to 54.2% in 2022. In contrast, pneumococcal vaccination rates showed more variability, starting at 29.3% in 2000, peaking at 39.4% in 2018, and declining to 30.2% in 2022, indicating challenges in maintaining high coverage. Influenza vaccination rates showed an overall increasing trend across all demographic groups: rates among Hispanic individuals increased from 32.1% in 2000 to 55.4% in 2022, non-Hispanic Whites from 43.4% to 52.7%, and non-Hispanic Blacks from 39.2% to 44.5%. Pneumococcal vaccination rates also increased but displayed more variability; Hispanic rates peaked at 33.3% in 2016, non-Hispanic Whites at 45.6% in 2019, and non-Hispanic Blacks at 41.7% in 2017. Higher educational attainment was consistently associated with higher vaccination rates for both vaccines.
Conclusions: This study highlights significant improvements in influenza and pneumococcal vaccination rates among adults with diabetes over the past two decades. However, disparities remain, particularly among racial and educational groups. Targeted strategies are necessary to address these disparities and enhance vaccination coverage, ultimately reducing the risk of severe infections in this vulnerable population.
Robert G. Lisziewicz
VERDI Solutions; Vienna, Austria
Felipe Oviedo
Microsoft AI for Good Research Laboratory; Redmond, USA
Andras G. Szasz
VERDI Solutions; Vienna, Austria
Juan L. Ferres
Microsoft AI for Good Research Laboratory; Redmond, USA
Franco Lori
VERDI Solutions; Vienna, Austria/ Research Institute for Genetic and Human Therapy; Milano, Italy
Julianna Lisziewicz
VERDI Solutions, GMBH
Abstract
Background: The COVID-19 pandemic has necessitated the development of efficient diagnostic tools to predict T-cell responses, which are crucial for viral clearance and protection against reinfection. Current diagnostic tests lack the ability to predict the epitope repertoire of an individual that induces T-cell responses.
Methods: We developed VERDI, a new machine learning-based diagnostic tool that leverages the sequence data of all the six HLA class I alleles of an individual to rank all putative epitopes based on their potential to induce T-cell responses. VERDI was trained on a comprehensive clinical dataset of 920 SARS-CoV-2 epitopes and validated using an independent dataset collected for the FDA-approved T-detect COVID test. We compared VERDI’s performance with existing HLA-allele-based models through statistical analyses.
Results: Our findings reveal that VERDI’s top-ranked epitopes accurately represent the individual’s epitope repertoire that participates in T-cell responses. VERDI outperformed current models, improving T-cell response prediction recall by threefold and precision by eightfold. It exhibited exceptional diagnostic accuracy, precision, and recall in predicting the potency of the top 20 epitopes. Despite experimental limitations that allow testing of only 1% of putative epitopes, VERDI accurately predicted 30% of these, implying a potentially higher accuracy if broader testing were feasible. Notably, the mean potency of the top-ranked epitopes predicted by VERDI, which reflects the strength of an individual’s SARS-CoV-2-specific T-cell responses, exhibited a Gaussian distribution.
Conclusions: VERDI is the first diagnostic tool that uses the complete HLA genotype data to predict the breadth and strength of an individual’s T-cell responses to SARS-CoV-2 infection. Its ability to accurately identify the potency of epitopes involved in individual T-cell responses and its superior performance compared to the state-of-the-art make it a new resource for personalized vaccine design and disease management.
Kunal Saha, MD, PhD, Ex-professor
Dept. of Pediatrics & Microbiology, Ohio State University Medical Center and Children’s Hospital, Columbus, Ohio, USA and President, People for Better Treatment (PBT), Commercial Point (Ground Floor), 79 Lenin Sarani, Kolkata, India.
Abstract
COVID-19 pandemic has devastated the world over the past three years with millions already dead. Despite making major strides to combat the pandemic with useful vaccines against the SARS-CoV-2 virus, potential for more dangers from new variants of COVID-19 cannot be ruled out. Several studies have recently shown that the number of COVID-19 deaths as reported by different nations was far less than the number of people who may have died due to pandemic. Although many countries across the globe may have undercounted the death toll due to COVID-19, India holds the ignominious distinction for the highest number of unrecognized COVID-19 deaths. Both unreliable science and willful spread of misinformation about true lethal nature of COVID-19 by devious governmental authorities are likely responsible for the gross underreporting of COVID-19 deaths. Complete scientific transparency and absolute immunity against political intrusion of healthcare would be essential to end the COVID-19 pandemic and to protect humanity against other pandemics in future.
