Covid-19 Vaccines — Immunity, Variants, Boosters

New England Journal of Medicine, Journal Year: 2022, Volume and Issue: 387(11), P. 1011 - 1020

Published: Aug. 31, 2022

T he coronavirus disease 2019 (Covid-19) pandemic has claimed an estimated 15 million lives, including more than 1 lives in the United States alone.The rapid development of multiple Covid-19 vaccines been a triumph biomedical research, and billions vaccine doses have administered worldwide.Challenges facing field include inequitable distribution, hesitancy, waning immunity, emergence highly transmissible viral variants that partially escape antibodies.This review summarizes current state knowledge about immune responses to importance both humoral cellular immunity for durable protection against severe disease. A nti v ir l Immunit yThe system is broadly divided into innate adaptive systems.Innate are first line defense viruses rapidly triggered when pattern-recognition receptors, such as toll-like recognize pathogen-associated molecular patterns.Innate antiviral includes secretion type I interferons, cytokines, certain responses, neutrophils, monocytes macrophages, dendritic cells, natural killer cells. Adaptive second viruses, involve antigen-specific recognition epitopes.Adaptive two complementary branches system: immunity.Humoral acute respiratory syndrome 2 (SARS-CoV-2) antibodies bind SARS-CoV-2 spike protein either neutralize virus or eliminate it through other effector mechanisms. 2,3ellular virus-specific B cells which provide long-term immunologic memory expand on reexposure antigen.B produce antibodies, CD8+ directly virally infected CD4+ help support responses.5][6][7] For variant largely escapes neutralizing may be particularly important longterm

Language: Английский

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2022 ACC Expert Consensus Decision Pathway on Cardiovascular Sequelae of COVID-19 in Adults: Myocarditis and Other Myocardial Involvement, Post-Acute Sequelae of SARS-CoV-2 Infection, and Return to Play

Journal of the American College of Cardiology, Journal Year: 2022, Volume and Issue: 79(17), P. 1717 - 1756

Published: March 16, 2022

Language: Английский

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COVID-19 vaccine update: vaccine effectiveness, SARS-CoV-2 variants, boosters, adverse effects, and immune correlates of protection

Journal of Biomedical Science, Journal Year: 2022, Volume and Issue: 29(1)

Published: Oct. 15, 2022

Abstract Coronavirus Disease 2019 (COVID-19) has been the most severe public health challenge in this century. Two years after its emergence, rapid development and deployment of effective COVID-19 vaccines have successfully controlled pandemic greatly reduced risk illness death associated with COVID-19. However, due to ability rapidly evolve, SARS-CoV-2 virus may never be eradicated, there are many important new topics work on if we need live for a long time. To end, hope provide essential knowledge researchers who improvement future vaccines. In review, provided an up-to-date summary current vaccines, discussed biological basis clinical impact variants subvariants, analyzed effectiveness various vaccine booster regimens against different strains. Additionally, reviewed potential mechanisms vaccine-induced adverse events, summarized studies regarding immune correlates protection, finally, next-generation

Language: Английский

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Risk of Myocarditis After Sequential Doses of COVID-19 Vaccine and SARS-CoV-2 Infection by Age and Sex

Circulation, Journal Year: 2022, Volume and Issue: 146(10), P. 743 - 754

Published: Aug. 22, 2022

Background: Myocarditis is more common after severe acute respiratory syndrome coronavirus 2 infection than COVID-19 vaccination, but the risks in younger people and sequential vaccine doses are less certain. Methods: A self-controlled case series study of ages 13 years or older vaccinated for England between December 1, 2020, 15, 2021, evaluated association vaccination myocarditis, stratified by age sex. The incidence rate ratio excess number hospital admissions deaths from myocarditis per million were estimated 1 to 28 days adenovirus (ChAdOx1) mRNA-based (BNT162b2, mRNA-1273) vaccines, a positive SARS-CoV-2 test. Results: In 42 842 345 receiving at least dose vaccine, 21 242 629 received 3 doses, 5 934 153 had before vaccination. occurred 2861 (0.007%) people, with 617 events Risk was increased first ChAdOx1 (incidence ratio, 1.33 [95% CI, 1.09–1.62]) first, second, booster BNT162b2 (1.52 1.24–1.85]; 1.57 1.28–1.92], 1.72 1.33–2.22], respectively) lower test (11.14 8.64–14.36] 5.97 4.54–7.87], respectively). risk higher second mRNA-1273 (11.76 7.25–19.08]) persisted (2.64 1.25–5.58]). Associations stronger men 40 all vaccines. old, (97 91–99] versus 16 12–18]). women years, similar (7 1–9] 8 6–8]). Conclusions: Overall, greater remains modest including mRNA vaccine. However, men, particularly

Language: Английский

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Circulating Spike Protein Detected in Post–COVID-19 mRNA Vaccine Myocarditis

Circulation, Journal Year: 2023, Volume and Issue: 147(11), P. 867 - 876

Published: Jan. 4, 2023

Cases of adolescents and young adults developing myocarditis after vaccination with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-targeted mRNA vaccines have been reported globally, but the underlying immunoprofiles these individuals not described in detail.

Language: Английский

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Myopericarditis following COVID-19 vaccination and non-COVID-19 vaccination: a systematic review and meta-analysis

The Lancet Respiratory Medicine, Journal Year: 2022, Volume and Issue: 10(7), P. 679 - 688

Published: April 11, 2022

Language: Английский

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Epidemiology of Myocarditis and Pericarditis Following mRNA Vaccination by Vaccine Product, Schedule, and Interdose Interval Among Adolescents and Adults in Ontario, Canada

JAMA Network Open, Journal Year: 2022, Volume and Issue: 5(6), P. e2218505 - e2218505

Published: June 24, 2022

Importance

Increased rates of myocarditis or pericarditis following receipt COVID-19 mRNA vaccines have been observed. However, few available data are associated with differences in specific to vaccine products, which may important implications for vaccination programs.

Objective

To estimate reported a by product, age, sex, dose number, and interdose interval.

Design, Setting, Participants

This population-based cohort study was conducted Ontario, Canada (population: 14.7 million) from December 2020 September 2021 used Ontario's registry passive vaccine-safety surveillance system. All individuals Canada, who received at least 1 between 14, 2020, 4, 2021, had episode the during this period were included. We obtained information on all doses administered province calculate pericarditis.

Exposures

Receipt (mRNA-1273 [Moderna Spikevax] BNT162b2 [Pfizer-BioNTech Comirnaty]).

Main Outcomes Measures

reports meeting levels 3 Brighton Collaboration case definitions Rates 95% CIs cases per 000 calculated

Results

Among 19 740 741 administered, there 297 inclusion criteria; 228 (76.8%) occurred male individuals, median age event 24 years (range, 12-81 years). Of cases, 207 (69.7%) second vaccine. When restricted their enhanced (on after June 1, 2021), highest rate observed aged 18 mRNA-1273 as (299.5 doses; CI, 171.2-486.4 doses); 59.2 (95% 19.2-138.1 doses). Overall both products significantly higher when interval 30 fewer days (BNT162b2: 52.1 [95% 31.8-80.5 doses]; mRNA-1273: 83.9 47.0-138.4 doses]) compared 56 more 9.6 6.5-13.6 16.2 10.2-24.6 doses]).

Conclusions Relevance

The findings Ontario adolescents adults suggest that intervals, addition be risk these vaccines. Vaccination program strategies, such age-based product considerations longer reduce

Language: Английский

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Myocarditis

New England Journal of Medicine, Journal Year: 2022, Volume and Issue: 387(16), P. 1488 - 1500

Published: Oct. 19, 2022

Myocarditis has increased with Covid-19 and vaccines. Precise diagnosis relies on endomyocardial biopsy, but MRI myocardial markers may be used. Treatment depends the cause degree of functional compromise.

Language: Английский

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COVID-19, Myocarditis and Pericarditis

Circulation Research, Journal Year: 2023, Volume and Issue: 132(10), P. 1302 - 1319

Published: May 11, 2023

Viral infections are a leading cause of myocarditis and pericarditis worldwide, conditions that frequently coexist. Myocarditis were some the early comorbidities associated with SARS-CoV-2 infection COVID-19. Many epidemiologic studies have been conducted since time concluding increased incidence myocarditis/pericarditis at least 15× over pre-COVID levels although condition remains rare. The was reported 1 to 10 cases/100 000 individuals COVID ranging from 150 4000 individuals. Before COVID-19, vaccines in rare cases, but use novel mRNA platforms led higher number cases than previous providing new insight into potential pathogenic mechanisms. COVID-19 vaccine-associated covers large range depending on vaccine platform, age, sex examined. Importantly, findings highlight occurs predominantly male patients aged 12 40 years regardless whether due virus-like or vaccine-a demographic has before This review discusses considering known symptoms, diagnosis, management, treatment, pathogenesis disease gleaned clinical research animal models. Sex differences immune response discussed, theories for how could lead proposed. Additionally, gaps our understanding need further raised.

Language: Английский

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Incidence, risk factors, natural history, and hypothesised mechanisms of myocarditis and pericarditis following covid-19 vaccination: living evidence syntheses and review

BMJ, Journal Year: 2022, Volume and Issue: unknown, P. e069445 - e069445

Published: July 13, 2022

Abstract Objectives To synthesise evidence on incidence rates and risk factors for myocarditis pericarditis after use of mRNA vaccination against covid-19, clinical presentation, short term longer outcomes cases, proposed mechanisms. Design Living syntheses review. Data sources Medline, Embase, the Cochrane Library were searched from 6 October 2020 to 10 January 2022; reference lists grey literature (to 13 2021). One reviewer completed screening another verified 50% exclusions, using a machine learning program prioritise records. A second all exclusions at full text, extracted data, (for factors) bias assessments modified Joanna Briggs Institute tools. Team consensus determined certainty ratings GRADE (Grading Recommendations, Assessment, Development Evaluation). Eligibility criteria selecting studies Large (>10 000 participants) or population based multisite observational surveillance data (incidence reporting confirmed covid-19 vaccination; case series (n≥5, course outcomes); opinions, letters, reviews, primary focused describing supporting hypothesised Results 46 included (14 incidence, seven factors, 11 characteristics course, three outcomes, 21 mechanisms). Incidence vaccines was highest in male adolescents young adults (age 12-17 years, range 50-139 cases per million (low certainty); 18-29 28-147 (moderate certainty)). For girls boys aged 5-11 years women with BNT162b2 (Pfizer/BioNTech) could be fewer than 20 certainty). third dose an vaccine had very low evidence. individuals is probably higher mRNA-1273 (Moderna) compared Pfizer Among 12-17, 18-29, 18-39 two might lower when administered ≥31 days ≤30 one specific men indicated that dosing interval need increase ≥56 substantially drop incidence. only small (n=8) found year olds. In adults, most (>90%) involved median 20-30 age symptom onset four (71-100%). Most people admitted hospital (≥84%) duration (two days). pericarditis, limited but more variation has been reported patient age, sex, timing, rate admission hospital. Three (3 months; n=38) follow-up suggested persistent echocardiogram abnormalities, as well ongoing symptoms drug treatments restriction activities >50% patients. Sixteen mechanisms described, little direct refuting Conclusions These findings indicate adolescent adult are vaccination. Use over Moderna waiting 30 between doses preferred this population. children rare low. limited. related appeared benign, although Prospective appropriate testing (eg, biopsy tissue morphology) will enhance understanding mechanism.

Language: Английский

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