COVID-19 Incidence Among 6th-12th Grade Students by Vaccination Status

Coronavirus disease 2019 (COVID-19), school closures, and quarantines have had substantial impacts on students’ health and education.
1,2,3 Clinical trials have shown severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2)Bio Med Frontiers vaccines to be safe and efficacious for adults, adolescents, and young children.
However, in some areas, vaccine uptake has been low among children and adolescents, especially compared to uptake in adults.
Additionally, real-world vaccine effectiveness data among adolescents and implications for in-person education are lacking. We investigated the impact of COVID-19 vaccination on SARS-CoV-2 incidence and within-school transmission in a cohort of 6th-12th grade students.

Chronic lymphocytic leukemia.

Chronic lymphocytic leukemia (CLL) is a low-grade B cell lymphoma with circulating cells, often revealed by hyperlymphocytosis. Its diagnosis and therapeutic indications (not systematic) have been defined in 2018.
In fact, CLL can be separated in two entities differentiating themselves by their IGHV mutational status, but the search of other prognostic parameters like TP53 disruption is mandatory before treatment.
Numerous genetic alterations and mutations exist in CLL. CLL cells are highly dependent from their b-cell receptor stimulation and from their microenvironment, Learn More which takes a central place in disease progression.
Infections, dysimmune manifestations, cancers and Richter transformation are classic complications, and patients have poor vaccine response even without a treatment.
Chemoimmunotherapy is being challenged by the new highly active drugs such as Bruton tyrosine-kinase inhibitors (ibrutinib, acalabrutinib) and by the association of venetoclax and anti-CD20.
Future treatment strategies might integrate both new drugs and classical chemoimmunotherapy.

Risk of Second Allergic Reaction to SARS-CoV-2 Vaccines: A Systematic Review and Meta-analysis.

 Vaccination against SARS-CoV-2 is a highly effective strategy to prevent infection and severe COVID-19 outcomes. The best strategy for a second dose of vaccine among persons who had an immediate allergic reaction to their first SARS CoV-2 vaccination is unclear.
To assess the risk of severe immediate allergic reactions (eg, anaphylaxis) to a second dose of SARS-CoV-2 mRNA vaccine among persons with immediate allergic reactions to their first vaccine dose.
MEDLINE, Embase, Web of Science, and the World Health Organization Global Coronavirus database were searched from inception through October 4, 2021.
Included studies addressed immediate allergic reactions of any severity to a second SARS-CoV-2 vaccine dose in persons with a known or suspected immediate allergic reaction (<4 hours after vaccination) after their first SARS-CoV-2 vaccine dose. Studies describing a second vaccine dose among persons reporting delayed reactions (>4 hours after vaccination) were excluded.
Paired reviewers independently selected studies, extracted data, and assessed risk of bias. Random-effects models were used for meta-analysis. The GRADE (Grading of Recommendation, Assessment, Development, and Evaluation) approach evaluated certainty of the evidence.

Risk of severe immediate allergic reaction and repeated severe immediate allergic reactions with a second vaccine dose.

Reaction severity was defined by the reporting investigator, using Brighton Collaboration Criteria, Ring and Messmer criteria, World Allergy Organization criteria, or National Institute of Allergy and Infectious Diseases criteria.
  • Among 22 studies of SARS-CoV-2 mRNA vaccines, 1366 individuals (87.8% women; mean age, 46.1 years) had immediate allergic reactions to their first vaccination.
  • Analysis using the pooled random-effects model found that 6 patients developed severe immediate allergic reactions after their second vaccination (absolute risk, 0.16% [95% CI, 0.01%-2.94%]), 232 developed mild symptoms (13.65% [95% CI, 7.76%-22.9%]), and, conversely, 1360 tolerated the dose (99.84% [95% CI, 97.09%-99.99%]). Among 78 persons with severe immediate allergic reactions to their first SARS-CoV-2 mRNA vaccination, 4 people (4.94% [95% CI, 0.93%-22.28%]) had a second severe immediate reaction, and 15 had nonsevere symptoms (9.54% [95% CI, 2.18%-33.34%]).
  • There were no deaths. Graded vaccine dosing, skin testing, and premedication as risk-stratification strategies did not alter the findings. Certainty of evidence was moderate for those with any allergic reaction to the first dose and low for those with severe allergic reactions to the first dose.
In this systematic review and meta-analysis of case studies and case reports, the risk of immediate allergic reactions and severe immediate reactions or anaphylaxis associated with the second dose of a SARS-CoV-2 mRNA vaccine was low among persons who experienced an immediate allergic reaction to their first dose.
These findings suggest that revaccination of individuals with an immediate allergic reaction to a first SARS-CoV-2 mRNA vaccine dose in a supervised setting equipped to manage severe allergic reactions can be safe.

Reactogenicity among healthcare workers following a BNT162b2 or mRNA-1273 second dose after priming with a ChAdOx1 nCOV-19 vaccine.

  • In March 2021, French authorities recommended a heterologous second dose of mRNA vaccine in persons aged less than 55 years, with administration 9-12 weeks after the first dose of ChAdOx1 nCoV-19.
  • This recommendation was despite a lack of data on reactogenicity and safety of the regimen. Since then, several studies have shown an acceptable short-term safety profile of ChAdOx1 nCoV-19 and BNT162b2 heterologous vaccination, although some transient increased reactogenicity has been described.
  • We performed a single center prospective observational cohort study among healthcare workers (HCW) in a tertiary care hospital to assess reactogenicity of BNT162b2 and mRNA-1273 vaccines administered as a second dose in participants primed with ChAdOx1 nCoV-19.
  • Among 1184 HCW, 356 (30%) agreed to participate. Of the participants, 32.3% were men, and the mean age was 35 years (SD 10.1). 229 HCW received BNT162b2 and 127 received mRNA-1273.
  • A systemic reaction was observed in 130/229 (56.8%) and 100/127 (78.7%) HCW respectively.
  • Injection site reactions were generally limited (grade 1 or 2 in 163/229 [97.6%] and 90/127 [85.7 %] respectively). After adjustment for age, sex and HCW role, receiving the mRNA-1273 vaccine was associated with higher reactogenicity with more grade 3 side effects (aOR=3.34, 95% CI 1.91-5.85), more systemic symptoms (aOR=2.82, 95% CI 1.69-4.7), and not being able to work (aOR=8.35, 95% CI 3.78-18.44), in comparison to receiving the BNT162b2 vaccine.
  •  Among patients receiving the mRNA1273 vaccine as a second dose, our study confirms good tolerance of the heterologous schedule with a higher risk of short term side effects in comparison to patients receiving the BNT162b2 vaccine.
  • Cost of human papillomavirus vaccine delivery at district and health facility levels in Zimbabwe: A school-based vaccination program targeting multiple cohorts.
After a pilot project in 2014-15 Zimbabwe introduced the human papillomavirus (HPV) vaccine nationally in 2018 for girls aged 10-14 years through a primarily school-based vaccination campaign with two doses administered at 12-month intervals.
In 2019, a first dose was delivered to a new cohort of girls in grade 5 of girls age 10 years if out-of-school (OOS), along with a second dose to the 2018 multiple cohorts.
Additional effort was made to identify and mobilize OOS girls by Village Health Workers (VHWs) in the community. Zimbabwe reported 1,569,905 doses of HPV vaccine administered during the 2018 and 2019 campaigns.
This analysis evaluated the cost of Zimbabwe’s national HPV vaccine introduction.A retrospective, incremental, ingredients-based cost analysis from the provider perspective was conducted in 2018 and 2019.
Financial and economic cost data were collected at district and health facility levels using a two-stage cluster sampling approach and four cost dimensions: program activity, resource input, payer, and administrative level. Costs are presented in 2020 US$ in total and per dose.
The total weighted costs for combined district and health facility administrative levels were US$ 828,731 (financial) and US$ 2,060,943 (economic). For service delivery, the total weighted cost per dose was US$ 0.16 (financial) and US$ 0.59 (economic).

Immunization Grade Rat Type I Collagen, 5 mg, lyophilized

1064 Chondrex 5 mg 206 EUR

Immunization Grade Mouse Type V Collgen, 0.1 mg, lyophilized

1096 Chondrex 0.1 mg 168 EUR

Immunization Grade Goat Type II Collagen, 5 mg, lyophilized

20071 Chondrex 5 mg 238 EUR

Immunization Grade Bovine Type II Collagen, 2 mg/ml x 5ml

20022 Chondrex 2 mg/ml x 5 ml 234 EUR

Immunization Grade Human Type I Collagen, 1 mg, lyophilized

1065 Chondrex 1 mg 315 EUR

Immunization Grade Mouse Type I Collagen, 5 mg, lyophilized

1066 Chondrex 5 mg 206 EUR

Immunization Grade Chick Type IX Collagen, 5 mg, lyophilized

1071 Chondrex 5 mg 331 EUR

Immunization Grade Chick Type XI Collagen, 5 mg, lyophilized

1081 Chondrex 5 mg 271 EUR

Immunization Grade Human Type XI Collagen, 1 mg, lyophilized

1085 Chondrex 1 mg 353 EUR

Immunization Grade Chick Type II Collagen, 10 mg, lyophilized

20011 Chondrex 10 mg 234 EUR

Immunization Grade Human Type II Collagen, 1 mg, lyophilized

20051 Chondrex 1 mg 374 EUR

Immunization Grade Sheep Type II Collagen, 5 mg, lyophilized

20081 Chondrex 5 mg 238 EUR

Immunization Grade Chick Type II Collagen, 2 mg/ml x 5 ml

20012 Chondrex 2 mg/ml x 5 ml 234 EUR

Immunization Grade Human Type II Collagen, 2 mg/ml x 0.5 ml

20052 Chondrex 2 mg/ml x 0.5 ml 374 EUR

Immunization Grade Mouse Type II Collagen, 2 mg/ml x 0.5 ml

20062 Chondrex 2 mg/ml x 0,5 ml 216 EUR

Immunization Grade Porcine Type II Collagen, 2 mg/ml x 5ml

20032 Chondrex 2 mg/ml x 5 ml 234 EUR

Immunization Grade Bovine Type I Collagen, 10 mg, lyophilized

1062 Chondrex 10 mg 152 EUR
The program activities with the largest share of total weighted financial cost were training (37% of total) and service delivery (30%), while the largest shares of total weighted economic costs were service delivery (45%) and training (19%). Efforts by VHWs to reach OOS girls resulted in an additional US$ 2.99 in financial cost per dose and US$ 7.79 in economic cost per dose.
 The service delivery cost per dose was lower than that documented in the pilot program cost analysis in Zimbabwe and studies elsewhere, reflecting a campaign delivery approach that spread fixed costs over a large vaccination cohort. The additional cost of reaching OOS girls with the HPV vaccine was documented for the first time in low- and middle-income countries, which may provide information on potential costs for other countries.

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