Severe adverse events more likely in previously infected COVID vaccinees
Americans who received an mRNA COVID-19 vaccine after SARS-CoV-2 infection are more likely to experience severe systemic adverse events (AEs) than their never-infected counterparts, according to a study published yesterday in Vaccine.
Researchers from the US Centers for Disease Control and Prevention (CDC) used v-safe vaccine surveillance data and online follow-up surveys from 3,862 adults who reported severe systemic AEs after receiving their first dose from Dec 14, 2020, to May 16, 2021. Each participant was matched with three vaccinated controls who reported no AEs. Most (90.1% of participants and 94.8% of controls) didn't report testing positive for COVID-19 before vaccination.
Among previously infected participants, the likelihood of severe AEs was 2.4 (95% confidence interval [CI], 1.89 to 3.09) times higher after receipt of the Moderna vaccine and 1.5 (95% CI, 1.17 to 2.02) times higher after the Pfizer/BioNTech vaccine than that of their COVID-naïve peers.
A total of 0.5% of all study participants reported visiting an emergency department or being hospitalized for AEs after the second dose. The greatest risk was seen in Moderna recipients who had tested positive for COVID-19 30 or fewer days before receipt of dose 1 (adjusted odds ratio, 6.05 compared with controls). But most participants who had severe systemic AEs after the first dose didn't require medical care in the 7 days after the second dose.
"Vaccine providers can use these findings to counsel patients who had pre-vaccination SARS-CoV-2 infection histories, experienced severe systemic AEs following dose 1, and are considering not receiving additional mRNA COVID-19 vaccine doses," the researchers wrote.
The authors noted that clinical trials of the Moderna and Pfizer COVID-19 vaccines had excluded people with a history of confirmed infection, limiting the understanding of the risk of AEs in this population.
"COVID-19 vaccine studies that include participants with a history of SARS-CoV-2 infection and collect data on immunological responses to SARS-CoV-2 infection and vaccination at study entry and following primary series and booster vaccinations may inform the development of future COVID-19 vaccines and the policies for their use," they concluded.
Nov 1 Vaccine study
Increased COVID-19 knowledge in teens linked to better mental health
US teens who could correctly answer survey questions about COVID-19 reported lower stress, anxiety, and depression as well as less loneliness and fear of missing out, according to a study today in Journal of Child and Family Studies.
The study analyzed surveys given by Washington State University (WSU) researchers to 215 teens in July of 2020. The survey was made up of 18 true or false statements about COVID-19, including how the virus is spread: 21.9% got all the answers correct, while most teens answered at least 15 out of 18 correctly.
Teen participants were also asked about social media use and general well-being. Almost all —98.1% — of teens reported using social media, but those who used the platform less reported lower levels of anxiety
"Knowledge was a good thing. The teens who did better on our quiz tended to report lower depression, anxiety and stress—just across the board," corresponding author Chris Barry, PhD, a WSU psychology professor, said in a university press release. "This is a one-time snapshot, so we don't really know cause and effect, but one presumption is that having accurate information was connected to feeling a little bit more ease during that time."
Oct 19 J Child Fam Stud study
Nov 2 WSU press release
Global COVID-19 cases decline except in Americas and Western Pacific
At the global level, COVID-19 cases fell again last week, down 17% from the week before, the World Health Organization (WHO) said today in its latest weekly update. Cases were up 5%, however, in the Americas and the Western Pacific.
Deaths were down 5% overall, but levels rose in four regions: Africa, the Americas, Southeast Asia, and the Western Pacific.
In the Americas, countries reporting the highest proportional increases last week were Guatemala, Panama, and Peru. Chile and Brazil also reported notable rises of 21% and 22%, respectively. In the Western Pacific, New Zealand and Mongolia saw the biggest proportional rises. Japan's cases rose 21% compared to the previous week, and South Korea's were up 37%.
Regarding variant spread, the WHO said that for the week ending Oct 16, BA.2.75 prevalence rose from 2.9% to 3.7%, with BQ.1 lineages rising from 5.7% to 9.0%, and XBB rising from 1.0% to 1.5%. Also, the prevalence of BA.5 lineages with additional spike mutations increased from 19.5% to 21.0%. Levels of BA.4.6 held steady, at 4.1%.
Last week, the WHO's virus evolution advisory group weighed in on the latest Omicron variant changes and held off on designating XBB and BQ.1 sublineages as variants of concern. BQ.1 proportions are rising rapidly in Europe and the United States, and XBB levels are rising in parts of Asia.
Nov 2 WHO weekly COVID update