Impaired Humoral Response in Renal Transplant Recipients to SARS-CoV-2 Vaccination with BNT162b2 (Pfizer-BioNTech)

The severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) has a major impact on transplant recipients, with mortality rates up to 20%. Therefore, the effect of established messenger RNA (mRNA)-based SARS-CoV-2 vaccines have to be evaluated for solid organ transplant patients (SOT) since they are known to have poor responses after vaccination. We investigated the SARS-CoV-2 immune response via SARS-CoV-2 IgG detection in 23 renal transplant recipients after two doses of the mRNA-based SARS-CoV-2 vaccine BNT162b2 following the standard protocol. The antibody response was evaluated once with an anti-SARS-CoV-2 IgG CLIA 15.8 +/− 3.0 days after the second dose. As a control, SARS-CoV-2 IgG was determined in 23 healthcare workers (HCW) and compared to the patient cohort. Only 5 of 23 (22%) renal transplant recipients were tested positive for SARS-CoV-2 IgG antibodies after the second dose of vaccine. In contrast, all 23 (100%) HCWs were tested positive for antibodies after the second dose. Thus, the humoral response of renal transplant recipients after two doses of the mRNA-based vaccine BNT162b2 (Pfizer-BioNTech, Kronach, Germany) is impaired and significantly lower compared to healthy controls (22% vs. 100%; p = 0.0001). Individual vaccination strategies might be beneficial in these vulnerable patients.

Covid-19 Vaccination Options for Immunosuppressed Cancer Patients

Background: Currently, many COVID-19 vaccine candidates are being developed to end the pandemic; however, immunosuppressed cancer patients have been excluded from the participating criteria. It is important that they are able to examine their options for achieving immunity against COVID-19. Purpose: This review aims to discuss the available options that can be taken to vaccinate immunosuppressed cancer patients when no vaccine is being developed for their safety. Method: A literature study was conducted using Google Scholar, DOAJ, and GARUDA Library on November 2, 2020, focusing on articles examining vaccination guidelines for immunosuppressed cancer patients. Results: The search found 200 articles, which were curated to obtain 13 articles that satisfied all inclusion criteria. These consist of four guidelines, five reviews, and four research articles. Based on the literature, immunosuppressed cancer patients have the option to use the vaccines currently under development, with precautions set for live attenuated and potentially infectious vaccines. Vaccination timing also needs to be adjusted so as to fall at a certain time before or after the immunosuppressive condition. Moreover, a more complete COVID-19 immunity can be achieved through a synergy between individual vaccination and the construction of herd immunity. Conclusion: Most of the vaccines currently under development may be safe for cancer patients, being mindful of several considerations. Here, herd immunity can serve as a complement to individual immunity.

New features of pertussis vaccination

The review provides information about the current features of the spread of whooping cough among children and adolescents. It is shown that there is a shift in morbidity to an older age group of the population, which is facilitated by changes in the properties of the pathogen and the widespread use of drugs based on cell-free technology as primary vaccination. Information is given about the possibility of preventing morbidity among schoolchildren and adults by introducing additional revaccinating doses against whooping cough with special drugs in the vaccination calendars. Information is given on effective protection of newborns against this infection by immunization of pregnant women. In our country, there is an opportunity to expand pertussis immunoprophylaxis among children of preschool-school age and adults within regional programs and individual vaccination with acellular pertussis-diphtheria-tetanus vaccines, which has a high profile of safety and immunological effectiveness.

Using Behavioral Insights to Increase Vaccination Policy Effectiveness

Even though there are policies in place, and safe and effective vaccines available, almost every country struggles with vaccine hesitancy, that is, a delay in acceptance or refusal of vaccination. Consequently, it is important to understand the determinants of individual vaccination decisions to establish effective strategies to support the success of country-specific public health policies. Vaccine refusal can result from complacency, inconvenience, a lack of confidence, and a rational calculation of pros and cons. Interventions should, therefore, be carefully targeted to focus on the reason for non-vaccination. We suggest that there are several interventions that may be effective for complacent, convenient, and calculating individuals whereas interventions that might be effective for those who lack confidence are scarce. Thus, efforts should be concentrated on motivating the complacent, removing barriers for those for whom vaccination is inconvenient, and adding incentives and additional utility for the calculating. These strategies might be more promising, economic, and effective than convincing those who lack confidence in vaccination.

A strategy to increase and assess vaccine coverage in the north of Portugal

In the Northern Health Region of Portugal, vaccine coverage is measured by checking and studying individual vaccination records in health centres. Each year from 2001-2004, birth cohorts completing 2, 6 and 14 years of age were selected for assessment. Data collection occurred on January the following year and meetings with district immunisation coordinators took place every March. For all vaccines and birth cohorts considered, vaccine coverage values observed in the north of Portugal were excellent. In this paper, we make comparisons with published international data on vaccine coverage and discuss validity issues; we believe that no serious biases have affected the validity of our vaccine coverage data but comparisons with international data must be addressed with caution; the methods we used have been useful in increasing vaccination coverage.