Featured Cover Konstorum, Anna; Mohanty, Subhasis; Zhao, Yujiao ...
Aging cell,
February 2023, Letnik:
22, Številka:
2
Journal Article
Recenzirano
Odprti dostop
Cover legend: The cover image is based on the Research Article Platelet response to infl uenza vaccination refl ects effects of aging by Anna Konstorum et al., https://doi.org/10.1111/acel.13749. ...Image Credit: Hannah Wang
Background: After primary vaccination schemes with rAd26-rAd5 (Sputnik V), ChAdOx1 nCoV-19, BBIBP-CorV or heterologous combinations, the effectiveness of homologous or heterologous boosters (Sputnik ...V, ChAdOx, Pfizer-BioNTech, Moderna) against SARS-CoV-2 infections, hospitalisations and deaths has been scarcely studied. Methods: Test-negative, case–control study, conducted in Argentina during omicron BA.1 predominance, in adults ≥50 years old tested for SARS-CoV-2 who had received two or three doses of COVID-19 vaccines. Outcomes were COVID-associated infections, hospitalisations and deaths after administering mRNA and vectored boosters, < or ≥60 days from the last dose. Findings: Of 422,124 individuals tested for SARS-CoV-2, 221,993 (52.5%) tested positive; 190,884 (45.2%) and 231,260 (54.8%) had received 2-dose and 3-dose vaccination schemes, respectively. The 3-dose scheme reduced infections, hospitalisations and death (OR 0.81 0.80–0.83; 0.28 0.25–0.32 and 0.25 0.22–0.28 respectively), but protection dropped after 60 days to 1.04 1.01–1.06; 0.52 0.44–0.61 and 0.38 0.33–0.45). Compared with 2-dose-schemes, homologous boosters after primary schemes with vectored-vaccines provided lower protection against infections < and ≥60 days (0.94 0.92–0.97 and 1.05 1.01–1.09, respectively) but protected against hospitalisations (0.30 0.26–0.35) and deaths (0.29 0.25–0.33), decreasing after 60 days (0.59 0.47–0.74 and 0.51 0.41–0.64, respectively). Heterologous boosters protected against infections (0.70 0.68–0.71) but decreased after 60 days (1.01 0.98–1.04) and against hospitalisations and deaths (0.26 0.22–0.31 and 0.22 0.18–0.25, respectively), which also decreased after 60 days (0.43 0.35–0.53 and 0.33 0.26–0.41, respectively). Heterologous boosters protected against infections when applied <60 days (0.70 0.68–0.71, p < 0.001), against hospitalisations when applied ≥60 days (0.43 0.35–0.53, p < 0.01), and against deaths < and ≥60 days (0.22 0.18–0.25, p < 0.01 and 0.33 0.26–0.41, p < 0.001). Interpretation: During omicron predominance, heterologous boosters such as viral vectored and mRNA vaccines, following Sputnik V, ChAdOx1, Sinopharm or heterologous primary schemes might provide better protection against death; this effect might last longer in individuals aged ≥50 than homologous boosters. Funding: None.
•The term ‘vaccine hesitancy’ is increasingly used to explain sub-optimal vaccination coverage.•The accepted definition includes ‘confidence’, ‘complacency’ and ‘convenience’.•We contend the ...inclusion of ‘convenience’ is problematic.•Insufficient emphasis is given to the social determinants of vaccination.•Accurate terminology is needed for researchers and providers to address under-vaccination.
Although vaccination uptake is high in most countries, pockets of sub-optimal coverage remain posing a threat to individual and population immunity. Increasingly, the term ‘vaccine hesitancy’ is being used by experts and commentators to explain sub-optimal vaccination coverage. We contend that using this term to explain all partial or non-immunisation risks generating solutions that are a poor match for the problem in a particular community or population. We propose more precision in the term ‘vaccine hesitancy’ is needed particularly since much under-vaccination arises from factors related to access or pragmatics. Only with clear terminology can we begin to understand where the problem lies, measure it accurately and develop appropriate interventions. This will ensure that our interventions have the best chance of success to make vaccines available to those who want them and in helping those who are uncertain about their vaccination decision.
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