Several COVID 19 vaccines have been shown to be up to 95% effective in preventing symptomatic COVID 19 infections. Globally, 17 vaccines are licensed by at least one national regulatory authority for public use. In total, 308 vaccine candidates are in various stages of development as of March 2021. Annual flu vaccination is also a part of public health recommendations in several countries as a preventative strategy to curb the seasonal epidemic that affects millions of people every year. More than 2.4 billion doses of COVID-19 vaccine have been administered globally, and this ongoing mass vaccination campaign will undoubtedly coincide with seasonal flu vaccination campaigns. The timing of booster doses of the COVID-19 vaccine in many countries will likely overlap with the 2021-2022 flu season in many contexts. Additionally, many other countries may still administer the first doses of COVID-19 vaccines during flu season. There are currently insufficient data regarding the co-administration of COVID-19 vaccines with other vaccines.
In order for effective public health policies, it is essential to understand how co-administration affects safety and immune responses. Researchers from the UK recently reported the results of a secondary study evaluating the safety, efficacy and immunogenicity of the NVX-CoV2373 vaccine when co-administered with an approved seasonal flu vaccine formula. This substudy was part of a UK Phase 3 randomized study on the safety and efficacy of the NVX-CoV2373 vaccine. Approximately 400 participants in the main study were selected for the secondary study who met the entry criteria for the substudy and had no contraindications to the flu shot. Participants in the substudy were randomized in a 1: 1 ratio to receive NVX-CoV2373 (n = 217) or placebo (n = 214) and received an approved and age-appropriate influenza vaccine along with the first dose of NVX-CoV2373. The substudy participants were younger and more racially diverse than the main study participants. They also had fewer comorbid conditions.
Participants were also monitored for physician-assisted adverse events (AEs) (MAAE), unsolicited adverse events (AEs), and serious AEs (SAEs). The most common reactogenic events in the co-administration group were tenderness or pain at the injection site, fatigue and muscle pain. Although co-administration of the vaccines did not result in any change in the immune response to the seasonal influenza vaccine. A reduction in antibody response to NVX-CoV2373 vaccine was observed. While the vaccine efficacy in the main study was 89.8%, the efficacy in the secondary study was 87.5%. According to the authors, this is the first study demonstrating the safety, efficacy and immunogenicity of a COVID-19 vaccine when co-administered with seasonal flu vaccines. The study results suggest that co-administration of COVID and flu vaccines is quite safe and could be a viable immunization strategy. It has also been suggested that preventive vaccination for other pathogens, particularly tetanus, may provide protection against severe COVID-19.
To identify factors that moderate the pathogenic effects of SARS-CoV-2, Jennifer Monereo-Sánchez et al., In a recent study, tested whether vaccination against other pathogens protects individuals against severe COVID-19. The researchers found that people with registered diphtheria or tetanus vaccinations were less likely to develop severe COVID-19 than people who had only received other vaccinations. In this study, the researchers used vaccination records of individuals from the large UK Biobank (UKB) population cohort, combined with data on COVID-19 testing and related hospitalization, comparing people vaccinated for DTP (diphtheria, tetanus and pertussis) than vaccinated ones. for other pathogens. The full sample size of the study was 103,049 individuals with a mean age of 71.46 years in March 2020; 54.19% of the sample was female. The researchers extracted the vaccination information for each participant, ranking them based on whether they received the vaccination for tetanus, diphtheria, pertussis, or any other vaccine (flu, measles, hepatitis, etc.).
Due to the important observations on the possible relationship of BCG vaccination with COVID-19 severity, the researchers identified individuals (n = 96) who were vaccinated with BCG and excluded them from this study. The results for those vaccinated for diphtheria and tetanus were similar: the researchers found that they tended to be less likely to test positive for COVID-19 than those not vaccinated. Using a large-scale elderly population sample, this study found that individuals vaccinated against diphtheria or tetanus in the past decade were half as likely to develop severe COVID-19 as people without these vaccinations. In particular, a history of diphtheria or tetanus vaccinations is associated with less severe manifestations of COVID-19: protection perhaps is by stimulating the immune system. The researchers undertook this study based on the hypothesis that previous vaccinations for other pathogens, particularly tetanus, may protect against severe COVID-19. For example, BCG vaccine against tuberculosis is known to boost the innate immune system and reduce respiratory tract infections.
Some studies have found a relationship between national BCG vaccination programs and death rates from COVID-19. The researchers, however, caution that further investigation of this research is needed due to the correlational nature of these findings.
- Edited by Dr. Gianfrancesco Cormaci, PhD, specialist in Clinical Biochemistry.
Toback S et al. medRxiv, 2021 Jun 9:21258556.
Monereo SJ et al. medRxiv 2021 Jun 9:21257809.
Dott. Gianfrancesco Cormaci
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