Messenger RNA (mRNA) BNT162b2 (Pfizer-BioNTech) and mRNA-1273 (Moderna) COVID-19 vaccines have been shown to be effective in preventing symptomatic COVID-19 in randomized placebo-controlled Phase III trials (1,2); however, the benefits of these vaccines for preventing asymptomatic and symptomatic SARS-CoV-2 (the virus that causes COVID-19) infection, particularly when administered in real-world conditions, is less well understood Using prospective cohorts of health care personnel, first responders, and other essential and frontline workers* in eight US locations during December 14, 2020-March 13, 2021, CDC routinely tested for SARS-CoV-2 infections every week regardless of symptom status and at the onset of symptoms consistent with COVID-19-associated illness Among 3,950 participants with no previous laboratory documentation of SARS-CoV-2 infection, 2,479 (628%) received both recommended mRNA doses and 477 (121%) received only one dose of mRNA vaccine† Among unvaccinated participants, 138 SARS-CoV-2 infections were confirmed by reverse transcription-polymerase chain reaction (RT-PCR) per 1,000 person-days§ In contrast, among fully immunized (≥14 days after second dose) persons, 004 infections per 1,000 person-days were reported, and among partially immunized (≥14 days after first dose and before second dose) persons, 019 infections per 1,000 person-days were reported Estimated mRNA vaccine effectiveness for prevention of infection, adjusted for study site, was 90% for full immunization and 80% for partial immunization These findings indicate that authorized mRNA COVID-19 vaccines are effective for preventing SARS-CoV-2 infection, regardless of symptom status, among working-age adults in real-world conditions COVID-19 vaccination is recommended for all eligible persons

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Interim Estimates of Vaccine Effectiveness of BNT162b2 and mRNA-1273 COVID-19 Vaccines in Preventing SARS-CoV-2 Infection Among Health Care Personnel, First Responders, and Other Essential and Frontline Workers - Eight U.S. Locations, December 2020-March 2021.

Comparing COVID-19 vaccines for their characteristics, efficacy and effectiveness against SARS-CoV-2 and variants of concern: A narrative review.

http://manuscript.elsevier.com/S1198743X21006042/pdf/S1198743X21006042.pdf

Comparing COVID-19 vaccines for their characteristics, efficacy and effectiveness against SARS-CoV-2 and variants of concern: a narrative review

http://www.cell.com/article/S0092867422000769/pdf

Immune imprinting, breadth of variant recognition, and germinal center response in human SARS-CoV-2 infection and vaccination

Background In mid-December 2020, Israel started a nationwide mass vaccination campaign against coronavirus disease 2019 (COVID-19) In the first few weeks, medical personnel, elderly citizens, and patients with chronic diseases were prioritized As such, patients with primary and secondary immunodeficiencies were encouraged to receive the vaccine Although the efficacy of RNA-based COVID-19 vaccines has been demonstrated in the general population, little is known about their efficacy and safety in patients with inborn errors of immunity (IEI) Objective Our aim was to evaluate the humoral and cellular immune response to COVID-19 vaccine in a cohort of patients with IEI Methods A total of 26 adult patients were enrolled, and plasma and peripheral blood mononuclear cells were collected from them 2 weeks following the second dose of Pfizer-BioNTech COVID-19 vaccine Humoral response was evaluated by testing anti–SARS-CoV-2 spike (S) receptor-binding domain and antinucleocapsid antibody titers and evaluating neutralizing ability by inhibition of receptor-binding domain–angiotensin-converting enzyme 2 binding Cellular immune response was evaluated by using ELISpot, estimating IL-2 and IFN-γ secretion in response to pooled SARS-CoV-2 S- or M-peptides Results Our cohort included 18 patients with a predominantly antibody deficiency, 2 with combined immunodeficiency, 3 with immune dysregulation, and 3 with other genetically defined diagnoses Twenty-two of them were receiving immunoglobulin replacement therapy Of the 26 patients, 18 developed specific antibody response, and 19 showed S-peptide–specific T-cell response None of the patients reported significant adverse events Conclusion Vaccinating patients with IEI is safe, and most patients were able to develop vaccine-specific antibody response, S-protein–specific cellular response, or both

Immunogenicity of Pfizer-BioNTech COVID-19 vaccine in patients with inborn errors of immunity.

SARS-CoV-2 Vaccine and Infection in Health Workers After more than 36,500 health care workers at the University of California received at least one dose of vaccine, 71% of 379 workers with positive...

https://www.nejm.org/doi/pdf/10.1056/NEJMc2101927

SARS-CoV-2 Infection after Vaccination in Health Care Workers in California.

Resurgence of Covid-19 in Vaccinated Health Workers From March through July 2021, a total of 227 health care workers at UCSD, 57% of whom were fully vaccinated, tested positive for SARS-CoV-2; the ...

https://www.nejm.org/doi/pdf/10.1056/NEJMc2112981

Resurgence of SARS-CoV-2 Infection in a Highly Vaccinated Health System Workforce.

Abstract Background Early medical subspecialty training is an emerging trend in medical education. These electives are still rare for Early Clinical Medical Students (ECMS). We describe the introduction of an Infectious Disease (ID) inpatient consult rotation elective for ECMS. Methods In addition to seeing patients and rounding with the inpatient ID consult team, we created a supplemental curriculum to provide added support for ECMS that included a checklist of clinical skills learning objectives, self-directed, publicly available mini-lectures on ID topics, and an ID Coach who provided directed and personalized tutoring for students. We surveyed ECMS, ID fellows and attendings on service, and ID Coaches to evaluate the acceptability, feasibility, and effectiveness of this rotation and curriculum. Results The majority of ECMS reported that the rotation was a useful educational experience and that the ID Coach was one of the most valuable aspects of the rotation. The majority of ID fellows and attendings reported that working with ECMS improved their job satisfaction and well-being. Conclusions This multifaceted approach to early medical subspecialty training was valuable for ECMS, ID fellows, and faculty. Ongoing improvements in this curriculum will provide a useful tool for medical education.

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Jocelyn Keehner

Papers

SARS-CoV-2 Infection after Vaccination in Health Care Workers in California.

Resurgence of SARS-CoV-2 Infection in a Highly Vaccinated Health System Workforce.

Evaluation of an Infectious Diseases Elective for Early Clinical Medical Students on Their Internal Medicine Clerkship