Venereal Disease Information 

About: Venereal Disease Information is an academic journal published by American College of Physicians. The journal publishes majorly in the area(s): Medicine & Syphilis. It has an ISSN identifier of 0003-4819. Over the lifetime, 1069 publications have been published receiving 2212 citations. The journal is also known as: Annals.org.

Antibody Response to a Fourth Messenger RNA COVID-19 Vaccine Dose in Kidney Transplant Recipients: A Case Series

Abstract: Background: Kidney transplant recipients receiving immunosuppressive drugs have impaired immune responses to messenger RNA (mRNA) COVID-19 vaccines (1). Consequently, despite standard vaccination with mRNA vaccines, many of these patients remain at high risk for severe disease during the ongoing pandemic. The U.S. Food and Drug Administration has authorized immunocompromised people to receive a third dose of mRNA vaccine after the standard 2-dose regimen to further boost protection, and French health authorities approved a third dose on 11 April 2021. Subsequent studies found that approximately 50% of patients who did not respond after a second dose seroconverted after a third dose, which produced an overall seroconversion rate of about 65% (2, 3). Antispike IgG titers above 143 binding antibody units (BAU) per milliliter correlate with the presence of neutralizing antibodies (the most widely accepted marker of disease protection) against the wild-type virus and the Alpha, Beta, and Gamma variants, but neutralization of the Delta variant requires higher antispike IgG titers (4). Therefore, patients with low titers of antispike IgG may remain insufficiently protected. In June 2021, French health authorities approved offering a fourth vaccine dose to recipients of solid organ transplants who had a weak response after a third dose. Objective: To investigate whether a fourth dose of an mRNA-based anti–SARS-CoV-2 vaccine would increase antispike IgG titers in kidney transplant recipients who showed a weak serologic response after 3 doses. Case Report: A fourth dose of mRNA vaccine (BNT162b2 [Pfizer], n= 34; mRNA-1273 [Moderna], n= 58) was given to 92 kidney transplant recipients from 3 independent French university hospitals (Strasbourg, Lyon, and Nantes) who had antispike IgG titers less than 143 BAU/mL 1 month after a third dose. All had measurements of antispike IgG titers 2 to 6 weeks later (median, 29 days [interquartile range, 26 to 34 days]). The Table shows the characteristics of these patients. There were no safety concerns with the fourth vaccine dose. After a median of 29 days, median antispike IgG levels increased from 16.4 BAU/mL (interquartile range, 5.9 to 62.3 BAU/mL) to 145 BAU/mL (interquartile range, 27.6 to 243 BAU/mL) (Figure) and 50% of patients reached the threshold of 143 BAU/mL. Patients who reached this threshold had a longer interval between their transplant and fourth vaccine dose and were less frequently treated with steroids (Table). The percentage of patients who had antispike IgG titers above 143 BAU/mL after the fourth dose was 48% for the BNT162b2 vaccine and 52% for the mRNA-1273 vaccine, and patients who received the mRNA-1273 vaccine had higher IgG titers (median, 150 vs. 122 BAU/mL). Only 1 patient was subsequently diagnosed with mild COVID-19, and he had an antispike IgG level of 28 BAU/mL 1 month after his fourth vaccine dose. Discussion: Our study indicates that a fourth dose of an mRNA-based vaccine produces a satisfactory antibody response in some kidney transplant recipients who did not respond adequately after 3 previous doses, and it supports the

A Novel International Monkeypox Outbreak

Abstract: Few clinicians practicing in the United States have ever seen a case of monkeypox infection. However, a new, unusual, multinational outbreak of monkeypox that is unfolding rapidly makes it important to know what a case might look like. This is critical not only to permitting rapid and proper medical and public health interventions but also to helping to understand the extent and spread of the outbreak. The current outbreak—which includes confirmed or suspected cases in the United States, the United Kingdom, Spain, Portugal, Italy, Belgium, Sweden, France, Canada, Australia, Germany, and the Netherlands— appears to have a pattern of spread that does not mirror past outbreaks outside of Africa, almost all of which have been related to importation via flights fromAfrica or exposure to infected exotic pets (1). This unusual monkeypox outbreak should prompt all clinicians to be attuned to the possibility of this infectious disease. Clinicians who suspect they may have a patient with monkeypox should contact their state or local health department immediately.

Carditis After COVID-19 Vaccination With a Messenger RNA Vaccine and an Inactivated Virus Vaccine

Abstract: Cases of carditis after the use of a messenger RNA (mRNA) COVID-19 vaccine have been reported in various populations worldwide. However, few studies have directly evaluated this association. Furthermore, it is unclear whether this potential risk involves vaccine platforms other than mRNA vaccines. This case–control study from Hong Kong aimed to examine the association between COVID-19 vaccination with an mRNA vaccine or an inactivated virus vaccine and the subsequent risk for carditis. The results of this study could be useful for public health policymakers to weigh the risk and benefit of population-wide COVID-19 vaccination programs.

Detection of Monkeypox Virus in Anorectal Swabs From Asymptomatic Men Who Have Sex With Men in a Sexually Transmitted Infection Screening Program in Paris, France

Abstract: Background: A monkeypox virus (MPXV) outbreak emerged in May 2022, affecting mostly men who have sex with men (MSM). Although most infections were characterized by cutaneous lesions, a recent report described 3 asymptomatic men with no cutaneous lesions but with positive results on anorectal MPXV polymerase chain reaction (PCR) testing (1). Determining whether MPXV infection can be asymptomatic may better inform epidemic management. Objective: To assess the presence of MPXV in anorectal samples among asymptomatic MSM routinely tested for bacte-rial sexually transmitted infections (2). Methods and Findings: We retrospectively performed testing for MPXV on all anorectal swabs that were collected in our center as part of a screening program for Neisseria gonorrhoeae and Chlamydia trachomatis . Per French guidelines, this screening is performed every 3 months among MSM with multiple sexual partners who are either taking HIV preexposure prophylaxis (PrEP) or living with HIV and receiving antiretroviral treatment could have urine samples and anal swabs collected at our clinic or a private laboratory. After the fi rst case of MPXV identi fi ed in France on 19 May 2022, screening was halted in patients who had lesions suspicious for MPXV We report on asymptomatic MSM who tested negative for N gonorrhoeae and C trachomatis on MPXV anal swabs collected the Infectious Disease and the Sexual Health Clinic Bichat-Claude Paris, France, from 5 June to routine

Case Series of Thrombosis With Thrombocytopenia Syndrome After COVID-19 Vaccination—United States, December 2020 to August 2021

Abstract: Using the Vaccine Adverse Event Reporting System, the number and demographic characteristics of cases of thrombosis with thrombocytopenia syndrome occurring after receipt of COVID-19 vaccines in the United States were determined.