Angel Justiz-Vaillant, Kimberly Roopnarine, Shaundell Solomon, Alyssa Phillips, Solange Salandy, Alyssa Subero, Sarah Seepersad, Nicholas Span, Phalmanie Ramnath, Akaasha Ramnarine, Bimala Ramdath, Chelsea Rampaul, Renissa Ramdial, Dana Phagoo, Thalia Ramdhanie, Vinaya Moonilal, Emily-Marie Poliah, Steffan Poonwassie, Karishta Punilal, Sarah Panchoo, Justice Parris, Steven Oudit, Trudy Muir, Johnson Nicholas-Joseph, Sanjeev Pakeerah, Vesham Sookoo, Patrice Richards, Tishia John, Darren Avinash Gopaul, Sachin Soodeen, Odette Arozarena-Barbosa, Arlene Williams, Chandrashehkar Unakal, Rodolfo Arozarena-Fundora, Reinand Thompson, Patrick E. Akpaka, Wezenet Tewodros, West Indian Immunology Society
Subject:
Medicine And Pharmacology,
Immunology And Allergy
Keywords:
Pfizer-BioNTech; Modern; Novavax; AstraZeneca; Sinopharm; Janssen; vaccine effectiveness (VE); COVID-19; Trinidad and Tobago
Online: 7 February 2024 (08:12:24 CET)
Vaccination against the SARS-CoV2 virus has shown great promise in managing the spread and severity of Covid-19. While these vaccines were able to provide a favourable response in controlling the SARS-CoV2 infection, its use came with accompanying side effects. This systematic review aimed to determine the effectiveness of the different Covid-19 vaccine subtypes and discover the side effects associated with each vaccine elsewhere but specially in Trinidad and Tobago. For this systematic review, the keywords “Pfizer-BioNTech OR Moderna OR Oxford-AstraZeneca OR Janssen OR Sinopharm OR Novavax AND Covid-19 vaccine efficacy” and “Covid-19 vaccines AND Trinidad and Tobago” were researched under PubMed, MEDLINE and other internet sources through which other notable journals, and documents were discovered and searched similarly as outlined previously. In doing so, 65 relevant articles were included as part of this review. Of the studies examined, overall the vaccine with the greatest VE was found to be Pfizer-BioNTech (95%), followed by Moderna (94.1%), Novavax (89.7%), AstraZeneca (70.4%), Sinopharm (67%) and finally Janssen (66.9%). The use of Pfizer-BioNTech or Moderna was most efficacious in response to the different Covid-19 variants. Some side effects were common for all vaccine types however adverse effects were more commonly seen with vaccination by mRNA vaccines, Pfizer-BioNTech and Oxford-Astrazeneca. Researchers targeted individuals aged 18 and above residing in various geographical areas of TT, specifically focusing on those who had not received the COVID-19 vaccine and expressed hesitancy towards it. Convenience sampling was used to select the study participants, and formal in-depth virtual interviews were conducted on a one-to-one basis, employing a semi-structured questionnaire to guide the discussions. The interviews were meticulously recorded and transcribed, following the principles of reflexive thematic analysis, to distill key insights from the participants' responses. The study's findings, derived from the perspectives of 25 participants, illuminated a complex tapestry of reasons underlying vaccine hesitancy in Trinidad and Tobago. Notably, prominent themes emerged, including fear, doubts regarding vaccine efficacy, a perceived inadequacy of information, a sense of susceptibility to the virus, deep-seated mistrust, alternative herbal remedies, and religious reservations. Interestingly, the motivations expressed by these vaccine-hesitant individuals for potentially receiving the vaccine in the future were rooted in notions of necessity, an increased sense of susceptibility to the virus, a desire to reach a certain health benchmark, and a need for assurance regarding the vaccine's safety and effectiveness. This comprehensive exploration of vaccine hesitancy in TT provides valuable insights for public health officials and policymakers in crafting targeted strategies to address this critical issue within the local context. Conclusion: The findings of this study determined that vaccination against the SARS-CoV2 virus provided beneficial outcomes against infection, Covid-19 related hospitalizations, ICU admissions and mortality. While vaccination was deemed highly appropriate in managing the spread of the SARS-CoV2 virus and enhancing the outcomes in infected persons, the effectiveness of the different vaccine platforms indicated that certain vaccine platforms are preferential to others in different populations. In terms of vaccine efficacy, nucleic acid vaccines such as Pfizer-BioNTech and Moderna showed the greatest effectiveness while inactivated whole virus vaccines such as Sinopharm and viral vectors like Janssen had the least effectiveness. The side effects, joint/muscle soreness, pain at the injection site, shoulder pain, headaches, fever, chills, weakness, epistaxis, renal and certain cardiovascular events were common for all vaccine types. Adverse effects were more frequent and severe with the mRNA vaccines by Pfizer-BioNTech and Oxford-Astrazeneca than inactivated whole virus vaccines. The data collected in this research can be very useful to help individuals make a decision on which vaccine would be appropriate for them. More long-term studies are needed to better gauge the scope of side effects for each vaccine type.
Subject:
Biology And Life Sciences,
Immunology And Microbiology
Keywords:
HIV; HPV; Prevalence; Vaccination strategy; HPV screening; cervical intraepithelial neoplasia
Online: 30 July 2024 (09:18:17 CEST)
Since the identification of acquired immunodeficiency syndrome (AIDS) in 1981, approximately 85.6 million people have been infected with HIV, resulting in 40.4 million deaths. As of 2022, 53% of the 39 million people living with HIV are women and girls. Despite the advent of antiretroviral therapy (ART) improving survival rates, cervical cancer remains prevalent among HIV-infected individuals. By 2030, cervical cancer is projected to cause 727,500 new cases and 432,000 deaths globally. Human papillomavirus (HPV) is a well-known cause of cervical cancer, with HIV infection exacerbating the prevalence of high-risk HPV (HR-HPV) and cervical intraepithelial neoplasia (CIN). HIV and HPV share transmission routes, and HIV worsens cervical carcinogenesis by inhibiting tumour suppressor genes and altering cell cycle regulation. Chronic inflammation and cytokine imbalances, notably increased IL-10 levels, are linked to cervical cancer progression. Despite ART improving overall health, cervical cancer remains a significant issue, highlighting the need for better screening and prevention measures. A cross-sectional study in Brazil evaluated cytokine levels in cervicovaginal lavage among HIV-positive women, revealing a high prevalence of specific HPV types. ART has been shown to reduce the likelihood of developing squamous intraepithelial lesions (SILs) and HR-HPV prevalence, although its impact on invasive cervical cancer remains inconclusive. In a study in Accra, 250 sexually active HIV-positive women exhibited a high HPV prevalence, emphasising the need for regular screening. HPV testing, visual inspection with acetic acid (VIA), and cytology-based tests are primary screening methods, each with specific advantages and limitations. A systematic review and meta-analysis indicated that ART is associated with a lower prevalence of HR-HPV and high-grade cervical lesions, suggesting that early ART initiation may reduce cervical lesion incidence and progression. HPV is a significant cause of sexually transmitted diseases, with high prevalence in sub-Saharan Africa. Studies show a substantial burden of HPV among men in the region, underscoring the potential benefits of HPV vaccination programs. A study in Tanzania highlighted a high prevalence of HR-HPV among HIV-positive men, suggesting the efficacy of HPV vaccines irrespective of HIV status. Cervical cancer rates in sub-Saharan Africa are alarmingly high, necessitating targeted vaccination and prevention strategies.