As the first authorized COVID-19 vaccine in Japan, the BNT162b2 mRNA COVID-19 vaccine is utilized for mass vaccination. Although efficacy has been proved, real-world evidence on reactogenicity in Japanese personnel is needed to prepare the public. Healthcare workers in a large academic hospital in Japan received two doses of the Pfizer-BioNTech vaccine from March 17 to May 19, 2021. Online questionnaires were distributed to registered recipients following each dose, from day 0 through day 8. Primary outcomes are the frequency of reactogenicity including local and systemic reactions. Length of absence from work was also analyzed. Most recipients self-reported reactogenicity after the first dose (97.3%; n=3,254; mean age [36.4]) and after the second dose (97.2%; n=3,165; mean age [36.5]). Systemic reactions following the second dose were substantially higher than the first dose, especially for fever (OR, 27.38; 95% CI, [22.00-34.06]; p<0.001), chills (OR, 16.49; 95% CI, [13.53-20.11]; p<0.001), joint pain (OR, 8.49; 95% CI, [7.21-9.99]; p<0.001), fatigue (OR, 7.18; 95% CI, [6.43-8.02]; p<0.001) and headache (OR, 5.43; 95% CI, [4.80-6.14]; p<0.001). Reactogenicity was more commonly seen in young, female groups. 19.3% of participants took days off from work after the second dose (2.2% after the first dose), with 4.7% absent for more than two days. Although most participants reported reactogenicity, severe cases were limited. This study provides real-world evidence for the general population and organizations to prepare for BNT162b2 mRNA COVID-19 vaccination in Japan and other countries in the region.

Zinc is a nutritionally essential trace mineral that is required for the activity of more than 200 enzymes involved in most major metabolic pathways. As such, zinc is necessary for a wide range of biochemical, immunological, and clinical functions. 1 Mild zinc deficiency may cause impaired taste and smell, reduced immunity, and an increased risk of pneumonia, 2-3 and severe zinc deficiency may be associated with skin disorders, impaired vision, decreased lymphocyte function, diarrhea, and anorexia. 4

Antiretroviral therapy alters lipid metabolism in HIV-infected patients. However, interpreting the impact of HIV infection on lipid metabolism is difficult because of various associated factors, including antiretroviral drugs and demographic characteristics. A few studies have associated HIV infection with lipid metabolism in antiretroviral-naïve HIV-infected patients. Because there were no data in this regard from Japan, the present study examined the impact of HIV infection, as well as demographic and clinical features, on lipid metabolism in antiretroviral-naïve HIV-infected patients in Japan. We performed a cross-sectional study to examine the impact of HIV disease, demographic and clinical characteristics on lipid metabolism among 168 HIV-infected Japanese men who were antiretroviral naïve and who did not have hemophilia, including patients who took medication for dyslipidemia. The mean age of the patients was 45.7 years; 0.6% of the patients took medication to dyslipidemia. The mean CD4 lymphocyte count was 289/μL, the mean baseline log10 HIV viral load was 4.2 HIV-1 RNA copies/mL, and 22% of the patients had a history of AIDS-defining events. A higher HDL-C concentration was associated with a higher CD4 lymphocyte count (p = 0.043). Also, a higher LDL-C concentration was associated with a higher CD4 lymphocyte count (p = 0.003). Infection with HIV was associated with dyslipidemia in antiretroviral-naïve patients. More advanced HIV disease was associated with less favorable lipid homeostatic profiles. These results are similar to findings from other countries.

Background The impact of subcutaneous fat accumulation remains controversial. This study assessed the association between visceral or subcutaneous fat area (VFA and SFA, respectively) and diabetes mellitus (DM) among Japanese subjects. Methods This was a cross-sectional study involving 1907 eligible participants (men, 1050; women, 857) who participated in a voluntary health check-up conducted at Juntendo University Hospital from January 2017 to December 2018, in Tokyo, Japan. Associations between VFA or SFA quartiles and DM were identified using adjusted odds ratios (AORs) and 95% confidence intervals (CIs) with multivariable logistic regression analysis adjusted for confounders. Receiver operating characteristic (ROC) curve analysis was used to assess appropriate cut-off values of VFA or SFA. Results Multivariate analyses showed that Q4 (≥ 125 cm2) of VFA was significantly positively associated with DM compared to Q1 (< 65 cm2) (AOR = 1.94, 95% CI 1.02–3.71), whereas there was no association between SFA and DM in men. Among women, Q4 (≥ 85 cm2) of VFA was significantly positively associated with DM compared to Q1 (< 30 cm2) (Q4, AOR = 6.15, 95% CI 1.65–22.99). Also, Q3 and Q4 (≥ 135 cm2) of SFA were significantly positively associated with DM compared to Q1 (< 90 cm2) (Q3, AOR = 5.64, 95% CI 1.21–26.25; Q4, AOR = 7.81, 95% CI 1.71–35.65). The appropriate cut-off value of VFA in men was 101.5 cm2. Those of VFA and SFA in women were 72.5 cm2 and 165.3 cm2, respectively. Conclusions Our results suggest the importance of considering SFA as well as VFA, especially in women, for primary and secondary prevention of DM.

In this study, we compared Ma Huang Tang (maoto), a traditional Japanese medicine (Kampo), with antiviral drugs to evaluate their respective and combined effect on the duration of fever and other subjective symptoms of influenza. Forty-five patients enrolled in this randomized control trial had positive type A influenza on rapid influenza antigen test, provided written consent, and sought treatment at Juntendo University Hospital between November 2008 and March 2009. Using a computer-gen- erated list, patients were randomly assigned to one of the four intervention groups: 1): maoto (TJ-27), 9 subjects; 2): Tamiflu (oseltamivir), 13 subjects; 3): Relenza (zanamivir), 6 subjects; and 4): maoto/oseltamivir combination, 9 subjects. Six outcome measures were evaluated, including fever, myalgia, headache, arthralgia, fatigue, and cough. Statistical differences were determined by the Bonferroni-adjusted t-test for multiple comparisons. Our results showed that there were no significant differences among the four groups in the time-course profile of fever and the number of days until fever resolution since treatment was initiated. In addition, no significant intergroup differences were detected in the number of days until resolution of myalgia, headache, fatigue, and cough. However, the maoto group reported a more rapid improvement in joint pain than the oseltamivir group (P = 0.01). In conclusion, maoto showed comparable efficacy as antiviral medications in reducing fever and influenza symptoms. As serious concerns over the indiscriminate use, adverse reactions, and resistance to current antiviral drugs continue to grow, maoto may serve as an elegant option for the treatment of influenza