Response to BNT162b2 mRNA COVID-19 vaccine among healthcare workers in Italy: a 3-month follow-up—Reply

Ferrara, Pietro; Antonazzo, Ippazio Cosimo; Polosa, Riccardo

doi:10.1007/s11739-021-02911-9

Cited by 5 publications

(10 citation statements)

References 4 publications

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“…Understanding possible factors that might influence the interindividual variability in vaccine response is important to ensure an effective response to vaccines [16][17][18]20,53]. While the mechanisms by which smoking impairs the humoral responses to COVID-19 vaccines deserve further research, our rapid review evidences the adverse effect of tobacco product use against immunogenicity to COVID-19 vaccination.…”

Section: Discussionmentioning

confidence: 97%

“…Linardou et al speculated that the smoking-attributable immunosuppressive effect is mediated by direct effects on T cells and the dendritic-cell system, which impairs host response to vaccination [38,[48][49][50]. A recently published study from the VASCO project, an ongoing broad Italian study on the response to BNT162b2 mRNA COVID-19 vaccine in HCWs [16][17][18]20], underlined that cigarette smoking affects the ability to form memory cells that are critical to the maintenance of the protective immune response induced by vaccines, as well as smoking being associated with increased monocyte-macrophages counts, which may influence the clearance of circulating antibodies, whose half-life is of average 3-4 weeks (depending on IgG isotype and attributes) [18,20]. In Yamamoto, a lower decrease in vaccine-induced IgG levels was also seen in users of HNB tobacco products (compared with never smokers), although to a lesser extent than that associated with cigarette smoking.…”

Section: Discussionmentioning

confidence: 99%

“…Additionally, despite medRxiv being a preprint platform, without a peer-review process, it collects and publishes scientific reports on a very fast track, allowing us to consider the most updated available evidence [56]. In our view, this represents an important strength, especially considering the large number of studies conducted daily on COVID-19 [15][16][17]. Moreover, grey literature (webpages of international health authorities) was also consulted in order to collect and analyse all the available evidence.…”

Section: Discussionmentioning

confidence: 99%

“…With the rapid global diffusion of the coronavirus disease 2019 (COVID-19)-the disease due to the severe acute respiratory syndrome-coronavirus 2 (SARS-CoV-2) [14,15], research efforts have been focused on the swift development of treatments and vaccines. Several COVID-19 vaccines have been developed and authorized since December 2020, and effective immunologic response to after immunization is crucial to limit the negative health outcomes of the pandemic [16,17]. Along with immunization efforts, real-world data have been collected worldwide in order to confirm the safety, immunogenicity, and efficacy of COVID-19 vaccines, and to understand the impact of societal and health factors that might affect the massive vaccination campaigns [17,18].…”

Section: Introductionmentioning

confidence: 99%

“…Several COVID-19 vaccines have been developed and authorized since December 2020, and effective immunologic response to after immunization is crucial to limit the negative health outcomes of the pandemic [16,17]. Along with immunization efforts, real-world data have been collected worldwide in order to confirm the safety, immunogenicity, and efficacy of COVID-19 vaccines, and to understand the impact of societal and health factors that might affect the massive vaccination campaigns [17,18]. Some of these analyses have described that vaccine-induced antibody titres are lower or decrease faster among smokers compared with nonsmokers, offering suggestions for further research about the impact of smoking on the humoral response to COVID-19 vaccines [19,20].…”

Section: Introductionmentioning

confidence: 99%

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The Effect of Smoking on Humoral Response to COVID-19 Vaccines: A Systematic Review of Epidemiological Studies

et al. 2022

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While the role of active smoking on response to vaccines is yet to be fully understood, some real-world studies have outlined a possible link between smoking and humoral response to COVID-19 vaccines. Thus, the present rapid systematic review aimed at summarizing the current epidemiological evidence on this association. Following PRISMA and WHO guidelines on rapid systematic reviews, we systematically reviewed published literature on this topic and discussed the findings according to the aim of analysing smoking and its impact on humoral response to COVID-19 postvaccination antibody titres. The search strategy yielded a total of 23 articles. The sample size amongst the studies ranged between 74 and 3475 participants (median, 360), with the proportion of smokers being between 4.2% and 40.8% (median, 26.0%). The studies included in this review analysis investigated the dynamics of antibody response to different type of COVID-19 vaccines. In 17 out of 23 studies, current smokers showed much lower antibody titres or more rapid lowering of the vaccine-induced IgG compared with nonsmokers. This rapid systematic review indicates that active smoking negatively impacts humoral response to COVID-19 vaccines, although the pathophysiologic mechanisms for this association have not been entirely suggested. The results advocate targeted policies to promote tailored health promotion initiatives, which can increase risk perception and ensure appropriate protection measures to be taken to avoid the health consequences of COVID-19 in smokers.

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Section: Discussionmentioning

confidence: 97%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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The Effect of Smoking on Humoral Response to COVID-19 Vaccines: A Systematic Review of Epidemiological Studies

et al. 2022

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Analytic modeling and risk assessment of aerial transmission of SARS-CoV-2 virus through vaping expirations in shared micro-environments

Sussman

Golberstein

Polosa

2022

Environ Sci Pollut Res

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It is well known that airborne transmission of COVID-19 in indoor spaces occurs through various respiratory activities: breathing, vocalizing, coughing, and sneezing. However, there is a complete lack of knowledge of its possible transmission through exhalations of e-cigarette aerosol (ECA), which is also a respiratory activity. E-cigarettes have become widely popular among smokers seeking a much safer way of nicotine consumption than smoking. Due to restrictive lockdown measures taken during the COVID-19 pandemic, many smokers and vapers (e-cigarette users) were confined to shared indoor spaces, making it necessary to assess the risk of SARS-CoV-2 virus aerial transmission through their exhalations. We summarize inferred knowledge of respiratory particles emission and transport through ECA, as well as a theoretical framework for explaining the visibility of exhaled ECA, which has safety implications and is absent in other respiratory activities (apart from smoking). We also summarize and briefly discuss the effects of new SARS-CoV-2 variants, vaccination rates, and environmental factors that may influence the spread of COVID-19. To estimate the risk of SARS-CoV-2 virus aerial transmission associated with vaping exhalations, we adapt a theoretical risk model that has been used to analyze the risks associated with other respiratory activities in shared indoor spaces. We consider home and restaurant scenarios, with natural and mechanical ventilation, with occupants wearing and not wearing face masks. We consider as “control case” or baseline risk scenario an indoor space (home and restaurant) where respiratory droplets and droplet nuclei are uniformly distributed and aerial contagion risk might originate exclusively from occupants exclusively rest breathing, assuming this to be the only (unavoidable) respiratory activity they all carry on. If an infected occupant uses an e-cigarette in a home or restaurant scenarios, bystanders not wearing face masks exposed to the resulting ECA expirations face a $$1\,\%$$ 1 % increase of risk of contagion with respect the control case. This relative added risk with respect to the control case becomes $$5-17 \%$$ 5 - 17 % for high-intensity vaping, $$44-176 \%$$ 44 - 176 % , and over $$260 \%$$ 260 % for speaking for various periods or coughing (all without vaping). Infectious emissions are significantly modified by mechanical ventilation, face mask usage, vaccination, and environmental factors, but given the lack of empiric evidence, we assume as a working hypothesis that all basic parameters of respiratory activities are equally (or roughly equally) affected by these factors. Hence, the relative risk percentages with respect to the control state should remain roughly the same under a wide range of varying conditions. By avoiding direct exposure to the visible exhaled vaping jet, wearers of commonly used face masks are well protected from respiratory droplets and droplet nuclei directly emitted by mask-less vapers. Compared to the control case of an already existing (unavoidable) risk from continuous breathing, vaping emissions in shared indoor spaces pose just a negligible additional risk of COVID-19 contagion. We consider that it is not necessary to take additional preventive measures beyond those already prescribed (1.5 m separation and wearing face masks) in order to protect bystanders from this contagion.

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Time-Varying Effect of Hybrid Immunity on the Risk of Breakthrough Infection after Booster Dose of mRNA COVID-19 Vaccine: The MOSAICO Study

et al. 2022

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This longitudinal observational study investigated the risk of breakthrough SARS-CoV-2 infection up to 6 months after a booster dose of an mRNA COVID-19 vaccine in infection-naïve vs. previously infected healthcare workers (HCWs), and whether this difference varied over time. A Cox proportional hazard regression model with Aalen’s additive analysis was fitted to examine the association between the risk of infections and predictor variables. Overall, we observed an incidence rate of 2.5 cases per 1000 person-days (95% confidence interval [CI] 2.0–3.0), which dropped at 0.8 per 1000 person-days (95% CI 0.3–2.0) in recipients with prior SARS-CoV-2 infection. The fitted analysis indicated an adjusted hazard ratio of 0.32 (95% CI 0.13–0.80; p-value = 0.01) for those with hybrid immunity with a slope that became steeply negative roughly starting from day 90. No difference was seen according to participants’ smoking habits. Characteristics of infected HCWs were also described. Our study quantifies the time-varying effects of vaccine-induced and hybrid immunity after the booster dose (during the Omicron variant predominance in Italy) and observed that the protection waned more rapidly in infection-naïve recipients starting from the third month. The results add important evidence that can be used to inform COVID-19 vaccination strategies.

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Response to BNT162b2 mRNA COVID-19 vaccine among healthcare workers in Italy: a 3-month follow-up—Reply

Cited by 5 publications

References 4 publications

The Effect of Smoking on Humoral Response to COVID-19 Vaccines: A Systematic Review of Epidemiological Studies

The Effect of Smoking on Humoral Response to COVID-19 Vaccines: A Systematic Review of Epidemiological Studies

Analytic modeling and risk assessment of aerial transmission of SARS-CoV-2 virus through vaping expirations in shared micro-environments

Time-Varying Effect of Hybrid Immunity on the Risk of Breakthrough Infection after Booster Dose of mRNA COVID-19 Vaccine: The MOSAICO Study

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