1- Monday Infectious Disease News – 5th July

1 – Vaccine side-effects and SARS-CoV-2 infection after vaccination in users of the COVID Symptom Study app in the UK: a prospective observational study

• The Pfizer-BioNTech (BNT162b2) and the Oxford-AstraZeneca (ChAdOx1 nCoV-19) COVID-19 vaccines have shown excellent safety and efficacy in phase 3 trials.
• This study aimed to investigate the safety and effectiveness of these vaccines in a UK community setting.
• Systemic and local side-effects after BNT162b2 and ChAdOx1 nCoV-19 vaccination occur at frequencies lower than reported in phase 3 trials.
• Both vaccines decrease the risk of SARS-CoV-2 infection after 12 days.

Source: The Lancet

2 – To give or not to give antibiotics is not the only question

• In a 1945 Nobel Lecture, Sir Alexander Fleming warned against the overuse of antibiotics, particularly in response to public pressure.
• One key question is how the emergence and dissemination of resistant bacteria or resistance genes can be delayed.
• This study emphasises that more studies are needed to identify the optimal duration of antibiotic therapy for common infections, which is important for making changes to the current guidelines, and to identify clinical biomarkers to guide antibiotic treatment in both hospital and ambulatory settings.

Source: The Lancet

3 – Effect of Vaccination on Household Transmission of SARS-CoV-2 in England

• Vaccination against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) prevents infection and reduces the severity of coronavirus disease 2019 (Covid-19) in vaccinated persons.
• This study investigated whether vaccination would reduce transmission in the household setting in the context of postvaccination infection.
• Overall, the likelihood of household transmission was approximately 40 to 50% lower in households of index patients who had been vaccinated 21 days or more before testing positive than in households of unvaccinated index patients; the findings were similar for the two vaccines.

Source: NEJM

4- Stewardship / Resistance Scan for Jun 25, 2021

• New C difficile guidelines favor fidaxomicin over vancomycin.
• For both initial and recurring CDI cases, the new guidelines, published in Clinical Infectious Diseases, now recommend using the antibiotic fidaxomicin rather than vancomycin, though in both cases vancomycin is considered an acceptable alternative.
• The previous CDI guidelines issued in 2018, recommended either drug for initial and recurrent CDI, but the authors of the new guidelines say a review of additional evidence from randomized controlled trials indicates fidaxomicin is now the preferred option, though the recommendation is conditional, with moderate and low certainty evidence.

Source: CIDRAP

5 – One COVID vaccine dose yields good protection in elderly, 2 studies find

• As COVID-19 vaccines were first being approved for emergency use in the United Kingdom, the UK Joint Committee on Vaccination and Immunisation decided to extend the interval before the second dose from 4 to 12 weeks to maximize the amount of people who could be vaccinated.
• A study involving more than 10,000 people 65 years and older found a VE of 65% to 68% 5 to 7 weeks post-vaccination, while one involving 466 people 80 years and older found a VE from 71% to 80%.
• These results provide reassurance that—in older adults (some of whom were frail and had many comorbidities)—both ChAdOx1 nCoV-19 [the AstraZeneca/Oxford vaccine] and BNT162b2 [the Pfizer/BioNTech vaccine] provide protection from COVID-19 and, in cases of breakthrough infection, probably decrease the likelihood of viral transmission.

Source: CIDRAP

6 – Early influenza vaccination rates decline in children during the COVID-19 pandemic

• This investigation sought to determine whether early season rates of pediatric influenza vaccination changed in a season when there was a concurrent COVID-19 pandemic.
• Early influenza vaccination rates declined in a year with a concurrent COVID-19 pandemic. Modeling that accounts for individual trends and demographic variables identified specific populations with lower odds of early vaccination in 2020.
• Additional research is needed to investigate whether the COVID-19 pandemic impacted parental intent to obtain the influenza vaccine, or introduced barriers to healthcare access.

Source: ScienceDirect

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