23 results on '"Gerson O. Penna"'
Search Results
2. Duration of protection of CoronaVac plus heterologous BNT162b2 booster in the Omicron period in Brazil
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Thiago Cerqueira-Silva, Vinicius de Araujo Oliveira, Enny S. Paixão, Juracy Bertoldo Júnior, Gerson O. Penna, Guilherme L. Werneck, Neil Pearce, Maurício L. Barreto, Viviane S. Boaventura, and Manoel Barral-Netto
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Science - Abstract
Primary CoronaVac vaccination followed by a BNT162b2 booster dose confers protection against some SARS-CoV-2 variants but its effectiveness against Omicron is unknown. Here, the authors show that this combination confers a high level of protection against severe outcomes for up to 120 days, with evidence of waning for those aged 80 or older.
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- 2022
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3. CoronaVac vaccine is effective in preventing symptomatic and severe COVID-19 in pregnant women in Brazil: a test-negative case-control study
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Enny S. Paixao, Kerry L. M. Wong, Flavia Jôse Oliveira Alves, Vinicius de Araújo Oliveira, Thiago Cerqueira-Silva, Juracy Bertoldo Júnior, Tales Mota Machado, Elzo Pereira Pinto Junior, Viviane S. Boaventura, Gerson O. Penna, Guilherme Loureiro Werneck, Laura C. Rodrigues, Neil Pearce, Mauricio L. Barreto, and Manoel Barral-Netto
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Vaccine effectiveness ,Inactivated vaccine ,Pregnant women ,COVID-19 ,SARS-CoV-2 ,Medicine - Abstract
Abstract Background More doses of CoronaVac have been administered worldwide than any other COVID-19 vaccine. However, the effectiveness of COVID-19 inactivated vaccines in pregnant women is still unknown. We estimated the vaccine effectiveness (VE) of CoronaVac against symptomatic and severe COVID-19 in pregnant women in Brazil. Methods We conducted a test-negative design study in all pregnant women aged 18–49 years with COVID-19-related symptoms in Brazil from March 15, 2021, to October 03, 2021, linking records of negative and positive SARS-CoV-2 reverse transcription polymerase chain reaction (RT-PCR) tests to national vaccination records. We also linked records of test-positive cases with notifications of severe, hospitalised or fatal COVID-19. Using logistic regression, we estimated the adjusted odds ratio and VE against symptomatic COVID-19 and against severe COVID-19 by comparing vaccine status in test-negative subjects to test-positive symptomatic cases and severe cases. Results Of the 19,838 tested pregnant women, 7424 (37.4%) tested positive for COVID-19 and 588 (7.9%) had severe disease. Only 83% of pregnant women who received the first dose of CoronaVac completed the vaccination scheme. A single dose of the CoronaVac vaccine was not effective at preventing symptomatic COVID-19. The effectiveness of two doses of CoronaVac was 41% (95% CI 27.1–52.2) against symptomatic COVID-19 and 85% (95% CI 59.5–94.8) against severe COVID-19. Conclusions A complete regimen of CoronaVac in pregnant women was effective in preventing symptomatic COVID-19 and highly effective against severe illness in a setting that combined high disease burden and marked COVID-19-related maternal deaths.
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- 2022
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4. Influence of age on the effectiveness and duration of protection of Vaxzevria and CoronaVac vaccines: A population-based study
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Thiago Cerqueira-Silva, Vinicius de Araújo Oliveira, Viviane S. Boaventura, Julia M. Pescarini, Juracy Bertoldo Júnior, Tales Mota Machado, Renzo Flores-Ortiz, Gerson O. Penna, Maria Yury Ichihara, Jacson Venâncio de Barros, Mauricio L. Barreto, Guilherme Loureiro Werneck, and Manoel Barral-Netto
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COVID-19 ,Vaccine ,Effectiveness ,CoronaVac ,Vaxzevria ,Public aspects of medicine ,RA1-1270 - Abstract
Summary: Background: Aging influences COVID-19 severity and response to vaccination, but previous vaccine effectiveness (VE) analyzes lack the power to evaluate its role in subgroups within the elderly age group. Here we analyzed the impact of age on viral vector and inactivated virus vaccines' effectiveness, the main platforms used in low- and middle-income countries. Methods: We report a retrospective longitudinal study of 75,919,840 Brazilian vaccinees from January 18 to July 24, 2021, evaluating documented infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), COVID-19-related hospitalisation, ICU admission, and death. Negative binomial regression models adjusted for sociodemographic characteristics were used for VE estimation. Findings: The overall analyzes of full vaccination showed VE against hospitalisation, ICU admission, and death of 91·4% (95%CI:90·1–92·5), 91·1% (95%CI:88·9–92·9) and 92·3% (95%CI:90·5–93·7) for Vaxzevria and 71·2% (95%CI:70·0–72·4), 72·2% (95%CI:70·2–74·0) and 73·7% (95%CI:72·1–75·2) for CoronaVac, respectively. VE for all outcomes is progressively lower with age. In fully-Vaxzevria-vaccinated individuals aged
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- 2022
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5. Phylogenomics and antimicrobial resistance of the leprosy bacillus Mycobacterium leprae
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Andrej Benjak, Charlotte Avanzi, Pushpendra Singh, Chloé Loiseau, Selfu Girma, Philippe Busso, Amanda N. Brum Fontes, Yuji Miyamoto, Masako Namisato, Kidist Bobosha, Claudio G. Salgado, Moisés B. da Silva, Raquel C. Bouth, Marco A. C. Frade, Fred Bernardes Filho, Josafá G. Barreto, José A. C. Nery, Samira Bührer-Sékula, Andréanne Lupien, Abdul R. Al-Samie, Yasin Al-Qubati, Abdul S. Alkubati, Gisela Bretzel, Lucio Vera-Cabrera, Fatoumata Sakho, Christian R. Johnson, Mamoudou Kodio, Abdoulaye Fomba, Samba O. Sow, Moussa Gado, Ousmane Konaté, Mariane M. A. Stefani, Gerson O. Penna, Philip N. Suffys, Euzenir Nunes Sarno, Milton O. Moraes, Patricia S. Rosa, Ida M. F. Dias Baptista, John S. Spencer, Abraham Aseffa, Masanori Matsuoka, Masanori Kai, and Stewart T. Cole
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Science - Abstract
Leprosy is caused by the yet-uncultured pathogen Mycobacterium leprae. Here, Benjak et al. obtain M. leprae genome sequences from DNA extracted from patients' skin biopsies and, by analysing 154 genomes from 25 countries, provide insight into the pathogen’s evolution and antimicrobial resistance.
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- 2018
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6. Mycobacterium leprae-Specific Antibodies in Multibacillary Leprosy Patients Decrease During and After Treatment With Either the Regular 12 Doses Multidrug Therapy (MDT) or the Uniform 6 Doses MDT
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Emerith M. Hungria, Samira Bührer-Sékula, Regiane M. Oliveira, Lúcio C. Aderaldo, Maria Araci A. Pontes, Rossilene Cruz, Heitor S. de Gonçalves, Maria L. F. Penna, Gerson O. Penna, and Mariane M. A. Stefani
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leprosy ,serology ,phenollic glycolipid-I antigen ,LID-1 ,ND-O-LID ,multidrug therapy ,Immunologic diseases. Allergy ,RC581-607 - Abstract
Leprosy serology reflects the bacillary load of patients and multidrug therapy (MDT) reduces Mycobacterium leprae-specific antibody titers of multibacillary (MB) patients. The Clinical Trial for Uniform Multidrug Therapy Regimen for Leprosy Patients in Brazil (U-MDT/CT-BR) compared outcomes of regular 12 doses MDT/R-MDT and the uniform 6 doses MDT/U-MDT for MB leprosy, both of regimens including rifampicin, clofazimine, and dapsone. This study investigated the impact of R-MDT and U-MDT and the kinetic of antibody responses to M. leprae-specific antigens in MB patients from the U-MDT/CT-BR. We tested 3,400 serum samples from 263 MB patients (R-MDT:121; U-MDT:142) recruited at two Brazilian reference centers (Dona Libânia, Fortaleza, Ceará; Alfredo da Matta Foundation, Manaus, Amazonas). Enzyme-linked immunosorbent assays with three M. leprae antigens [NT-P-BSA: trisaccharide-phenyl of phenollic glycolipid-I antigen (PGL-I); LID-1: Leprosy Infectious Disease Research Institute Diagnostic 1 di-fusion recombinant protein; and ND-O-LID: fusion complex of disaccharide-octyl of PGL-I and LID-1] were performed using around 13 samples per patient. Samples were collected at baseline/M0, during MDT (R-MDT:M1–M12 months, U-MDT:M1–M6 months) and after MDT discontinuation (first, second year). Statistical significance was assessed by the Mann–Whitney U test for comparison between groups (p values 0.0001). Anti-ND-O-LID antibodies decreased during and after treatment in both groups, similarly to anti-PGL-I antibodies. Intraindividual serology results in R-MDT and U-MDT patients showed that the difference in serology decay to all three antigens was dependent upon time only. Our serology findings in MB leprosy show that regardless of the duration of the U-MDT and R-MDT, both of them reduce M. leprae-specific antibodies during and after treatment. In leprosy, antibody levels are considered a surrogate marker of the bacillary load; therefore, our serological results suggest that shorter U-MDT is also effective in reducing the patients’ bacillary burden similarly to R-MDT.Clinical Trial RegistrationClinicalTrials.gov, NCT00669643.
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- 2018
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7. Combining Digital and Molecular Approaches Using Health and Alternate Data Sources in a Next-Generation Surveillance System for Anticipating Outbreaks of Pandemic Potential
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Pablo Ivan P Ramos, Izabel Marcilio, Ana I Bento, Gerson O Penna, Juliane F de Oliveira, Ricardo Khouri, Roberto F S Andrade, Roberto P Carreiro, Vinicius de A Oliveira, Luiz Augusto C Galvão, Luiz Landau, Mauricio L Barreto, Kay van der Horst, and Manoel Barral-Netto
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Public aspects of medicine ,RA1-1270 - Abstract
Globally, millions of lives are impacted every year by infectious diseases outbreaks. Comprehensive and innovative surveillance strategies aiming at early alert and timely containment of emerging and reemerging pathogens are a pressing priority. Shortcomings and delays in current pathogen surveillance practices further disturbed informing responses, interventions, and mitigation of recent pandemics, including H1N1 influenza and SARS-CoV-2. We present the design principles of the architecture for an early-alert surveillance system that leverages the vast available data landscape, including syndromic data from primary health care, drug sales, and rumors from the lay media and social media to identify areas with an increased number of cases of respiratory disease. In these potentially affected areas, an intensive and fast sample collection and advanced high-throughput genome sequencing analyses would inform on circulating known or novel pathogens by metagenomics-enabled pathogen characterization. Concurrently, the integration of bioclimatic and socioeconomic data, as well as transportation and mobility network data, into a data analytics platform, coupled with advanced mathematical modeling using artificial intelligence or machine learning, will enable more accurate estimation of outbreak spread risk. Such an approach aims to readily identify and characterize regions in the early stages of an outbreak development, as well as model risk and patterns of spread, informing targeted mitigation and control measures. A fully operational system must integrate diverse and robust data streams to translate data into actionable intelligence and actions, ultimately paving the way toward constructing next-generation surveillance systems.
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- 2024
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8. Vaccine effectiveness of two-dose BNT162b2 against symptomatic and severe COVID-19 among adolescents in Brazil and Scotland over time: a test-negative case-control study
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Pilar T V Florentino, Tristan Millington, Thiago Cerqueira-Silva, Chris Robertson, Vinicius de Araújo Oliveira, Juracy B S Júnior, Flávia J O Alves, Gerson O Penna, Srinivasa Vital Katikireddi, Viviane S Boaventura, Guilherme L Werneck, Neil Pearce, Colin McCowan, Christopher Sullivan, Utkarsh Agrawal, Zoe Grange, Lewis D Ritchie, Colin R Simpson, Aziz Sheikh, Mauricio L Barreto, Igor Rudan, Manoel Barral-Netto, Enny S Paixão, University of St Andrews. School of Medicine, University of St Andrews. Sir James Mackenzie Institute for Early Diagnosis, and University of St Andrews. Population and Behavioural Science Division
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RM ,Adolescent ,SARS-CoV-2 ,COVID-19 ,Vaccine Efficacy ,3rd-DAS ,AC ,RM Therapeutics. Pharmacology ,Infectious Diseases ,SDG 3 - Good Health and Well-being ,RA0421 ,RA0421 Public health. Hygiene. Preventive Medicine ,Case-Control Studies ,Brazil/epidemiology ,Humans ,Brazil ,BNT162 Vaccine ,COVID-19/epidemiology - Abstract
VK is funded by an NHS Research Scotland Senior Clinical Fellowship (SCAF/15/02), the UK Medical Research Council (MC_UU_00022/2), and the Scottish Government Chief Scientist Office (SPHSU17). MB-N and VdAO are funded by the Fazer o Bem Faz Bem programme from JBS SA. MB-N is also funded by CNPQ and FAPESB (PNX0008/2014). EPS is funded by the Wellcome Trust (213589/Z/18/Z). For the purpose of open access, the author has applied a CC BY public copyright licence to any author accepted manuscript version arising from this submission. Background Little is known about vaccine effectiveness over time among adolescents, especially against the SARS-CoV-2 omicron (B.1.1.529) variant. This study assessed the associations between time since two-dose vaccination with BNT162b2 and the occurrence of symptomatic SARS-CoV-2 infection and severe COVID-19 among adolescents in Brazil and Scotland. Methods We did test-negative, case-control studies in adolescents aged 12–17 years with COVID-19-related symptoms in Brazil and Scotland. We linked records of SARS-CoV-2 RT-PCR and antigen tests to national vaccination and clinical records. We excluded tests from individuals who did not have symptoms, were vaccinated before the start of the national vaccination programme, received vaccines other than BNT162b2 or a SARS-CoV-2 booster dose of any kind, or had an interval between their first and second dose of fewer than 21 days. Additionally, we excluded negative SARS-CoV-2 tests recorded within 14 days of a previous negative test, negative tests recorded within 7 days after a positive test, any test done within 90 days after a positive test, and tests with missing sex and location information. Cases (SARS-CoV-2 test-positive adolescents) and controls (test-negative adolescents) were drawn from a sample of individuals in whom tests were collected within 10 days of symptom onset. We estimated the adjusted odds ratio and vaccine effectiveness against symptomatic COVID-19 for both countries and against severe COVID-19 (hospitalisation or death) for Brazil across fortnightly periods. Findings We analysed 503 776 tests from 2 948 538 adolescents in Brazil between Sept 2, 2021, and April 19, 2022, and 127 168 tests from 404 673 adolescents in Scotland between Aug 6, 2021, and April 19, 2022. Vaccine effectiveness peaked at 14–27 days after the second dose in both countries during both waves, and was significantly lower against symptomatic infection during the omicron-dominant period in Brazil (64·7% [95% CI 63·0–66·3]) and in Scotland (82·6% [80·6–84·5]), than it was in the delta-dominant period (80·7% [95% CI 77·8–83·3] in Brazil and 92·8% [85·7–96·4] in Scotland). Vaccine efficacy started to decline from 27 days after the second dose for both countries, reducing to 5·9% (95% CI 2·2–9·4) in Brazil and 50·6% (42·7–57·4) in Scotland at 98 days or more during the omicron-dominant period. In Brazil, protection against severe disease remained above 80% from 28 days after the second dose and was 82·7% (95% CI 68·8–90·4) at 98 days or more after receiving the second dose. Interpretation We found waning vaccine protection of BNT162b2 against symptomatic COVID-19 infection among adolescents in Brazil and Scotland from 27 days after the second dose. However, protection against severe COVID-19 outcomes remained high at 98 days or more after the second dose in the omicron-dominant period. Booster doses for adolescents need to be considered. Publisher PDF
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- 2022
9. Syndromic Detection of Upper Respiratory Infections in Primary Healthcare as a Candidate for COVID-19 Early Warning in Brazil: A Retrospective Ecological Study
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Vinicius de Araújo Oliveira, Alberto Sironi, Pilar Tavares Veras Florentino, Izabel Marcilio, Thiago Cerqueira-Silva, Renzo Flores-Ortiz, Tales Mota Machado, Gerson O. Penna, Marcos Barreto, and Manoel Barral-Netto
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- 2023
10. Effectiveness of BNT162b2 booster after CoronaVac primary regimen in pregnant people during omicron period in Brazil
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Pilar T V Florentino, Flávia J O Alves, Thiago Cerqueira-Silva, Vinicius de Araújo Oliveira, Juracy B S Júnior, Gerson O Penna, Viviane Boaventura, Guilherme L Werneck, Neil Pearce, Laura C Rodrigues, Mauricio L Barreto, Manoel Barral-Netto, and Enny S Paixão
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Infectious Diseases ,COVID-19 Vaccines ,Pregnancy ,Humans ,Female ,Antibodies, Viral ,Brazil ,BNT162 Vaccine - Published
- 2022
11. Protection conferred by vaccine plus previous infection (hybrid immunity) with vaccines of three different platforms during the Omicron variant period in Brazil
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Thiago Cerqueira-Silva, Vinicius de Araujo Oliveira, Enny S. Paixão, Pilar Tavares Veras Florentino, Gerson O. Penna, Neil Pearce, Guilherme L. Werneck, Maurício L. Barreto, Viviane S. Boaventura, and Manoel Barral-Netto
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Hybrid immunity (infection plus vaccination) provided high protection against infection and severe disease in the periods of delta and gamma variants of concern. However, the protection of hybrid immunity in the Omicron era remains unknown. We performed a test-negative study using Brazilian national databases between January 01 and March 22, 2022, a period of predominant circulation of the Omicron variant in Brazil. Hybrid immunity offered low protection against infection, with rapid waning, compared to unvaccinated with or without previous infection. For severe illness (hospitalisation or death), the protection, although already high for unvaccinated pre-infected increased regardless of the type of vaccine (Ad26.COV2.S, BNT162b2, ChAdOx-1 or CoronaVac).In conclusion, during the Omicron-dominant period in Brazil, hybrid immunity offered high protection against severe illness and low protection against infection.
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- 2022
12. Vaccination plus previous infection: protection during the omicron wave in Brazil
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Thiago Cerqueira-Silva, Vinicius de Araujo Oliveira, Enny S Paixão, Pilar Tavares Veras Florentino, Gerson O Penna, Neil Pearce, Guilherme L Werneck, Maurício L Barreto, Viviane S Boaventura, and Manoel Barral-Netto
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Infectious Diseases ,Vaccination ,Humans ,Brazil - Published
- 2022
13. Effectiveness of CoronaVac, ChAdOx1 nCoV-19, BNT162b2, and Ad26.COV2.S among individuals with previous SARS-CoV-2 infection in Brazil: a test-negative, case-control study
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Thiago Cerqueira-Silva, Jason R Andrews, Viviane S Boaventura, Otavio T Ranzani, Vinicius de Araújo Oliveira, Enny S Paixão, Juracy Bertoldo Júnior, Tales Mota Machado, Matt D T Hitchings, Murilo Dorion, Margaret L Lind, Gerson O Penna, Derek A T Cummings, Natalie E Dean, Guilherme Loureiro Werneck, Neil Pearce, Mauricio L Barreto, Albert I Ko, Julio Croda, and Manoel Barral-Netto
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COVID-19 Vaccines ,Infectious Diseases ,Ad26COVS1 ,SARS-CoV-2 ,Case-Control Studies ,ChAdOx1 nCoV-19 ,COVID-19 ,Humans ,BNT162 Vaccine ,Brazil - Abstract
BACKGROUND: COVID-19 vaccines have proven highly effective among individuals without a previous SARS-CoV-2 infection, but their effectiveness in preventing symptomatic infection and severe outcomes among individuals with previous infection is less clear. We aimed to estimate the effectiveness of four COVID-19 vaccines against symptomatic infection, hospitalisation, and death for individuals with laboratory-confirmed previous SARS-CoV-2 infection. METHODS: Using national COVID-19 notification, hospitalisation, and vaccination datasets from Brazil, we did a test-negative, case-control study to assess the effectiveness of four vaccines (CoronaVac [Sinovac], ChAdOx1 nCoV-19 [AstraZeneca], Ad26.COV2.S [Janssen], and BNT162b2 [Pfizer-BioNtech]) for individuals with laboratory-confirmed previous SARS-CoV-2 infection. We matched cases with RT-PCR positive, symptomatic COVID-19 with up to ten controls with negative RT-PCR tests who presented with symptomatic illnesses, restricting both groups to tests done at least 90 days after an initial infection. We used multivariable conditional logistic regression to compare the odds of test positivity and the odds of hospitalisation or death due to COVID-19, according to vaccination status and time since first or second dose of vaccines. FINDINGS: Between Feb 24, 2020, and Nov 11, 2021, we identified 213 457 individuals who had a subsequent, symptomatic illness with RT-PCR testing done at least 90 days after their initial SARS-CoV-2 infection and after the vaccination programme started. Among these, 30 910 (14·5%) had a positive RT-PCR test consistent with reinfection, and we matched 22 566 of these cases with 145 055 negative RT-PCR tests from 68 426 individuals as controls. Among individuals with previous SARS-CoV-2 infection, vaccine effectiveness against symptomatic infection 14 or more days from vaccine series completion was 39·4% (95% CI 36·1-42·6) for CoronaVac, 56·0% (51·4-60·2) for ChAdOx1 nCoV-19, 44·0% (31·5-54·2) for Ad26.COV2.S, and 64·8% (54·9-72·4) for BNT162b2. For the two-dose vaccine series (CoronaVac, ChAdOx1 nCoV-19, and BNT162b2), effectiveness against symptomatic infection was significantly greater after the second dose than after the first dose. Effectiveness against hospitalisation or death 14 or more days from vaccine series completion was 81·3% (75·3-85·8) for CoronaVac, 89·9% (83·5-93·8) for ChAdOx1 nCoV-19, 57·7% (-2·6 to 82·5) for Ad26.COV2.S, and 89·7% (54·3-97·7) for BNT162b2. INTERPRETATION: All four vaccines conferred additional protection against symptomatic infections and severe outcomes among individuals with previous SARS-CoV-2 infection. The provision of a full vaccine series to individuals after recovery from COVID-19 might reduce morbidity and mortality. FUNDING: Brazilian National Research Council, Fundação Carlos Chagas Filho de Amparo à Pesquisa do Estado do Rio de Janeiro, Oswaldo Cruz Foundation, JBS, Instituto de Salud Carlos III, Spanish Ministry of Science and Innovation, and Generalitat de Catalunya.
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- 2022
14. Waning of mRNA Boosters after Homologous Primary Series with BNT162b2 or ChadOx1 Against Symptomatic Infection and Severe COVID-19 in Brazil and Scotland: A Test-Negative Design Case-Control Study
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Thiago Cerqueira-Silva, Syed Ahmar Shah, Chris Robertson, Mauro Niskier Sanchez, Srinivasa Vittal Katikireddi, Vinicius de Araújo Oliveira, Enny S. Paixão, Igor Rudan, Juracy Bertoldo Júnior, Gerson O. Penna, Neil Pearce, Guilherme Werneck, Mauricio Lima Barreto, Viviane Sampaio Boaventura, Aziz Sheikh, and Manoel Barral-Netto
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- 2022
15. Vaccine Effectiveness of Two-Dose BNT162b2 Over Time Against COVID-19 Symptomatic Infection and Severe Cases Among Adolescents: Test Negative Design Case Control Studies in Brazil and Scotland
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Pilar Tavares Veras Florentino, Tristan Millington, Thiago Cerqueira-Silva, Chris Robertson, Vinicius de Araújo Oliveira, Juracy Bertoldo Júnior, Flávia Jôse O. Alves, Gerson O. Penna, Srinivasa Vittal Katikireddi, Viviane Sampaio Boaventura, Guilherme Werneck, Neil Pearce, Colin McCowan, Zoe Grange, Lewis D Ritchie, Colin Simpson, Aziz Sheikh, Mauricio Lima Barreto, Igor Rudan, Manoel Barral-Netto, and Enny S. Paixão
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History ,Polymers and Plastics ,Business and International Management ,Industrial and Manufacturing Engineering - Published
- 2022
16. Effectiveness of mRNA boosters after homologous primary series with BNT162b2 or ChAdOx1 against symptomatic infection and severe COVID-19 in Brazil and Scotland: A test-negative design case–control study
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Thiago Cerqueira-Silva, Syed Ahmar Shah, Chris Robertson, Mauro Sanchez, Srinivasa Vittal Katikireddi, Vinicius de Araujo Oliveira, Enny S. Paixão, Igor Rudan, Juracy Bertoldo Junior, Gerson O. Penna, Neil Pearce, Guilherme Loureiro Werneck, Mauricio L. Barreto, Viviane S. Boaventura, Aziz Sheikh, and Manoel Barral-Netto
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Scotland/epidemiology ,SARS-CoV-2/genetics ,Case-Control Studies ,Humans ,Brazil/epidemiology ,RNA, Messenger ,General Medicine ,BNT162 Vaccine ,COVID-19/epidemiology - Abstract
Background Brazil and Scotland have used mRNA boosters in their respective populations since September 2021, with Omicron’s emergence accelerating their booster program. Despite this, both countries have reported substantial recent increases in Coronavirus Disease 2019 (COVID-19) cases. The duration of the protection conferred by the booster dose against symptomatic Omicron cases and severe outcomes is unclear. Methods and findings Using a test-negative design, we analyzed national databases to estimate the vaccine effectiveness (VE) of a primary series (with ChAdOx1 or BNT162b2) plus an mRNA vaccine booster (with BNT162b2 or mRNA-1273) against symptomatic Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infection and severe COVID-19 outcomes (hospitalization or death) during the period of Omicron dominance in Brazil and Scotland compared to unvaccinated individuals. Additional analyses included stratification by age group (18 to 49, 50 to 64, ≥65). All individuals aged 18 years or older who reported acute respiratory illness symptoms and tested for SARS-CoV-2 infection between January 1, 2022, and April 23, 2022, in Brazil and Scotland were eligible for the study. At 14 to 29 days after the mRNA booster, the VE against symptomatic SARS-CoV-2 infection of ChAdOx1 plus BNT162b2 booster was 51.6%, (95% confidence interval (CI): [51.0, 52.2], p < 0.001) in Brazil and 67.1% (95% CI [65.5, 68.5], p < 0.001) in Scotland. At ≥4 months, protection against symptomatic infection waned to 4.2% (95% CI [0.7, 7.6], p = 0.02) in Brazil and 37.4% (95% CI [33.8, 40.9], p < 0.001) in Scotland. VE against severe outcomes in Brazil was 93.5% (95% CI [93.0, 94.0], p < 0.001) at 14 to 29 days post-booster, decreasing to 82.3% (95% CI [79.7, 84.7], p < 0.001) and 98.3% (95% CI [87.3, 99.8], p < 0.001) to 77.8% (95% CI [51.4, 89.9], p < 0.001) in Scotland for the same periods. Similar results were obtained with the primary series of BNT162b2 plus homologous booster. Potential limitations of this study were that we assumed that all cases included in the analysis were due to the Omicron variant based on the period of dominance and the limited follow-up time since the booster dose. Conclusions We observed that mRNA boosters after a primary vaccination course with either mRNA or viral-vector vaccines provided modest, short-lived protection against symptomatic infection with Omicron but substantial and more sustained protection against severe COVID-19 outcomes for at least 3 months.
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- 2023
17. Effectiveness of CoronaVac, ChAdOx1, BNT162b2 and Ad26.COV2.S among individuals with prior SARS-CoV-2 infection in Brazil
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Thiago Cerqueira-Silva, Jason R. Andrews, Viviane S. Boaventura, Otavio T. Ranzani, Vinicius de Araújo Oliveira, Enny S Paixão, Juracy Bertoldo Júnior, Tales Mota Machado, Matt D.T. Hitchings, Murilo Dorion, Margaret L Lind, Gerson O. Penna, Derek A.T. Cummings, Natalie E Dean, Guilherme Loureiro Werneck, Neil Pearce, Mauricio L. Barreto, Albert I. Ko, Julio Croda, and Manoel Barral-Netto
- Abstract
BackgroundCOVID-19 vaccines have proven highly effective among SARS-CoV-2 naive individuals, but their effectiveness in preventing symptomatic infection and severe outcomes among individuals with prior infection is less clear.MethodsUtilizing national COVID-19 notification, hospitalization, and vaccination datasets from Brazil, we performed a case-control study using a test-negative design to assess the effectiveness of four vaccines (CoronaVac, ChAdOx1, Ad26.COV2.S and BNT162b2) among individuals with laboratory-confirmed prior SARS-CoV-2 infection. We matched RT-PCR positive, symptomatic COVID-19 cases with RT-PCR-negative controls presenting with symptomatic illnesses, restricting both groups to tests performed at least 90 days after an initial infection. We used multivariable conditional logistic regression to compare the odds of test positivity, and the odds of hospitalization or death due to COVID-19, according to vaccination status and time since first or second dose of vaccines.FindingsAmong individuals with prior SARS-CoV-2 infection, vaccine effectiveness against symptomatic infection ≥ 14 days from vaccine series completion was 39.4% (95% CI 36.1-42.6) for CoronaVac, 56.0% (95% CI 51.4-60.2) for ChAdOx1, 44.0% (95% CI 31.5-54.2) for Ad26.COV2.S, and 64.8% (95% CI 54.9-72.4) for BNT162b2. For the two-dose vaccine series (CoronaVac, ChAdOx1, and BNT162b2), effectiveness against symptomatic infection was significantly greater after the second dose compared with the first dose. Effectiveness against hospitalization or death ≥ 14 days from vaccine series completion was 81.3% (95% CI 75.3-85.8) for CoronaVac, 89.9% (95% CI 83.5-93.8) for ChAdOx1, 57.7% (95% CI −2.6-82.5) for Ad26.COV2.S, and 89.7% (95% CI 54.3-97.7) for BNT162b2.InterpretationAll four vaccines conferred additional protection against symptomatic infections and severe outcomes among individuals with previous SARS-CoV-2 infection. Provision of a full vaccine series to individuals following recovery from COVID-19 may reduce morbidity and mortality.FundingBrazilian National Research Council, Fundação Carlos Chagas Filho de Amparo à Pesquisa do Estado do Rio de Janeiro, Oswaldo Cruz Foundation, JBS S.A., Instituto de Salud Carlos III, Spanish Ministry of Science and Innovation, Generalitat de Catalunya.RESEARCH IN CONTEXTEvidence before this studyWe searched PubMed, medRxiv, and SSRN for articles published from January 1, 2020 until December 15, 2021, with no language restrictions, using the search terms “vaccine effectiveness” AND “previous*” AND (“SARS-CoV-2” OR “COVID-19”). We found several studies evaluating ChAdOx1 and BNT162b2, and one additionally reporting on mRNA-1273 and Ad26.COV2.S, which found that previously infected individuals who were vaccinated had lower risk of symptomatic SARS-CoV-2 infection. One study found that risk of hospitalization was lower for previously infected individuals after a full series of BNT162b2 or mRNA-1273. Limited evidence is available comparing effectiveness of one versus two doses among individuals with prior infection. No studies reported effectiveness of inactivated vaccines among previously infected individuals.Added value of this studyWe used national databases of COVID-19 case surveillance, laboratory testing, and vaccination from Brazil to investigate effectiveness of CoronaVac, ChAdOx1, Ad26.COV2.S and BNT162b2 among individuals with a prior, laboratory-confirmed SARS-CoV-2 infection. We matched >22,000 RT-PCR-confirmed re-infections with >145,000 RT-PCR-negative controls using a test-negative design. All four vaccines were effective against symptomatic SARS-CoV-2 infections, with effectiveness from 14 days after series completion ranging from 39-65%. For vaccines with two-dose regimens, the second dose provided significantly increased effectiveness compared with one dose. Effectiveness against COVID-19-associated hospitalization or death from 14 days after series completion was >80% for CoronaVac, ChAdOx1and BNT162b2.Implications of all the available evidenceWe find evidence that four vaccines, using three different platforms, all provide protection to previously infected individuals against symptomatic SARS-CoV-2 infection and severe outcomes, with a second dose conferring significant additional benefits. These results support the provision of a full vaccine series among individuals with prior SARS-CoV-2 infection.
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- 2021
18. Vaccine effectiveness of heterologous CoronaVac plus BNT162b2 in Brazil
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Thiago Cerqueira-Silva, Srinivasa Vittal Katikireddi, Vinicius de Araujo Oliveira, Renzo Flores-Ortiz, Juracy Bertoldo Júnior, Enny S. Paixão, Chris Robertson, Gerson O. Penna, Guilherme L. Werneck, Maurício L. Barreto, Neil Pearce, Aziz Sheikh, Manoel Barral-Netto, and Viviane S. Boaventura
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Aged, 80 and over ,COVID-19 Vaccines ,SARS-CoV-2 ,COVID-19 ,Vaccine Efficacy ,General Medicine ,General Biochemistry, Genetics and Molecular Biology ,RA0421 ,QA273 ,Brazil/epidemiology ,Humans ,BNT162 Vaccine ,Brazil ,COVID-19/epidemiology ,Aged - Abstract
There is considerable interest in the waning of effectiveness of coronavirus disease 2019 (COVID-19) vaccines and vaccine effectiveness (VE) of booster doses. Using linked national Brazilian databases, we undertook a test-negative design study involving almost 14 million people (~16 million tests) to estimate VE of CoronaVac over time and VE of BNT162b2 booster vaccination against RT–PCR-confirmed severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and severe COVID-19 outcomes (hospitalization or death). Compared with unvaccinated individuals, CoronaVac VE at 14–30 d after the second dose was 55.0% (95% confidence interval (CI): 54.3–55.7) against confirmed infection and 82.1% (95% CI: 81.4–82.8) against severe outcomes. VE decreased to 34.7% (95% CI: 33.1–36.2) against infection and 72.5% (95% CI: 70.9–74.0) against severe outcomes over 180 d after the second dose. A BNT162b2 booster, 6 months after the second dose of CoronaVac, improved VE against infection to 92.7% (95% CI: 91.0−94.0) and VE against severe outcomes to 97.3% (95% CI: 96.1−98.1) 14–30 d after the booster. Compared with younger age groups, individuals 80 years of age or older had lower protection after the second dose but similar protection after the booster. Our findings support a BNT162b2 booster vaccine dose after two doses of CoronaVac, particularly for the elderly.
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- 2021
19. Commitment to reducing disability: the Brazilian experience
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M Leide W, Oliveira, M Aparecida F, Grossi, Carmelita F, Oliveira, Sebastião A, Sena, Egon, Daxbacher, and Gerson O, Penna
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Disability Evaluation ,Primary Health Care ,Leprosy ,Population Surveillance ,Humans ,Disabled Persons ,Brazil - Published
- 2011
20. Trend of case detection and leprosy elimination in Brazil
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Maria L F, Penna and Gerson O, Penna
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Models, Statistical ,Endemic Diseases ,Health Policy ,Leprosy ,Prevalence ,Humans ,Brazil - Abstract
Only six countries did not meet the leprosy elimination target during 2005, amongst them Brazil. In 2006, the Brazilian Ministry of Health announced a reduction of the detection rate of 24% or 10 900 cases from 2004 to 2005. A negative binomial parabolic regression model was adjusted to the detection rate historical series from 1980 to 2004, in order to predict the 2005 detection rate and its 95% confidence interval. This analysis showed that the number of new leprosy cases for 2005 could not be predicted from the previous behaviour of the data what calls for an epidemiological or operational explanation hypothesis. The hypothesis that this drop in detected case number is due to operational change, as a reduction in diagnosis or a modification in the reporting routine, is more likely. Recent change in prevalence case definition turned the prevalence ratio a function of only one variable, the detection rate, as the duration of the diagnosed disease became fixed. In the early nineties, based on epidemiological data evaluation, the BMoH recognized the impossibility of reaching the elimination goal, but it committed to seek leprosy control. This position changed after some years. Leprosy Elimination is a strategy supported by the national and international public opinion. As a one for all recipe, it may cause unwanted effects for it is not flexible enough to deal with different epidemiological behaviours and public health traditions.
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- 2007
21. Estimating underreporting of leprosy in Brazil using a Bayesian approach.
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Guilherme L de Oliveira, Juliane F Oliveira, Júlia M Pescarini, Roberto F S Andrade, Joilda S Nery, Maria Y Ichihara, Liam Smeeth, Elizabeth B Brickley, Maurício L Barreto, Gerson O Penna, Maria L F Penna, and Mauro N Sanchez
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Arctic medicine. Tropical medicine ,RC955-962 ,Public aspects of medicine ,RA1-1270 - Abstract
BackgroundLeprosy remains concentrated among the poorest communities in low-and middle-income countries and it is one of the primary infectious causes of disability. Although there have been increasing advances in leprosy surveillance worldwide, leprosy underreporting is still common and can hinder decision-making regarding the distribution of financial and health resources and thereby limit the effectiveness of interventions. In this study, we estimated the proportion of unreported cases of leprosy in Brazilian microregions.Methodology/principal findingsUsing data collected between 2007 to 2015 from each of the 557 Brazilian microregions, we applied a Bayesian hierarchical model that used the presence of grade 2 leprosy-related physical disabilities as a direct indicator of delayed diagnosis and a proxy for the effectiveness of local leprosy surveillance program. We also analyzed some relevant factors that influence spatial variability in the observed mean incidence rate in the Brazilian microregions, highlighting the importance of socioeconomic factors and how they affect the levels of underreporting. We corrected leprosy incidence rates for each Brazilian microregion and estimated that, on average, 33,252 (9.6%) new leprosy cases went unreported in the country between 2007 to 2015, with this proportion varying from 8.4% to 14.1% across the Brazilian States.Conclusions/significanceThe magnitude and distribution of leprosy underreporting were adequately explained by a model using Grade 2 disability as a marker for the ability of the system to detect new missing cases. The percentage of missed cases was significant, and efforts are warranted to improve leprosy case detection. Our estimates in Brazilian microregions can be used to guide effective interventions, efficient resource allocation, and target actions to mitigate transmission.
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- 2021
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22. Whole genome sequencing distinguishes between relapse and reinfection in recurrent leprosy cases.
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Mariane M A Stefani, Charlotte Avanzi, Samira Bührer-Sékula, Andrej Benjak, Chloé Loiseau, Pushpendra Singh, Maria A A Pontes, Heitor S Gonçalves, Emerith M Hungria, Philippe Busso, Jérémie Piton, Maria I S Silveira, Rossilene Cruz, Antônio Schetinni, Maurício B Costa, Marcos C L Virmond, Suzana M Diorio, Ida M F Dias-Baptista, Patricia S Rosa, Masanori Matsuoka, Maria L F Penna, Stewart T Cole, and Gerson O Penna
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Arctic medicine. Tropical medicine ,RC955-962 ,Public aspects of medicine ,RA1-1270 - Abstract
Since leprosy is both treated and controlled by multidrug therapy (MDT) it is important to monitor recurrent cases for drug resistance and to distinguish between relapse and reinfection as a means of assessing therapeutic efficacy. All three objectives can be reached with single nucleotide resolution using next generation sequencing and bioinformatics analysis of Mycobacterium leprae DNA present in human skin.DNA was isolated by means of optimized extraction and enrichment methods from samples from three recurrent cases in leprosy patients participating in an open-label, randomized, controlled clinical trial of uniform MDT in Brazil (U-MDT/CT-BR). Genome-wide sequencing of M. leprae was performed and the resultant sequence assemblies analyzed in silico.In all three cases, no mutations responsible for resistance to rifampicin, dapsone and ofloxacin were found, thus eliminating drug resistance as a possible cause of disease recurrence. However, sequence differences were detected between the strains from the first and second disease episodes in all three patients. In one case, clear evidence was obtained for reinfection with an unrelated strain whereas in the other two cases, relapse appeared more probable.This is the first report of using M. leprae whole genome sequencing to reveal that treated and cured leprosy patients who remain in endemic areas can be reinfected by another strain. Next generation sequencing can be applied reliably to M. leprae DNA extracted from biopsies to discriminate between cases of relapse and reinfection, thereby providing a powerful tool for evaluating different outcomes of therapeutic regimens and for following disease transmission.
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- 2017
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23. Anti-PGL-1 Positivity as a Risk Marker for the Development of Leprosy among Contacts of Leprosy Cases: Systematic Review and Meta-analysis.
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Maria Lucia F Penna, Gerson O Penna, Paula C Iglesias, Sonia Natal, and Laura C Rodrigues
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Arctic medicine. Tropical medicine ,RC955-962 ,Public aspects of medicine ,RA1-1270 - Abstract
There is no point of care diagnostic test for infection with M. Leprae or for leprosy, although ELISA anti PGL-1 has been considered and sometimes used as a means to identify infection.A systematic review of all cohort studies, which classified healthy leprosy contacts, at entry, according to anti-PGL1 positivity, and had at least one year follow up. The outcome was clinical diagnosis of leprosy by an experienced physician. The meta-analysis used a fixed model to estimated OR for the association of PGL-1 positivity and clinical leprosy. A fixed model also estimated the sensibility of PGL-1 positivity and positive predictive value.Contacts who were anti PGL-1 positive at baseline were 3 times as likely to develop leprosy; the proportion of cases of leprosy that were PGL-1 positive at baseline varied but was always under 50%.Although there is a clear and consistent association between positivity to anti PGL-1 and development of leprosy in healthy contacts, selection of contacts for prophylaxis based on anti PGL1 response would miss more than half future leprosy cases. Should chemoprophylaxis of controls be incorporated into leprosy control programmes, PGL1 appears not to be a useful test in the decision of which contacts should receive chemoprophylaxis.
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- 2016
- Full Text
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