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Document Type
Rapid Review
Review Code
EOC210302 RR
Question Submitted
March 30, 2021
Date Completed
April 21, 2021
Status
3. Completed
Research Team
EOC
Document Type
Rapid Review
Review Code
EOC210302 RR
Question Submitted
March 30, 2021
Date Completed
April 21, 2021
Status
3. Completed
Research Team
EOC
Key Findings
The group designated in Saskatchewan as Clinically Extremely Vulnerable (CEV) is a heterogenous clinical population with factors that impair their immune response to differing degrees.
Very Limited evidence is currently available to assess the immune response following vaccination is selected clinical populations; no evidence is available to assess vaccine efficacy or effectiveness in these populations. The clinical relevance of measured immune response with respect to protection from disease is still uncertain.
In considering the immune response of the CEV population, it is recommended that the absolute difference in immune response between 1 and 2 doses be considered, as it is possible some patient groups will have lowered protection regardless of vaccine strategy.
In terms of clinical subgroups: oOrgan transplantation recipients on immunosuppressive medication: solid organ transplant recipients receiving anti-metabolite maintenance immunosuppression therapy were less likely to develop an antibody response to an mRNA vaccine, compared to those receiving other types of therapies (37% vs 63%). In a study of 242 kidney transplant recipients on immunosuppressive therapy only 10.8% became seropositive at 28 days after a single dose of mRNA vaccine. oCancer: A study of 151 elderly patients with solid and hematological malignancies and 54 healthy controls who received one or two doses of BNT162b2 (Pfizer-BioNTech) vaccine shows approximately 39% of solid cancer patients, 13% of hematological cancer patients, and 97% of healthy controls (p<0.0001) developed anti-S IgG 21 days following a single dose vaccine. However, response in solid cancer patients increased to 95% within 2 weeks of the second dose at 21 days. oOther immunocompromising conditions (e.g., auto-immune disorders and therapy): some level of immunity is generated with vaccination; however, what this means clinically is unknown. It seems that ensuring the dosing is properly timed around biologic therapy is important.
Category
Clinical Management
Healthcare Services
Subject
Vaccines
Vaccination
Risk
Comorbidities
Population
All
Other
vulnerable populations (clinically)
Clinical Setting
Cardiac unit
Community
Dialysis unit
ICU
Long Term Care
Medicine Unit
NICU
Oncology
Primary care
Public Health
Priority Level
Level 3 Two weeks (14 days)
Cite As
Azizian, A; Lee, S; Shumilak, G; Groot, G; Reeder, B; Miller, L; Howell-Spooner, B. What are the risks or benefits of extended intervals between doses of COVID-19 vaccines compared to recommended dosing in extremely vulnerable populations? 2021 Apr 20, Document no.: EOC210302 RR. In: COVID-19 Rapid Evidence Reviews [Internet]. SK: SK COVID Evidence Support Team, c2021. 15 p. (CEST rapid review report).
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Document Type
Rapid Review
Review Code
EOC071001 RR
Question Submitted
July 10, 2020
Date Completed
July 27, 2020
Status
3. Completed
Research Team
EOC
Document Type
Rapid Review
Review Code
EOC071001 RR
Question Submitted
July 10, 2020
Date Completed
July 27, 2020
Status
3. Completed
Research Team
EOC
Key Findings
· The terms cluster and outbreak both describe the occurrence of new disease cases within a particular location and time period. The number of cases within a cluster are not necessarily greater than what is expected, however in an outbreak the number of cases does exceed the usual norm. · In an outbreak the cases are confirmed to be epidemiologically linked while in a cluster an epidemiological connection is only suspected. · Not all clusters are outbreaks, however each cluster needs to be investigated
· Understanding how to characterize COVID-19 cases based on a suspected or proven epidemiological link can better guide prevention of disease spreading
Category
Administration
Epidemiology
Subject
Disease Outbreak
Public Health
Health Planning
Decision Making
Population
All
Clinical Setting
Community
Emergency
Long Term Care
Other
All acute care.
Priority Level
Level 5 completed within 2 weeks
Cite As
Radu, L; Badea, A; Groot, G; Ellsworth, C; Young, C. What is the definition of an outbreak versus a cluster for COVID-19 in different clinical and community settings in Canada, the US, and the UK? 2020 Jul 27; Document no.: EOC071001 RR. In: COVID-19 Rapid Evidence Reviews [Internet]. SK: SK COVID Evidence Support Team, c2020. 11 p. (CEST rapid review report)
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