bluuebunny/crossref_metadata_2025_split huggingface dataset:
1931. Antibodies to SARS-CoV-2 in a Medical School Department of Pediatrics
Authors: Del Bianco Gabriela P , Hammoud Roukaya Al , Aitken Mary E , Somasunderam Anoma , Hernandez Stacy Gomez , Rodriguez Gilhen , Aguilera Elizabeth A , Murphy James , Heresi Gloria 
Published: December 2022

Abstract

Background
Healthcare workers are at high risk of Covid-19 (C19) infection and received priority for C19 vaccinations. Therefore, we conducted a serosurvey to determine anti-C19 antibodies and evidence of C19 infection in health care employees who did or did not have direct contact with patients.

Methods
49 participants provided finger stick blood samples collected onto filter papers and tested for antibodies to C19 using Bio-Plex Pro Human SARS-CoV-2 IgG reagents. Antibodies to C19 nucleocapsid (N), receptor-binding domain (RBD), spike 1 (S1), and spike 2 (S2) were measured. Samples were collected 8 to 11 months after C19 vaccines were made available.

Results
All participants received two doses of Pfizer BioNTech or Moderna RNA-based C19 vaccines, and all showed serological evidence of antibodies to C19 RBD, S1, and S2. Antibodies to N, considered a marker of C19 infection, were detected in 16 individuals, of whom 10 reported having a PCR documented C19 infections. 6 individuals had evidence of C19 infection of which they were not aware. Antibody levels were notably higher following infection and for not infected participants following Pfizer-BioNTech vaccination. There was a 20% higher infection rate in participants with direct patient contact.

Conclusion
This vaccinated population had significant rates of strong antibody responses to C19 infection and a notable rate of C19 infections, most notable in those providing direct patient care.

Disclosures
All Authors: No reported disclosures.
1933. Assessment of Effectiveness of mRNA COVID-19 Vaccines Among Health Care Personnel: Monroe County, NY December 2020-March 2022
Authors: Russ Savanah , Myers Christopher J , Diseases Infectious , Licherdell Erin , Peer Thomas , Hurley Christine , Concannon Cathleen , Bowden Acacia , Chinchilli Ellen , Alvarado Alan , Dumyati Ghinwa 
Published: December 2022

Abstract

Background
Risk of infection with SARS-CoV-2 has remained high among health care personnel (HCP) throughout the pandemic, due to both exposure in the community and occupational settings. While vaccine uptake among health care workers is high, real-world continual monitoring of vaccine effectiveness (VE) among this population is crucial for informing future vaccination and prevention efforts.

Methods
Data for this analysis came from a test-negative case-control study conducted among HCP working at two acute care hospitals in Monroe County, NY from December 2020 through March 2022, performed as part of the CDC Emerging Infections Program. Case participants were identified as HCP who had at least one COVID-19 like symptom, and a positive polymerase-chain-reaction (PCR) SARS-CoV-2 test during the study time period. Control participants had a negative SARS-CoV-2 PCR test, regardless of presence of COVID-19 like symptoms. Cases and controls were matched based on the study week of their test date. Conditional logistic regression was used to assess vaccine effectiveness against symptomatic infection. Effectiveness was assessed between December 2020-May 2021, May 2021-October 2021, and October 2021-March 2022.

Results
From December 28th, 2020 through March 12th, 2022, 881 cases and 1794 controls were enrolled. Vaccine effectiveness against symptomatic infection was greatest from December 2020 through May 2021, with mRNA complete series effectiveness at 93.1% (95% CI: 86.9%-96.3%) with complete series VE falling to 25.1% (95% CI: 0.0%-50.9%) during May 2021-October 2021. Waning immunity following receipt of second dose was observed across all time periods. Vaccine effectiveness following receipt of one booster vaccine was found to be 59.2% (95% CI: 43.5-70.6), with evidence of waning immunity two months from receipt of the booster (VE: 46.6%; 95% CI: 14.6%-66.7%).

Conclusion
Protection provided by the COVID-19 mRNA vaccines against symptomatic infection is highly variable among HCP, based on the circulating dominant variant and the time since receipt of each dose. Monitoring of vaccine effectiveness, as well as waning immunity, among this high-risk population is essential to guide future vaccine policies.

Disclosures
christopher J. Myers, MS, Infectious diseases, Pfizer: Grant/Research Support Ghinwa Dumyati, MD, Pfizer: Grant/Research Support.
1946. Efficacy of Approved versus Unapproved Vaccines for SARS-CoV-2 Infection in Randomised Blinded Clinical Trials
Authors: Navarro Andrea Perez , Pilkington Victoria , Hill Andrew , Pepperrell Toby 
Published: December 2022

Abstract

Background
Five SARS-CoV-2 vaccines are approved in North America and/or Europe: Pfizer/BioNTech, Moderna, Janssen, Oxford-AstraZeneca and Novavax. Other vaccines have been developed, including Sinopharm, SinoVac, QazVac, Covaxin, Soberana, Corbevac, Medicago, Clover and Cansino, but are not approved in high income countries. This meta-analysis compared the efficacy of approved and unapproved vaccines in randomised clinical trials (RCTs).

Methods
A systematic review of clinical trial registries, PUBMED and EMBASE identified placebo-controlled RCTs of SARS-CoV-2 vaccines prospectively evaluating risks of symptomatic or severe infection with clearly defined endpoints. For each trial, risk of bias was assessed using Cochrane tool 2.0 and the CONSORT checklist. In the pre-defined meta-analysis, relative risks of symptomatic infection and severe disease were compared for each vaccine versus placebo, using Cochrane-Mantel Haenszel Tests (random effects method).

Results
There were 21 RCTs assessing efficacy of the COVID-19 vaccines identified. One RCT was excluded for high risk of bias. Ten RCTs in 206,667 participants evaluated 5 approved vaccines; 10 RCTs in 158,599 participants evaluated 8 unapproved vaccines. In the meta-analysis, prevention of symptomatic infection was 84% (95% C.I. 68-92%) for approved vaccines versus 72% (95% C.I. 65-77%) for unapproved vaccines, with no significant difference between vaccine types (p=0.13). Prevention of severe SARS-CoV-2 infection was 95% (95% C.I. 78-99%) for approved vaccines versus 84% (95% C.I. 72-91%) for unapproved vaccines (p=0.12). In addition, the risk of serious adverse events was similar between vaccine types (p=0.49).
Efficacy of approved and unapproved SARS-CoV-2 vaccines
Percentage efficacy of approved and unapproved SARS-CoV-2 vaccines against symptomatic infection (Panel A) and severe disease (Panel B). Vaccines are arranged by approval-status (approved vaccines to the left and unapproved vaccines to the right of discontinuous line) and colour-coded by vaccine type. Error bars represent 95% confidence intervals.
RIBSP, Research Institute for Biological Safety Problems; IFV, Instituto Finlay de Vacunas.

Conclusion
This meta-analysis of 20 RCTs in 365,266 participants, showed no significant difference in efficacy between the approved and unapproved SARS-CoV-2 vaccines for endpoints of either symptomatic or severe infection. Differences in study design, end-point definitions, variants and prevalence of infection may have influenced the results. Head-to-head RCTs will be required to make definitive conclusions. If efficacy is proved definitively, new patent-free vaccines could lower costs of worldwide SARS-CoV-2 vaccination campaigns significantly.

Disclosures
All Authors: No reported disclosures.
1950. Factors Influencing COVID-19 Vaccine Uptake among Reproductive-Aged Women in Jamaica
Authors: Pinkney Jodian A , Carroll Kamali , Bryan Lenroy , Witter Givana , Ashour Dina , Shebl Fatma , Hyle Emily P , Ojikutu Bisola , Bogart Laura 
Published: December 2022

Abstract

Background
Little is known about the factors which influence COVID-19 vaccine uptake among reproductive-aged women in Jamaica.

Methods
We conducted a cross-sectional, web-based survey of 192 reproductive-aged women in Jamaica from February 1- 8, 2022. Participants were recruited from a convenience sample of women (patients, providers and staff) at a tertiary care hospital whose demographic characteristics are shown in Table 1. We assessed self-reported COVID-19 vaccination status, vaccine confidence (defined as confidence in the safety and efficacy of vaccines and the system that delivers them) and medical mistrust beliefs (e.g., “I don’t trust the COVID-19 vaccine”). We conducted exploratory factor analysis using principal axis factoring and oblique equamax rotation on 22 survey items. Three factors were extracted which conceptually aligned with three subscales: lack of vaccine confidence, government-related COVID-19 medical mistrust, and race-based COVID-19 medical mistrust; we retained items with factor loadings &gt; 0.40. The final subscale variables and their descriptive statistics are shown in Table 2. In addition, we used multivariable modified Poisson regression to calculate adjusted prevalence ratios (aPR) and 95% confidence intervals (CI) for the association between vaccine uptake and pregnancy status adjusting for education and factors scores. Variables with a p value &lt; 0.1 were retained in the final regression model.

Results
Of 192 respondents, 72(38%) were pregnant and 120 (62%) were non-pregnant. Pregnancy was negatively associated with vaccine uptake (aPR=0.70, 95%CI=0.51 - 0.96; p=0.029). Women with higher scores on the lack of vaccine confidence subscale (i.e., less confident in vaccine) were less likely to be vaccinated (aPR=0.72, 95%CI=0.61 - 0.86; p&lt; 0.001). Government-related COVID-19 medical mistrust and race-based COVID-19 medical mistrust were not significantly associated with vaccine uptake (see Table 3).

Conclusion
Findings suggest that pregnancy and lack of vaccine confidence are factors associated with lower vaccine uptake among reproductive-aged women in Jamaica. Bolstering vaccine confidence, through the use of evidence-based interventions, may help to increase COVID-19 vaccine uptake in this population.

Disclosures
All Authors: No reported disclosures.
1968. SARS-CoV-2 Anti-Spike IgG Antibodies in Neonates After Maternal Vaccination Against COVID-19 During Pregnancy and Outcomes
Authors: Casillas Casillas Maria C , Lopez-Enriquez Claudia C , Reyes Jimena , Ramírez Haua Jose L , Rendon Macias Mario E 
Published: December 2022

Abstract

Background
Worldwide, attempts to understand the neonatal response and the benefits of immunity conferred by the mother to continue preventing COVID-19 infection in vulnerable groups. Therefore, research on the efficacy of vaccination against SARS-CoV-2 in pregnancy remains as an important tool to prevention of complications.

Methods
Cross-sectional study in which blood samples from 379 neonates taken from the umbilical cord. The inclusion criteria were: newborns of mothers with a history of vaccination against SARS-CoV-2 during pregnancy. Infants whose mothers had COVID-19 infection at birth, or receiving any immunosuppressive treatment during pregnancy were excluded.

Results
379 neonates were studied for their antispike IgG levels. The majority were full-term female neonates were of adequate weight for their gestational age and without complications during their birth, 28 neonates required NICU care for their. Antispike IgG levels were obtained in 94.9% . Mothers received first dose at first trimester in 28.4%, second trimester in 51.9% and in the third trimester 19.6). A total of 318 mothers (87.8%) completed the two-dose schedule receiving the same vaccine, six (1.6%) received another anti-COVID vaccine, and the remaining 39 (10.7%) received only one dose of vaccine. 64.9% were vaccinated with the BNT162b2 vaccine, were higher leves when received two vaccine doses compared to only one. Vaccines that stimulated highest levels were mRNA-1273 and BNT162b2, lowest levels were found in the CoronaVac and Ad5-nCoV vaccines. Finally, it should be noted that only four neonates presented levels below 0.8 BAU/mL (non-positive).

Conclusion
This study provides evidence on timing of maternal anti-COVID vaccination, antibody production, and transplacentary transfer ensuring maternal and neonatal protection through vaccination is key to encourage women to be vaccinated against COVID-19 during pregnancy. Follow-up studies in infants are needed to understand the persistence of placental-transferred antispike IgG and the role of breast milk antibodies in maximizing the protection of infants at this stage of risk of severe SARS-Cov-2 disease. These findings have implications for determining new public health and vaccination strategies for pregnant women.

Disclosures
All Authors: No reported disclosures.
1969. SARS-CoV-2 seroprevalence among patients with cancer and healthcare workers from an oncology referral center during the first year of COVID-19 vaccination in Mexico
Authors: Villaseñor-Echavarri Rodrigo , De-la-Rosa-Martinez Daniel , Frias-Jimenez Emmanuel , Martin-Onraet Alexandra , Ruiz-Garcia Erika , Cruz-Cruz Alonso , Herrera-Montalvo Luis Alonso , Vilar-Compte Diana 
Published: December 2022

Abstract

Background
Cancer patients (CPs) with COVID-19 have an increased risk of adverse outcomes. In addition, CPs seem to have a lower immune response to SARS-CoV-2 vaccination. This study aimed to evaluate SARS-CoV-2 spike antibodies (anti-S Abs) following COVID-19 vaccination in CPs and healthcare workers (HCWs).

Methods
We conducted a point-seroprevalence study in CPs and HCWs who received a two-dose scheme with either BNT162b2, AZD1222, or Sputnik-V vaccine. We measured anti-S Abs by quantitative immunoassay to assess humoral immune response. Besides, we quantified anti-nucleocapsid antibodies in a subgroup of individuals to determine prior infection. We compared anti-S Abs titers in both groups and stratified by vaccine type, prior infection, and clinical characteristics. We conducted a multivariate logistic regression to determine variables associated with a poor humoral response.

Results
Six hundred forty-one individuals were included: 174 (27%) CPs and 467 (73%) HCWs. The median anti-S Abs titter was higher among HCWs compared to CPs (2568 U/mL vs. 1807 U/mL, p=0.002). Both CPs and HCWs with prior infection had higher anti-S Abs titter (p&lt; 0.001). Regardless of the time since vaccination, a higher proportion of subjects with titers &lt; 250 U/mL was observed in CPs (p&lt; 0.001) (Fig 2). In the multivariate analysis, older age (p=0.036), AZD1222 (p=0.003), and Sputnik-V (p=0.020) were associated with lower humoral response among the entire cohort.
SARS-CoV-2 spike antibody titers among cancer patients and healthcare workers.
Global differences in anti-S Abs titers between CPs and HCWs groups (a) and antibody titers in CPs and HCWs groups stratified by type of received vaccine (b). Abbreviations: CP: Cancer patients, HCW: Healthcare workers.
SARS-CoV-2 spike antibody titers according to time since vaccination among cancer patients and healthcare workers.
Abbreviations: CP: Cancer patients, HCW: Healthcare workers.

Conclusion
In this study, both CPs and HCWs showed an adequate response to vaccination; however, CPs had lower anti-S Abs titers and a faster decline over time. Based on our results, new strategies should be assessed to sustain the humoral response to vaccination and thus decrease the COVID-19 burden among the oncologic population.

Disclosures
All Authors: No reported disclosures.
1974. Title: A novel low-dose self-amplifying mRNA vaccine (GRT-R910) induces strong and broad boost in cellular and humoral immune response following primary series with a chimpanzee adenovirus SARS-CoV-2 vaccination
Authors: Turgut Tolga , Ahmed Uzma , Kachura Melissa , Kraemer Lauren , Nganje Charmaine , Hart Meghan , Jaroslavsky Jason , Kounlavouth Sonia , Marral Martina , Venkatraman Harshni , Kuan J C , Palmer Christine , Scallan Ciaran , Rappaport Amy , Jooss Karin , Uriel Alison , Ustianowski Andrew 
Published: December 2022

Abstract

Disclosures
Ciaran Scallan, PhD, Gritstone Bio: Salaried employee of Gritstone|Gritstone Bio: Stocks/Bonds Andrew Ustianowski, MD, PhD, Gilead: Advisor/Consultant|Gilead: Board Member|Gilead: Honoraria|Gilead: Speaker fees|Pfizer: Honoraria|Pfizer: Speaker fees|Vir/GlaxoSmithKline: Advisor/Consultant|Vir/GlaxoSmithKline: Board Member.

Background
The SARS-CoV-2 pandemic continues, with new variants of concern fueling periodic increases in COVID-19 cases. Authorized vaccines have provided protection against severe disease but less so for incident cases. Boosts with these vaccines have demonstrated waning protection. New vaccines, including those which induce immunity against more conserved regions outside of Spike, may improve upon these and be key to long-term protection and may be a useful approach against novel coronaviruses.

Methods
GO-009 (CORAL-Boost, NCT05148962) is an open-label study, conducted in the UK, of a self-amplifying mRNA vaccine encoding for Wuhan Spike (S) and highly conserved non-S T cell epitopes (GRT-R910; R910). R910 is given as 1 or 2 doses after vaccination with an authorized adenovirus or mRNA SARS-CoV-2 vaccine. The first two cohorts assessed 10µg and 30µg doses of R910 in older (≥60y) adults who had previously received ChAdOx1. Subsequent cohorts assess two boost doses in older and younger adults who have received an adenovirus or mRNA vaccine. Primary objectives are safety and reactogenicity and secondary objectives include cellular and humoral immunogenicity.

Results
Ten and seven adults received 10 or 30µg (cohorts 1 and 2) of R910, respectively. Reactogenicity and unsolicited adverse events were mostly mild/moderate and transient. The majority of severe events (malaise, fatigue, myalgia, Inj. site pain/tenderness/swelling) after dose 1 were experienced by 1 subject in cohort 2. Analysis of both IgG binding and neutralizing antibodies demonstrated a boost of anti-S antibodies after one dose of R910; geomean ID50 titers from 92 to 2370 and 99 to 1553 for 10 and 30µg, respectively. ELISpot analyses demonstrated that R910 boosted and broadened T cell responses to S and non-S T cell epitopes.

Conclusion
R910 was well tolerated. One R910 boost vaccination increased existing humoral and cellular immunity against S while inducing a broad T cell response against non-S SARS-CoV-2 proteins. A 10µg R910 boost increased neutralizing antibody titers comparable to a 10-fold higher dose (100µg) with authorized mRNA vaccines in a similar population (Munro et al 2021). A 10µg dose was selected for further study. Data post mRNA primary series will also be presented.
1988. Piperacillin-tazobactam plus Ceftriaxone for Enterococcus faecalis endocarditis: A Single Center Experience
Authors: Lee Rachael A , Rodriguez Martin , Stripling Joshua , Thottacherry Elizabeth 
Published: December 2022

Abstract

Background
Enterococcus faecalis is a leading cause of Infective Endocarditis (IE). IE guidelines recommend combination of penicillin (PCN) or ampicillin (AMP) with ceftriaxone (CTX) in susceptible strains. OPAT allows for antibiotic continuation at home; however outpatient AMP is limited due to frequent dosing and instability. Piperacillin-tazobactam (PTZ) has similar but not identical activity against penicillin binding proteins (PBP) compared to AMP and PCN, suggesting that PTZ may be a substitute in OPAT. This study compares outcomes in those with E. faecalis IE discharged with either PTZ or PCN with CTX.
Results of primary outcomes including death at 90 days and readmission at 90 days for those discharged on either PTZ or PCN in combination with CTX for E. faecalis endocarditis
Results of non infectious complications and changes in antibiotic therapy in both groups post discharge

Methods
This single center retrospective study took place from 2016 - 2020. Adults &gt; 18 years with AMP susceptible E. faecalis IE diagnosed using Duke’s criteria and blood or tissue cultures were included, with cultures confirming PCN susceptibility. Primary endpoint was failure of therapy at 90 days, defined as death due to any cause or infection relapse. Secondary outcomes were duration of antibiotics, change in regimen and non-infectious complications.

Results
Overall, 34 patients were identified, 17 in each group. Average age was 60–80 years, majority having a high Charleston comorbidity index. One did not have available AMP susceptibility but was PCN susceptible. 19 were managed surgically (65% PTZ group, 47% PCN group). Average total antibiotic course was 8.2 and 7.3 weeks in PTZ and PCN groups, with average OPAT course being 4.5 and 4.4 weeks. Primary endpoint was met in 18% patients in the PTZ group and 24% in the PCN group. Of the PCN group, 1 was admitted 4 months later due to an E. faecalis device infection, outside of primary endpoint. Nearly 80% completed antibiotic therapy with 29% in the PTZ group and 35% in the PCN group readmitted for non-infectious complications, including metabolic imbalances, stroke, volume overload and gastro-intestinal bleed. Hyperkalemia was seen in the PCN group with 3 patients requiring readmission. Seizures were not reported with combined PCN and ceftriaxone.

Conclusion
Similar outcomes were seen using either PTZ or PCN with CTX for treatment of enterococcal IE. Discharging patients on PCN is not always a feasible option. In these instances, PTZ could be considered as an alternative OPAT agent despite dissimilar mechanism of action compared to AMP and PCN.

Disclosures
All Authors: No reported disclosures.