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Mid-term follow-up after COVID-19 vaccination in adults with CHD: a prospective study

Published online by Cambridge University Press:  11 April 2023

Flavia Fusco Open the ORCID record for Flavia Fusco [Opens in a new window] ,
Giancarlo Scognamiglio ,
Anna Selvaggia Roma ,
Massimiliana Abbate ,
Giovanni Papaccioli ,
Assunta Merola ,
Michela Palma ,
Nunzia Borrelli ,
Rosaria Barracano Open the ORCID record for Rosaria Barracano [Opens in a new window]  and
Anna Correra
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Flavia Fusco*
Affiliation:
Adult Congenital Heart Disease Unit, AO dei Colli – Monaldi Hospital, Naples, Italy
Giancarlo Scognamiglio
Affiliation:
Adult Congenital Heart Disease Unit, AO dei Colli – Monaldi Hospital, Naples, Italy
Anna Selvaggia Roma
Affiliation:
Adult Congenital Heart Disease Unit, AO dei Colli – Monaldi Hospital, Naples, Italy
Massimiliana Abbate
Affiliation:
Adult Congenital Heart Disease Unit, AO dei Colli – Monaldi Hospital, Naples, Italy
Giovanni Papaccioli
Affiliation:
Adult Congenital Heart Disease Unit, AO dei Colli – Monaldi Hospital, Naples, Italy
Assunta Merola
Affiliation:
Adult Congenital Heart Disease Unit, AO dei Colli – Monaldi Hospital, Naples, Italy
Michela Palma
Affiliation:
Adult Congenital Heart Disease Unit, AO dei Colli – Monaldi Hospital, Naples, Italy
Nunzia Borrelli
Affiliation:
Adult Congenital Heart Disease Unit, AO dei Colli – Monaldi Hospital, Naples, Italy
Rosaria Barracano
Affiliation:
Adult Congenital Heart Disease Unit, AO dei Colli – Monaldi Hospital, Naples, Italy
Anna Correra
Affiliation:
Adult Congenital Heart Disease Unit, AO dei Colli – Monaldi Hospital, Naples, Italy
Nicola Grimaldi
Affiliation:
Adult Congenital Heart Disease Unit, AO dei Colli – Monaldi Hospital, Naples, Italy
Giovanni Domenico Ciriello
Affiliation:
Adult Congenital Heart Disease Unit, AO dei Colli – Monaldi Hospital, Naples, Italy
Maurizio D’Abbraccio
Affiliation:
Vaccination Unit for Vulnerable Patients, AO dei Colli – Cotugno Hospital, Naples, Italy
Cristina Scavone
Affiliation:
Section of Pharmacology “L. Donatelli”, Department of Experimental Medicine, University of Campania “LuigiVanvitelli”, Naples, Italy
Annalisa Capuano
Affiliation:
Section of Pharmacology “L. Donatelli”, Department of Experimental Medicine, University of Campania “LuigiVanvitelli”, Naples, Italy
Berardo Sarubbi
Affiliation:
Adult Congenital Heart Disease Unit, AO dei Colli – Monaldi Hospital, Naples, Italy
*
Author for correspondence: Dr F. Fusco, MD, Adult Congenital Heart Disease Unit, Monaldi Hospital, Via Leonardo Bianchi, 80131 Naples, Italy. Tel: +390817064206; Fax: +390817062501. E-mail: flavia.fusco@ospedalideicolli.it
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Abstract

Background:

Long-term data on COVID-19 vaccine safety, immunogenicity, and acceptance in adults with CHD are lacking.

Methods:

This is a prospective study including adults with CHD patients undergoing COVID-19 vaccination from January 2021 to June 2022. Data on adverse events, antispike IgG titre, previous or subsequent COVID-19 infection, booster doses, and patients’ attitude towards vaccination were collected.

Results:

Four hundred and ninety CHD patients (36 ± 13 years, 53% male, 94% with moderate/complex defects) were prospectively included: 433 (88%) received a Pfizer–BioNTech mRNA vaccine, 31 (6%) Moderna mRNA vaccine, 23 (5%) AstraZeneca–Oxford ChAdOx1 nCov-19 vaccine, and 3 (0.6%) Janssen Vaccine; 310 (63%) received a booster dose. Median follow-up after vaccination was 1.53 [1.41–1.58] years. No major adverse event was reported. Eighty-two fully vaccinated patients contracted COVID-19 during follow-up after a median of 5.4 [4.3–6.5] months from the last dose. One patient with Ebstein’s disease died from severe COVID-19. Symptoms’ duration in patients who tested positive after vaccination was significantly shorter than in the group tested positive before vaccination (5.5 [3–8] versus 9 [2.2–15] days, p = 0.04). Median antispike IgG titre measured in 280 individuals (57%) at a median of 1.4 [0.7–3.3] months from the last dose was 2381 [901–8307] BAU/ml. Sixty patients (12%) also showed positive antinucleocapsid antibodies, demonstrating previous SARS-COV2 exposure. Twenty-nine percent appeared to have concerns regarding vaccine safety and 42% reported fearing potential effects of the vaccine on their cardiac disease before discussing with their CHD cardiologist.

Conclusion:

COVID-19 vaccines appear safe in the mid-term follow-up in adults with CHD with satisfactory immunogenicity and reduction of symptoms’ duration in case of infection.

Keywords

COVID-19Adult CHDvaccinationcoronavirus disease 2019prospective study
Type
Original Article
Information
Cardiology in the Young , Volume 33 , Issue 12 , December 2023 , pp. 2574 - 2580
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Copyright
© The Author(s), 2023. Published by Cambridge University Press

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References

Rafaniello, C, Ferrajolo, C, Sullo, MG, et al. Cardiac events potentially associated to remdesivir: an analysis from the European spontaneous adverse event reporting system. Pharmaceuticals (Basel) 2021; 14: 611. DOI 10.3390/ph14070611.CrossRefGoogle ScholarPubMed
Scavone, C, Mascolo, A, Rafaniello, C, et al. Therapeutic strategies to fight COVID-19: which is the status artis? Br J Pharmacol 2021; 179: 2128–2148. DOI 10.1111/bph.15452.CrossRefGoogle ScholarPubMed
Data from Global Change Data Lab, a non-profit organization based in the United Kingdom. https://ourworldindata.org/covid-vaccinations?country=ITA. Retrieved September 15, 2021.Google Scholar
Andrews, N, Stowe, J, Kirsebom, F, et al. Covid-19 vaccine effectiveness against the Omicron (B.1.1.529) variant. N Engl J Med 2022; 386: 1532–1546.CrossRefGoogle ScholarPubMed
Dhama, K, Nainu, F, Frediansyah, A, et al. Global emerging Omicron variant of SARS-CoV-2: impacts, challenges and strategies. J Infect Public Health 2023; 16: 4–14.CrossRefGoogle ScholarPubMed
Broberg, CS, Kovacs, AH, Sadeghi, S, et al. COVID-19 in adults with congenital heart disease. J Am Coll Cardiol 2021; 77: 1644–1655.CrossRefGoogle ScholarPubMed
Fusco, F, Scognamiglio, G, Merola, A, et al. COVID-19 vaccination in adults with congenital heart disease: real-world data from an Italian tertiary centre. Int J Cardiol Congenit Heart Dis 2021; 6: 100266.CrossRefGoogle ScholarPubMed
World Health Organization. Adverse Events Following Immunization (AEFI). Retrieved September 15, 2021, from https://www.who.int/teams/regulation-prequalification/regulation-and-safety/pharmacovigilance/health-professionals-info/aefi Google Scholar
Italian Medicine Agency. https://www.aifa.gov.it/documents/20142/648668/dir_2010_84_it_0.pdf/b9932078-18b6-011c-8780-1e703514041c Google Scholar
Italian Medicine Agency. https://www.aifa.gov.it/documents/20142/834226/Valutazione_studi_infezione_da_SARS-CoV-2_Comitati+Etici_25.05.2020.pdf/caa67824-8e48-eb0d-610c-2557927a7b0b Google Scholar
Stout, KK, Daniels, CJ, Aboulhosn, JA, et al. AHA/ACC guideline for the management of adults with congenital heart disease: a report of the American College of Cardiology/American Heart Association task force on clinical practice guidelines. J Am Coll Cardiol 2019; 73: e81–e192. DOI 10.1016/j.jacc.2018.08.1029. Erratum in: J Am Coll Cardiol 2019; 73: 2361–2362.CrossRefGoogle Scholar
Scognamiglio, G, Fusco, F, Merola, A, Palma, M, Correra, A, Sarubbi, B. Caring for adults with CHD in the era of coronavirus disease 2019 pandemic: early experience in an Italian tertiary centre. Cardiol Young 2020; 30: 1405–1408. DOI 10.1017/S1047951120002085.CrossRefGoogle Scholar
Driggin, E, Maddox, TM, Ferdinand, KC, et al. ACC health policy statement on cardiovascular disease considerations for COVID-19 vaccine prioritization: a report of the American College of Cardiology solution set oversight committee. J Am Coll Cardiol 2021; 77: 1938–1948.CrossRefGoogle Scholar
Assenza, GE, Castaldi, B, Flocco, S, et al. COVID-19 vaccine priority access for adults and children with congenital heart disease: a statement of the Italian Society of Pediatric Cardiology. Congenit Heart Dis 2021; 16: 427–431.CrossRefGoogle Scholar
Sabatino, J, Di Salvo, G, Calcaterra, G, et al. Adult congenital heart disease: special considerations for COVID-19 and vaccine allocation/prioritization. Int J Cardiol Congenit Heart Dis 2021; 4: 100186.CrossRefGoogle ScholarPubMed
European Centre for Disease Prevention and Control. https://www.ecdc.europa.eu/en/news-events/impact-surge-china-covid-19-cases Google Scholar
Agenzia Italiana del Farmaco. FAQ Vaccini a mRNA. Retrieved January 02, 2023, from https://www.aifa.gov.it/domande-e-risposte-su-vaccini-mrna Google Scholar
European Medicines Agency. https://www.ema.europa.eu/en/human-regulatory/overview/public-health-threats/coronavirus-disease-covid-19/treatments-vaccines/vaccines-covid-19/safety-covid-19-vaccines Google Scholar
Beatty, AL, Peyser, ND, Butcher, XE, et al. Analysis of COVID-19 vaccine type and adverse effects following vaccination. JAMA Netw Open 2021; 4: e2140364. DOI 10.1001/jamanetworkopen.2021.40364.CrossRefGoogle ScholarPubMed
Maniscalco, GT, Scavone, C, Mascolo, A, et al. The safety profile of COVID-19 vaccines in patients diagnosed with multiple sclerosis: a retrospective observational study. J Clin Med 2022; 11: 6855. DOI 10.3390/jcm11226855.CrossRefGoogle ScholarPubMed
Patone, M, Mei, XW, Handunnetthi, L, et al. Risk of myocarditis after sequential doses of COVID-19 vaccine and SARS-CoV-2 infection by age and sex. Circulation 2022; 146: 743–754. DOI 10.1161/CIRCULATIONAHA.122.059970.CrossRefGoogle ScholarPubMed
Oster, ME, Shay, DK, Su, JR, et al. Myocarditis cases reported after mRNA-based COVID-19 vaccination in the US from December 2020 to August 2021. JAMA 2022; 327: 331–340. DOI 10.1001/jama.2021.24110.CrossRefGoogle ScholarPubMed
Xu, R, Shi, G, Zheng, S, Tung, TH, Zhang, M. COVID-19 vaccine hesitancy between family decision-makers and non-decision-makers among college teachers. Ann Med 2023; 55: 292–304.CrossRefGoogle ScholarPubMed
Smith, LE, Sim, J, Amlôt, R, et al. Side-effect expectations from COVID-19 vaccination: findings from a nationally representative cross-sectional survey (CoVAccS - wave 2). J Psychosom Res 2021; 152: 110679. DOI 10.1016/j.jpsychores.2021.110679.CrossRefGoogle ScholarPubMed
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