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BACKGROUND: Vaccine effectiveness for first-generation coronavirus disease (COVID-19) vaccines among People Living with HIV (PLHIV) in India remains unexplored. This study entails the estimation of the real-world effectiveness of COVID-19 vaccines (AZD1222/Covishield, BBV152/Covaxin) among PLHIV and the identification of variants of SARS-CoV-2 among those infected with COVID-19. METHODS: An ambi-directional cohort study was conducted among 925 PLHIV above 18 years of age in two districts of central Kerala, India, from February 2022 to March 2023. Selected PLHIV were recruited as Participant Liaison Officers (PLOs) for the follow-up on the study participants. At enrolment, basic details, baseline CD4 count, and a Nasopharyngeal (NP) swab for RT-PCR were collected. In the follow-up phase, NP swabs were collected from subjects with COVID-19 symptoms. Positive subjects had a CD4 count and genomic sequencing performed. RESULTS: The mean age of the participants was 46.93 ± 11.00 years. The majority, 819 (93.6%), of participants had received at least one dose of any vaccine, while 56 (6.4%) were unvaccinated. A total of 649 (79.24%) participants were vaccinated with Covishield and 169 (20.63%) with Covaxin. In the vaccinated group, 158 (19.3%) reported COVID-19 infection. Vaccine Effectiveness (VE) for one dose of any vaccine was 43.2% (95% CI: 11.8-64.5), p = 0.015. The effectiveness of full vaccination with Covishied was 63.8% (95% CI: 39.3-79.2), p < 0.001, and Covaxin was 73.4% (95% CI: 44.3-87.3). VE was highest, at 60.7% (95% CI: 23.6-81.3), when the two doses of the vaccine were given at an interval of less than 6 weeks. Participants with a baseline CD4 count > 350 had greater protection from COVID-19, at 53.4% (95% CI: 19.6-75.3) p = 0.004. The incident cases were sub-variants of Omicron (BA.2, BA.2.38, BA.2.10). CONCLUSIONS: Full vaccination with Covishield and Covaxin was effective against COVID-19 infection among PLHIV on treatment; albeit, that of Covaxin was higher. A gap of 4 to 6 weeks between the two doses of COVID-19 vaccine was found to have higher VE among PLHIV.

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Context: Anemia in pregnancy is a significant public health concern with detrimental aftereffects on maternal and fetal well-being universally, especially in developing countries like India. Aims: To estimate the prevalence of anemia in pregnant women in rural areas of Kozhikode by hemoglobin estimation and to study the selected factors associated with anemia. Settings and Design: A cross-sectional study was conducted among 295 antenatal women in all three trimesters residing in six selected panchayats of Kozhikode district from July 2016 to March 2017. Materials and Methods: The cluster sampling method was followed. Data were obtained from antenatal women, applying a pretested semi-structured questionnaire. Hemoglobin estimation was done using the Humacount 30TS automated hematology analyzer. Statistical Analysis Used: Data were analyzed using SPSS 18 software. Results: The prevalence of anemia was 40%. Of this, 30.5% had mild anemia and 9.5% had moderate anemia. There were no cases of severe anemia. The prevalence was more in the second trimester. Factors such as excess menstrual blood loss prior to present pregnancy, early age at first delivery, trimester, and parity were found to be significantly associated with anemia. Conclusion: Anemia continues to be a serious public health problem. Health system should pay more attention on different factors that contribute to anemia, and planners should formulate an apt policy and implement necessary changes in existing programs.

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BACKGROUND: The reports on adverse experiences following vaccination are scanty from India. It is important to know the real-world post-vaccination experience outside of clinical trial conditions. OBJECTIVES: The study aims to estimate the incidence of adverse events following immunization with the ChAdOx1 nCoV-19 coronavirus vaccine and to identify the predictors for the development of vaccine adverse events. METHODS: A prospective observational study was conducted among health care workers who received the ChAdOx1 nCoV-19 coronavirus vaccine. Study participants were monitored at the site for 30 min following vaccination and were followed up for 7 days after receiving the second dose, with a purpose-specific designed online surveillance form to enquire about any adverse events following vaccination. We used the Chi-squared test for categorical variables and multivariate regression analysis to identify predictors for the development of vaccine adverse effects. RESULTS: Of 411 participants, the mean age was 30.77 ± 12.5 years and 76.2% were females. Overall, 207 (50.4%) respondents reported at least one post-vaccination symptom receiving either dose of coronavirus vaccination. Fever (34.8%), local pain at the injection site (28.0%), tiredness (25.5%), chills (20%), myalgia (18.7%), headache (17.8%), injection site stiffness (5.4%), joint pain (4.6%) and nausea-vomiting (3.8%) were the most prevalent symptoms following the first dose. Adverse reactions reported after the second dose were milder and less frequent. Postvaccination symptoms were more likely in the younger age group, those with comorbidity particularly, bronchial asthma , and a history of allergy to food/drugs. CONCLUSION: All the adverse reactions were of a minor type and non-serious. Side effects were less common in older adults (>60 years). Reactions to the second dose were lesser in intensity and frequency. Younger age, history of allergy, and comorbidities, particularly asthma, were found to be major predictors for the development of adverse events and require more watchful vaccine administration.

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A 30-year-old male working in an abattoir in UAE returned home to Kerala, South India, after getting diagnosed with Crimean-Congo hemorrhagic fever infection. He was admitted to a tertiary care center on the day of arrival and was placed under isolation. Due to the risk of spread of infection among health-care workers, contact-tracing and symptom-monitoring activities were undertaken. As strict standard contact precautions, isolation, contact identification and listing, quarantine, and sensitization of health-care workers were implemented, no secondary cases occurred.