Reduction of intubation requirement in coronavirus disease 2019 infection from the fifth dose of coronavirus disease 2019 vaccine: An expectation from an appraisal on data from an endemic area in Southeast Asia :Rujittika Mungmunpuntipantip, Viroj Wiwanitkit, Journal of Preventive, Diagnostic and Treatment Strategies in Medicine

ORIGINAL ARTICLE
Year : 2023 | Volume : 2 | Issue : 1 | Page : 39--42

Reduction of intubation requirement in coronavirus disease 2019 infection from the fifth dose of coronavirus disease 2019 vaccine: An expectation from an appraisal on data from an endemic area in Southeast Asia

Rujittika Mungmunpuntipantip¹, Viroj Wiwanitkit²,
¹ Private Academic Consultant, Bangkok, Thailand
² Department of Community Medicine, Dr. D. Y. Patil Vidhyapeth, Pune, Maharashtra, India

Correspondence Address:
Rujittika Mungmunpuntipantip
Private Academic Consultant, 111 Bangkok 122, Bangkok 103300
Thailand

Abstract

BACKGROUND: There is still no cure for coronavirus disease 2019 (COVID-19), which is a global emergency. The best choice for disaster management is vaccination. The principal COVID-19 preventive tactic of COVID-19 immunization is now widely accepted. Some scientists are advocating a fifth dosage vaccine in the event of the arrival of a new strain as well as the probable loss of public immunity following routine mass vaccination. AIM AND OBJECTIVE: The fifth dose of COVID-19 is typically reported to have successfully avoided mortality, although there is still concern about how to prevent severe COVID-19 cases that necessitate intubation. After receiving the fifth dosage of the COVID-19 vaccine, the authors of this study evaluated an extra protection rate that would reduce the need for intubation in COVID-19 infection. MATERIALS AND METHODS: The authors of this study employed a clinical model technique to assess an extra protection rate leading to a decrease in the need for intubation in COVID-19 infection following the fifth dose of COVID-19 vaccine immunization. RESULTS: According to the study, just four vaccine doses are required and are highly successful in preventing the need for intubation, thus there is no further benefit in this regard. However, the fifth dose may still be helpful in reducing the risk of contracting COVID-19. CONCLUSION: Clinical experiments have proven its efficacy in preventing omicron COVID-19 infection. However, there is no additional benefit in terms of lowering the need for intubation because just four immunization doses are necessary and extremely effective in doing so.

How to cite this article:
Mungmunpuntipantip R, Wiwanitkit V. Reduction of intubation requirement in coronavirus disease 2019 infection from the fifth dose of coronavirus disease 2019 vaccine: An expectation from an appraisal on data from an endemic area in Southeast Asia.J Prev Diagn Treat Strategies Med 2023;2:39-42

How to cite this URL:
Mungmunpuntipantip R, Wiwanitkit V. Reduction of intubation requirement in coronavirus disease 2019 infection from the fifth dose of coronavirus disease 2019 vaccine: An expectation from an appraisal on data from an endemic area in Southeast Asia. J Prev Diagn Treat Strategies Med [serial online] 2023 [cited 2023 Jun 3 ];2:39-42
Available from: http://www.jpdtsm.com/text.asp?2023/2/1/39/371630

Full Text

Introduction

Coronavirus disease 2019 (COVID-19) is still a global emergency with no feasible treatment.[1] Vaccination is the best option for disaster management.[2] COVID-19 vaccination is now universally accepted as an effective primary COVID-19 preventive strategy. Traditionally, two vaccine doses are required for full vaccination. Immunity levels may decrease following vaccination, necessitating the need of self-protective behavior. When there is a novel developing variant and a probable decline in antibodies following standard immunization, several experts recommend using an additional booster dose of the COVID-19 vaccine.[3],[4] A third dosage booster is commonly used in various circumstances.[5] The third dosage vaccine is currently accepted for its utility in terms of efficacy,[6] according to a recent Yasri and Wiwanitkit paper.

However, there is still a lack of evidence on the specific new troublesome variant omicron, and there has been no systematic examination into the specific preventive benefit of a boostering vaccination with a specific focus on preventing overall infection and COVID-19 death. A comprehensive strategy based on various complete standard vaccination backgrounds confirmed the efficacy of the third dose of the COVID-19 vaccine. In some situations, the fourth boostering is already being used in addition to the third dosage of COVID-19 vaccination.[6],[7] According to Mungmunpuntipantip and Wiwanitkit's clinical mathematical modeling analysis, the fourth dose of COVID-19 is still advantageous if the highly potent mRNA vaccine is used as a booster vaccination.[8] In general, in some local reports (such as https://www.tnnthailand.com/news/covid19/108553/andhttps://www.infoquest.co.th/2022/202745), the additional fourth dosage of COVID-19 vaccination has already been shown to be effective against COVID-19 infection, with success in completely preventing mortality.

Nonetheless, some experts continue to advocate for a second dose of vaccine in the event of a new strain, as well as the predicted loss of public immunity following routine mass inoculation. Because the fifth vaccine dose's efficacy is uncertain, any inquiry into it is intriguing.

The COVID-19 outbreak is currently ongoing and the current situation remains unchanged. The situation in our environment, Indochina, is still critical. Local policymakers have announced an intention to use the fifth dose of COVID-19 vaccination (https://mgronline.com/indochina/detail/9650000048134). The fifth dose of the COVID-19 vaccine's efficacy in giving additional protection against COVID-19 infection is intriguing. Because it is already known that the fourth dose can successfully avoid mortality, the left's focus is on the prevention of severe COVID-19 infection, which necessitated intubation therapy. Following the fifth dosage of COVID-19 vaccine immunization, the authors of this study used a clinical model technique to estimate an extra protection rate leading to a decrease in the requirement for intubation in COVID-19 infection.

Materials and Methods

Study design and purpose

The purpose of this study is to estimate an extra protection rate that is further related to a decrease in the requirement for intubation in COVID-19 infection. This study is part of the authors' team's effort to analyze and monitor the efficacy of COVID-19 immunization in a series of continuous studies. The current study, like previous studies, focuses on clinical mathematical modeling.[8],[9] According to an in vitro and in vivo study, the technique is typical in silico mathematical modeling technique with little impact from environmental complicating elements. “Primary data” refers to basic information on the protective efficacy rates of various vaccination types.[9] Various vaccines have different immunogenicity mechanisms, according to a basic assumption. Vaccines created with various biotechnologies have a diverse set of essential components, resulting in a diverse set of immunoprotection inductions. The highest level of effective immunity or protective efficacy will be obtained once routine immunization is introduced. In this work, background protective effect refers to the reported immunoprotection rate following the administration of the vaccine in its whole four times and data that are based on publicly accessible data from a developing country (https://www.infoquest.co.th/2022/202745). The background data on both protection against infection and reducing intubation are used.

Sampling

The current study is a clinical mathematical model study that manipulates parameters using all of the original data. Since there is no sampling, there is no issue with selection bias or inadequate sample size.

Ethical consideration

The present study is clinical mathematical modeling and does not deal with any human, animal, or clinical samples. Ethical committee approval is not applicable and informed consent is also not applicable.

Clinical mathematical model analysis

The modeling approach employed in this investigation was the same as in a previous study that examined the effects of a booster dose of the COVID-19 vaccine. The protective efficacy after the fourth dose is probably going to be regarded as background protective efficacy for modeling purposes.[6] If given as a booster dosage, the additional protection from the fifth dose can augment boostering action and raise the protective efficacy rate, but it would not go over the baseline protective efficacy rate. However, the background protective efficacy of the boostering vaccine will not be more than the ultimate protection efficacy, which is essential in present models. The background protective efficacy of the second dose will therefore be equal to the efficacy of the additional dose. Under the previously mentioned primary condition, the final projected protective efficacy rate will be calculated as “background protective effect + additional protection from the fifth dose.” Then, using the formula “anticipated protection rate–background protective activity,” the additional protection rate is determined.

Using basic data from a developing tropical nation in Southeast Asia (GPS location: 18°49'26.7“N 98°56'58.6”E) with a problem of highly endemic uncontrollable infection, this model simulates and predicts the role of COVID-19's fifth dose (25th world rank in the number of COVID-19 cases, 51th world rank in size of country and 20th world rank in the number of population). Background In this situation, different people receive heterologous two-dose COVID-19 vaccinations along with two booster doses. The most recent publicly available data on the effectiveness of the fourth dose COVID-19 vaccine are the foundation of the current modeling analysis. The most recent report, available at https://www.infoquest.co.th/2022/202745, uses real-world government statistics from a region of Indochina where COVID-19 is still widely spread (data on May 22, 2022). The fourth dose of the COVID-19 vaccine, according to the article, is successful at preventing a specific death due to omicron COVID-19 infection. The fourth dose of the COVID-19 vaccine, per the report, has an efficacy of 76% for preventing a specific omicron COVID-19 infection and a specific 99% for preventing a severe illness, resulting in a reduction in the need for intubation in COVID-19 infections.

Results

The expected effectiveness of the fifth immunization dosage against infection is shown in [Table 1] based on the modeling analysis. Simulations show that the fifth dosage of immunization can still boost immunity and offer further protection against omicron COVID-19 infection. Despite this, the fifth dose of immunization can still improve immunity without reducing the need for intubation any further. All vaccines can be beneficial, but the mRNA vaccination is the best for boosters.{Table 1}

Discussion

COVID-19 is a respiratory illness with a wide clinical spectrum and becomes the biggest global public health at present.[11] COVID-19 is still an important problem. There are several attempts to manage the situation. Several new approaches such as telehealth, new therapies, and new vaccines are introduced to cope with the situation.[10],[12],[13],[14] After receiving the COVID-19 vaccination, protection starts to wane, raising the possibility of re-infection. Prevention is essential because COVID-19 infection is still a possibility even after receiving both doses of the vaccination. In addition, some particular groups, such as dialysis patients, have inadequate immunity after receiving two immunization doses. Consequently, booster vaccine doses have been advised and given in a number of situations. The effectiveness of the subsequent booster dose of the vaccine has only been the subject of a small number of studies, most of which have focused on immune-deficient populations. The immune response can be boosted by a booster dose of the vaccination, but this is not always essential, according to many experts today.[5]

The final dosage vaccination against COVID-19 is frequently used to boost immunity in immunocompromised patients and to fend off the virus's evolving version.[5] Due to a failure to control the disease, some settings, including those in Indochina, have in the past used a fourth dosage of the vaccine. After the fourth dose, the vaccine's effectiveness and usefulness are confirmed.[7] Numerous studies have discovered that the fourth booster dose can still aid in the development of an immune response against the current COVID-19 strain.[15],[16] It is obvious that the mortality can be successfully managed after the fourth dose. Nevertheless, disease control is a problem, and intubation-required serious infections continue to receive attention. The fifth dose of COVID-19 immunization has been questioned by researchers in one region where the first and second doses have a history of being ineffective.

Using primary data from a developing Asian region with a problem of highly endemic uncontrollable infection, this model simulates and predicts the role of COVID-19's fifth dose. Background COVID-19 vaccination differs in this environment, with some people receiving a heterologous two-dose COVID-19 vaccine plus two booster doses. Indeed, in the prior study on evaluating the efficacy of the fifth dose vaccination, there is still a function for the boostering dosage based on the ability to prevent overall COVID-19, with no particular data on any variety.[17] However, given Indochina's rapidly expanding omicron variety, the current study can provide more specific data that represents the actual situation, and updated real-life data. The local data might show that the fourth COVID-19 vaccine dose or second extra booster might completely prevent mortality, which is concordant with the real-life data reported from Israel, where the fourth dose of the COVID-19 vaccine is also generally used.[18] However, there was no information on the boostering vaccine's incrementing characteristic or the increased protection rate against intubation requirements.

The fifth dose enhancing COVID-19 vaccination regimen was found to play a role in infection immunogenicity but not in death prevention in this investigation because the previous four doses of vaccine had already fulfilled the preventive property. The current study adds to a recent report on the effectiveness of the fifth dose of COVID-19 in disease prevention among patients with underlying chronic kidney disease and organ transplant recipients.[19],[20] The observed in the previous report that there is an increased protective immunity rate after the fourth dose of COVID-19 administration among kidney transplant cases is concordant with the present modeling study.[20] If a fifth booster dose is anticipated, a number of mRNA COVID-19 vaccine alternatives should be considered.

Conclusion

Finally, this study showed that infection immunogenicity is influenced by the fifth dosage increasing COVID-19 vaccine regimen. Clinical experiments have proven its efficacy in preventing omicron COVID-19 infection. However, there is no additional benefit in terms of lowering the need for intubation because just four immunization doses are necessary and extremely effective in doing so. The fifth dose, however, can still be beneficial in preventing COVID-19 infection. To further manage the severe case, the role of the next sixth dose COVID-19 vaccine is an issue for further researching.

Limitation of the study

This study is a retrospective analysis of clinical mathematical models. The outbreak's situation is changing quickly, thus if the scenario changes, the outcomes might also change.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

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