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HOW REPEATED INFLUENZA VACCINATION EFFECTS MIGHT APPLY TO COVID-19 VACCINES
If repeated COVID-19 vaccination leads to blunted vaccine effectiveness or a reduction in protection relative to people who are unvaccinated, findings from new studies comparing different influenza vaccine types and vaccine strategies point to at least four lessons to be learned including, vaccine effectiveness studies might need to stratify their estimates by those with and without documented previous infection and by the differences in previous vaccination status to disentangle changes in vaccine effectiveness versus changes in population susceptibility over time.
Full Access: Lancet
ANTITHROMBOTIC THERAPY FOR VENOUS THROMBOEMBOLISM
Antithrombotic Therapy for VTE Disease: Second Update of the CHEST Guideline and Expert Panel Report Patients with low-risk pulmonary embolism should receive outpatient treatment.
Direct-acting oral anticoagulants (DOACs) should be used to treat acute VTE for the 3-month treatment phase. Oral Xa inhibitors should be used to treat acute VTE in a patient with cancer for both the initial and extended treatment phases. In patients with acute VTE, treat with full dose DOACs for 3 months followed by reduced-dose DOACs for extended therapy if indicated.
Extended anticoagulation therapy beyond 3 months is not routinely recommended in patients with major or minor transient risk factors.
Full Access: JAMA
ACUTE AND PERSISTENT EFFECTS OF COMMONLY USED ANTIBIOTICS ON THE GUT MICROBIOME AND RESISTOME IN HEALTHY ADULTS
To understand acute and persistent effects of antibiotics on the gut microbiota, researchers quantify microbiome dynamics before, during, and 6 months after exposure to 4 commonly used antibiotic regimens. Findings include an acute decrease in species richness and culturable bacteria after antibiotics, with most healthy adult microbiomes returning to pre-treatment species richness after 2 months, but with an altered taxonomy, resistome, and metabolic output, as well as an increased antibiotic resistance burden. Azithromycin delays the recovery of species richness, resulting in greater compositional distance. A subset of patients had a persistent reduction in microbiome diversity after antibiotics. These results improve our quantitative understanding of the impact of antibiotics on commensal microbiome dynamics, resilience, and recovery.
Full Access: Cell