Solid Organ Rejection following SARS-CoV-2 Vaccination or COVID-19 Infection: A Systematic Review and Meta-Analysis

Saad Alhumaid; Ali A. Rabaan; Kuldeep Dhama; Shin Jie Yong; Firzan Nainu; Khalid Hajissa; Nourah Al Dossary; Khulood Khaled Alajmi; Afaf E. Al Saggar; Fahad Abdullah AlHarbi; Mohammed Buhays Aswany; Abdullah Abdulaziz Alshayee; Saad Abdalaziz Alrabiah; Ahmed Mahmoud Saleh; Mohammed Ali Alqarni; Fahad Mohammed Al Gharib; Shahd Nabeel Qattan; Hassan M. Almusabeh; Hussain Yousef AlGhatm; Sameer Ahmed Almoraihel; Ahmed Saeed Alzuwaid; Mohammed Ali Albaqshi; Murtadha Ahmed Al Khalaf; Yasmine Ahmed Albaqshi; Abdulsatar H Al Brahim; Mahdi Mana Al Mutared; Hassan Al-Helal; Header A Alghazal; Abbas Al Mutair

doi:10.3390/vaccines10081289

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Solid Organ Rejection following SARS-CoV-2 Vaccination or COVID-19 Infection: A Systematic Review and Meta-Analysis

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Solid Organ Rejection following SARS-CoV-2 Vaccination or COVID-19 Infection: A Systematic Review and Meta-Analysis

Saad Alhumaid, Ali A. Rabaan, Kuldeep Dhama, Shin Jie Yong, Firzan Nainu, Khalid Hajissa, Nourah Al Dossary, Khulood Khaled Alajmi, Afaf E. Al Saggar, Fahad Abdullah AlHarbi, …

Vaccines (Basel), Vol.10(8), p.1289

01/08/2022

DOI: https://doi.org/10.3390/vaccines10081289

PMID: 36016180

Abstract

allograft

COVID-19

disease

infection

meta-analysis

organ

rejection

Review

SARS-CoV-2

systematic review

transplant

vaccination

vaccine

Background: Solid organ rejection post-SARS-CoV-2 vaccination or COVID-19 infection is extremely rare but can occur. T-cell recognition of antigen is the primary and central event that leads to the cascade of events that result in rejection of a transplanted organ. Objectives: To describe the results of a systematic review for solid organ rejections following SARS-CoV-2 vaccination or COVID-19 infection. Methods: For this systematic review and meta-analysis, we searched Proquest, Medline, Embase, Pubmed, CINAHL, Wiley online library, Scopus and Nature through the Preferred Reporting Items for Systematic Reviews and Meta Analyses (PRISMA) guidelines for studies on the incidence of solid organ rejection post-SARS-CoV-2 vaccination or COVID-19 infection, published from 1 December 2019 to 31 May 2022, with English language restriction. Results: One hundred thirty-six cases from fifty-two articles were included in the qualitative synthesis of this systematic review (56 solid organs rejected post-SARS-CoV-2 vaccination and 40 solid organs rejected following COVID-19 infection). Cornea rejection (44 cases) was the most frequent organ observed post-SARS-CoV-2 vaccination and following COVID-19 infection, followed by kidney rejection (36 cases), liver rejection (12 cases), lung rejection (2 cases), heart rejection (1 case) and pancreas rejection (1 case). The median or mean patient age ranged from 23 to 94 years across the studies. The majority of the patients were male ( n = 51, 53.1%) and were of White (Caucasian) ( n = 51, 53.7%) and Hispanic ( n = 15, 15.8%) ethnicity. A total of fifty-six solid organ rejections were reported post-SARS-CoV-2 vaccination [Pfizer-BioNTech ( n = 31), Moderna ( n = 14), Oxford Uni-AstraZeneca ( n = 10) and Sinovac-CoronaVac ( n = 1)]. The median time from SARS-CoV-2 vaccination to organ rejection was 13.5 h (IQR, 3.2–17.2), while the median time from COVID-19 infection to organ rejection was 14 h (IQR, 5–21). Most patients were easily treated without any serious complications, recovered and did not require long-term allograft rejection therapy [graft success ( n = 70, 85.4%), graft failure ( n = 12, 14.6%), survived ( n = 90, 95.7%) and died ( n = 4, 4.3%)]. Conclusion: The reported evidence of solid organ rejections post-SARS-CoV-2 vaccination or COIVD-19 infection should not discourage vaccination against this worldwide pandemic. The number of reported cases is relatively small in relation to the hundreds of millions of vaccinations that have occurred, and the protective benefits offered by SARS-CoV-2 vaccination far outweigh the risks.

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Title: Solid Organ Rejection following SARS-CoV-2 Vaccination or COVID-19 Infection: A Systematic Review and Meta-Analysis
Creators - without role: Saad Alhumaid - Ministry of Health
Ali A. Rabaan - Saudi Aramco Medical Services Organization
Kuldeep Dhama - Indian Veterinary Research Institute
Shin Jie Yong - Sunway University
Firzan Nainu - Hasanuddin University
Khalid Hajissa - Universiti Sains Malaysia
Nourah Al Dossary - Administration of Pharmaceutical Care, Al-Ahsa Health Cluster, Ministry of Health, Al-Ahsa 31982, Saudi Arabia Molecular Diagnostic Laboratory, Johns Hopkins Aramco Healthcare, Dhahran 31311, Saudi Arabia College of Medicine, Alfaisal University, Riyadh 11533, Saudi Arabia Department of Public Health/Nutrition, The University of Haripur, Haripur 22620, Khyber Pakhtunkhwa, Pakistan Division of Pathology, ICAR-Indian Veterinary Research Institute, Izatangar, Bareilly 243122, Uttar Pradesh, India Department of Biological Sciences, School of Medical and Life Sciences, Sunway University, Subang Jaya 47500, Malaysia Department of Pharmacy, Faculty of Pharmacy, Hasanuddin University, Makassar 90245, Indonesia Department of Medical Microbiology & Parasitology, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian 16150, Malaysia General Surgery Department, Alomran General Hospital, Ministry of Health, Al-Ahsa 36358, Saudi Arabia Pharmacy Department, Al-Ahsa Mental Health Hospital, Al-Ahsa 31982, Saudi Arabia Administration of Accreditation, Quality and Performance Excellence Management, Riyadh 3rd Health Cluster, Ministry of Health, Riyadh 13717, Saudi Arabia Clinical Pharmacy Services—Nephrology Department, King Saud Hospital, Ministry of Health, Riyadh 56437, Saudi Arabia Administration of Supply and Shared Services, C1 Riyadh Health Cluster, Ministry of Health, Riyadh 11622, Saudi Arabia Administration of Compliance, Directorate of Health Affairs, Ministry of Health, Eastern Region, Al-Ahsa 36441, Saudi Arabia Diagnostic Radiology Department, Prince Sultan Military Medical City, Riyadh 12233, Saudi Arabia Clinical Pharmacy Department, Gurayat General Hospital, Ministry of Health, Gurayat 77471, Saudi Arabia Pharmacy Department, Aljafr General Hospital, Ministry of Health, Al-Ahsa 77110, Saudi Arabia Respiratory Therapy Department, Maternity and Children Hospital, Ministry of Health, Al-Ahsa 36422, Saudi Arabia Pharmacy Department, King Fahad Hofuf Hospital, Ministry of Health, Al-Ahsa 36441, Saudi Arabia Psychological Service Department, Ardha and Mental Health Complex, Ministry of Health, Najran 66248, Saudi Arabia Division of Laboratory, Medical Microbiology Department, Maternity and Children Hospital, Ministry of Health, Al-Ahsa 36422, Saudi Arabia Microbiology Laboratory, Prince Saud Bin Jalawi Hospital, Ministry of Health, Al-Ahsa 36424, Saudi Arabia Research Center, Almoosa Specialist Hospital, Al-Ahsa 36342, Saudi Arabia College of Nursing, Princess Norah Bint Abdulrahman University, Riyadh 11564, Saudi Arabia School of Nursing, Wollongong University, Wollongong, NSW 2522, Australia Department of Nursing, Prince Sultan Military College, Dharan 34313, Saudi Arabia
Khulood Khaled Alajmi - Pharmacy Department, Al-Ahsa Mental Health Hospital, Al-Ahsa 31982, Saudi Arabia
Afaf E. Al Saggar - Administration of Pharmaceutical Care, Al-Ahsa Health Cluster, Ministry of Health, Al-Ahsa 31982, Saudi Arabia Molecular Diagnostic Laboratory, Johns Hopkins Aramco Healthcare, Dhahran 31311, Saudi Arabia College of Medicine, Alfaisal University, Riyadh 11533, Saudi Arabia Department of Public Health/Nutrition, The University of Haripur, Haripur 22620, Khyber Pakhtunkhwa, Pakistan Division of Pathology, ICAR-Indian Veterinary Research Institute, Izatangar, Bareilly 243122, Uttar Pradesh, India Department of Biological Sciences, School of Medical and Life Sciences, Sunway University, Subang Jaya 47500, Malaysia Department of Pharmacy, Faculty of Pharmacy, Hasanuddin University, Makassar 90245, Indonesia Department of Medical Microbiology & Parasitology, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian 16150, Malaysia General Surgery Department, Alomran General Hospital, Ministry of Health, Al-Ahsa 36358, Saudi Arabia Pharmacy Department, Al-Ahsa Mental Health Hospital, Al-Ahsa 31982, Saudi Arabia Administration of Accreditation, Quality and Performance Excellence Management, Riyadh 3rd Health Cluster, Ministry of Health, Riyadh 13717, Saudi Arabia Clinical Pharmacy Services—Nephrology Department, King Saud Hospital, Ministry of Health, Riyadh 56437, Saudi Arabia Administration of Supply and Shared Services, C1 Riyadh Health Cluster, Ministry of Health, Riyadh 11622, Saudi Arabia Administration of Compliance, Directorate of Health Affairs, Ministry of Health, Eastern Region, Al-Ahsa 36441, Saudi Arabia Diagnostic Radiology Department, Prince Sultan Military Medical City, Riyadh 12233, Saudi Arabia Clinical Pharmacy Department, Gurayat General Hospital, Ministry of Health, Gurayat 77471, Saudi Arabia Pharmacy Department, Aljafr General Hospital, Ministry of Health, Al-Ahsa 77110, Saudi Arabia Respiratory Therapy Department, Maternity and Children Hospital, Ministry of Health, Al-Ahsa 36422, Saudi Arabia Pharmacy Department, King Fahad Hofuf Hospital, Ministry of Health, Al-Ahsa 36441, Saudi Arabia Psychological Service Department, Ardha and Mental Health Complex, Ministry of Health, Najran 66248, Saudi Arabia Division of Laboratory, Medical Microbiology Department, Maternity and Children Hospital, Ministry of Health, Al-Ahsa 36422, Saudi Arabia Microbiology Laboratory, Prince Saud Bin Jalawi Hospital, Ministry of Health, Al-Ahsa 36424, Saudi Arabia Research Center, Almoosa Specialist Hospital, Al-Ahsa 36342, Saudi Arabia College of Nursing, Princess Norah Bint Abdulrahman University, Riyadh 11564, Saudi Arabia School of Nursing, Wollongong University, Wollongong, NSW 2522, Australia Department of Nursing, Prince Sultan Military College, Dharan 34313, Saudi Arabia
Fahad Abdullah AlHarbi - Alfaisal University
Mohammed Buhays Aswany - Administration of Pharmaceutical Care, Al-Ahsa Health Cluster, Ministry of Health, Al-Ahsa 31982, Saudi Arabia Molecular Diagnostic Laboratory, Johns Hopkins Aramco Healthcare, Dhahran 31311, Saudi Arabia College of Medicine, Alfaisal University, Riyadh 11533, Saudi Arabia Department of Public Health/Nutrition, The University of Haripur, Haripur 22620, Khyber Pakhtunkhwa, Pakistan Division of Pathology, ICAR-Indian Veterinary Research Institute, Izatangar, Bareilly 243122, Uttar Pradesh, India Department of Biological Sciences, School of Medical and Life Sciences, Sunway University, Subang Jaya 47500, Malaysia Department of Pharmacy, Faculty of Pharmacy, Hasanuddin University, Makassar 90245, Indonesia Department of Medical Microbiology & Parasitology, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian 16150, Malaysia General Surgery Department, Alomran General Hospital, Ministry of Health, Al-Ahsa 36358, Saudi Arabia Pharmacy Department, Al-Ahsa Mental Health Hospital, Al-Ahsa 31982, Saudi Arabia Administration of Accreditation, Quality and Performance Excellence Management, Riyadh 3rd Health Cluster, Ministry of Health, Riyadh 13717, Saudi Arabia Clinical Pharmacy Services—Nephrology Department, King Saud Hospital, Ministry of Health, Riyadh 56437, Saudi Arabia Administration of Supply and Shared Services, C1 Riyadh Health Cluster, Ministry of Health, Riyadh 11622, Saudi Arabia Administration of Compliance, Directorate of Health Affairs, Ministry of Health, Eastern Region, Al-Ahsa 36441, Saudi Arabia Diagnostic Radiology Department, Prince Sultan Military Medical City, Riyadh 12233, Saudi Arabia Clinical Pharmacy Department, Gurayat General Hospital, Ministry of Health, Gurayat 77471, Saudi Arabia Pharmacy Department, Aljafr General Hospital, Ministry of Health, Al-Ahsa 77110, Saudi Arabia Respiratory Therapy Department, Maternity and Children Hospital, Ministry of Health, Al-Ahsa 36422, Saudi Arabia Pharmacy Department, King Fahad Hofuf Hospital, Ministry of Health, Al-Ahsa 36441, Saudi Arabia Psychological Service Department, Ardha and Mental Health Complex, Ministry of Health, Najran 66248, Saudi Arabia Division of Laboratory, Medical Microbiology Department, Maternity and Children Hospital, Ministry of Health, Al-Ahsa 36422, Saudi Arabia Microbiology Laboratory, Prince Saud Bin Jalawi Hospital, Ministry of Health, Al-Ahsa 36424, Saudi Arabia Research Center, Almoosa Specialist Hospital, Al-Ahsa 36342, Saudi Arabia College of Nursing, Princess Norah Bint Abdulrahman University, Riyadh 11564, Saudi Arabia School of Nursing, Wollongong University, Wollongong, NSW 2522, Australia Department of Nursing, Prince Sultan Military College, Dharan 34313, Saudi Arabia
Abdullah Abdulaziz Alshayee - Ministry of Health
Saad Abdalaziz Alrabiah - Ministry of Health
Ahmed Mahmoud Saleh - Alfaisal University
Mohammed Ali Alqarni - Alfaisal University
Fahad Mohammed Al Gharib - Administration of Pharmaceutical Care, Al-Ahsa Health Cluster, Ministry of Health, Al-Ahsa 31982, Saudi Arabia Molecular Diagnostic Laboratory, Johns Hopkins Aramco Healthcare, Dhahran 31311, Saudi Arabia College of Medicine, Alfaisal University, Riyadh 11533, Saudi Arabia Department of Public Health/Nutrition, The University of Haripur, Haripur 22620, Khyber Pakhtunkhwa, Pakistan Division of Pathology, ICAR-Indian Veterinary Research Institute, Izatangar, Bareilly 243122, Uttar Pradesh, India Department of Biological Sciences, School of Medical and Life Sciences, Sunway University, Subang Jaya 47500, Malaysia Department of Pharmacy, Faculty of Pharmacy, Hasanuddin University, Makassar 90245, Indonesia Department of Medical Microbiology & Parasitology, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian 16150, Malaysia General Surgery Department, Alomran General Hospital, Ministry of Health, Al-Ahsa 36358, Saudi Arabia Pharmacy Department, Al-Ahsa Mental Health Hospital, Al-Ahsa 31982, Saudi Arabia Administration of Accreditation, Quality and Performance Excellence Management, Riyadh 3rd Health Cluster, Ministry of Health, Riyadh 13717, Saudi Arabia Clinical Pharmacy Services—Nephrology Department, King Saud Hospital, Ministry of Health, Riyadh 56437, Saudi Arabia Administration of Supply and Shared Services, C1 Riyadh Health Cluster, Ministry of Health, Riyadh 11622, Saudi Arabia Administration of Compliance, Directorate of Health Affairs, Ministry of Health, Eastern Region, Al-Ahsa 36441, Saudi Arabia Diagnostic Radiology Department, Prince Sultan Military Medical City, Riyadh 12233, Saudi Arabia Clinical Pharmacy Department, Gurayat General Hospital, Ministry of Health, Gurayat 77471, Saudi Arabia Pharmacy Department, Aljafr General Hospital, Ministry of Health, Al-Ahsa 77110, Saudi Arabia Respiratory Therapy Department, Maternity and Children Hospital, Ministry of Health, Al-Ahsa 36422, Saudi Arabia Pharmacy Department, King Fahad Hofuf Hospital, Ministry of Health, Al-Ahsa 36441, Saudi Arabia Psychological Service Department, Ardha and Mental Health Complex, Ministry of Health, Najran 66248, Saudi Arabia Division of Laboratory, Medical Microbiology Department, Maternity and Children Hospital, Ministry of Health, Al-Ahsa 36422, Saudi Arabia Microbiology Laboratory, Prince Saud Bin Jalawi Hospital, Ministry of Health, Al-Ahsa 36424, Saudi Arabia Research Center, Almoosa Specialist Hospital, Al-Ahsa 36342, Saudi Arabia College of Nursing, Princess Norah Bint Abdulrahman University, Riyadh 11564, Saudi Arabia School of Nursing, Wollongong University, Wollongong, NSW 2522, Australia Department of Nursing, Prince Sultan Military College, Dharan 34313, Saudi Arabia
Shahd Nabeel Qattan - Administration of Pharmaceutical Care, Al-Ahsa Health Cluster, Ministry of Health, Al-Ahsa 31982, Saudi Arabia Molecular Diagnostic Laboratory, Johns Hopkins Aramco Healthcare, Dhahran 31311, Saudi Arabia College of Medicine, Alfaisal University, Riyadh 11533, Saudi Arabia Department of Public Health/Nutrition, The University of Haripur, Haripur 22620, Khyber Pakhtunkhwa, Pakistan Division of Pathology, ICAR-Indian Veterinary Research Institute, Izatangar, Bareilly 243122, Uttar Pradesh, India Department of Biological Sciences, School of Medical and Life Sciences, Sunway University, Subang Jaya 47500, Malaysia Department of Pharmacy, Faculty of Pharmacy, Hasanuddin University, Makassar 90245, Indonesia Department of Medical Microbiology & Parasitology, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian 16150, Malaysia General Surgery Department, Alomran General Hospital, Ministry of Health, Al-Ahsa 36358, Saudi Arabia Pharmacy Department, Al-Ahsa Mental Health Hospital, Al-Ahsa 31982, Saudi Arabia Administration of Accreditation, Quality and Performance Excellence Management, Riyadh 3rd Health Cluster, Ministry of Health, Riyadh 13717, Saudi Arabia Clinical Pharmacy Services—Nephrology Department, King Saud Hospital, Ministry of Health, Riyadh 56437, Saudi Arabia Administration of Supply and Shared Services, C1 Riyadh Health Cluster, Ministry of Health, Riyadh 11622, Saudi Arabia Administration of Compliance, Directorate of Health Affairs, Ministry of Health, Eastern Region, Al-Ahsa 36441, Saudi Arabia Diagnostic Radiology Department, Prince Sultan Military Medical City, Riyadh 12233, Saudi Arabia Clinical Pharmacy Department, Gurayat General Hospital, Ministry of Health, Gurayat 77471, Saudi Arabia Pharmacy Department, Aljafr General Hospital, Ministry of Health, Al-Ahsa 77110, Saudi Arabia Respiratory Therapy Department, Maternity and Children Hospital, Ministry of Health, Al-Ahsa 36422, Saudi Arabia Pharmacy Department, King Fahad Hofuf Hospital, Ministry of Health, Al-Ahsa 36441, Saudi Arabia Psychological Service Department, Ardha and Mental Health Complex, Ministry of Health, Najran 66248, Saudi Arabia Division of Laboratory, Medical Microbiology Department, Maternity and Children Hospital, Ministry of Health, Al-Ahsa 36422, Saudi Arabia Microbiology Laboratory, Prince Saud Bin Jalawi Hospital, Ministry of Health, Al-Ahsa 36424, Saudi Arabia Research Center, Almoosa Specialist Hospital, Al-Ahsa 36342, Saudi Arabia College of Nursing, Princess Norah Bint Abdulrahman University, Riyadh 11564, Saudi Arabia School of Nursing, Wollongong University, Wollongong, NSW 2522, Australia Department of Nursing, Prince Sultan Military College, Dharan 34313, Saudi Arabia
Hassan M. Almusabeh - Administration of Pharmaceutical Care, Al-Ahsa Health Cluster, Ministry of Health, Al-Ahsa 31982, Saudi Arabia Molecular Diagnostic Laboratory, Johns Hopkins Aramco Healthcare, Dhahran 31311, Saudi Arabia College of Medicine, Alfaisal University, Riyadh 11533, Saudi Arabia Department of Public Health/Nutrition, The University of Haripur, Haripur 22620, Khyber Pakhtunkhwa, Pakistan Division of Pathology, ICAR-Indian Veterinary Research Institute, Izatangar, Bareilly 243122, Uttar Pradesh, India Department of Biological Sciences, School of Medical and Life Sciences, Sunway University, Subang Jaya 47500, Malaysia Department of Pharmacy, Faculty of Pharmacy, Hasanuddin University, Makassar 90245, Indonesia Department of Medical Microbiology & Parasitology, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian 16150, Malaysia General Surgery Department, Alomran General Hospital, Ministry of Health, Al-Ahsa 36358, Saudi Arabia Pharmacy Department, Al-Ahsa Mental Health Hospital, Al-Ahsa 31982, Saudi Arabia Administration of Accreditation, Quality and Performance Excellence Management, Riyadh 3rd Health Cluster, Ministry of Health, Riyadh 13717, Saudi Arabia Clinical Pharmacy Services—Nephrology Department, King Saud Hospital, Ministry of Health, Riyadh 56437, Saudi Arabia Administration of Supply and Shared Services, C1 Riyadh Health Cluster, Ministry of Health, Riyadh 11622, Saudi Arabia Administration of Compliance, Directorate of Health Affairs, Ministry of Health, Eastern Region, Al-Ahsa 36441, Saudi Arabia Diagnostic Radiology Department, Prince Sultan Military Medical City, Riyadh 12233, Saudi Arabia Clinical Pharmacy Department, Gurayat General Hospital, Ministry of Health, Gurayat 77471, Saudi Arabia Pharmacy Department, Aljafr General Hospital, Ministry of Health, Al-Ahsa 77110, Saudi Arabia Respiratory Therapy Department, Maternity and Children Hospital, Ministry of Health, Al-Ahsa 36422, Saudi Arabia Pharmacy Department, King Fahad Hofuf Hospital, Ministry of Health, Al-Ahsa 36441, Saudi Arabia Psychological Service Department, Ardha and Mental Health Complex, Ministry of Health, Najran 66248, Saudi Arabia Division of Laboratory, Medical Microbiology Department, Maternity and Children Hospital, Ministry of Health, Al-Ahsa 36422, Saudi Arabia Microbiology Laboratory, Prince Saud Bin Jalawi Hospital, Ministry of Health, Al-Ahsa 36424, Saudi Arabia Research Center, Almoosa Specialist Hospital, Al-Ahsa 36342, Saudi Arabia College of Nursing, Princess Norah Bint Abdulrahman University, Riyadh 11564, Saudi Arabia School of Nursing, Wollongong University, Wollongong, NSW 2522, Australia Department of Nursing, Prince Sultan Military College, Dharan 34313, Saudi Arabia
Hussain Yousef AlGhatm - Ministry of Health
Sameer Ahmed Almoraihel - Ministry of Health
Ahmed Saeed Alzuwaid - Ministry of Health
Mohammed Ali Albaqshi - Ministry of Health
Murtadha Ahmed Al Khalaf - Administration of Pharmaceutical Care, Al-Ahsa Health Cluster, Ministry of Health, Al-Ahsa 31982, Saudi Arabia Molecular Diagnostic Laboratory, Johns Hopkins Aramco Healthcare, Dhahran 31311, Saudi Arabia College of Medicine, Alfaisal University, Riyadh 11533, Saudi Arabia Department of Public Health/Nutrition, The University of Haripur, Haripur 22620, Khyber Pakhtunkhwa, Pakistan Division of Pathology, ICAR-Indian Veterinary Research Institute, Izatangar, Bareilly 243122, Uttar Pradesh, India Department of Biological Sciences, School of Medical and Life Sciences, Sunway University, Subang Jaya 47500, Malaysia Department of Pharmacy, Faculty of Pharmacy, Hasanuddin University, Makassar 90245, Indonesia Department of Medical Microbiology & Parasitology, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian 16150, Malaysia General Surgery Department, Alomran General Hospital, Ministry of Health, Al-Ahsa 36358, Saudi Arabia Pharmacy Department, Al-Ahsa Mental Health Hospital, Al-Ahsa 31982, Saudi Arabia Administration of Accreditation, Quality and Performance Excellence Management, Riyadh 3rd Health Cluster, Ministry of Health, Riyadh 13717, Saudi Arabia Clinical Pharmacy Services—Nephrology Department, King Saud Hospital, Ministry of Health, Riyadh 56437, Saudi Arabia Administration of Supply and Shared Services, C1 Riyadh Health Cluster, Ministry of Health, Riyadh 11622, Saudi Arabia Administration of Compliance, Directorate of Health Affairs, Ministry of Health, Eastern Region, Al-Ahsa 36441, Saudi Arabia Diagnostic Radiology Department, Prince Sultan Military Medical City, Riyadh 12233, Saudi Arabia Clinical Pharmacy Department, Gurayat General Hospital, Ministry of Health, Gurayat 77471, Saudi Arabia Pharmacy Department, Aljafr General Hospital, Ministry of Health, Al-Ahsa 77110, Saudi Arabia Respiratory Therapy Department, Maternity and Children Hospital, Ministry of Health, Al-Ahsa 36422, Saudi Arabia Pharmacy Department, King Fahad Hofuf Hospital, Ministry of Health, Al-Ahsa 36441, Saudi Arabia Psychological Service Department, Ardha and Mental Health Complex, Ministry of Health, Najran 66248, Saudi Arabia Division of Laboratory, Medical Microbiology Department, Maternity and Children Hospital, Ministry of Health, Al-Ahsa 36422, Saudi Arabia Microbiology Laboratory, Prince Saud Bin Jalawi Hospital, Ministry of Health, Al-Ahsa 36424, Saudi Arabia Research Center, Almoosa Specialist Hospital, Al-Ahsa 36342, Saudi Arabia College of Nursing, Princess Norah Bint Abdulrahman University, Riyadh 11564, Saudi Arabia School of Nursing, Wollongong University, Wollongong, NSW 2522, Australia Department of Nursing, Prince Sultan Military College, Dharan 34313, Saudi Arabia
Yasmine Ahmed Albaqshi - Maternity and Children's Hospital
Abdulsatar H Al Brahim - Administration of Pharmaceutical Care, Al-Ahsa Health Cluster, Ministry of Health, Al-Ahsa 31982, Saudi Arabia Molecular Diagnostic Laboratory, Johns Hopkins Aramco Healthcare, Dhahran 31311, Saudi Arabia College of Medicine, Alfaisal University, Riyadh 11533, Saudi Arabia Department of Public Health/Nutrition, The University of Haripur, Haripur 22620, Khyber Pakhtunkhwa, Pakistan Division of Pathology, ICAR-Indian Veterinary Research Institute, Izatangar, Bareilly 243122, Uttar Pradesh, India Department of Biological Sciences, School of Medical and Life Sciences, Sunway University, Subang Jaya 47500, Malaysia Department of Pharmacy, Faculty of Pharmacy, Hasanuddin University, Makassar 90245, Indonesia Department of Medical Microbiology & Parasitology, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian 16150, Malaysia General Surgery Department, Alomran General Hospital, Ministry of Health, Al-Ahsa 36358, Saudi Arabia Pharmacy Department, Al-Ahsa Mental Health Hospital, Al-Ahsa 31982, Saudi Arabia Administration of Accreditation, Quality and Performance Excellence Management, Riyadh 3rd Health Cluster, Ministry of Health, Riyadh 13717, Saudi Arabia Clinical Pharmacy Services—Nephrology Department, King Saud Hospital, Ministry of Health, Riyadh 56437, Saudi Arabia Administration of Supply and Shared Services, C1 Riyadh Health Cluster, Ministry of Health, Riyadh 11622, Saudi Arabia Administration of Compliance, Directorate of Health Affairs, Ministry of Health, Eastern Region, Al-Ahsa 36441, Saudi Arabia Diagnostic Radiology Department, Prince Sultan Military Medical City, Riyadh 12233, Saudi Arabia Clinical Pharmacy Department, Gurayat General Hospital, Ministry of Health, Gurayat 77471, Saudi Arabia Pharmacy Department, Aljafr General Hospital, Ministry of Health, Al-Ahsa 77110, Saudi Arabia Respiratory Therapy Department, Maternity and Children Hospital, Ministry of Health, Al-Ahsa 36422, Saudi Arabia Pharmacy Department, King Fahad Hofuf Hospital, Ministry of Health, Al-Ahsa 36441, Saudi Arabia Psychological Service Department, Ardha and Mental Health Complex, Ministry of Health, Najran 66248, Saudi Arabia Division of Laboratory, Medical Microbiology Department, Maternity and Children Hospital, Ministry of Health, Al-Ahsa 36422, Saudi Arabia Microbiology Laboratory, Prince Saud Bin Jalawi Hospital, Ministry of Health, Al-Ahsa 36424, Saudi Arabia Research Center, Almoosa Specialist Hospital, Al-Ahsa 36342, Saudi Arabia College of Nursing, Princess Norah Bint Abdulrahman University, Riyadh 11564, Saudi Arabia School of Nursing, Wollongong University, Wollongong, NSW 2522, Australia Department of Nursing, Prince Sultan Military College, Dharan 34313, Saudi Arabia
Mahdi Mana Al Mutared - Ministry of Health
Hassan Al-Helal - Maternity and Children's Hospital
Header A Alghazal - Ministry of Health
Abbas Al Mutair - Saad Specialist Hospital
Publication Details: Vaccines (Basel), Vol.10(8), p.1289
Publisher: MDPI
Identifiers: 9913531808331
Academic Unit: Alfaisal University; Princess Nourah bint Abdulrahman University
Language: English
Resource Type: Journal article