Canadian Medical Association

person receiving a vaccine

COVID-19 research continues to proliferate, and COVID-19 studies continue to be featured as daily POEMs (Patient-Oriented Research that Matters). Many of them are highly rated for clinical relevance by CMA members.

POEMs are synopses of new evidence, carefully filtered for relevance to patient care and evaluated for validity by the Essential Evidence Plus editorial team at Wiley Publishing and distributed daily to members of the Canadian Medical Association (CMA) by email.

How POEMs are rated

Through the CMA Joule subscription, CMA members can rate the daily POEMs and receive CPD credit by completing a validated questionnaire. This is called the Information Assessment Method. A POEM is rated according to clinical relevance, cognitive impact, use of the information in practice and expected benefit for the patient. Dr. Roland Grad (MD, MSc, McGill University, Montreal, Quebec, Canada) and Dr. Mark H. Ebell (MD, MS, University of Georgia, Athens, Georgia) analyze ratings and report on the most clin¬ically relevant POEMs as rated by CMA members in an annual series published in American Family Physician. The recent publication on the top POEMs from 2021 marks the 11th installment.

Not receiving POEMs? Sign up now. CMA members can also read current and past synopses, collect credits and discuss practice changing updates via the POEMs archive.

Here are some of the most recent top-rated POEMs related to COVID-19:

COVID-19 vaccine is not associated with adverse birth outcomes

Bottom line: Vaccination against COVID-19 during pregnancy is not associated with an increase in adverse pregnancy outcomes, including preterm birth, infants who are small for gestational age and stillbirth. Other research has also not found problems with vaccination during pregnancy.

Similar likelihood of adverse effects with mRNA and inactivated virus vaccines for COVID-19

Bottom line: An mRNA vaccine did not have statistically more or fewer adverse events as compared with an inactivated whole virus vaccine in this large cohort study. For both vaccines, the rates of adverse events were low and may not be different from the rate of these events occurring in the general population over the approximately five to seven weeks of evaluation in this study.

COVID-19 vaccine moderately effective (48%) at preventing symptomatic infection in children 5 to 11 years old

Bottom line: The Pfizer-BioNTech vaccine provides moderate protection against symptomatic infection in children 5 to 11 years. The decreasing level of protection in older children suggests that older children may benefit from a higher dose, but this requires further study. There were too few complications to provide meaningful information, and data on severity of illness were not available.

Likelihood of long COVID varies by variant, sex and vaccination status

Bottom line: Among adult health care workers, this study found that long COVID is less likely in those who have been infected with more recent variants of COVID-19 and in those who have received three doses of vaccine.

Three-dose vaccine or two doses plus previous infection protects against severe disease from BA.1 or BA.2 COVID-19 variants

Bottom line: Three doses of vaccine with or without previous infection or two doses of vaccine plus previous infection both conferred excellent protection against serious disease in the first part of the Omicron wave. A limitation of this study is that the authors did not report results for the BA.4 and BA.5 variants. 

Hybrid and natural immunity are robust but, like vaccine immunity, wane over time

Bottom line: Both natural immunity and hybrid immunity provide protection against subsequent COVID-19 infection that is on par with that of boosted patients. Patients who have recovered from COVID-19 should still get the vaccine. Unfortunately, immunity wanes over time for all groups. 

CMA members have access to POEMs and the journal American Family Physician via ClinicalKey, a tool included with their membership.

Do you have a question on COVID-19 or another clinical topic? Contact the Ask a Librarian team to request a literature search.

This material is for informational purposes only. It is not intended to be a substitute for professional medical advice and should not be relied on as health or personal advice. The opinions stated by the authors are made in a personal capacity and do not necessarily reflect those of the Canadian Medical Association and its subsidiaries including CMA Joule.

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