Person: Vial Cox, María Cecilia
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Vial Cox
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María Cecilia
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María Cecilia Vial Cox
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Publication A Third Dose of SARS-CoV-2 mRNA Vaccine Improves Immune Response in Chronic Kidney Disease Patients(2023) Poli Harlowe, María Cecilia; Vial Cox, María Cecilia; Rey, Emma; González, Natalia; Cortés, Lina; Hormazabal, Juan; Ramírez, Carolina; De la Cruz, Javiera; Ulloa, CamiloChronic kidney disease (CKD) patients have an increased risk of morbidity and mortality following SARS-CoV-2 infection. Vaccination in these patients is prioritized, and monitoring of the immune response is paramount to define further vaccination strategies. This prospective study included a cohort of 100 adult CKD patients: 48 with kidney transplant (KT) and 52 on hemodialysis without prior COVID-19. The patients were assessed for humoral and cellular immune responses after four months of an anti-SARS-CoV-2 primary two-dose vaccination scheme (CoronaVac or BNT162b2) and one month after a booster third dose of BNT162b2 vaccine. We identified poor cellular and humoral immune responses in the CKD patients after a primary vaccination scheme, and these responses were improved by a booster. Robust polyfunctional CD4+ T cell responses were observed in the KT patients after a booster, and this could be attributed to a higher proportion of the patients having been vaccinated with homologous BNT162b2 schemes. However, even after the booster, the KT patients exhibited lower neutralizing antibodies, attributable to specific immunosuppressive treatments. Four patients suffered severe COVID-19 despite three-dose vaccination, and all had low polyfunctional T-cell responses, underscoring the importance of this functional subset in viral protection. In conclusion, a booster dose of SARS-CoV-2 mRNA vaccine in CKD patients improves the impaired humoral and cellular immune responses observed after a primary vaccination scheme.Publication Overcoming Health Inequities: Spatial Analysis of Seroprevalence and Vaccination Against COVID-19 in Chile(2024) Muriel Ramírez-Santana , Juan Hormazábal, Luis Canales, Pablo Vial, and Ximena Aguilera; Correa, Juan; Núñez Franz, Loreto; Apablaza, Mauricio; Rubilar, Paola; Vial Cox, María Cecilia; Cortes, Lina Jimena; Hormazabal, Juan; Canales, Luis; Vial, Pablo; Aguilera, XimenaBackground: In unequal economies, the spread of the first waves of the COVID-19 was usually associated withlow socioeconomic status of individuals and their families. Chile exemplified this. By mid-2020, Chile had one ofthe highest SARS-CoV-2 infection rates in the world predominantly in poorer areas. A year later, the countrylaunched a universal vaccination campaign based on the national strategy of immunization established in1975. By 2022, Chile presented one of the highest COVID-19 vaccination coverages globally, reaching 94.3%of the population with the primary scheme by the end of 2022.Objective: This study analyzes the spatial distribution of SARS-CoV-2 seroprevalence at the beginning of the pan-demic (2020) compared with the seroprevalence after 2 years of ongoing epidemic and COVID-19 vaccinationcampaigns (2022).Methods: Two population-based random samples of individuals aged 7 years and older from two Chilean citieswere studied. Utilizing an enzyme-linked immunosorbent assay test, IgG antibodies were measured in serum of1061 participants in 2020, and 853 in 2022.Results: Using the Global Moran’s Index, the seroprevalence distribution pattern for the year 2020 showed clus-tering in the two cities. Conversely, seroprevalence and vaccinations were homogeneously distributed in 2022.These results show the success of the vaccination campaign in Chile, not only in coverage but also because itwidely reached all individuals.Conclusions: The uptake of this preventive measure is high, regardless of the social and economic factors,achieving broad population immunity. The extensive deployment of the primary health care network contrib-uted to reducing health inequities and promoting to universal health access.