COVID-19 vaccine effectiveness against severe COVID-19 requiring oxygen therapy, invasive mechanical ventilation, and death in Japan: A multicenter case-control study (MOTIVATE study).

INTRODUCTION: Since the SARS-CoV-2 Omicron variant became dominant, assessing COVID-19 vaccine effectiveness (VE) against severe disease using hospitalization as an outcome became more challenging due to incidental infections via admission screening and variable admission criteria, resulting in a wide range of estimates. To address this, the World Health Organization (WHO) guidance recommends the use of outcomes that are more specific to severe pneumonia such as oxygen use and mechanical ventilation. METHODS: A case-control study was conducted in 24 hospitals in Japan for the Delta-dominant period (August-November 2021; "Delta") and early Omicron (BA.1/BA.2)-dominant period (January-June 2022; "Omicron"). Detailed chart review/interviews were conducted in January-May 2023. VE was measured using various outcomes including disease requiring oxygen therapy, disease requiring invasive mechanical ventilation (IMV), death, outcome restricting to "true" severe COVID-19 (where oxygen requirement is due to COVID-19 rather than another condition(s)), and progression from oxygen use to IMV or death among COVID-19 patients. RESULTS: The analysis included 2125 individuals with respiratory failure (1608 cases [75.7%]; 99.2% of vaccinees received mRNA vaccines). During Delta, 2 doses provided high protection for up to 6 months (oxygen requirement: 95.2% [95% CI:88.7-98.0%] [restricted to "true" severe COVID-19: 95.5% {89.3-98.1%}]; IMV: 99.6% [97.3-99.9%]; fatal: 98.6% [92.3-99.7%]). During Omicron, 3 doses provided high protection for up to 6 months (oxygen requirement: 85.5% [68.8-93.3%] ["true" severe COVID-19: 88.1% {73.6-94.7%}]; IMV: 97.9% [85.9-99.7%]; fatal: 99.6% [95.2-99.97]). There was a trend towards higher VE for more severe and specific outcomes. CONCLUSION: Multiple outcomes pointed towards high protection of 2 doses during Delta and 3 doses during Omicron. These results demonstrate the importance of using severe and specific outcomes to accurately measure VE against severe COVID-19, as recommended in WHO guidance in settings of intense transmission as seen during Omicron

On-line analysis of free-tropospheric water-soluble acidic gases and particulate anions on the summit of Mt. Fuji, Japan

Atmospheric gaseous and particulate pollutants emitted from local or regional sources cause transboundary air pollution. To better understand this environmental issue, it is useful to monitor the free troposphere, reflecting the global air quality, with high temporal resolution. During the summer of 2016, we operated an original on-line monitor on the summit of Mt. Fuji, Japan (3776 m a.s.l.) to measure water-soluble acidic gases and particulate anions in the free troposphere. Mt. Fuji is a free-standing mountain and, therefore, hardly affected by air pollutants emitted from the local region. The lab-made gas/particle collector coupled ion chromatograph successfully provided meaningful data on an hourly basis. The average concentrations of HNO3, SO2, NO3-, and SO42- (n = 64 each) were, respectively 1.8 ± 0.9, 2.3 ± 2.5, 0.22 ± 0.16, and 3.9 ± 2.6 nmol m-3. The gaseous HNO3 was the predominant form compared to particulate NO3-. For the sulfur component, the percentage of particulate form was higher than that of the gaseous one. The high time-resolution monitoring enabled us to classify the observed data based on the air parcel inflow direction to the sampling point even when it changed dramatically. As a result, the oxidation of SO2 to SO42- in atmospheric transport can be discussed for each air parcel. It was suggested that the SO2 oxidation was enhanced in the air parcels that passed over the Asian Continent

Online Collector for Water-Soluble Atmospheric Particulate Matter Compatible with a Parallel Plate Wet Denuder

A particle collector that allows high time resolution monitoring of particulate matter was fabricated and coupled with an ion chromatograph for online analysis of particulate ions in the atmosphere. The system was applied to the atmospheric observation for over a month in Tokushima, Japan. The average particulate anion concentrations were 6.42 nmol m−3 for Cl−, 18.8 nmol m−3 for NO3−, and 22.1 nmol m−3 for SO42−. The atmospheric particle collection efficiency was more than 98.4%, and the continuous observations were successfully achieved without problems

Online Analysis of Water-soluble Acidic Gases and Anions in Particles at the Southeastern Foot of Mt. Fuji

During the summer of 2018, we monitored the concentrations of water-soluble acid gases and particulate anions at the southeastern foot (1284 m a.s.l.) of Mt. Fuji, Japan, using gas/particle-ion chromatographs. All samples analyzed contained quantifiable levels of anions. The average concentrations of acid gas and particulate anion concentrations were, respectively, 1.10±0.37 nmol m−3 for HCl, 3.49±1.72 nmol m−3 for HONO, 1.23±0.59 nmol m−3 for HNO3, 0.33±0.20 nmol m−3 for SO2, 3.61±3.69 nmol m−3 for Cl−, 0.65±0.22 nmol m−3 for NO2−, 4.29±2.98 nmol m−3 for NO3−, and 4.47±3.57 nmol m−3 for SO42−. We found that the concentration of soluble acidic gases increased during the daytime, while no characteristic diurnal patterns were observed in the particulate anions

Diurnal Variations in Partitioning of Atmospheric Glyoxal and Methylglyoxal between Gas and Particles at the Ground Level and in the Free Troposphere

This work presents diurnal variations of gas- and particle-phase dicarbonyls (glyoxal (Gly) and methylglyoxal (Mgly)) in the atmosphere, which are important compounds that contribute to the formation and growth of atmospheric particulate matter. To obtain variations in partitioning, continuous collection of gaseous dicarbonyls was performed using a parallel plate wet denuder, and at the same time, the dicarbonyls in particle were collected using a spray-type particle collector downstream. Hourly samples were analyzed by high performance liquid chromatography–electrospray ionization–tandem mass spectrometry. This method is advantageous to monitor the gaseous and particulate carbonyls separately without loss during sampling. Sampling was performed in summer and winter in a midsize city (Kumamoto, Japan). The concentrations of the dicarbonyls increased in the summer daytime, which suggests that they are mostly formed by secondary production in the local atmosphere. The dicarbonyls and formaldehyde (HCHO) were found in both gas and particle phases, and partitioning to the particle phase was highest for Gly, followed by Mgly and HCHO. It was observed that the compounds moved to the particle phase in the midnight and early morning hours according to the growth of hygroscopic aerosols in summer. The particle/gas ratio also increased in the presence of high PM_2.5, which is transported from the Chinese Continent in winter. The dicarbonyls were also observed on Mt. Fuji (3776 m) in the free troposphere. From back trajectory data and information on volatile organic compounds, they were most likely produced from relatively long-lifetime organic compounds from the Chinese Continent and biogenic volatile organic compounds emitted in the Japan Alps mountain range. Higher particle/gas ratios at the Mt. Fuji station indicate that low temperatures and high humidity precede the partition. The estimated effective Henry’s law constants for the dicarbonyls, 10⁸ order in mol/kgH₂O/atm for summer data, were much higher than those for ideal liquid/vapor equilibrium but close to reported results obtained by chamber experiments. In the proposed method, oligomers in particle were also counted as the compounds. The dicarbonyl compounds existed up to submolar levels in real atmospheric aerosols, which suggests they undergo further reactions in the particle phase