IMPORTANCE A surge of COVID-19 occurred from March to June 2021, in New Delhi, India, linked to the B.1.617.2 (Delta) variant of SARS-CoV-2. COVID-19 vaccines were rolled out for health care workers (HCWs) starting in January 2021. OBJECTIVE To assess the incidence density of reinfection among a cohort of HCWs and estimate the effectiveness of the inactivated whole virion vaccine BBV152 against reinfection. DESIGN, SETTING, AND PARTICIPANTS This was a retrospective cohort study among HCWs working at a tertiary care center in New Delhi, India.EXPOSURES Vaccination with 0, 1, or 2 doses of BBV152. MAIN OUTCOMES AND MEASURESThe HCWs were categorized as fully vaccinated (with 2 doses and Ն15 days after the second dose), partially vaccinated (with 1 dose or 2 doses with <15 days after the second dose), or unvaccinated. The incidence density of COVID-19 reinfection per 100 personyears was computed, and events from March 3, 2020, to June 18, 2021, were included for analysis.Unadjusted and adjusted hazard ratios (HRs) were estimated using a Cox proportional hazards model. Estimated vaccine effectiveness (1 − adjusted HR) was reported. RESULTS Among 15 244 HCWs who participated in the study, 4978 (32.7%) were diagnosed with COVID-19. The mean (SD) age was 36.6 (10.3) years, and 55.0% were male. The reinfection incidence density was 7.26 (95% CI: 6.09-8.66) per 100 person-years (124 HCWs [2.5%], total person follow-up period of 1696 person-years as time at risk). Fully vaccinated HCWs had lower risk of reinfection (HR, 0.14 [95% CI, 0.08-0.23]), symptomatic reinfection (HR, 0.13 [95% CI, 0.07-0.24]), and asymptomatic reinfection (HR, 0.16 [95% CI, 0.05-0.53]) compared with unvaccinated HCWs.Accordingly, among the 3 vaccine categories, reinfection was observed in 60 of 472 (12.7%) of unvaccinated (incidence density, 18.05 per 100 person-years; 95% CI, 14.02-23.25), 39 of 356 (11.0%) of partially vaccinated (incidence density 15.62 per 100 person-years; 95% CI,, and 17 of 1089 (1.6%) fully vaccinated (incidence density 2.18 per 100 person-years; 95% CI, 1.35-3.51) HCWs. The estimated effectiveness of BBV152 against reinfection was 86% (95% CI, 77%-92%); symptomatic reinfection, 87% (95% CI, 76%-93%); and asymptomatic reinfection, 84% (95% CI, 47%-95%) among fully vaccinated HCWs. Partial vaccination was not associated with reduced risk of reinfection. (continued) Key Points Question What are the rate of reinfection of SARS-CoV-2 among a cohort of health care workers (HCWs) and the estimated effectiveness of the inactivated whole virion vaccine BBV152 against reinfection? Findings In this cohort study of 4978 HCWs who were infected with SARS-CoV-2 from March 3, 2020, to June 18, 2021, the incidence density of reinfection was 7.26 per 100 personyears. A protective association of 86% against reinfection was observed among HCWs who completed the 2-dose schedule of BBV152 and for whom at least 15 days elapsed without reinfection after vaccination. Meaning The results of this study suggest that complete vaccination with BBV152 amo...

We prospectively observed 62 pre-term very low birth weight neonates initiated on nasal continuous positive airway pressure (CPAP) for respiratory distress in the first 24 h of life to devise a clinical score for predicting its failure. CPAP was administered using short binasal prongs with conventional ventilators. On multivariate analysis, we found three variables-gestation <28 weeks [adjusted odds ratio (OR) 6.5; 95% confidence interval (CI) 1.5-28.3], pre-term premature rupture of membranes [adjusted OR 5.3; CI 1.2-24.5], and product of CPAP pressure and fraction of inspired oxygen ≥1.28 at initiation to maintain saturation between 88% and 93% [adjusted OR 3.9; CI 1.0-15.5] to be independently predictive of failure. A prediction model was devised using weighted scores of these three variables and lack of exposure to antenatal steroids. The clinical scoring system thus developed had 75% sensitivity and 70% specificity for prediction of CPAP failure (area under curve: 0.83; 95% CI 0.71-0.94).

Both demand and supply side strategies are effective and promote equity. Improving service delivery in a population previously primed by demand side intervention appears to be the most useful.

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Supplementing iron at 2 weeks of age in preterm VLBW infants did not improve either serum ferritin or the haematological parameters at 2 months when compared to the standard practice of starting iron from 8 weeks of age.