Peer Review History

Original SubmissionSeptember 1, 2021
Decision Letter - Subish Palaian, Editor

PONE-D-21-28369Adverse events following immunization with ChAdOx1 nCoV-19 and BBIBP-CorV vaccine: a real-world, comparative study among healthcare professionals of NepalPLOS ONE

Dear Author,

Thank you for submitting your manuscript to PLOS ONE. After careful consideration, we feel that it has merit but does not fully meet PLOS ONE’s publication criteria as it currently stands. Therefore, we invite you to submit a revised version of the manuscript that addresses the points raised during the review process. The reviewer comments are available below for your reference. 

Please submit your revised manuscript by 24th April. If you will need more time than this to complete your revisions, please reply to this message or contact the journal office at plosone@plos.org. When you're ready to submit your revision, log on to https://www.editorialmanager.com/pone/ and select the 'Submissions Needing Revision' folder to locate your manuscript file.

Please include the following items when submitting your revised manuscript:

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  • An unmarked version of your revised paper without tracked changes. You should upload this as a separate file labeled 'Manuscript'.

If you would like to make changes to your financial disclosure, please include your updated statement in your cover letter. Guidelines for resubmitting your figure files are available below the reviewer comments at the end of this letter.

If applicable, we recommend that you deposit your laboratory protocols in protocols.io to enhance the reproducibility of your results. Protocols.io assigns your protocol its own identifier (DOI) so that it can be cited independently in the future. For instructions see: https://journals.plos.org/plosone/s/submission-guidelines#loc-laboratory-protocols. Additionally, PLOS ONE offers an option for publishing peer-reviewed Lab Protocol articles, which describe protocols hosted on protocols.io. Read more information on sharing protocols at https://plos.org/protocols?utm_medium=editorial-email&utm_source=authorletters&utm_campaign=protocols.

We look forward to receiving your revised manuscript.

Kind regards,

Subish Palaian

Academic Editor

PLOS ONE

Journal requirements:

When submitting your revision, we need you to address these additional requirements.

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2. Please include additional information regarding the survey or questionnaire used in the study and ensure that you have provided sufficient details that others could replicate the analyses. For instance, if you developed a questionnaire as part of this study and it is not under a copyright more restrictive than CC-BY, please include a copy, in both the original language and English, as Supporting Information.

3. Please amend your current ethics statement to address the following concerns:

a) Did participants provide their written or verbal informed consent to participate in this study?

b) If consent was verbal, please explain i) why written consent was not obtained, ii) how you documented participant consent, and iii) whether the ethics committees/IRB approved this consent procedure.

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We will update your Data Availability statement on your behalf to reflect the information you provide.

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Additional Editor Comments:

Dear author,

Regards.

The manuscript has been reviewed by two reviewers and the comments are available below. The comments are mainly related to the methodology and data analysis. Kindly revise the manuscript based on the comments.

Best wishes

Subish Palaian

[Note: HTML markup is below. Please do not edit.]

Reviewers' comments:

Reviewer's Responses to Questions

Comments to the Author

1. Is the manuscript technically sound, and do the data support the conclusions?

The manuscript must describe a technically sound piece of scientific research with data that supports the conclusions. Experiments must have been conducted rigorously, with appropriate controls, replication, and sample sizes. The conclusions must be drawn appropriately based on the data presented.

Reviewer #1: Partly

Reviewer #2: Partly

**********

2. Has the statistical analysis been performed appropriately and rigorously?

Reviewer #1: I Don't Know

Reviewer #2: Yes

**********

3. Have the authors made all data underlying the findings in their manuscript fully available?

The PLOS Data policy requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception (please refer to the Data Availability Statement in the manuscript PDF file). The data should be provided as part of the manuscript or its supporting information, or deposited to a public repository. For example, in addition to summary statistics, the data points behind means, medians and variance measures should be available. If there are restrictions on publicly sharing data—e.g. participant privacy or use of data from a third party—those must be specified.

Reviewer #1: No

Reviewer #2: Yes

**********

4. Is the manuscript presented in an intelligible fashion and written in standard English?

PLOS ONE does not copyedit accepted manuscripts, so the language in submitted articles must be clear, correct, and unambiguous. Any typographical or grammatical errors should be corrected at revision, so please note any specific errors here.

Reviewer #1: Yes

Reviewer #2: No

**********

5. Review Comments to the Author

Please use the space provided to explain your answers to the questions above. You may also include additional comments for the author, including concerns about dual publication, research ethics, or publication ethics. (Please upload your review as an attachment if it exceeds 20,000 characters)

Reviewer #1: Thank you for the invitation to review this manuscript. The manuscript is mostly well-written and presented. The study is interesting and relevant. A few corrections to language may be required at certain places.

My concerns are related to the Methodology of the study. The population of health care professionals in Nepal is large and a sample of 606 health care professionals (HCPs) may not adequately represent this population. The sampling method in this study was a convenience one as stated by the authors. I am not sure that this sample can adequately provide data from the population of HCPs in Nepal. The authors have provided no information about the geographical distribution of the respondents within the country. Does the sample correspond to the population of HCPs in Nepal regarding demographic characteristics? I am not sure that the conclusions as mentioned in the abstract follow from the study results. The conclusions in the main manuscript seem OK. As the denominator is small I am not sure prevalence of adverse effects can be calculated. The findings will be only the prevalence among the study sample, and it will be difficult to generalize it to the general population of HCPs in Nepal.

In the Results can the authors explain why they mention no vaccine breakthrough infection was noted. The authors have not mentioned about IRB approval and obtaining written, informed consent from the participants in this study. I would recommend specialised statistical review of this manuscript.

The authors should deposit the de-identified data in a publicly available repository.

Reviewer #2: The findings from this study will be of importance to advocate the public on vaccination and reduce their anxiety regarding the side effects.

Overall, please check the grammatical errors and paraphrasing needs to be done as per recommendation.

Results

1) The first Chi-square analysis seems unnecessary as the parameters are not associated with the dosing completion since the vaccination is dependent upon availability and the set duration between first and second dose.

2) The graphs need legends and appropriate choice of graph type is imperative.

Conclusion

This article has been clearly written however the conclusion about the anaphylaxis being rare is a bit of a stretch as this has not been evaluated in this study.

**********

6. PLOS authors have the option to publish the peer review history of their article (what does this mean?). If published, this will include your full peer review and any attached files.

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Reviewer #1: No

Reviewer #2: No

[NOTE: If reviewer comments were submitted as an attachment file, they will be attached to this email and accessible via the submission site. Please log into your account, locate the manuscript record, and check for the action link "View Attachments". If this link does not appear, there are no attachment files.]

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Attachments
Attachment
Submitted filename: PONE-D-21-28369_HZ.pdf
Revision 1

Response to Reviewers Date: April 30, 2022

Paper Title: Adverse events following immunization with ChAdOx1 nCoV-19 and BBIBP-CorV vaccine: a real-world, comparative study among healthcare professionals of Nepal

Journal Name: PLOS ONE

Paper ID: PONE-D-21-28369

Dear Editor

Thank you very much for providing reviewers’ insightful remarks on our manuscript. We have made the necessary changes and revised the manuscript accordingly, and detailed point–by–point corrections are given below:

Review Reports:

Reviewer #1:

Thank you for the invitation to review this manuscript. The manuscript is mostly well-written and presented. The study is interesting and relevant. A few corrections to language may be required at certain places.

Authors reply: We would like to thank the reviewer for the kind words. We have revised the grammatical errors according to your suggestion.

My concerns are related to the Methodology of the study. The population of health care professionals in Nepal is large and a sample of 606 health care professionals (HCPs) may not adequately represent this population. The sampling method in this study was a convenience one as stated by the authors. I am not sure that this sample can adequately provide data from the population of HCPs in Nepal. The authors have provided no information about the geographical distribution of the respondents within the country. Does the sample correspond to the population of HCPs in Nepal regarding demographic characteristics? I am not sure that the conclusions as mentioned in the abstract follow from the study results. The conclusions in the main manuscript seem OK. As the denominator is small I am not sure prevalence of adverse effects can be calculated. The findings will be only the prevalence among the study sample, and it will be difficult to generalize it to the general population of HCPs in Nepal.

Authors reply: We have calculated the sample size for the present study from a previously published article. However, we agree with you that, the sample size included in the present study might not be representative of the large population of the HCPs in Nepal. Moreover, geographic and ethnic variety was also not considered in the present study which limits the generalizability of the findings. We have mentioned these issues in the limitation section of the manuscript (Page 13, Line 223-227).

“Moreover, the small sample size of the present study might not be representative of the large population of HCPs in Nepal. Moreover, information about the geographic location and ethnic characteristics of the participants were not collected. Hence, the prevalence of vaccine-related adverse events found in the present study might not be generalizable for the overall population of the country.”

In the Results can the authors explain why they mention no vaccine breakthrough infection was noted.

Authors reply: Thanks for mentioning the issue. We have added the definition of vaccine breakthrough infection as an explanation of the statement which was missing in the previous version (Page 10, Line 174-175).

“No vaccine breakthrough infection which is defined as infection by SARS-CoV-2 after at least 14 days of completion of two-dose vaccination was reported in the study.”

The authors have not mentioned about IRB approval and obtaining written, informed consent from the participants in this study. I would recommend specialised statistical review of this manuscript.

Authors reply: Thanks for mentioning the issue. The statement regarding ethical considerations is now mentioned in the manuscript (Page 6. Line 122-125).

“The ethical clearance of the research proposal was obtained from the Nepal Health Research Council (NHRC) (Reference no. 351). Informed written consent was obtained through email from the participants who agreed to participate in the study as explained on the first page of the survey form.”

The authors should deposit the de-identified data in a publicly available repository.

Authors reply: Thanks for your suggestion. The data will be made publicly available.

Reviewer #2:

The findings from this study will be of importance to advocate the public on vaccination and reduce their anxiety regarding the side effects.

Overall, please check the grammatical errors and paraphrasing needs to be done as per recommendation.

Authors reply: We would like to thank the reviewer for the kind words. We have revised the grammatical errors according to your suggestion.

Results

1) The first Chi-square analysis seems unnecessary as the parameters are not associated with the dosing completion since the vaccination is dependent upon availability and the set duration between first and second dose.

Authors reply: Thanks for your suggestion. We have omitted the Chi-square analysis from Table 1.

2) The graphs need legends and appropriate choice of graph type is imperative.

Authors reply: Thanks for your suggestion. We have added legends in the graphs.

Conclusion

This article has been clearly written however the conclusion about the anaphylaxis being rare is a bit of a stretch as this has not been evaluated in this study.

Authors reply: Thanks for your valuable comment. We agree with you and deleted the statement from the conclusion (Page 13, Line 235).

We would like to thank the reviewers for the valuable comments. We have revised the documents to the best of our ability, but we will definitely be happy to provide further improvement if there are further clarifications required.

With best regards

Dr. Md. Golam Hossain

Professor of Health Research Group

Department of Statistics, University of Rajshahi

Rajshahi-6205, Bangladesh

E-mail: hossain95@yahoo.com

Attachments
Attachment
Submitted filename: Response to Reviewers.docx
Decision Letter - Kovy Arteaga-Livias, Editor

PONE-D-21-28369R1Adverse events following immunization with ChAdOx1 nCoV-19 and BBIBP-CorV vaccine: a real-world, comparative study among healthcare professionals of NepalPLOS ONE

Dear Dr. Hossain,

Thank you for submitting your manuscript to PLOS ONE. After careful consideration, we feel that it has merit but does not fully meet PLOS ONE’s publication criteria as it currently stands. Therefore, we invite you to submit a revised version of the manuscript that addresses the points raised during the review process.

==============================

ACADEMIC EDITOR:The second reviewer from your first round of review has not responded, so we had to use a third reviewer.

We have noted that the reviewer has given citation suggestions, whether or not you follow the suggestions will not affect the final decision. Consider only those that fit your research topic.

==============================

Please submit your revised manuscript by Sep 03 2022 11:59PM. If you will need more time than this to complete your revisions, please reply to this message or contact the journal office at plosone@plos.org. When you're ready to submit your revision, log on to https://www.editorialmanager.com/pone/ and select the 'Submissions Needing Revision' folder to locate your manuscript file.

Please include the following items when submitting your revised manuscript:

  • A rebuttal letter that responds to each point raised by the academic editor and reviewer(s). You should upload this letter as a separate file labeled 'Response to Reviewers'.
  • A marked-up copy of your manuscript that highlights changes made to the original version. You should upload this as a separate file labeled 'Revised Manuscript with Track Changes'.
  • An unmarked version of your revised paper without tracked changes. You should upload this as a separate file labeled 'Manuscript'.
If you would like to make changes to your financial disclosure, please include your updated statement in your cover letter. Guidelines for resubmitting your figure files are available below the reviewer comments at the end of this letter.

If applicable, we recommend that you deposit your laboratory protocols in protocols.io to enhance the reproducibility of your results. Protocols.io assigns your protocol its own identifier (DOI) so that it can be cited independently in the future. For instructions see: https://journals.plos.org/plosone/s/submission-guidelines#loc-laboratory-protocols. Additionally, PLOS ONE offers an option for publishing peer-reviewed Lab Protocol articles, which describe protocols hosted on protocols.io. Read more information on sharing protocols at https://plos.org/protocols?utm_medium=editorial-email&utm_source=authorletters&utm_campaign=protocols.

We look forward to receiving your revised manuscript.

Kind regards,

Kovy Arteaga-Livias

Academic Editor

PLOS ONE

Journal Requirements:

Please review your reference list to ensure that it is complete and correct. If you have cited papers that have been retracted, please include the rationale for doing so in the manuscript text, or remove these references and replace them with relevant current references. Any changes to the reference list should be mentioned in the rebuttal letter that accompanies your revised manuscript. If you need to cite a retracted article, indicate the article’s retracted status in the References list and also include a citation and full reference for the retraction notice.

[Note: HTML markup is below. Please do not edit.]

Reviewers' comments:

Reviewer's Responses to Questions

Comments to the Author

1. If the authors have adequately addressed your comments raised in a previous round of review and you feel that this manuscript is now acceptable for publication, you may indicate that here to bypass the “Comments to the Author” section, enter your conflict of interest statement in the “Confidential to Editor” section, and submit your "Accept" recommendation.

Reviewer #1: All comments have been addressed

Reviewer #3: All comments have been addressed

**********

2. Is the manuscript technically sound, and do the data support the conclusions?

The manuscript must describe a technically sound piece of scientific research with data that supports the conclusions. Experiments must have been conducted rigorously, with appropriate controls, replication, and sample sizes. The conclusions must be drawn appropriately based on the data presented.

Reviewer #1: Yes

Reviewer #3: Yes

**********

3. Has the statistical analysis been performed appropriately and rigorously?

Reviewer #1: Yes

Reviewer #3: Yes

**********

4. Have the authors made all data underlying the findings in their manuscript fully available?

The PLOS Data policy requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception (please refer to the Data Availability Statement in the manuscript PDF file). The data should be provided as part of the manuscript or its supporting information, or deposited to a public repository. For example, in addition to summary statistics, the data points behind means, medians and variance measures should be available. If there are restrictions on publicly sharing data—e.g. participant privacy or use of data from a third party—those must be specified.

Reviewer #1: Yes

Reviewer #3: Yes

**********

5. Is the manuscript presented in an intelligible fashion and written in standard English?

PLOS ONE does not copyedit accepted manuscripts, so the language in submitted articles must be clear, correct, and unambiguous. Any typographical or grammatical errors should be corrected at revision, so please note any specific errors here.

Reviewer #1: Yes

Reviewer #3: Yes

**********

6. Review Comments to the Author

Please use the space provided to explain your answers to the questions above. You may also include additional comments for the author, including concerns about dual publication, research ethics, or publication ethics. (Please upload your review as an attachment if it exceeds 20,000 characters)

Reviewer #1: Kindly deposit the data associated with the study in a public repository. Otherwise the authors have addressed the comments.

Reviewer #3: Title:

I suggest removing the title of "Real world". The instrument in this case was designed specifically for this study.

Summary:

Avoiding the term "fully", currently there are people with 3 or even 4 doses of vaccination.

Introduction.

I suggest considering an additional base bibliography. https://doi.org/10.54034/mic.e1262

Methods.

There was some way to confirm that the respondents were health personnel. The instrument was online, so how could membership in the group of HCWs be verified?

Results.

Avoid the use of "partially" and "Fully". Indicate 1 or two doses.

Were there subjects with a heterologous vaccine schedule?

Discussion.

Add a paragraph about the possible presence of variants during the study period. https://doi.org/10.54034/mic.e1256

**********

7. PLOS authors have the option to publish the peer review history of their article (what does this mean?). If published, this will include your full peer review and any attached files.

If you choose “no”, your identity will remain anonymous but your review may still be made public.

Do you want your identity to be public for this peer review? For information about this choice, including consent withdrawal, please see our Privacy Policy.

Reviewer #1: Yes: Pathiyil Ravi Shankar

Reviewer #3: No

**********

[NOTE: If reviewer comments were submitted as an attachment file, they will be attached to this email and accessible via the submission site. Please log into your account, locate the manuscript record, and check for the action link "View Attachments". If this link does not appear, there are no attachment files.]

While revising your submission, please upload your figure files to the Preflight Analysis and Conversion Engine (PACE) digital diagnostic tool, https://pacev2.apexcovantage.com/. PACE helps ensure that figures meet PLOS requirements. To use PACE, you must first register as a user. Registration is free. Then, login and navigate to the UPLOAD tab, where you will find detailed instructions on how to use the tool. If you encounter any issues or have any questions when using PACE, please email PLOS at figures@plos.org. Please note that Supporting Information files do not need this step.

Revision 2

Response to Reviewers Date: July 23, 2022

Paper Title (old): “Adverse events following immunization with ChAdOx1 nCoV-19 and BBIBP-CorV vaccine: a real-world, comparative study among healthcare professionals of Nepal”

Paper title (New): “Adverse events following immunization with ChAdOx1 nCoV-19 and BBIBP-CorV vaccine: a comparative study among healthcare professionals of Nepal”

Journal Name: PLOS ONE

Paper ID: PONE-D-21-28369R1

Dear Editor

Thank you very much for providing reviewers’ insightful remarks on our manuscript. We have made the necessary changes and revised the manuscript accordingly, and detailed point–by–point corrections are given below:

Review Reports:

Reviewer #1:

Kindly deposit the data associated with the study in a public repository. Otherwise the authors have addressed the comments.

Authors’ reply: Thank you for your comment. We have already submitted the dataset to the Journal repository during manuscript submission.

Reviewer #3:

Title:

I suggest removing the title of "Real world". The instrument in this case was designed specifically for this study.

Authors’ reply: Thank you for your suggestion. According to your suggestion, we have removed “Real world” from the title. The new title is, “Adverse events following immunization with ChAdOx1 nCoV-19 and BBIBP-CorV vaccine: a comparative study among healthcare professionals of Nepal”

Summary:

Avoiding the term "fully", currently there are people with 3 or even 4 doses of vaccination.

Authors’ reply: We have avoided the term “fully” [Line: 46].

Introduction:

I suggest considering an additional base bibliography. https://doi.org/10.54034/mic.e1262

Authors’ reply: We have added the suggested bibliography [reference 4].

Methods:

There was some way to confirm that the respondents were health personnel. The instrument was online, so how could membership in the group of HCWs be verified?

Authors’ reply: Thank you for your comment. We have circulated the online questionnaire within the professional social media groups of the HCWs. However, we did not take any specific measure to verify their identity as HCWs which we have mentioned in the limitation section [Page 13, line 234-235].

Results.

Avoid the use of "partially" and "Fully". Indicate 1 or two doses.

Were there subjects with a heterologous vaccine schedule?

Authors’ reply: Thank you for the suggestion. We have corrected the manuscript accordingly [Table 1, Page, 7; Line:138-141].

Discussion.

Add a paragraph about the possible presence of variants during the study period. https://doi.org/10.54034/mic.e1256

Authors’ reply: Thank you for the suggestion. We have added the statement in the discussion [Page 12, line 215-216]

We would like to thank the reviewers for the valuable comments. We have revised the documents to the best of our ability, but we will definitely be happy to provide further improvement if there are further clarifications required.

With best regards

Dr. Md. Golam Hossain

Professor of Health Research Group

Department of Statistics, University of Rajshahi

Rajshahi-6205, Bangladesh

E-mail: hossain95@yahoo.com

Attachments
Attachment
Submitted filename: Response to Reviewers.docx
Decision Letter - Kovy Arteaga-Livias, Editor

Adverse events following immunization with ChAdOx1 nCoV-19 and BBIBP-CorV vaccine: a comparative study among healthcare professionals of Nepal

PONE-D-21-28369R2

Dear Dr. Hossain,

We’re pleased to inform you that your manuscript has been judged scientifically suitable for publication and will be formally accepted for publication once it meets all outstanding technical requirements.

Within one week, you’ll receive an e-mail detailing the required amendments. When these have been addressed, you’ll receive a formal acceptance letter and your manuscript will be scheduled for publication.

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If your institution or institutions have a press office, please notify them about your upcoming paper to help maximize its impact. If they’ll be preparing press materials, please inform our press team as soon as possible -- no later than 48 hours after receiving the formal acceptance. Your manuscript will remain under strict press embargo until 2 pm Eastern Time on the date of publication. For more information, please contact onepress@plos.org.

Kind regards,

Kovy Arteaga-Livias

Academic Editor

PLOS ONE

Additional Editor Comments (optional):

Reviewers' comments:

Formally Accepted
Acceptance Letter - Kovy Arteaga-Livias, Editor

PONE-D-21-28369R2

Adverse events following immunization with ChAdOx1 nCoV-19 and BBIBP-CorV vaccine: a comparative study among healthcare professionals of Nepal

Dear Dr. Hossain:

I'm pleased to inform you that your manuscript has been deemed suitable for publication in PLOS ONE. Congratulations! Your manuscript is now with our production department.

If your institution or institutions have a press office, please let them know about your upcoming paper now to help maximize its impact. If they'll be preparing press materials, please inform our press team within the next 48 hours. Your manuscript will remain under strict press embargo until 2 pm Eastern Time on the date of publication. For more information please contact onepress@plos.org.

If we can help with anything else, please email us at plosone@plos.org.

Thank you for submitting your work to PLOS ONE and supporting open access.

Kind regards,

PLOS ONE Editorial Office Staff

on behalf of

Dr. Kovy Arteaga-Livias

Academic Editor

PLOS ONE

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