In todays Health Alert, the FDA may approve new COVID-19 vaccines as early as this week, according to insiders. This news comes as the US is currently experiencing its biggest summer surge in COVID-19 cases since July 2022
The updated mRNA vaccines from Moderna and Pfizer are set to tackle the KP.2 variant.If the FDA gives the green light, these vaccines could start showing up in pharmacies within a week and theyll be available at doctors' offices soon after.
It's still unclear if Novavaxs updated shot will be approved at the same time. Novavax uses a different approach with protein-based technology and targets a different strain, JN.1. Protein-based vaccines take longer to produce, so it might take a bit longer before that shot becomes available.
If the FDA approves Moderna and Pfizers updated COVID-19 shots this week, it would happen a few weeks earlier than last year. Thats great news, especially with COVID levels being high right now. Hospitalizations and deaths have been on the rise, though theyre still lower than in previous years. Experts say this summers surge is driven by new variants and waning immunity. The most common strain were seeing in the US now is KP.3.1.1, which is responsible for about 37% of cases. The variant has tripled in cases over the past month.
With kids heading back to school, the virus has more opportunity to spread. That puts parents, grandparents, and others at risk.
Back in June, the CDC recommended that everyone over six months old get the updated COVID-19 vaccine along with their flu shot this year. Usually, people get flu shots in the fall, as the CDC recommends that everyone get the vaccine by the end of October.
However, with COVID cases already high and kids returning to the classroom, getting an updated vaccine earlier is a good idea, especially for those at higher risk. I have three sons heading back to school, so Ill be getting the updated shot as soon as I can to help avoid infection.
In the meantime, wearing an N95 or KN95 mask in crowded indoor spaces is a good precaution. Its also a good idea to keep a couple of COVID-19 tests at home. That way, if anyone develops symptoms, you can quickly test and take steps to reduce the spread in your household. And remember, some people can spread the virus even without symptoms. So the best way to protect yourself is to get vaccinated as soon as those new COVID-19 shots are available.
COVID-19 activity remains elevated across most of the United States, but some regions of the country are seeing some declines, as the proportion of KP.3.1.1 variant continues to rise, the Centers for Disease Control and Prevention (CDC) said today in its latest updates.
Nationally, wastewater detections of SARS-CoV-2 are at the very high level for the second straight week. The highest levels are still in the West and South, followed by the Midwest and the Northeast. The CDC's latest update, however, shows downward trends from high levels in the South and Midwest.
For respiratory virus activity in general, the nation's levels are low, with most illnesses caused by COVID, with flu and respiratory syncytial virus (RSV) levels still low, the CDC said in its latest snapshot. It noted an upward trend for RSV, though.
COVID indicators show that the burden is highest in people ages 65 and older and in children younger than 2 years old.
The proportion of KP.3.1.1 variant continues to rise, the CDC said in its latest variant proportion estimates. KP.3.1.1, one of many JN.1 offshoots, is thought to more easily evade immunity from earlier infection and vaccination. The variant now makes up 36.8% of sequences, up from 22.8% in the previous 2 weeks.
Among the CDC's other metrics, test positivity rose slightly last week and is at 18.1% nationally, but was highest in Texas and surrounding states. Emergency department visits for COVID declined a bit from the previous week, but are still at the moderate level in parts of the South.
Hospitalization levels are declining from an early-August peak. Deaths from COVID continue to rise, however, up 18.7% from the previous week.
Dr. Eric Topol:
The U.S. has invested, but not enough, in a couple of nasal vaccine programs.
But this is what we need, William, to get us out of the woods, because our biggest problem right now is we're not able, really, in any significant way, to stop the infection and the risk of long COVID and the small, but persistent risk of severe COVID hospitalizations and fatalities.
So we have got to double down, triple down on the nasal vaccines because there's been so much recent work to show that this is feasible. It's just a matter of getting the clinical trials done and scaling up manufacturing.
But I'm quite confident that we will have a nasal vaccine. We should have had it by now, in fact, even more than one. But we're moving in slow-mo. We're not putting in the resources like we did for the initial shots back in 2020. So we got to take that more seriously. This is our big vulnerability right now, is infections.
Four years out from the outbreak of the COVID-19 pandemic, life is largely back to normal in Philadelphia, with residents treating COVID illness as a reality thats here to stay.
The Centers for Disease Control and Prevention have indicated they agree, with an official telling NPR recently that the agency considers the virus endemic in other words, a disease with a constant and predictable presence.
But some epidemiologists in Philadelphia and around the country are not convinced. They note the virus is still relatively unpredictable. The unexpectedly high surge in cases this summer is a prime example, they say.
Everyone has accepted COVID as a common respiratory viral infection maybe too much, said Neil Fishman, chief medical officer of the Hospital of the University of Pennsylvania.
READ MORE: In new recommendations, the CDC says COVID patients can end isolation 24 hours after symptoms improve
The Inquirer asked local public health experts about endemic disease, how COVID might not fit the definition, and what Philadelphians can do to avoid getting sick as cases rise. Heres what we learned:
In a pandemic, a newer virus or infection sweeps through a very large population. By contrast, a virus that is endemic sees a predictable ebb and flow of cases every year. The best examples are influenza, which occurs in late fall and early winter, and RSV, which has the same seasonality, Fishman said.
But just because a disease is endemic does not mean that its not dangerous, he cautioned.
People forget that 40,000 people a year die of influenza in the United States, he said.
COVID killed about 50,000 people in the United States in 2023, making it the 10th-leading cause of death. In 2022, it was the fourth-leading cause of death, and the third-leading cause of death from March 2020 to October 2021, ABC News reported this week.
Endemic doesnt mean benign. Its still a serious disease, Fishman said.
No. Even if most people are behaving like COVID is endemic, that doesnt mean that the disease is affecting the public in predictable cycles like the flu does, some scientists say.
Fishman thinks it may take another five years or longer for COVID to settle into a truly predictable pattern of seasonal illness.
It might take a little longer for COVID to become truly endemic because of its ability to mutate, he said.
Many epidemiologists had noted a decrease in COVID cases the last two summers and were expecting to see similar drops this year. Instead, cases have surged, with the CDC reporting that infections are growing or likely growing in 32 states as of Aug. 6.
It still fluctuates a lot, said Thersa Sweet, an associate teaching professor of epidemiology at Drexel University. We wouldnt have expected it to have an increase like were seeing now, but we are.
Id say its sort of endemic. Its here, its not going away, but we are still seeing unpredictable surges.
NPR reported that the endemic distinction will not change the CDCs recommended health response to the virus, including advising people to stay home when theyre sick and get vaccinated to prevent the spread of the disease.
Its still important for public health agencies to continue to monitor how the virus spreads and which variants are circulating, said Shara Epstein, the medical director of the Philadelphia health departments Division of Disease Control.
Scientists will continue to work to develop new and better vaccines and treatments, she said in a statement. And individuals can help keep themselves and their communities safe by receiving updated vaccines and staying home when they are sick.
The amount of COVID detected in wastewater now the most accurate way to track the virus since most cases are no longer reported to health agencies has been rising nationally since May. Current nationwide viral activity levels are close to where they were in January.
We are seeing high levels of virus around the country, and Philadelphia is no exception, Epstein said.
Wastewater tested from three sites in Philadelphia show COVIDs presence in the city has been slowly increasing since the spring, though deaths and hospitalizations have remained low.
Viral activity levels in the rest of the state have also been rising; the CDC says activity levels are currently high in Pennsylvania and in Delaware. (Viral activity is currently moderate in New Jersey, according to the agency.)
A number of factors might be contributing to the spike. These are guesses on my part, but we keep seeing these new variants that pop up that are more infectious, Sweet said. Thats probably the biggest reason why its so unpredictable.
Vaccination rates are still low for the latest COVID vaccines, released last fall and designed to provide immunity against newer variants of the virus. According to the CDC, about 25% of Philadelphians above the age of 18 had received their new vaccinations as of May, in line with state and national vaccine uptake.
The CDC calling COVID endemic means little in daily life.
Ive had COVID recently I have no idea where I got it, Fishman said. People are sick and not staying home, theyre riding public transportation, theyre going to work and transmitting disease to others.
People should wash their hands, stay home when theyre sick, and consider masking on public transportation and in other enclosed spaces, Fishman said. He regularly masks on public transportation; the latest public health guidance lists masks as a preventative measure people can take in addition to the CDCs core recommendations for preventing COVID. Those include vaccination, good hygiene, and seeking medical treatments like Paxlovid if youre at high risk for serious complications.
New COVID vaccines are expected in the fall, which will add protection against the newer COVID variants circulating.
The spread of COVID-19 has been on the rise again in Virginia recent months following a steady decline through early May, state data shows, and diagnosis is 128% higher than this time last year.
Experts advise that the public get the new vaccine, which should be available within a few weeks.
For the week ending Aug. 10, 3% of emergency department visits were for patients diagnosed with COVID-19, according to a Virginia Department of Health spokesperson. State health officials also monitor wastewater to gauge the spread of the coronavirus, and activity is considered very high in Virginia and nationally.
Wastewater data is useful to experts because its independent of the publics decision to get tested or seek medical care, said Logan Anderson, a VDH spokesperson.
The very high levels of SARS-CoV-2 in wastewater likely means that many people are sick with COVID-19 but have more mild illness and are able to recover at home, Anderson said in an email.
Anderson added that, in keeping with the seasonal pattern of COVID-19, experts expect the virus to have a peak in late summer then worsen again mid-winter with another peak around the new year.
The Centers for Disease Control recommends that everyone six months and older should get a 2024-25 coronavirus vaccine expected to be available in mid- to late-September. This latest inoculation is designed to target the KP.2 variant, which was causing about 4% of COVID-19 infections as of March but became the most common variant by May is expected to remain so this fall and winter, according to Anderson.
When you are sick, stay home and only go back to normal activities when, for at least 24 hours, both your symptoms have improved and you have no fever without the use of anti-fever medication, Anderson said. If you have flu or COVID talk to a health-care provider to see if antiviral treatment is right for you.
The COVID-19 deaths for the week ending Aug. 10 are 1.7% what they were in January 2021, according to the CDC.
The rate of coronavirus hospitalizations for all age groups was about 4 per 100,000 people in mid-March before dropping to about 0.4 per 100,000 people by mid-May. Since then, the rate has slowly climbed back up to just over 2 per 100,000 as of the week ending Aug. 10, according to the VDH.
Hospitalizations for the week ending Aug. 10 were up 10.4% from the previous week. Over the past six months in Virginia, the peak of COVID-19-related deaths came the week ending March 16 when 24 people died. The lowest point came the week ending June 29 when one person died. From there, deaths spiked again the week of July 20 when 14 people died, with five deaths from the disease through Aug. 3.
Over the past six months, the percent of total inpatient hospital beds in use by COVID-19 patients has reached a new peak, though still considered low by VDH. Since the low point of 0.42% for the week ending June 1, the percent of beds occupied by COVID-19 patients has risen to 2.23% for the week ending Aug. 10 the pre-June 1 peak was 1.6% which is 18.6% higher than the previous week.
Gavin Stone,757-712-4806,gavin.stone@virginiamedia.com
The declaration by the World Health Organisation (WHO) making mpox a global health emergency has brought it to the spotlight, triggering a high alert in many countries.
With mpox spreading to over 116 countries, it may appear similar to the Covid-19 pandemic.
However, a WHO official recently said that "mpox is not the new Covid", which means that a pandemic like the Covid-19 is highly unlikely.
MPOX VS COVID-19
Mpox and Covid-19 are caused by different viruses, each belonging to distinct viral families with unique genetic compositions and characteristics.
The mpox virus is a member of the Orthopoxvirus genus, which also includes the variola virus responsible for smallpox. Mpox is a DNA virus with a double-stranded genome, which is relatively stable compared to RNA viruses.
This stability means that the mpox virus mutates at a slower rate, leading to fewer and more gradual changes in its strains over time.
Historically, two main strains of the mpox virus have been identified: the Central African (Congo Basin) strain (Clade 1b), which is more virulent and has a higher mortality rate, and the West African strain (Clade 2), which is less severe.
In contrast, Covid-19 is caused by the SARS-CoV-2 virus, a member of the coronavirus family. This is an RNA virus, which means it is a single-stranded RNA genome that is more prone to mutations.
The high mutation rate in RNA viruses has led to the emergence of multiple variants of SARS-CoV-2 over the course of the Covid-19 pandemic. These variants, such as Alpha, Delta, and Omicron, have shown significant differences in their transmissibility, severity, and ability to evade immunity.
The frequent mutations in SARS-CoV-2 have led to continuous monitoring and adjustments in vaccination strategies.
The key difference between the strains of mpox and Covid-19 lies in the nature and pace of their evolution.
The relatively stable DNA genome of mpox leads to slower changes and fewer variants, while the RNA genome of SARS-CoV-2 allows for rapid evolution and the emergence of numerous variants with distinct properties.
Symptoms
The symptoms of mpox include fever, headache, muscle aches, backache, swollen lymph nodes, chills, and exhaustion. A key symptom is a rash that progresses to fluid-filled blisters, often starting on the face and spreading to other parts of the body.
Symptoms of Covid-19 vary widely but typically include fever, cough, difficulty breathing, fatigue, muscle or body aches, loss of taste or smell, sore throat, congestion, nausea, and diarrhea. Some cases of Covid-19 can also be asymptomatic.
Transmission
Mpox primarily spreads through direct contact with the rash, scabs, or bodily fluids of an infected person or animal. It can also spread through respiratory droplets during prolonged face-to-face contact and from contaminated objects like bedding.
Covid-19 mainly spreads through respiratory droplets and aerosols when an infected person coughs, sneezes, talks, or breathes. It can also spread by touching surfaces contaminated with the virus and then touching the face.
Incubation Period
Mpox is typically lasts 5 to 21 days, while Covid-19 usually lasts 2 to 14 days.
Severity and Mortality
Mpox is generally less severe than smallpox, with a mortality rate ranging from 1% to 10%, depending on the strain and the region. Most cases are mild and self-limiting.
The severity of Covid-19 varies widely, from mild or asymptomatic cases to severe pneumonia and death. The mortality rate varies based on factors like age, underlying health conditions, and access to healthcare.
Vaccination
The smallpox vaccine provides some protection against mpox. Specific mpox vaccines have been developed and are used in outbreak situations. There are currently two vaccines (JYNNEOS and ACAM2000) being used for mpox, recommended by WHO experts and approved by health authorities in several countries.
Several vaccines specifically targeting SARS-CoV-2 have been developed and widely administered globally. Current vaccines that have been administered worldwide are Covishield, Covaxin, Novavax, Pfizer and Moderna.
Prevention
Mpox can be prevented through vaccination, practising personal hygiene by washing your hands frequently. If you're at risk of mpox and haven't been vaccinated, don't be in close contact with anyone, this includes skin-to-skin touch and sex. Avoid contact with objects that a person with mpox has used.
Covid-19 can be prevented by isolation or quarantines, social distancing, widespread vaccination, and maintaining personal hygiene.
Published By:
Daphne Clarance
Published On:
Aug 22, 2024
A new round of COVID-19 vaccines will be rolled out soon. Scott Olson/Getty Images hide caption
The Food and Drug Administration is expected to green light new COVID-19 vaccines any day now to help people protect themselves from the latest strains of the virus.
The new COVID vaccines are designed to keep the shots up to date with the virus, which keeps evolving to evade our immune systems.
The new formulations cover the variants that have been circulating more recently, Dr. Peter Marks, who runs the FDA Center for Biologics Evaluation and Research, tells NPR. So the hope is that the closer we match the strain, the better protection one will have, and perhaps the longer the protection well have.
The Pfizer-BioNTech and Moderna mRNA vaccines expected to get the go-ahead this week target the KP.2 variant. The Novavax vaccine, which is based on an older technology, targets an earlier strain called JN.1.
Both target strains have already been overtaken by even newer variants, but theyre all still part of the omicron group. The hope is the vaccines are close enough to boost immunity and protect people through the rest of the surprisingly big summer wave and the surge expected this winter.
The vaccine is not intended to be perfect. Its not going to absolutely prevent COVID-19," Marks says. "But if we can prevent people from getting serious cases that end them up in emergency rooms, hospitals or worse dead thats what were trying to do with these vaccines.
The new vaccines should cut the risk of getting COVID by 60% to 70% and reduce the risk of getting seriously ill by 80% to 90%, Marks says. The shots are expected to become available as soon as this weekend to anyone age 6 months and older.
Right now were in a wave, so youd like to get protection against whats going on right now, Marks says. So I would probably get vaccinated in as timely a manner as possible. Because right now the match is reasonably close. Youre probably going to get the most benefit youre going to get from this vaccine against whats currently circulating. So when this gets into pharmacies I will probably be on line as soon as it gets rolled out.
To maximize the chances of getting the best protection, people should wait at least two or three months since their last bout of COVID or their last shot to get one of the new vaccines, Marks says.
Some people could consider waiting until September or October if theyre especially concerned about maximizing protection through the winter surge and over the holidays.
Getting vaccinated sometime in the September to early October time frame seems like a pretty reasonable thing to do to help bring you protection through the December/January time frame, says Marks. It doesnt, like, suddenly stop. This is not like something that suddenly cuts off at three or four months. Its just that the immunity will decrease with time.
In my opinion, everyone should get one of the new vaccines, says Dr. George Diaz, chief of medicine at Providence Regional Medical Center Everett in Everett, Wash., and a spokesperson for the Infectious Disease Society of America. Being vaccinated yourself will prevent transmission to other people. So that will help reduce the spread of the disease in the community, especially to the most vulnerable people. So youre not just helping yourself but also helping others.
In addition, getting vaccinated reduces the risk for long COVID, Diaz adds.
Others question whether everyone necessarily needs another shot, arguing most younger healthy people still probably have enough immunity from all the shots and infections theyve already gotten to protect them from getting really sick.
Anyone who wants to get this vaccine should get it, says Dr. Paul Offit, a vaccine expert at the University of Pennsylvania who advises the FDA. It certainly makes sense why someone would want to get it because it lessens your chance of getting a mild or moderate infection for about four to six months and to some extent lessens your chances of spreading the virus. But the calculation could be different for younger people. Were I a 35-year-old healthy adult whod already had several doses of vaccine and one or two natural infections I wouldnt feel compelled to get it, Offit says.
And regardless of the public health advice, its far from clear how many people will want one of the new shots. Only about 22% of eligible adults got one of the last ones.
But for anyone who does want the COVID vaccine, they can get the flu shot at the same time. In addition, federal officials are recommending anyone age 75 and older also get one of the new vaccines to protect against the respiratory syncytial virus, or RSV. Same goes for pregnant people and those ages 65 to 74 who are at high risk of getting seriously ill from RSV.
Older at-risk people will probably be able to get a second shot with the new COVID vaccines in the spring or early summer to help protect them against another wave next summer.
Insured people can get all three vaccines for free if they get their shot from an in-network provider. But a federal program that paid for the vaccines for uninsured adults expired.
In the public health community were very concerned about how they will access protection and looking for ways for how were going to solve that problem, says Dr. Kelly Moore, who runs Immunize.org, an advocacy group. We know that the people who are uninsured are the least likely to be able to afford becoming ill missing work, staying home from school.
Up First briefing: Tim Walz DNC speech; COVID-19 vaccines Tim Walz stepped into the spotlight last night at the DNC giving the crowd a pep talk. Here are five other takeaways from the convention so far. And, new COVID-19 vaccines are on the way.
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NPR's senior political editor/correspondentDomenico Montanaro joins the newsletter today to break down the DNC so far:
Gov. Tim Walz of Minnesota, Kamala Harris' vice-presidential pick, stepped into the spotlight on night three of the Democratic National Convention in Chicago and he gave the crowd a pep talk, as Democrats tried to make a broad appeal. Here are six takeaways from the DNC so far:
Democratic vice presidential nominee Minnesota Gov. Tim Walz reacts with his daughter Hope Walz after accepting the Democratic vice presidential nomination on stage during the third day of the Democratic National Convention. Win McNamee/Getty Images hide caption
Stay informed during the 2024 election season and beyond by subscribing to the NPR Politics newsletter and listening to the NPR Politics podcast.
Harris will close out the DNC tonight, formally accepting the Democratic Partys presidential nomination. Shell also lay out her vision for the country. Harris short campaign has allowed her to build momentum while saying less than most candidates have about how they would govern. Over the last four years, as vice president, President Bidens policy agenda has also been hers. Now, she has the ability to navigate major issues with a little more authority.
New COVID-19 vaccines that might combat the latest virus strains are expected to be approved any day now by the Food and Drug Administration. The new vaccines have been reformulated to stay up to date with the virus, which keeps evolving to evade our immune systems. The Pfizer-BioNtech and Moderna vaccines target the K-P-2 variant. The Novavax vaccine targets an earlier strain called JN.1. Both target strains have already been overtaken by newer variants, but the hope is the vaccines are close enough to boost immunity and protect people through the rest of the summer wave and the surge expected this winter. Dr. Peter Marks, who runs the FDA Center for Biologics Evaluation and Research, tells NPR the new vaccines could cut the risk of getting COVID by 60% to 70% and reduce the risk of getting seriously ill by 80% to 90%.
The federal investigation into Diamond Shruumz products hasn't yet pinned down what's responsible for the illnesses. Preston Gannaway/for NPR hide caption
Dr. Michael Moss couldnt explain why an ICU patient was convulsing after eating a mushroomed-infused candy bar. Moss, a toxicologist at the University of Utah Hospital, began contacting poison centers across the country for help. He discovered similar cases were popping up: Patients with nausea, vomiting, agitation, seizures, loss of consciousness and other symptoms. There are now 130 documented illnesses including two suspected deaths all tied to the same brand of mushroom edibles, called Diamond Shruumz, according to the Food and Drug Administration. The edibles maker said it has ceased production and distribution of the products, citing toxic levels of muscimol, the compound found in Amanita muscaria, the mushroom used to make the edible. But its still not clear that the mushroom is to blame for the illnesses.
Abby Ingwersen works on a client at Nice Try Tattoo in New York. Mengwen Cao for NPR hide caption
Young tattoo artists are challenging the traditional ways of running a business and how they poke ink into skin. Theyre working to leave a permanent mark, from forming independent collectives to reviving the stick and poke method that uses a singular needle to etch designs. Independent studios like these rose during the pandemic, pushing styles and tastes to evolve, but the goal has remained the same: To create distinctive, meaningful, permanent art.
Independent Presidential Candidate Robert F. Kennedy Jr. announced attorney, tech entrepreneur and philanthropist Nicole Shanahan to the Kennedy campaign as his vice presidential running mate during an event in Oakland, Calif., on March 26. Anadolu via Getty Images hide caption
Independent Presidential Candidate Robert F. Kennedy Jr. announced attorney, tech entrepreneur and philanthropist Nicole Shanahan to the Kennedy campaign as his vice presidential running mate during an event in Oakland, Calif., on March 26.
This newsletter was edited byObed Manuel.
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Severe COVID-19 was associated with elevated risks for depression and serious mental illness months after infection, especially among unvaccinated people, a cohort study involving more than 18 million individuals in the U.K. found.
Compared to the period before a COVID infection or to individuals without an infection, those hospitalized for COVID had substantially higher risks for depression in the 4 weeks after admission, both in the pre-vaccine era (adjusted hazard ratio [aHR] 16.3, 95% CI 15.6-17.0) and among unvaccinated (aHR 15.6, 95% CI 13.9-17.4) and vaccinated (aHR 12.9, 95% CI 12.0-14.0) individuals in the vaccine era. In all three groups, the risk for depression remained elevated up to a year later.
Similarly, elevated risks for serious mental illness were observed among hospitalized patients in the 4 weeks after a COVID diagnosis, reported Jonathan Sterne, PhD, of the University of Bristol in England, and colleagues in JAMA Psychiatry:
Rates of most mental illnesses examined -- including anxiety, post-traumatic stress disorder, eating disorders, addiction, and self-harm -- were higher in the first 4 weeks after a COVID hospitalization.
"The main surprise was that the association of COVID-19 with subsequent mental ill-health appeared restricted to severe COVID-19 that led to hospitalization," Sterne told MedPage Today. "There was little association of COVID-19 that did not lead to hospitalization with subsequent mental ill health."
Serious mental illness was a composite of schizophrenia, schizoaffective disorder, bipolar disorder, and psychotic depression.
Vaccination may attenuate adverse effects of COVID on mental illnesses, the authors posited. "Potential mechanisms include reduced systemic inflammation and psychological benefits of vaccination, such as reduced concern about COVID-19 and increased social engagement," they wrote.
"The main benefit of COVID-19 vaccination is that it provides substantial protection against severe COVID-19. Therefore, our findings underscore the importance of COVID-19 vaccination, particularly in groups at highest risk of severe COVID-19," Sterne emphasized.
"Serious mental illnesses are associated with more intensive healthcare needs and longer-term health and other adverse effects, and so longer-term monitoring for onset of new mental illnesses among patients hospitalized because of COVID-19 may be justified," he added.
Regardless of whether patients with COVID were hospitalized, in the pre-vaccine era the overall risk of depression in the 4 weeks after infection was 93% higher (aHR 1.93, 95% CI 1.88-1.98) than before or without COVID. The overall risk of developing serious mental illness was 49% higher (aHR 1.49, 95% CI 1.41-1.57). Among those who remained unvaccinated, the overall risks of depression (aHR 1.79, 95% CI 1.68-1.90) and serious mental illness (aHR 1.45, 95% CI 1.27-1.65) were also elevated.
Incidence of depression up to 28 weeks later and of serious mental illness across all time periods was greater in people 60 years and older, which may reflect increased risk for severe disease as well as anxiety about severe outcomes, the authors pointed out.
Of note, incidence of mental illnesses remained elevated for more than 28 weeks after a COVID-19 diagnosis. The estimated excess risk of depression at 28 weeks after COVID was 1,033 per 100,000 people in the pre-vaccine era and 1,008 per 100,000 in the unvaccinated group, whereas the risk among vaccinated people was less than half that, at 451 per 100,000.
The trend for serious mental illness at 28 weeks was similar, with an estimated excess risk of 235 and 209 per 100,000 in the pre-vaccine era and among the unvaccinated, respectively, versus 53 per 100,000 in the vaccinated group.
The study analyzed data from three cohorts during the pre-vaccine (January 2020 to June 2021) and vaccine eras (June to December 2021; the Delta variant period):
The average ages of the pre-vaccine and vaccinated cohorts were 49 and 53, respectively, and about half were female. The average age of the unvaccinated cohort was 35 years and about 42% were female. Diagnoses of COVID were confirmed by test results, by a general practitioner, or from hospital or death records.
The authors acknowledged several limitations to the study. Unvaccinated people may have been less likely to test for COVID or use health services, with a possible underestimation of effects. Conversely, people with a diagnosis of COVID and related hospitalization may have been more likely to be diagnosed with mental illness in a hospital setting. It is also possible that the mental health effects observed were not unique to infection with SARS-CoV-2.
Katherine Kahn is a staff writer at MedPage Today, covering the infectious diseases beat. She has been a medical writer for over 15 years.
Disclosures
The study was supported by the COVID-19 Longitudinal Health and Wellbeing National Core Study, which is funded by the Medical Research Council and the U.K. National Institute for Health and Care Research (NIHR).
Sterne reported grants from the NIHR, the U.K. Research and Innovation (UKRI) Medical Research Council, and Health Data Research U.K. Co-authors reported relationships with AstraZeneca, the Bennett Foundation, the Wellcome Trust, NIHR Oxford Biomedical Research Centre, NIHR Applied Research Collaboration Oxford and Thames Valley, the Mohn-Westlake Foundation, the National Health Service England, Induction Healthcare, UKRI, and Health Data Research U.K.
Primary Source
JAMA Psychiatry
Source Reference: Walker VM, et al "COVID-19 and mental illnesses in vaccinated and unvaccinated people" JAMA Psychiatry 2024; DOI: 10.1001/jamapsychiatry.2024.2339.
