Category: Corona Virus Vaccine

Senators Demand Answers From Social Security on COVID-19 Relief Clawbacks

Three US senators asked the Social Security Administration (SSA) to respond to a news report that said it reduced or suspended the benefits of people who received COVID-19 relief payments, according to . KFF Health News reported that the COVID-19 relief payments totaling as much as $3200 per person led the SSA to claw back other federal benefits, like monthly support payments for those impoverished, disabled, or aged 65 years or older. Also, the SSA sent notices to some people receiving Supplemental Security Income benefits who had more money than the $2000 asset limit due to COVID relief that alleged they were overpaid, asking them to repay the government; in some cases, SSA cut off benefit payments. The senators letter requested answers to a list of questions within 30 days.

Mifepristone, a drug taken almost exclusively to induce abortions or manage miscarriages, is tightly regulated by the federal and state governments and remains widely unavailable to patients experiencing pregnancy loss, according to Stateline. The American College of Obstetricians and Gynecologists recommended the use of both mifepristone and misoprostol to aid in passing pregnancy tissue, but a study revealed that only 1% of patients received the recommended 2-drug protocol due to mifepristone restrictions. These restrictions resulted in disparities in miscarriage care nationwide, even affecting states without abortion restrictions, as mifepristone is only available at hospitals, health clinics, and doctors offices that routinely provide abortions. Also, federal law requires all patients who receive the drug to sign a form acknowledging their desire to end their pregnancy, even if they experienced a miscarriage. Efforts to increase mifepristone access for miscarriage care are being opposed by anti-abortion groups who feel it is part of a larger campaign to make it more available for elective abortion.

Pharmaceutical companies are conducting trials in an attempt to get weight-loss shots approved for patients 6 years and older with obesity, according to Bloomberg. Eli Lilly & Co is planning to test its diabetes drug tirzepatide (Mounjaro), and Novo Nordisk A/S is planning to test (liraglutide) Saxenda, in patients as young as 6. If either drug is approved, it would be the first glucagon-like peptide-1 receptor agonists available to patients that young anywhere in the world, as the FDA and the European Medicines Agency have only greenlit them in adolescents 12 and older thus far. Pediatric obesity experts say the availability of these medications is a game-changer, as according to the CDC, about 20% of children 6 and older are obese. For pharmaceutical companies, making these medications available to a younger demographic has a huge financial upside. Despite these benefits, it is currently unclear how widely the medications would be used.

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What We're Reading: Senators Demand Answers on COVID-19 ... - AJMC.com Managed Markets Network

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FOX 5 NY's Morgan McKay has a closer look at the numbers and the industries that are leading the charge.

NEW YORK - New York City has recovered the nearly 1 million jobs that were lost during the COVID-19 pandemic, bringing the total to now a record high at more than 4.7 million jobs.

At an event that felt more like a re-election rally, Mayor Eric Adams touted that New York City is back in business.

Adams says this is all thanks to his administrations work prioritizing public safety, putting more officers on the streets, combating crime on the subway, and boosting union salaries.

"No one wanted to be on our subway system," Mayor Adams said. "We were hemorrhaging jobs and people were taking flights to Florida. Well you know what, they want to be back now."

But Andrew Rein from the Citizens Budget Commission says the citys recovery is a year behind the rest of the nations. There are also still around 80,000 fewer jobs in leisure, hospitality, retail, and wholesale trades.

"Thats because with remote work and the acceleration of online retail, fewer people are buying stuff in stores, fewer people are coming downtown every day," Rein said.

New York City is also headed toward a fiscal cliff with a budget gap ranging from $9 - 13 billion.

Rein says that while migrants are one reason the city is hemorrhaging money, the majority of this budget gap comes from the fact the city has been relying heavily on leftover COVID aid to fund programs.

The problem is much of this money is set to run out next year and the following year.

"Two- thirds of that gap is really of the city's own making, in part using the Wall Street bonuses and really using that federal one time COVID aid to bolster grow and fund programs that are going to continue," Rein said. "But that money is going to go away so the city needs to figure out which of the priority programs to continue and which it has to shrink."

Link:

NYC regains nearly all jobs lost during the COVID-19 pandemic - FOX 5 New York

During the countrys second COVID wave, 95,000 to 167,000 hospital patients in England were infected with SARS-CoV-2 in the hospital, partly due to a lack of single rooms, suggests a study published yesterday in Nature.

University of Oxford researchers analyzed data on in-hospital COVID-19 transmission, probable pathways of spread, and factors tied to elevated transmission risk at 356 National Health Service (NHS) hospitals during England's second pandemic wave, from June 2020 to March 2021.

"Hospital transmission directly affects patients likely to have multiple factors associated with poor outcomes; it puts healthcare workers (HCWs) at risk and compromises their ability to provide safe patient care; it disrupts service delivery; and it can have a major role in disseminating infection to vulnerable groups in the community," the study authors wrote.

An estimated 95,000 to 167,000 hospital patients (1% to 2% of all admissions) were infected with SARS-CoV-2 over the study period. A time-series analysis suggested that patients who acquired COVID-19 in the hospital were the main source of viral spread to other patients.

"Increased transmission to inpatients was associated with hospitals having fewer single rooms and lower heated volume per bed [the volume of heated areas divided by number of beds]," the researchers wrote. "Moreover, we show that reducing hospital transmission could substantially enhance the efficiency of punctuated lockdown measures in suppressing community transmission."

An analysis of the empirical length-of-stay distribution, the estimated incubation period distribution, and polymerase chain reaction (PCR) COVID-19 test sensitivity as a function of time since infection estimated that a policy of PCR testing of symptomatic patients would detect 26% of hospital-acquired infections, with 12% of infections meeting the criteria for definite healthcare-linked infection.

Adding PCR testing of asymptomatic patients 3 and 6 days after admission would boost the proportion of cases detected to 33% but wouldn't substantively alter the percentage considered definitely related to healthcare. Adding symptomatic PCR tests with testing for all patients at 7-day intervals would increase the proportion of detected hospital-acquired infections to 44% and the percentage considered definitely healthcare-associated to 17%.

These findings reveal the previously unrecognized scale of hospital transmission, have direct implications for targeting of hospital control measures and highlight the need to design hospitals better equipped to limit the transmission of future high-consequence pathogens.

"These low probabilities for detection and classification as definite healthcare-associated are a consequence of the typically short lengths of patient stay and low PCR sensitivities early in the course of infection," the researchers wrote.

Cumulative rates of hospital-acquired infection varied by region, with the highest rates in the northwest and the lowest in the southwest and London. Because the strongest predictor of in-hospital infections is the number of patients with healthcare-associated infections the previous week, so one patient with a healthcare-associated infection the previous week is associated with a further 1.07 patient infections the following week.

"Between 1% and 2% of hospital admissions are likely to have acquired SARS-CoV-2 infection while in hospital during the 'second wave' in England, with only a minority of these infections correctly classified as 'healthcare-associated' based purely on the time elapsed between admission and positive test," the authors wrote.

"These findings reveal the previously unrecognized scale of hospital transmission, have direct implications for targeting of hospital control measures and highlight the need to design hospitals better equipped to limit the transmission of future high-consequence pathogens," they added. "The role of hospital transmission in seeding COVID-19 into care homes and other vulnerable groups in the community must be further investigated."

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Researchers estimate 1% or 2% of hospital patients in England ... - University of Minnesota Twin Cities

As federal heath officials urge Americans to get the new COVID-19 booster this fall, new variants of the virus continue to spread in the United States, stoking fears about a winter surge.

In August, a highly mutated COVID-19 variant called BA.2.86, or "Pirola," made headlines after it was detected in humans and wastewater samples in the U.S. and several other countries.

Health officials have been closely monitoring the new variant as it spreads. Initially, Pirola set off alarm bells for some scientists due to its large number of mutations, which differentiate it from previous omicron subvariants that have gained dominance since 2021.

According to the U.S. Centers for Disease Control and Prevention, BA.2.86 is notable because it has multiple genetic differences, and it was detected in several locations in a short amount of time, the agency said in an update on BA.2.86 on Aug. 30.

In a risk assessment, the CDC said it BA.2.86 may be more capable of bypassing existing immunity from COVID-19 vaccines or prior infection, but there is no evidence it causes more severe illness.

Less than 1,000 cases of BA.2.86 have been reported worldwide so far, and the variant did not appear to drive the late summer surge in cases and hospitalizations in the U.S., experts told NBC News.

However, concerns about Pirolas ability to cause breakthrough infections have resurfaced as health officials roll out new COVID-19 vaccines, which target the omicron XBB.1.5 variant.

Moderna and Pfizer have said their updated COVID-19 vaccines appear to generate a strong immune response against BA.2.86, and experts anticipate the shots will provide good protection against newer strains circulating this fall, TODAY.com previously reported.

Additionally, data from lab studies suggest the Pirola variant may be less contagious and immune-evasive than previously feared, NBC News reported.

It's unclear whether BA.2.86 will cause a surge in infections this winter, but there's no reason to panic, experts say.

Here's what experts know so far about BA.2.86, aka Pirola, the symptoms it's causing, its ability to spread and how it could impact COVID vaccine vaccines this fall.

BA.2.86, which health experts dubbed Pirola on social media, was first detected in late July. It appears to have descended from the omicron BA.2 sublineage, which caused surges of the virus in early 2022, Andrew Pekosz, Ph.D., virologist at Johns Hopkins University, tells TODAY.com.

The critical thing about this variant (BA.2.86) is that it has a whole host of mutations compared to some of the omicron variants that emerged about two years ago, says Pekosz.

Early data show BA.2.86 has 34 more mutations in its spike protein than BA.2, which drove a COVID surge in 2022, and an additional 36 more mutations than XBB.1, which rapidly took over the U.S. in early 2023, according to an Aug. 24 paper in The BMJ.

The mutations or changes in the virus sequence can affect how contagious a virus is, how well it responds to treatment and how severely it affects people, per the CDC.

It represents a highly mutated form of SARS-CoV-2, says Pekosz in other words, BA.2.86 looks very different from the prevailing omicron XBB subvariants circulating.

Right now, "there's no data on symptoms associated with infection because the case numbers are just too small," Pekosz says.

In its risk assessment of BA.2.86, the CDC said "at this point, there is no evidence that this variant is causing more severe illness," but this may change as additional scientific data comes in.

Common symptoms of other COVID-19 variants and subvariants include:

Based on what the CDC knows now about BA.2.86, existing tests and medications used to treat COVID-19 "appear to be effective with this variant," the agency said.

The World Health Organization first classified BA.2.86 as a variant under monitoring on Aug. 17. Since then, BA.2.86 variant has been linked to over 640 cases in 30 countries, per the global virus database GISAID.

The countries reporting the highest number of cases are the United Kingdom, United States, Sweden, Denmark, Spain, Canada, South Africa, and France. BA.2.86 has also been detected in wastewater samples in additional countries, the CDC said.

So far, there have been 65 cases reported in at least 15 in the U.S. in either people or wastewater, per GISAID and the CDC.

The variant is probably spreading much more broadly than weve detected so far, says Pekosz, adding that a lack of testing and sequencing is likely causing a delay in reporting.

Right now, the EG.5 or Eris subvariant, a descendant of the omicron XBB sublineage, accounts for the largest proportion, 23.6%, of COVID-19 infections in the U.S., according to the latest estimates from the CDC.

After EG.5, the next most common subvariant circulating in the U.S. is another omicron XBB descendant, HV.1, followed by the closely related FL.1.5.1 or "Fornax," and offshoots of the XBB.1.16 orArcturus variant, per CDC data as of Oct. 13.

Globally, EG.5 and XBB.1.16 are the most prevalent COVID-19 strains, according to the latest WHO COVID-19 situation report.

Right now, it's too early to tell whether BA.2.86 is more transmissible than other variants, says Pekosz. "It's impossible to gauge anything about transmissibility or disease severity from that (small number of cases)," he adds.

However, based on what we know about the genetic sequence of BA.2.86 and the mutations in its spike protein, the variant will likely be able to escape preexisting immunity to COVID-19, Pekosz says.

The CDC echoed this in its BA.2.86 risk assessment, which stated that the variant could be more capable of causing infection in people who previously had COVID-19 or got vaccinated.

"Most of the mutations that we find in the spike protein are probably going to affect the ability of antibodies to bind and neutralize the virus," Pekosz adds.

In other words, BA.2.86 could escape not only immunity from vaccination or prior infection up until this point, but also vaccine-induced immunity from the coming fall vaccine, Pekosz adds.

"That's why this variant is very concerning to us from a scientific standpoint," he adds. "We need more sequences and cases to understand the variant's transmissibility."

According to the CDC, laboratories are currently researching the antibody neutralization of BA.2.86 to better understand how the immune system may interact with the virus.

We really dont know if BA.2.86 will lead to increased numbers of cases, Pekosz says. "The sequence cant tell us how much disease the virus will cause, nor can it tell us how well its spreading," says Pekosz. Only time and more data will tell.

However, the BA.2.86 does not appear to be behind the late summer COVID surge around the country, which was likely driven by a combination of EG.5 and otheromicron variantscirculating.

Nationwide, COVID hospitalizations appear to be trending downwards. In the last two weeks, average daily hospitalizations in the U.S. decreased by 9.5%, according to anNBC News analysis.

However, CDC director Dr. Mandy Cohen said that cases are expected to increase this fall and winter, TODAY.com previously reported.

In September, federal health officials approved a new COVID-19 booster to roll out this fall. The updated vaccines for 2023-2024, which target the omicron XBB.1.5 variant, are recommended by the CDC for everyone ages 6 months and older.

In recent weeks, millions of doses have arrived at pharmacies and doctors offices around the country. The CDC encourages everyone eligible to get at least one dose of the updated vaccine to protect against serious outcomes of COVID-19 this fall and winter.

Right now, there are three vaccine options authorized by the FDA. These include two mRNA vaccines from drugmakers Moderna and Pfizer, which are recommended for everyone ages 6 months and older, as well as a protein-based shot from Novavax, which is approved for everyone ages 12 and older.

Manufacturers have reformulated the vaccines to protect against the omicron XBB.1.5 subvariant, which was the dominant strain circulating for most of 2023 but has since been overtaken by Eris, Fornax, and Arcturus.

Although the new boosters do not include BA.2.86, recent data has suggested that the updated vaccines may provide more protection than initially thought against Pirola.

Moderna said that clinical trial data confirmed its new vaccine "showed an 8.7 to 11-fold increase in neutralizing antibodies against circulating variants, including BA.2.86."

The boosters will be well-matched to the other strains currently making people sick, says Pekosz and they will still be effective at reducing severe disease and hospitalization, per the CDC so it's important for people to stay up to date with COVID vaccines.

The CDC is encouraging everyone eligible get at least one dose of the updated COVID-19 vaccine, especially those at higher risk, which includes people over the age of 65, those with underlying health conditions and the immunocompromised.

In addition to vaccination, people can protect themselves against COVID-19 by taking precautions such as wearing a mask, practicing social distancing, avoiding sick people and maintaining good hand hygiene.

Caroline Kee is a health reporter at TODAY based in New York City.

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COVID Variant BA.2.86: All About Its Symptoms and Spread - TODAY

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A vaccine designed to protect against three different deadly coronaviruses shows success in mouse studies, demonstrating the viability of a pan-coronavirus vaccine developed by researchers at the Duke Human Vaccine Institute.

Published in the journal Cell Reports, the single nanoparticle vaccine included components of a previous vaccine that was shown to protect mice and primates against multiple variants of SARS-CoV-2, which is the virus that causes COVID-19. In this study, the vaccine protected mice from SARS-CoV-1, another form of SARS coronavirus that can infect humans, and a MERS coronavirus that has led to periodic, deadly outbreaks around the world.

"We are making important progress toward a broadly protective coronavirus vaccine," said senior author Kevin O. Saunders, Ph.D., associate director of the Duke Human Vaccine Institute. "These are pathogens that cause or have the potential to cause significant human infections and loss of life, and a single vaccine that provides protection could slow down or even prevent another pandemic."

Saunders and colleagues built the tri-valent vaccine using a nanoparticle loaded with a key fragment called a receptor binding domain from each of the coronaviruses. The fragmenta docking site on the virus that enables it to infiltrate the body's cellsprovides enough information for immune cells to build an effective response against actual coronaviruses that enter the body.

In earlier studies in mice and primates, the researchers demonstrated that an earlier iteration of the nanoparticle vaccine was effective against multiple SARS-CoV-2 variants. Human tests are planned next year for a version that carries immunogens to different SARS-CoV-2 strains, including those that have dominated since the original outbreak in late 2019.

The current work expands the components of the vaccine to include an additional SARS-related virus and MERS virus. In lab studies, as well as in mice, the researchers found that the vaccine candidate generated inhibitory immune molecules called antibodies against all three pathogenic human coronavirus types.

Importantly, vaccinated mice did not grow sick when challenged with either SARS-like or MERS-like viruses.

"This study demonstrates proof-of-concept that a single vaccine that protects against both MERS and SARS viruses is an achievable goal," Saunders said. "Given that one MERS and two SARS viruses have infected humans in the last two decades, the development of universal coronavirus vaccines is a global health priority."

More information: Vaccine-mediated protection against Merbecovirus and Sarbecovirus challenge in mice, Cell Reports (2023). DOI: 10.1016/j.celrep.2023.113248. http://www.cell.com/cell-reports/full 2211-1247(23)01260-3

Journal information: Cell Reports

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Single vaccine protects against three deadly strains of coronavirus - Medical Xpress

TIMESOFINDIA.COM | Last updated on - Oct 19, 2023, 13:00 IST

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A vaccine has been designed to protect against three deadly coronavirus strains and has been successful in mouse studies. The vaccine developed by researchers at the Duke Human Vaccine Institute demonstrates the viability of a pan-coronavirus vaccine. The vaccine offers protection against "SARS-CoV-1, another form of SARS coronavirus that can infect humans, and a MERS coronavirus that has led to periodic, deadly outbreaks around the world," the institute has said in an official statement.

The vaccine has been designed by Kevin O. Saunders, Ph.D., associate director of the Duke Human Vaccine Institute and his colleagues. The vaccine has used a nanoparticle loaded with receptor binding domain from each of the coronaviruses. This provides information to the body's immunity system to work against the coronaviruses when they infect the body.

This study demonstrates proof-of-concept that a single vaccine that protects against both MERS and SARS viruses is an achievable goal, Saunders said. Given that one MERS and two SARS viruses have infected humans in the last two decades, the development of universal coronavirus vaccines is a global health priority.

So far, the researchers have published the result of the vaccine trial on mouse. The findings have been published in the Cell journal. "Human tests are planned next year for a version that carries immunogens to different SARS-CoV-2 strains, including those that have dominated since the original outbreak in late 2019," the institute has siad. The researchers aim to include additional SARS-related virus and MERS virus to the components of the vaccine.

MERS or Middle East respiratory syndrome is a viral illness cause by a type of coronavirus. It was first identified in Saudi Arabia in 2012. The common symptoms of MERS are shortness of breath, diarrhea, fever and cough. Some patients also expeirence organ failure and septic shock due to MERS. Currently, no vaccine or specific treatment for MERS is currently available.

Is COVID back? 10 recent developments to know

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Single vaccine against three types of coronavirus sees success - Times of India

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Trivalent coronavirus vaccine created by Duke scientists shows promising early results - WTVD-TV

Many people first became familiar with the term mRNA when Pfizers and Modernas COVID vaccines were rolled out. In the simplest terms, mRNA, which stands for messenger ribonucleic acid, is a type of genetic material that gives cells in our bodies instructions to make specific proteins.

More recently the 2023 Nobel prize in physiology or medicine was awarded to Katalin Karik and Drew Weissman from the University of Pennsylvania for their discoveries in mRNA biology.

These scientists work has underpinned multiple successful COVID vaccines, which undoubtedly shifted the course of the pandemic. But their discoveries have likewise opened the door to a range of possible therapeutics which, until recently, remained elusive.

Read more: Nobel prize in medicine awarded to mRNA pioneers here's how their discovery was integral to COVID vaccine development

Within each of our cells are ribosomes, micro-machines that manufacture proteins, which in turn make up everything from muscle and bone to enzymes and hormones.

mRNA is the intermediate chemical message that carries the genetic code locked in the chromosomes of our DNA to the cytoplasm, the fluid that fills our cells and where proteins are made.

The ability to deliver genetic information directly into a cell has been one of medicines most obstinate challenges. While mRNA was theoretically the most attractive way to achieve this, it was of little use as a therapy. This is because our immune system mistakes the foreign RNA as being an invading virus, mounting a powerful and toxic immune response. Injecting naked mRNA therefore can make you very sick.

So it was pivotal when Karak and Weissman pioneered a technique to cloak mRNA from the immune system, alongside lipid nanoparticles to protect the RNA and allow it to be delivered safely to our cells.

This paved the way for mRNA COVID vaccines which instruct our cells to make spike proteins, proteins on the surface of SARS-CoV-2 (the virus that causes COVID). This is turn primes our immune system to make anti-spike antibodies that then block SARS-CoV-2 from infecting our cells.

Their discovery has opened up new possibilities for how we treat common infectious illnesses as well as genetic diseases that have previously defied treatment.

Influenza kills up to 650,000 people globally each year. At the moment, seasonal vaccines need to be made annually once the main circulating strain has been identified. Manufacture takes about six months, by which time the original flu strain may have evolved. At best the seasonal vaccine is about 60% effective.

We need a better vaccine and mRNA technology offers the potential of a universal influenza vaccine, with multiple candidates currently undergoing human clinical trials. A vaccine, if successful, could replace the current seasonal shots.

The mRNA vaccines are based on a specific part of the influenza protein, called hemagglutinin, teaching the cells to recall it and therefore inducing broad immunity across many influenza strains. In this vaccine, hemagglutinin is the equivalent target the spike protein is in the COVID vaccines.

Read more: 3 mRNA vaccines researchers are working on (that aren't COVID)

Targeting cancer is another promising avenue for mRNA technology, with mRNA-based cancer immunotherapies already at the trial stage.

One technique uses mRNA to mimic neoantigens (short bits of tumour proteins on the surface of the tumour cells) identified from an individual patients tumour cells. Once delivered to the patients immune system, their body should produce powerful killer cells called cytotoxic T cells, eliciting a strong anti-tumour immune response.

Chimeric antigen receptor T cells (CAR-T) therapy is a form of cancer immunotherapy currently in use around the world to treat certain forms of leukaemia. It uses immune cells called T cells that are genetically altered in a lab to help them locate and destroy cancer cells more effectively.

Traditionally CAR-T therapy has required a patients T cells to be harvested from white blood cells, modified, and then injected back into the patient. With mRNA technology the time consuming and most expensive steps are could be eliminated by delivering the CAR gene directly to T cells in the bloodstream.

mRNA technology is also transforming our response to some genetic diseases. Hereditary angioedema is a rare and potentially fatal genetic disorder where patients suffer severe and repeated attacks of swelling in their organs and tissues.

Scientists had discovered that a specific liver gene called KLKB1 prompts these swelling attacks. Researchers developed mRNA as a system to genetically edit and in turn silence the offending gene, with initial results positive for patients.

A similar trial using mRNA to edit the liver gene transthyretin alleviated symptoms in patients suffering a life-threatening hereditary condition called ATTR amyloidosis which affects the nerves and heart.

Therapeutics based on mRNA technology are still in their infancy and hurdles remain. For example, mRNA is short-lived in cells and protein is only made for a short time. Increasing the life-span of mRNA in cells would reduce the amount of mRNA required (the dosage). Scientists are working on this and a couple of methods have shown promise.

These caveats aside, the ability to deliver genetic information directly into cells could be a new frontier for medical therapeutics.

Excerpt from:

Beyond COVID vaccines: what else could mRNA technology do for our health? - The Conversation Indonesia

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Is the Novavax COVID Vaccine Better than mRNA Vaccines? What We Know So Far - Scientific American

Last month, the Centers for Disease Control and Prevention recommended that everyone in the U.S. 6 months and older receive an updated Covid vaccine targeting the XBB.1.5 variant. Since then, some notable voices, including Paul Offit, have publicly questioned whether the updated vaccine is needed for those who are not in a high-risk group. He recently wrote, At this point in the pandemic, it is hard to make a case for vaccinating everyone. Lets focus on those who are most likely to benefit. Otherwise, we run the risk of further confusing and frustrating the American public.

Of course there is room for reasonable debate on this important topic. But so far these arguments have been light on specific evidence and are themselves prone to causing confusion (at least if my family and friends are any indication). They downplay both the individual and population-level benefits of vaccination and risk undermining the uptake of the updated Covid vaccine among those who need it most.

Updated Covid vaccinations for all makes sense for eight key reasons:

1.) There is little downside. The vaccines are extremely safe. Skeptics have not been able to cite any real downsides of getting vaccinated. The Covid-19 vaccines are now among the most distributed and safety monitored vaccines in history. The risk of myocarditis for young adult males is even lower upon subsequent doses than the already very small risk following primary series doses, and the risk of adverse cardiac outcomes in this group was many times higher after a Covid infection than after vaccination.

2.) Its not obvious who is high-risk. Universal recommendations are simpler and likely increase uptake in the most vulnerable. The message that the Covid vaccine is not necessary for some is confusing and will deter many people who would benefit from getting it because they dont realize they are high risk. Theres good reason for that: There is no clearly defined group that has no risk of severe Covid, and it is not easy to know who is at highest risk. Increasing age is the strongest risk factor, but otherwise most people dont know if they are particularly vulnerable to severe Covid or not. Even age isnt clear-cut. Many older people I know underestimate their risk based on age alone because they are generally healthy.

Also, the vast majority of the U.S. population has an underlying condition that would qualify under a risk-based recommendation. (For example, more than 70% of adults are overweight or obese). There is evidence that universal recommendations for flu vaccination increased uptake among the most vulnerable groups.

3.) Covid vaccines protect against Covid. I dont want to get Covid. Even for healthy people who dont end up in the hospital, Covid can be a nasty illness that can mean days or weeks of missed work and school. I get the flu shot every year to avoid getting really sick, even for a few days. That protection is worth a lot to me, even if it only lasts for the three- to four-month flu season. Neutralizing antibodies increase considerably after vaccination, lowering (but not eliminating) the risk of infection for several months. The updated XBB Covid vaccine is still a good match to circulating variants, meaning this near-term protection may be particularly good right now.

4.) Vaccination likely reduces the risk of long Covid and helps in the recovery for some. Those questioning universal vaccination have been noticeably silent about long Covid. Each Covid infection confers some additional risk of longer-term consequences. Evidence presented at the Advisory Committee on Immunization Practices (ACIP) meeting on the updated vaccine suggested three doses of vaccine were more protective than two doses against long Covid. There is also suggestive evidence that vaccination can alleviate existing long Covid symptoms. While the evidence on long Covid and vaccination is still developing, its more than enough to merit consideration in these conversations.

5.) Fewer infections mean less transmission. Less transmission means fewer cases. Fewer cases means fewer serious cases and deaths. Thats math. While Covid vaccines dont block transmission completely as we once hoped, they do reduce the likelihood of transmission. The outspoken voices who say we dont need universal vaccination are not thinking in terms of population health. If my vaccine protects me from an infection, even in the short term, I cant pass the virus to others. This means that my vaccine also protects other people, particularly those whose immune systems dont respond as well to vaccines.

And even if I do get infected, a recent vaccination has been shown to lower the risk of transmission to household contacts. Thinking only about individual-level benefits discounts population-level benefits of broader vaccination like fewer cases overall.

6.) We do need updated vaccines, and lots of people didnt get the last one. While some argue that the primary Covid vaccine series is sufficient to protect against severe disease and death without additional doses, the evidence suggests otherwise. This year, a large percentage of those hospitalized for Covid-19 had been vaccinated with the primary series but not the bivalent booster, even under age 65 (see figure below). There is evidence that the 2022 bivalent booster, especially in the first few months after receipt, provided additional protection against critical illness and hospitalization, including at the younger ages Offit suggests dont need another dose. The study Offit cites to argue that not everyone benefited from additional doses of vaccine doesnt actually say that at all. It looks only at the relative risk of severe disease in people with two doses of the vaccine and different risk factors, finding not surprisingly that the risk was higher among older people and those with comorbidities.

7.) Kids benefit from the vaccine, too. While kids ages 5-17 have the lowest burden of severe illness, hundreds in this age group have died due to Covid-19 in the U.S. Half of the deaths were in kids with no underlying conditions. The rate of Covid-19 hospitalizations and deaths in kids is higher than pre-vaccine rates for chicken pox and meningitis, vaccine-preventable diseases for which there are universal vaccine recommendations. No parent will be surprised to learn that the majority of the time, children are the source of household Covid transmission.

So besides protection from severe disease which is a real concern reducing acute illness in kids means fewer days of missed school for kids and work for parents (not to mention teachers). Babies under 6 months old are not eligible for the vaccine but infants under 1 year old have the highest pediatric rates of Covid hospitalization and death, so reducing infections in older siblings protects them, too. Take-up of the vaccine in kids overall has been very low, so a universal recommendation for the updated vaccine could help increase overall coverage.

8) The cost-benefit makes sense. I get it: Vaccines are not free to society. While the federal government paid on average around $21 per dose for previous Covid vaccines, it will pay more than three times that this year. Private insurers will pay even more than that. While the vaccine is free to both insured and uninsured individuals, this cost is still real.

But cost-benefit scenarios presented to ACIP showed that universal vaccination was worth the cost under most scenarios. Compared with only vaccinating those older than 65, universal vaccine recommendations were projected to prevent about 200,000 more hospitalizations and 15,000 more deaths over the next two years. These modeling exercises dont even typically account for things like potential long Covid and lost productivity of parents staying home with sick kids. So, if anything the collective benefits are likely underestimated.

While its true that some countries are taking a high-risk only approach to updated vaccines, that by itself doesnt mean its the right choice. In the U.K., some members of Parliament have pushed to expand the scope of the fall Covid vaccine roll-out to alleviate winter pressures on the National Health Service.

The initial launch of the updated Covid vaccines in the U.S. has been bumpy without pandemic-era emergency funding and distribution. Canceled appointments can deter even the most enthusiastic vaccine seekers. Messages from trusted public health experts downplaying the benefits of vaccination will only reduce the incentive to push through logistical hassles.

The bottom line is that everyone can benefit from the updated Covid vaccine. So if youre on the fence, hop on off of it.

Jennifer Beam Dowd is a professor of demography and population health at the Leverhulme Centre for Demographic Science, University of Oxford. She is also editor-in-chief of the science communication platform Those Nerdy Girls.

Excerpt from:

Eight reasons why you should get an updated Covid vaccine - STAT - STAT