Category: Corona Virus Vaccine

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Scientists find early success in vaccine to tackle multiple … – The National

October 19, 2023

A vaccine being developed to combat three deadly coronaviruses has had some success in early studies in mice.

The breakthrough at the Duke Human Vaccine Institute in the US has shown the vaccine protected mice against Covid-19, severe acute respiratory syndrome (Sars) and Mers the Middle East respiratory syndrome first identified in Saudi Arabia in 2012.

The research offers hope that a pan-coronavirus vaccine could one day be developed further to protect human beings from numerous viruses.

The single nanoparticle vaccine included components of a previous vaccine that protected mice and primates against variants of Sars-CoV2, the virus that causes Covid-19.

This study demonstrates proof-of-concept that a single vaccine that protects against Mers and Sars viruses is an achievable goal

Kevin Saunders, Duke Human Vaccine Institute.

Scientists in the US built the tri-valent vaccine using a nanoparticle loaded with a key fragment called a receptor binding domain from each of the three viruses.

That fragment acts as a docking site on each virus, boosting immunity by enabling it to infiltrate the bodys cells to protect them against actual coronaviruses that may enter the body.

Further tests are planned on human subjects next year in the hope a vaccine can be developed that carries immunogens to attack several coronavirus strains.

We are making important progress toward a broadly protective coronavirus vaccine, said Kevin Saunders, author of the study and 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.

Sars is a viral respiratory disease similar to Covid-19.

It was first identified in February 2003, during an outbreak that emerged in China and then spread to four other countries in Asia.

In the following months, the illness spread to more than 24 countries, including in the Americas and Europe before it was contained later that year.

During the 2003 outbreak, the World Health Organisation reported 8,098 cases of illness and 774 deaths.

Symptoms were similar to influenza, with a dry cough after several days, with most sufferers developing pneumonia.

While the worlds attention has been focused on the coronavirus in recent years, a related pathogen -- the Middle East Respiratory Syndrome (MERS) -- has been continuing to circulate and cause deaths. Reuters

Since the disease emerged a decade ago, there have been 2,605 confirmed cases, about 84 per cent of them in Saudi Arabia. AFP

Ulrich Wernery, scientific director of the Central Veterinary Research Laboratory in Dubai, takes samples from a camel to assist with a study of Mers. Pawan Singh / The National

Passengers walk past a thermal scanner at Manila International Airport in the Philippines. The country is one of 18 that have reported cases of the MERS coronavirus. AP

Camel owners do not want to vaccinate their herd because the animals themselves do not become ill.

Saudi Arabia has urged its citizens and foreign workers to wear masks and gloves when dealing with camels. AFP

Better hygiene and other virus control measures have helped to reduce the number of people infected with the virus from camels. Pawan Singh / The National

Almost a decade later a similar virus emerged in the Middle East.

Since Mers was first reported in 2012, there have been more than 2,600 confirmed laboratory cases, with the majority in Saudi Arabia.

Of those, there have been 856 related deaths from Mers, the virus believed to be passed on from dromedary camels.

A man in the UAE tested positive for the Mers virus this year.

The WHO said the man, 28, an expatriate living in Al Ain, was admitted to hospital on June 8.

It said 108 contacts were identified and monitored for 14 days from the last date of exposure to the patient.

No further cases were detected.

The research by the Duke Human Vaccine Institute could pave the way for a human vaccine to protect against all three deadly viruses.

This study demonstrates proof-of-concept that a single vaccine that protects against Mers and Sars viruses is an achievable goal, Mr 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.

Updated: October 19, 2023, 8:50 AM

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Scientists find early success in vaccine to tackle multiple ... - The National

VDH: COVID cases still low, but rising – Vermont Biz

October 19, 2023

by Timothy McQuiston, Vermont Business Magazine COVID-19 cases, hospitalizations and deaths have edged up in Vermont since the end of summer, continuing a trend that began in August. The Rutland Regional Medical Center and the UVM Health Network hospital in Plattsburgh, NY (CVPH), have recently tightened visitation guidelines. Meanwhile, the CDC has released a new vaccine booster.

The Vermont Department of Health reported October 11, 2023, that COVID-19 hospitalizations fell to a statewide total of 31, down from 47 last week, they were 31 before that and 22 three weeks ago. COVID-19 activity remains in the "Low" range, according to the VDH. Reported cases last week were 287, up from 283 last week, 311 before that and 197 three weeks ago.

There were 6 COVID-related deaths reported last week (after 4 the previous week) for a pandemic total of 1,032 as of October 7 (this is the most recent update). Fatalities have slowed from prior years. VDH reported 15 COVID-related deaths in March, 20 in April, 10 in May, 10 in June (these are fewest since the summer of 2021), 11 in July, 14 in August, 17 in September and 3 so far in October.

CDC states that already an estimated 97% of Americans have some level of immunity, from either vaccination or infection or both, which they said will help keep down new transmission and lessen serious outcomes.

Of the total deaths to date, 823 have been of Vermonters 70 or older. There have been 3 deaths of Vermonters under 30 since the beginning of the pandemic.

(see data below)

Report Timeframe: October 1 to October 7, 2023

Statewide hospitalization levels: Low. New COVID-19 admissions are below 10 per 100,000 Vermonters per day.

The hospitalizations dataset contains day-level data reported from all Vermont hospitals each Tuesday. Reported numbers are subject to correction by reporting hospitals, and data from several days during the previous reporting week were marked as corrected as of October 10, 2023.

The number of reportable COVID-19 cases is still available in this report, below. Laboratory-confirmed and diagnosed COVID-19 cases and COVID-19 outbreaks must still be reported to the Vermont Department of Health.

As of this report, there were 9 outbreaks last week, with 4 in long-term care facilities and 4 in schools/childcare centers. Outbreaks have fallen significantly since fall 2022.

Vermont Department of Health recommendations: Preventing COVID-19 (healthvermont.gov)

CDC recommendations: COVID-19 by County | CDC

Vermont has the second lowest fatality rate in the US (119.4 per 100K; Hawaii 99.6/100K). Mississippi (430.9/100K) and Oklahoma (428.0/100K) have the highest rates. The US average is 287.1/100K (CDC data).

There has been a total of 1,147,253 COVID-related deaths to date in the US (CDC) and 6,961,014 globally (WHO).

Following an analysis of COVID-19 data, the VDH reported in early January a cumulative 86 additional COVID-associated deaths that occurred over the course of the pandemic but had not been previously reported. Most of those deaths occurred in 2022.

COVID-19 Update for the United States

Early Indicators

Test Positivity

% Test Positivity

10.1%

(October 1 to October 7, 2023)

Trend in % Test Positivity

-0.8% in most recent week

Emergency Department Visits

% Diagnosed as COVID-19

1.4%

(October 1 to October 7, 2023)

Trend in % Emergency Department Visits

-17.7% in most recent week

These early indicators represent a portion of national COVID-19 tests and emergency department visits. Wastewater information also provides early indicators of spread.

Severity Indicators

Hospitalizations

Hospital Admissions

16,766

(October 1 to October 7, 2023)

Trend in Hospital Admissions

-8.2% in most recent week

Deaths

% of All Deaths in U.S. Due to COVID-19

2.5%

(October 1 to October 7, 2023)

Trend in % COVID-19 Deaths

-3.8% in most recent week

Total Hospitalizations

6,405,961

The Delta variant took off in August 2021, which resulted in the heaviest number of deaths before vaccines and their boosters helped alleviate serious COVID cases. Multiple Omicron variants are now circulating and appear more virulent than previous variants, but perhaps not more dangerous, according to the CDC.

AP April 5, 2023: WHO downgrades COVID pandemic, says it's no longer a global health emergency

Walk-in vaccination clinics run by the state closed on January 31, 2023. Learn more

Vermonters are reminded that all state COVID testing sites were closed as of June 25, 2022. PCR and take-home tests are available through doctors' offices, pharmacies and via mail from the federal government. The federal government officially ended its pandemic response as of May 11, 2023. See more information BELOW or here: https://www.healthvermont.gov/covid-19/testing.

Starting May 11, 2023, the CDC and Vermont Department of Health will no longer use the COVID-19 Community Level to measure COVID-19 activity in the U.S. and Vermont. Instead, Vermont's statewide COVID-19 level will be measured by the rate of COVID-19 in people being admitted to the hospital, per 100,000 residents.

Focusing on hospitalization data is a better estimate of how COVID-19 is impacting the community now that reported COVID-19 cases represent a smaller proportion of actual infections. This also allows us to compare Vermonts hospitalization levels with other parts of the country.

The Delta variant caused a surge in COVID-related fatalities last fall and into the winter.

The highest concentration of deaths was from September 2021 through February 2022. Overall, December 2020 and January 2022 were the worst months with 72 fatalities each.

The US confirmed its first case of COVID-19 on January 20, 2020.

Vermonters ages 6 months and older are eligible for COVID-19 vaccines. Getting vaccinated against COVID-19 is the safer way to build protection from serious illnesseven for those who have already had COVID-19. Learn more about COVID-19 vaccines (CDC)

COVID-19 vaccines are free and widely available. Anyone can get vaccinated in Vermont, including those who live in another state, are non-U.S. citizens, or who have no insurance. See Vermont's current vaccine rates

Know your rights when getting free vaccines.

You are considered up-to-date if you are over the age of 6 years old and have received a bivalent (updated) COVID-19 vaccine.Learn more about kid vaccines

If you are unable or choose not to get a recommended bivalent mRNA vaccine, you will be up to date if you received the Novavax COVID-19 vaccine doses approved for your age group.

Find more on recommended doses from CDC

COVID Vaccine Information for Health Care Professionals

More on COVID-19 Vaccines (CDC)

Recommended COVID Vaccine Doses (CDC)

Find a COVID-19 vaccine near you.

Image

Use Vaccines.gov to find a location near you, then call or visit the location's website to make an appointment.

Vaccines.gov

Everyone 6 months of age and older is eligible to get a COVID-19 vaccination.Most children are also now eligible for a bivalent dose that offers increased protection against the original strain and omicron variants.

See more on recommended vaccine doses by age group (CDC)

Resources for parents and caregivers

Confident Care for Kids

Tips for Helping Kids Feel Ready for Any Vaccine (Vermont Family Network)

#factsheet

What Families with Children Should Know About COVID-19 Vaccines (translated)

https://www.youtube.com/watch?v=lWcqHOgQIVg&t=5s

Conversations About COVID-19 Vaccines for Children with Vermont Pediatricians (American Academy of Pediatrics)

If you cannot get vaccines through any of the options above, our local health offices

offer immunization clinics by appointment.

Need a ride? If you do not have transportation to get a free COVID-19 vaccine or booster, please contact your local public transportation provider or callVermont Public Transportation Association (VPTA)

at 833-387-7200.

English language learners, or immigrant or refugee community members, who would like to learn about more about vaccine clinics can contact theAssociation of Africans Living in Vermont

(AALV) at 802-985-3106.

If you lost your vaccine card or your information is wrong:

Recommendations for keeping your vaccination card and record up to date

Find more COVID-19 translations

COVID-19 resources for people who are deaf and hard of hearing

Report your COVID-19 test results

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VDH: COVID cases still low, but rising - Vermont Biz

COVID mRNA vaccines offer strong protection for young kids, data … – University of Minnesota Twin Cities

October 19, 2023

Quinn Dombrowski / Flickr cc

A study yesterday in JAMA Network Open based on outcomes seen among Singaporean children ages 4 years and younger showed good protection for two doses of monovalent mRNA COVID vaccines during an Omicron surge.

The authors said the findings support vaccinating this age-group, despite low incidence of severe disease or hospitalization.

The study was conducted from October 1, 2022, to March 31, 2023, after all Singaporean children ages 1 to 4 had been vaccinated with mRNA two-dose vaccines in a community vaccination campaign following approval of vaccines for this age-group in August 2022.

The 6-month study period coincided with an Omicron XBB surge in Singapore, during which schools remained open, mask wearing was optional, and close contacts of COVID-19 cases were allowed to remain in school if well.

A total of 121,628 children (median age, 3.1 years) were included in the study, contributing 21,015,956 person-days of observation. A total of 45,693 children (37.6%) had a prior SARS-CoV-2 infection, with most having had prior infection during the earlier Omicron BA.1/2 wave, the authors said.

In kids with no previous COVID-19, vaccination was 63.3% effective in protecting against infection. Protection was higher, 74.6%, in those with a documented prior infection. Data were insufficient to assess vaccine effectiveness in fully vaccinated children with prior SARS-CoV-2 infection, the authors said.

There were no hospitalizations among fully vaccinated children, and no deaths were reported during the study.

Rapid increases in pediatric COVID-19 infections coinciding with periods of high community transmission may still place health care systems under strain.

Though vaccinating children under the age of 5 is debatable, the authors said, "Rapid increases in pediatric COVID-19 infections coinciding with periods of high community transmission may still place health care systems under strain."

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COVID mRNA vaccines offer strong protection for young kids, data ... - University of Minnesota Twin Cities

People with HIV at higher risk of COVID reinfection: CDC – ABC News

October 19, 2023

People with HIV were more likely to have been vaccinated and boosted.

October 18, 2023, 12:13 PM ET

4 min read

People with HIV are at increased risk of being reinfected with the virus that causes COVID-19, according to new federal data.

Researchers from the Centers for Disease Control and Prevention and the Chicago Department of Public Health followed adult residents in Chicago from their first reported infection from March 2020 through the end of May 2022, according to the report published Wednesday by the CDC.

The team compared COVID test laboratory data and COVID vaccine administration data to Chicago's Enhanced HIV/AIDS Reporting System.

About 5% experienced reinfection among more than 453,000 Chicago residents who tested positive for the virus.

Rates of reinfection were higher among people with HIV (6.7%) than among people without HIV (5.2%).

People with HIV are more likely to have completed a primary COVID vaccine series plus a booster before their reinfection -- 31.8% versus 27% for those without HIV.

Reinfection rates were consistently higher throughout the pandemic for people with HIV and were highest during the original omicron variant phase, according to the report.

"Understanding if persons with HIV have a higher risk for SARS-CoV-2 reinfection may help tailor future COVID-19 public health guidance," the authors wrote. "[Persons with HIV] should follow the recommended COVID-19 vaccine schedule, including booster doses, to avoid SARS-CoV-2 reinfections."

Those who were reinfected were more likely to be male, older and Black or African American compared to those without HIV, the study found.

People with HIV were also less likely to have been unvaccinated at the time of their first infection compared to people without HIV.

The report notes the findings are a reminder about the risks of reinfection for those who are immunocompromised.

HIV can weaken the immune system, infecting and destroying CD4 cells, which causes the white blood cell count to drop and compromises the immune system.

This means that people with HIV are susceptible to COVID infection especially those who are not on antiretroviral therapy (ART).

ART is a combination of drugs that suppresses a person's viral load until HIV Is virtually undetectable. The ability of ART to control viral replication has been shown to greatly improve immune system function, studies show.

"Evaluating the association between HIV infection and SARS-CoV-2 reinfections using surveillance data can help strengthen public health recommendations including the need for extra doses as part of a primary series, booster doses of vaccine, and optimized ART in [persons with HIV]," the authors wrote. "Tailored guidance and prevention messaging for [persons with HIV] can help reduce the elevated risk we identified in this analysis and limit continued SARS-CoV-2 transmission."

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People with HIV at higher risk of COVID reinfection: CDC - ABC News

Novel mechanism of the COVID-19 associated coagulopathy (CAC … – Nature.com

October 19, 2023

The severe acute respiratory syndrome coronavirus 2; SARS-CoV-2 is responsible for coronavirus disease1,2. COVID-19 induced coagulopathy appears to be different from the traditional coagulopathy in many ways since it meets the criteria for the relatively newly defined entity of sepsis-induced coagulopathy (SIC) that is characterized, and quantified according to reduced platelet counts, increased international normalized ratio (INR), and higher organ dysfunction in SARS-CoV-2 patients3. The findings during the last few years after COVID-19 pandemic have suggested that SARS-CoV-2 has a connection with various blood disorders, including a higher risk of clot formation and sometimes bleeding problems in acutely infected patients4,5,6,7. During infection, the frequently observed micro- and macro- thrombotic events are due to the perpetuation of a state of hypercoagulability that has been termed as the COVID-19-associated coagulopathy (CAC) and, in fact, it is different from the regular clotting problems8. The so-called CAC represents a key aspect for the development of multi-organ damage in patients. In CAC the changes are represented by high levels of D-dimer and fibrinogen; however, CAC also has some common features with disseminated intravascular coagulation (DIC) and SIC, but there are differences between these clinical observations. It appears that the pathogenesis of CAC is more complex and is influenced by an interconnection between the inflammatory system and coagulation, in the phenomenon of immuno-thrombosis and thrombo-inflammation. In CAC many factors come into play including the neutrophils, inflammatory cytokines, complement system as well as fibrinolytic system. Finally, changes in platelet function coupled with endothelial dysfunction also play roles in CAC. Though we are still piecing together exactly how it happens, several factors such as problems with endothelial lining, inflammation, and an intense immune system response affects in raising the risk of clotting. Moreover, in severely acute infection, the immune system can go off the track. This can lead to additional issues with a part of the immune system called the complement system, which can also damage blood vessels making clotting problems worse9.

When platelets get activated, they stick together and release chemicals that promote inflammation. This makes blood clot formation more easily. In regular clotting, the making of thrombin helps turn fibrinogen into fibrin the material that makes up clots. Conditions like hemophilia, where some clotting factors are missing, or DIC, where too much of this process happens, lead to standard clotting problems. So, the main differences between CAC and regular clotting problems lie in how they happen. In regular clotting problems, making of thrombin is important for clotting to occur but in CAC, the risk of blood clots arises from a mix of inflammation, problems with blood vessel lining, platelet activation, and issues with the immune systems response9. The spike protein or SP also interacts with the clotting process. This contributes to the unique clotting situation seen in CAC. Understanding these aspects of CAC is crucial for devising care for COVID-19 patients, especially for people with weakened immune systems like diabetics, who face clotting-related problems more often than those without diabetes10,11,12,13,14,15,16.

Briefly, the coronaviruses that cause severe acute respiratory syndrome (SARS), such as SARS-CoV, MERS-CoV (responsible for the middle east respiratory syndrome), and SARS-CoV-2, need transmembrane serine protease 2 (TMPRSS2) for their entry into the host cells. Subsequent studies have also shown that SARS-CoV-2 requires the angiotensin-converting enzyme 2 (ACE2) as the main receptor together with TMPRSS2 for infecting the host cells productively17,18,19. SARS-CoV-2 is a single-stranded ribonucleic acid (RNA) virus that encodes a variety of proteins, including 4 structural proteins such as (1) Membrane/Matrix (M), (2) Envelope (E), and (3) Spike (S) proteins that assemble around (4) Nucleocapsid (N) and its RNA. As mentioned above, the virus infects host cells upon binding to ACE2 receptor, and subsequent action of proteases, including the transmembrane protease serine 2 (TMPRSS2). The virus exhibits a high infectious rate and can provoke a wide array of symptoms beginning with the cytokine storm20,21. The recent pandemic is the third outbreak due to a highly pathogenic -coronavirus in only just two decades. Thus, there is a tremendous need to acquire in-depth knowledge of the virus infection cycle, as well as the cellular and molecular pathways that are involved in the viral replication and mounting of the innate and adaptive immune responses in the host. We believe that answers to these fundamental questions will help us in the development of safer, and efficient therapeutics and pan--coronavirus vaccines against emerging SARS-CoV-2 variants and their subvariants of concern22. ACE turns angiotensin I into angiotensin II, which has multiple effects throughout our body such as increase in blood pressure. Angiotensin I is cleaved by angiotensin-converting enzyme (ACE) to produce angiotensin II, and then Angiotensin II binds to its receptors and exerts its effects in the brain, kidney, adrenal, vascular wall, and the heart. Although SARS-CoV-2 spike protein (SP) masks the ACE2, but it increases the availability of angiotensin (Ang II; 18) and decreases the Ang (17), suggesting a role in hypertension23,24,25,26. Although COVID-19 has been linked to orthostatic tachycardia (OT), again the mechanisms are largely unknown. The heart rate of the patient increases by ~30 beats/min; however, the blood flow to the brain decreases that causes hypoperfusion, and vascular contributions to cognitive impairment and dementia (VCID). This also suggests a role of vascular coagulopathy, and thrombosis for the decrease in the blood flow to brain27. Since so many complications are associated with COVID-19 including the vascular coagulopathy/thromboembolism, endothelial dysfunction, stiffness, fibrosis, and extracellular matrix (ECM) fragmentation9,28,29,30,31,32,33,34,35,36, but the underlying mechanisms of these events are unclear.

The ongoing research in our laboratory is based on our previous studies that have shown activation of inflammatory M1 macrophages with renal infiltrates in the hACE2 mice administered with SP, intranasally37. In COVID-19 patients there is an elevated level of neopterin (NPT)38,39. Because NPT is generated by activated pro-inflammatory macrophages (M1) in response to COVID-19 via inducible nitric oxide synthase (iNOS), tetrahydrobiopterin (BH4), and peroxinitrite (ONOO-) along with activation of proteinases. We are of the opinion that iNOS generates NPT and decreases BH4, eNOS activity and a disintegrin and metalloproteinase thrombospondin 13 domain (ADAMTS13), anti-thrombosis/anti-coagulant but at the same time activates urinary neutrophil gelatinase associated lipocalin2 (NGAL2, pro-thrombosis/pro-coagulant), and transmembrane serine proteinase S2 (TMPTSS2, proteolytic factor processing of COVID-19) and matrix metalloproteinases (MMPs), leading to renal dysfunction and failure18,40,41,42,43. NGAL and FGF23 (vascular hypertrophic factor) are high and ADAMTS13 is low post COVID-19 sequelae44,45,46,47,48. Again, the recognition of endothelial dysfunction within the realm of COVID-19 is emerging as a pivotal and defining aspect of SARS-CoV-2 infection, and its post infection implications especially against the background of the intricate interplay between endothelial cells and immune constituents, exemplified by the dynamic interaction with neutrophils in the context of thromboembolism, assumes paramount significance. This alliance between endothelial cells lining and immune effector molecules that our work has reported earlier prompts a series of inquiries that underscore the pivotal role of endothelial cells in the intricate landscape of thromboembolic events37. A further deeper exploration into the mechanisms underpinning endothelial dysfunction can unravel its contribution to the disruption of coagulation equilibrium, particularly within the intricate milieu of CAC. This knowledge will enhance our comprehension of the pathophysiological mechanisms at play but also to pave the way for the identification of strategic interventions aimed at safeguarding our patients during the throes of acute infection. Hence, by delving into the nuanced of how endothelial dysfunction precipitates coagulation dysregulation, particularly within the context of COVID-19 related coagulopathic manifestations, a potential roadmap might emerge via an understanding of the molecular interactions that could hold the promise of unveiling therapeutic avenues designed to shield afflicted patients during the critical phase of acute infection49.

Interestingly, CAC in glomerular capillaries-microvascular wall, the interaction between macrophages, neutrophil and immune cells, causes build-up layers of damage endothelial via iNOS, NGAL2, eNOS, and ADAMTS13, sets the stage of pro-thrombotic and pro-coagulant processes. This also contributes to focal glomerulosclerosis lesions in COVID-19 patients50,51. The levels of transmembrane (TMPRSS2), EMMPRIN (CD147) and ECM proteinases are elevated post COVID-1918. These proteinases are associated with collagen/elastin breakdown during renal glomerular remodeling. However, because the turnover of collagen is rapid than elastin, the degraded elastin is replaced by collagen, causing fibrosis, stiffness, and thickening of the basement membrane in the glomeruli, instigating impaired glomerular filtration rate (GFR)52. Therefore, an increase in M1 macrophages iNOS decreases BH4 bioavailability to eNOS, causing glomerular capillary microvascular endothelial dysfunction. The oxidative peroxinitrite (ONOO-) activates NGAL2 and FGF23 and decrease in ADAMTS1353,54. The transmembrane serine (TMPRSS2), EMMPRIN and MMPs/TIMPs are activated, leading to renal dysfunction. Interestingly, there appears to be evidence of fibrosis with hypertrophy in the glomeruli of hACE2 mice administered with SP within 4 weeks post COVID-19 sequelae, as expected, since this will suggest that there is acute kidney injury (AKI) with preserved glomerular filtration rate (GFR), that can be reversed by iNOS blocker37. However, if there is chronic thickening of the basement membrane, post COVID-19, this will suggest that there is chronic kidney disease (CKD). In that situation an inhibitor of proteinases, such as TMPRSS2 will be able to mitigate the COVID-19 induced CKD. This is important and novel in the sense that post COVID-19 morbidities, and mortalities can be halted with a TMPRSS2 inhibitor.

Further, in the landscape of biomarkers linked to endothelial dysfunction, the circulating inflammatory coagulation markers assume a pivotal role, notably the fibrin(ogen), D-dimer, P-selectin, and von Willebrand Factor (VWF). These biomarkers, in their close relationship with endothelial cells, platelets, and erythrocytes, contribute significantly to the pathological progression observed in acute COVID-19 cases55. For example, the fibrin(ogen) and D-dimer are indicative of ongoing coagulation and fibrinolysis processes, exhibiting a dynamic connection with MMP-2, MMP-9, and MMP-1356. These MMPs can potentially modulate the stability of blood clots, thereby impacting both clot formation and dissolution. The interplay between these biomarkers might amplify the coagulopathic tendencies observed in severe COVID-19 patients, thus accentuating the pro-thrombotic environment. Interestingly, the Von Willebrand Factor (VWF) and P-selectin are integral to platelet adhesion and aggregation, and intersect with ADAMTS-13, a critical regulator of VWF cleavage57,58. Thus, a dysregulation of ADAMTS-13 in COVID-19 could lead to increased VWF activity, thereby fostering the microvascular thrombosis. This interaction, coupled with the intricate role of MMPs, might contribute to the endothelial activation and damage central to the disease pathogenesis. On the other hand, the renal NGAL, is a biomarker of kidney injury, and that usually reflects the broader systemic impact of inflammation and coagulation in COVID-19 patients59. Its interplay with MMP-7 or matrilysins (it was originally described as PUMP-1; putative uterine metalloprotease-1), and was long considered a third member of the stromelysin family, although it appeared only distantly related to the other stromelysins, and later dubbed MMP-7, a possible reference to ion transporters, underscores the systemic implications of electrolyte imbalance in severely ill patients, potentially affecting both coagulation and vascular health60,61. Furthermore, TMPRSS2, an enzyme facilitating viral entry, adds another layer to this complex narrative. Its interplay with these biomarkers might signify a feedback loop where the virus-induced dysregulation contributes to coagulopathic tendencies, potentially mediated by the interplay of endothelial cells, platelets, and erythrocytes62,63,64,65,66. In a nutshell, the interaction between fibrin(ogen), D-dimer, P-selectin, VWF, and biomarkers like MMPs, ADAMTS-13, renal NGAL, PUMP, and TMPRSS2 intertwine within the context of acute COVID-19. This intricate interplay encompasses endothelial dysfunction, platelet aggregation, coagulopathy, and systemic impact, collectively contributing to the complex pathogenesis observed in severe cases. Understanding these connections will aid not only in deciphering disease mechanisms but also in the identification of potential avenues for therapeutic intervention for the patients.

In the intricate landscape of biomarkers linked to endothelial dysfunction, certain circulating inflammatory coagulation biomarkers assume a pivotal role, notably the fibrin(ogen), D-dimer, P-selectin, and von Willebrand Factor (VWF). These biomarkers, in their close relationship with endothelial cells, platelets, and erythrocytes, contribute significantly to the pathological progression observed in acute COVID-19 cases. For example, the fibrin(ogen) and D-dimer are indicative of ongoing coagulation and fibrinolysis processes, exhibiting a dynamic connection with MMP-2, MMP-9, and MMP-13. These MMPs can potentially modulate the stability of blood clots, thereby impacting both clot formation and dissolution. The interplay between these biomarkers might amplify the coagulopathic tendencies observed in severe COVID-19 patients, thus accentuating the pro-thrombotic environment. Interestingly, the Von Willebrand Factor (VWF) and P-selectin are integral to platelet adhesion and aggregation, and intersect with ADAMTS-13, a critical regulator of VWF cleavage. Thus, a dysregulation of ADAMTS-13 in COVID-19 could lead to increased VWF activity, thereby fostering the microvascular thrombosis. This interaction, coupled with the intricate role of MMPs, might contribute to the endothelial activation and damage central to the disease pathogenesis. On the other hand, the renal NGAL, is a biomarker of kidney injury, and that usually reflects the broader systemic impact of inflammation and coagulation in COVID-19 patients. Its interplay with MMP-7 or matrilysins (it was originally described as putative uterine metalloprotease-1 (PUMP-1) in 1988, and was long considered a third member of the stromelysin family, although it appeared only distantly related to the other stromelysins, and later dubbed MMP-7, a possible reference to ion transporters, underscores the systemic implications of electrolyte imbalance in severely ill patients, potentially affecting both coagulation and vascular health. Furthermore, the TMPRSS2, an enzyme facilitating viral entry, adds another layer to this complex narrative. Its interplay with these biomarkers might signify a feedback loop where the virus-induced dysregulation contributes to coagulopathic tendencies, potentially mediated by the interplay of endothelial cells, platelets, and erythrocytes. In summary, the interaction between fibrin(ogen), D-dimer, P-selectin, VWF, and the mentioned biomarkers like MMPs, ADAMTS-13, renal NGAL, PUMP, and TMPRSS2 intertwines within the context of acute COVID-19. This intricate interplay encompasses endothelial dysfunction, platelet aggregation, coagulopathy, and systemic impact, collectively contributing to the complex pathogenesis observed in severe cases. Understanding these connections will aid not only in deciphering disease mechanisms but also in identifying potential avenues for therapeutic interventions.

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Novel mechanism of the COVID-19 associated coagulopathy (CAC ... - Nature.com

Ban on COVID vaccine mandates by private businesses, including … – The Texas Tribune

October 17, 2023

Sign up for The Brief, The Texas Tribunes daily newsletter that keeps readers up to speed on the most essential Texas news.

A sweeping ban on COVID-19 vaccine mandates for employees of private Texas businesses passed the Texas Senate early Friday, although medical facilities would be allowed to enact other policies to help lower the risks to vulnerable patients.

Senate Bill 7, by Galveston Republican Sen. Mayes Middleton, would subject private employers to state fines and other actions if they fire or punish employees or contractors who refuse the shot.

The bill offers no exceptions for doctors offices, clinics or other health facilities, but senators did agree to allow those entities to require unvaccinated employees to wear personal protective gear such as face masks or take other reasonable measures to manage the spread.

The legislation passed on a 19-12 party line vote just after midnight and is heading to the House, where similar efforts stalled out earlier this year. It now awaits referral to a House committee.

The vote comes after years of Republican attempts to reign in COVID-related restrictions like mask mandates and vaccine requirements. Supporters said the bill is critical to support individual rights to make their own health care decisions without negative consequences to their livelihoods.

No one should be forced to make that awful decision between making a living for their family and their health or individual vaccine preference, Middleton told senators during a bill hearing earlier this week.

Opponents argued that the coronavirus is still dangerous to many people, that it can lead to long COVID even in those who experience mild symptoms, and that the ban takes away the ability of health care professionals to institute vaccine policies that lower the risk of viral spread for their patients. It also, some critics say, infringes on the rights of business owners to make their own policy decisions.

Including health care facilities and doctors offices in the ban triggered objections by two members of the Senate Health and Human Services committee who have had kidney transplants Sen. Kelly Hancock, R-North Richland Hills, and Sen. Borris Miles, D-Houston.

It also drew skepticism by the Republican chair of the committee, Sen. Lois Kolkhorst, R-Brenham, who on Thursday supported allowing health care facilities to enact other policies for employees who choose not to be vaccinated.

I think that we've been able to put the words in place that give us a good sound policy, that going forward if a health care worker does not want to be vaccinated, that the hospital or the health care facility can help mitigate that with mask and gloves and different things, but it has to be reasonable, Kolkhorst said during the floor debate.

Experts in the medical and scientific community say the COVID-19 vaccine does not prevent the spread entirely, but it can reduce transmission and significantly diminish symptoms and severity of the illness.

Bill purists fought against allowing health care providers to circumvent, even slightly, the ban proposed by Middletons legislation and wanted to see it passed as originally written.

Both Middleton and state Sen. Bob Hall, R-Edgewood, have openly said they dont trust the vaccines safety and efficacy. Hall said earlier this week that he believes the pandemic and vaccine response was a test by the government to find out how people will react when the state forces them to mask up, lock down, and take a vaccine then subsequently controls their lives.

In late 2021, Republican Gov. Greg Abbott issued an executive order banning the mandates, but it led to confusion over who was covered by the order and how enforceable it was. That order expired in June, triggering a legislative attempt to codify it during the regular session earlier this year. After that attempt failed, Abbott added the issue to the agenda for this years third special legislative session.

A new state law banning governmental entities from requiring the COVID-19 vaccine went into effect last month.

Kolkhorst said earlier this week that the debate comes down to a mistrust of science stemming from a lack of what she and some others believe is reliable data on the safety and efficacy of the COVID-19 vaccine.

Legislation she and Middleton carried during the regular session earlier this year included exemptions for all private employers that allow employees to opt out for medical or conscience reasons.

It also would have exempted health care facilities from the ban on vaccine mandates as long as they didnt force employees to take it if their doctors determined they were medically not a good candidate.

In both cases, the business or facility also would have been required to have procedures for unvaccinated staff to protect other employees from exposure.

That bill passed the Senate but died near the end of the regular session in May without a hearing in a House committee. A similar effort died in 2021 after business groups rallied against it.

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Ban on COVID vaccine mandates by private businesses, including ... - The Texas Tribune

Public knowledge varies greatly on flu and COVID-19 | Penn Today – Penn Today

October 17, 2023

There is wide variability in what the U.S. public knows about the seasonal flu and COVID-19, but some facts are much more strongly associated with an individuals vaccination behavior.

For several years, the Annenberg Public Policy Centers nationally representative Annenberg Public Health and Knowledge Survey (ASAPH) has assessed public knowledge of vital health information, including how to prevent and treat the seasonal flu and COVID-19, two of the three illnesses in last years tripledemic outbreak that overwhelmed some health care facilities (the third was RSV, or respiratory syncytial virus).

Even after taking education into account, survey data reveal that the answers to just eight questions are better than many others at predicting whether a person has been vaccinated against the flu or is willing to get an annual COVID-19 vaccine if recommended by public health officials.

Knowledge about the nature, effects, and prevention against a potentially deadly virus is valuable in its own right, says Kathleen Hall Jamieson, director of the Annenberg Public Policy Center (APPC). But some knowledge is more associated with vaccination than other knowledge.

APPC research director Dan Romersays the ASAPH surveys, which were administered with a nationally representative panel of U.S. adults, posed two dozen questions to assess public health knowledge of the flu and COVID-19. All of those questions were related to forms of vaccination acceptanceeither with having received a flu shot or expressing a willingness to get an annual COVID-19 vaccine. Weve picked the eight questionsfour for the flu and four for COVIDthat had the strongest ability to independently predict taking either action, Romer says.

The survey data come from the 10th and 12th waves of the Annenberg Science and Public Health Knowledge Survey (ASAPH), a nationally representative panel of U.S. adults first empaneled in April 2021 that was conducted for the Annenberg Public Policy Center by SSRS, an independent market research company.

The flu questions were asked in the 10th wave of the survey, which was conducted Jan. 10-16, 2023, among 1,657 U.S. adults. Individuals who got at least three questions right about the flu vaccine are more likely than average to say they had received a flu shot in the 2022-23 flu season.

The COVID-19 questions were asked in the 12th wave of the survey, which was fielded in August 2023. Individuals who got at least three questions right about the COVID-19 vaccine are more likely than average to say they were very or somewhat willing to get a yearly COVID-19 vaccination if the CDC were to recommend it.

Read more at Annenberg Public Policy Center.

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Public knowledge varies greatly on flu and COVID-19 | Penn Today - Penn Today

Harris County stops tracking COVID-19 positivity rates, but instead are testing wastewater, health officials say – KTRK-TV

October 17, 2023

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Novavax positive on updated COVID vaccine availability in US – Reuters

October 17, 2023

A vial labelled "Novavax V COVID-19 Vaccine" is seen in this illustration taken January 16, 2022. REUTERS/Dado Ruvic/Illustration/File Photo Acquire Licensing Rights

Oct 16 (Reuters) - Novavax (NVAX.O) said on Monday it was "encouraged" by the broad availability of its updated COVID-19 vaccine being rolled out in the U.S., days after rival Pfizer (PFE.N) slashed its full-year revenue forecast.

"It is too soon to evaluate U.S. vaccination rates given that vaccinations will continue in the coming weeks," Novavax added.

Shares of vaccine maker Novavax and rival Moderna (MRNA.O) were down 6% to 7% after Pfizer on Friday flagged concerns on lower-than-expected sales of its COVID-19 vaccine and treatment.

Novavax also said it continues to work in close partnership with the European Medicines Agency (EMA), after the regulator delayed a decision to give approval for the company's variant-tailored COVID-19 shot.

The company will provide an update on its upcoming third-quarter earnings in early November 2023.

Reporting by Khushi Mandowara in Bengaluru; Editing by Devika Syamnath

Our Standards: The Thomson Reuters Trust Principles.

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Novavax positive on updated COVID vaccine availability in US - Reuters

COVID-19 Vaccination Uptake Associated With HIV Viral … – AJMC.com Managed Markets Network

October 17, 2023

HIV care engagement was likely a cause of quicker COVID-19 vaccination uptake in people who inject drugs who also had HIV and had achieved viral suppression, according to a study published in Preventive Medicine Reports. Vaccine uptake could be further helped with targeted improvements in HIV care, the authors noted.

The vaccines against COVID-19 have been proven safe and effective for people living with HIV (PWH), a population that benefits from the vaccine due to their vulnerability. HIV has previously been associated with higher risks of COVID-19 infection, severe outcomes, and risk of death. Using injection drugs is associated with an increased number of comorbidities, contributing to these individuals higher odds of mortality and intensive care unit (ICU) admission for COVID-19 when using opioids. This study aimed to find differences in vaccine uptake for COVID-19 by HIV status and viral load in people who use injectable drugs.

The researchers used the ALIVE Study to gather a population for this study. Participants who were alive as of April 6, 2021, were included. The ALIVE study collected data on adults 18 years and older who lived in or near Baltimore, Maryland, and who had a history of using injection drugs. Characteristics, substance use behaviors, and health status were all collected biannually from participants. Viral load was assessed through blood samples. Vaccination status data for COVID-19 were collected from the Chesapeake Regional Information Systems for our Patients health information exchange, which collects data from throughout the region. Sociodemographic, substance use, and health status self-reported data were also included.

Healthcare cure concept with a hand in blue medical gloves holding Coronavirus, Covid 19 virus, vaccine vial | Image credit: Leigh Prather - stock.adobe.com

There were 960 participants included in the study, with most participants identifying as Black (78%) and male (67%); 74% were 50 years or older. In this overall sample, 70% were vaccinated with at least 1 dose of the COVID019 vaccine. Among the 317 PWH (28%), 85% had a viral load of less than 400 copies/L.

Median time to completion of the primary series of the vaccine was 24.3 weeks (95% CI, 19.9-28.9). The median time to vaccination was faster in PWH who were virally suppressed (12.4 weeks; 95% CI, 9.4-18.4) compared with participants who did not have HIV (28.3 weeks; 95% CI, 23.9-40.4). However, PWH with detectable viral loads were slower to vaccination (median time undefined because <50% completed the primary series). The primary series was completed fastest in those 65 years and older (8.1 weeks; 95% CI, 5.0-20.9) compared with those younger than 50 years (undefined) or aged 50 to 64 years (15.6 weeks; 95% CI, 13.1-20.6); participants were also faster to get vaccinated if they were Black, were male, or had a previous chronic lung disease. Participants who had a lower income or were homeless were slower to the uptake of the vaccine.

Participants who reported recent injection drug use were slow to completion of the primary series. Participants who reported noninjection stimulant use and were smoking 1 pack or more a day of cigarettes also reported slower completion of primary series.

In unadjusted models, participants who were virally suppressed PWH had a higher likelihood of completing the COVID-19 vaccine series than those without HIV (HR, 1.43; 95% CI, 1.18-1.73). In an adjusted model, PWH who had an undetectable viral load were also more likely to complete their primary series (adjusted HR, 1.23; 95% CI, 1.07-1.50). PWH who had higher viral loads were found to be less likely to complete the primary series (adjusted HR, 0.72; 95% CI, 0.45-1.16) than those without HIV, although this result was not statistically significant.

There were some limitations to this study. Using the start date of phase 3 general eligibility for the vaccine rather than the first day of phase 1A select eligibility could have excluded participants who were vaccinated prior to the index date. There were not enough data on employment to draw any conclusions on its association with vaccine eligibility. This study could not account for changes in variables occurring during follow-up.

The researchers found that there was a significant relationship between HIV viral suppression in people using injectable drugs and increasing uptake of the COVID-19 vaccine.

While additional research is warranted in the context of HIV, injection drug use, and COVID-19 prevention, our findings support interventions targeting both sociostructural barriers to care as well as interventions to improve the HIV care continuum for the added value of health care engagement and COVID-19 vaccine uptake, the authors concluded.

Research

Baker P, Cepeda JA, Schluth C, et al. Time-to-completion of COVID-19 vaccination primary series varies by viral load status among people who inject drugs in Baltimore, Maryland. Prev Med Rep. Published online September 28, 2023. doi:10.1016/j.pmedr.2023.102448

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COVID-19 Vaccination Uptake Associated With HIV Viral ... - AJMC.com Managed Markets Network

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