Category: Corona Virus

The pandemic is over.

Its a pronouncement weve heard several times in the more than 2 years since the World Health Organization declared COVID-19 a pandemic.

As California enters fall with the coronavirus very much on the decline, some are once again declaring victory. But health experts say that despite the significant progress, its less about turning the page than about understanding that COVID-19 remains quite unpredictable.

The heat was recently turned up on the long-simmering question when President Biden declared the pandemic is over during an interview with 60 Minutes. Days later, Biden acknowledged the criticism he received over his statement but added that the pandemic basically is not where it was.

It wasnt the first time the president has sought to project the end of the pandemic. On the Fourth of July 2021 almost seven months into the nations vaccine rollout Biden said, were closer than ever to declaring our independence from a deadly virus.

But that declaration, which came when the U.S. COVID-19 death toll stood at a bit more than 605,000, proved premature. Nearly 450,000 COVID-19 deaths have been reported since, fueled by last summers Delta variant and the dual-pronged Omicron waves that first struck after Thanksgiving.

Officials across the nation widely acknowledge the substantial gains made in the fight against COVID-19. The U.S. is awash in vaccines and effective therapeutics, and new boosters targeting the dominant circulating coronavirus strain are now available.

And even after the arrival of the Omicron variant which sent cases soaring to unprecedented levels California came nowhere close to reinstituting the shutdowns or other stringent restrictions that typified earlier phases of the pandemic.

Still, public health experts remain concerned at the considerable number of daily deaths. And there is worry that too few Americans have gotten a single booster shot, which is important to protect against severe illness.

We are much better off now, Dr. Anthony Fauci, Bidens chief medical advisor for the pandemic, said at a recent virtual talk of the Center for Strategic and International Studies. But we are not where we need to be if we are going to, quote, live with the virus.

Theres no doubt conditions have improved since the darkest days of the pandemic, when more than 3,000 Americans were dying every day. Since August, the U.S. has been reporting 350 to 500 COVID-19 deaths a day. Thats above the low of about 200 before last years Delta surge, and is unacceptably high, Fauci said.

Over a year, that would add up to 125,000 to 180,000 COVID-19 deaths four to five times the average annual number of flu deaths, which is about 35,000.

Four to five hundred deaths a day is just unacceptable, Dr. Ashish Jha, the White House COVID-19 response coordinator, said Tuesday at another Center for Strategic and International Studies forum. It is a level of suffering and death that we do not accept as living with COVID.

While theres no shortage of pundits, politicians and other prognosticators clamoring to declare the end of the pandemic, the ultimate call is up to the WHO.

And thats a decision that will likely be based on a scientific committees review of data, not personal sentiment.

The definition of a pandemic is an outbreak of disease that has then spread beyond any one or two countries to a global spread, said Dr. Robert Kim-Farley, an epidemiologist and infectious-disease expert with the UCLA Fielding School of Public Health.

One challenge to defining the end of a pandemic is figuring out when weve returned to some kind of baseline for coronavirus cases and deaths. For now, we dont have what the baseline is for COVID because weve never had it before, Kim-Farley said.

Before the coronavirus, the last time the WHO declared a global pandemic was the H1N1 swine flu in 2009. That pandemic, however, ended up being less deadly than initially feared, and the agency declared its end the following year.

A prior system outlined by the WHO broke a pandemic flus trajectory into several phases including a post-peak period, in which pandemic activity appears to be decreasing; however, it is uncertain if additional waves will occur, followed by a post-pandemic period.

But COVID-19 is the first pandemic known to be caused by a coronavirus.

World Health Organization Director-General Tedros Adhanom Ghebreyesus speaks at the agencys headquarters in Geneva last year.

(Laurent Gillieron / Keystone/Associated Press)

WHO Director-General Tedros Adhanom Ghebreyesus has sought to balance the unmistakable data showing the pandemic is improving while emphasizing its not over. He noted in early September that the number of weekly reported COVID-19 deaths had fallen to the lowest level since the start of the pandemic.

We have never been in a better position to end the pandemic. We are not there yet, but the end is in sight, Tedros said.

He also compared the fight against COVID-19 to a marathon runner who hasnt yet completed the race.

Now is the worst time to stop running, he said. If we dont take this opportunity now, we run the risk of more variants, more deaths, more disruption and more uncertainty.

Scientists will have to see many months of stability before its certain the pandemic is over. Declaring the end too soon could be like sounding an all-clear announcement after a major earthquake when theres still the potential for significant aftershocks.

There are also additional practical ramifications.

My fear is always that when you hear that the pandemic is over, we stop getting resources for the things we desperately need to keep each other safe, Los Angeles County Public Health Director Barbara Ferrer said. We need money for vaccines so that theyre still free. We need to have free testing. We need to have free access to the therapeutics in order to get through the next few months. So my hope is no one thinks that we dont need those resources to continue to do the hard work were doing.

To say were not in a pandemic phase anymore, metaphorically, also means that the feds arent really ready to support some of these efforts to drive down these deaths, according to Dr. Peter Chin-Hong, a UC San Francisco infectious-disease expert.

Chin-Hong said his definition of a pandemics end is when theres a level of predictability and a lower number of deaths and neither of those criteria has been met.

Its weird to say that the pandemic is over now, based on one time point. Its really more of a longitudinal assessment, or studying trends over time, Chin-Hong said. Its just like saying, before Omicron hit, that the pandemic was over.

COVID-19 was the third leading cause of death in the U.S. in 2021, behind only heart disease and cancer. And during the first four months of this year, the per capita death rate for the illness in L.A. County was higher than the rate for diabetes, motor vehicle crashes and flu/pneumonia.

Older residents are continuing to die at elevated rates. L.A. Countys COVID-19 death rate between May and July 2022 for those age 65 and older was significantly higher than during the same time period in 2021. The pandemic also continues to disproportionately affect poorer residents and people of color.

Its clear that were in such a better place this year than weve ever been in the pandemic, Ferrer said. But theres a lot we still need to do to get to the end.

Unvaccinated individuals also remain at higher risk both of being infected and of suffering the worst health outcomes of COVID-19.

Thats why everyones thinking the end of this year will be another surge because [a number of] people who have had natural infection, say in January, with the beginning of Omicron, would have dwindled in their immunity where they could be more susceptible to getting infected again, Chin-Hong said.

In July, unvaccinated Californians were 2.5 times more likely to get COVID-19 and 3.6 times more likely to die from the disease than those who had completed their primary vaccination series, according to the most recent data available from the state Department of Public Health.

When someone, especially a person whos unvaccinated, gets infected a second time, youre like playing COVID roulette. You dont know if youre going to get very ill at that point, Chin-Hong said. Whereas, if somebody has received three doses of a vaccine, for example, I know that I can be more confident that that person wouldnt be seriously ill.

Many experts expect COVID-19 will eventually settle to the point that it causes about 100,000 deaths a year in the U.S., still well above the typical annual mortality from the flu.

Is that acceptable? Maybe it is to society, but its something we didnt have in 2019, Chin-Hong said.

The ultimate wildcard is whether another problematic new variant soars to prominence.

The ultimate goal would be [to] get to a level of control thats low enough that it doesnt disrupt our social order and essentially dominate what happens in society, Fauci said. Were heading in that direction, but we must be aware that as we get into this coming late fall and winter, that it is likely we will see another variant emerge.

Already, there is one relatively new Omicron subvariant, BA.2.75.2, that officials are keeping a wary eye on.

Another Omicron subvariant, BA.5, remains the dominant version of the coronavirus circulating nationwide making up an estimated 83.1% of cases during the weeklong period ending Saturday, according to data from the U.S. Centers for Disease Control and Prevention. However, its grip has slipped of late, coinciding with small gains by newer subvariants such as BA.4.6 and BF.7.

For now, the only certainty when it comes to the coronavirus is uncertainty.

Who knows when the next stage is going to be? Who knows what the variants are going to be? And whats going to happen in 2023 after this potential winter surge? Chin-Hong asked.

As Ferrer put it Tuesday: It would be foolish not to be prepared for uncertainty because weve just seen so much uncertainty.

We feel very optimistic. Weve got great tools. For the first time were going to enter into the winter with a booster dose thats actually made to match whats circulating right now, which is going to give us a lot of protection, she said during an update to the L.A. County Board of Supervisors. But people do have to get vaccinated, and its hard to motivate people to get vaccinated if they feel like the pandemic is over.

So I think we have to be realistic, to say were in a much better place than weve been for a long time, weve got a great tool for this fall. But we still need to be real about the fact that the pandemic is not over.

See original here:

Is the COVID pandemic over? Too soon to say, experts insist - Los Angeles Times

Mike Stucka USA TODAY NETWORK| The Bulletin

Connecticut reported 4,809 new cases of coronavirus in the week ending Sunday, from 4,876 the week before of the virus that causes COVID-19.

Connecticut ranked 10th among the states where coronavirus was spreading the fastest on a per-person basis, a USA TODAY Network analysis of Johns Hopkins University data shows. In the latest week coronavirus cases in the United States decreased 19.4% from the week before, with 323,859 cases reported. With 1.07% of the country's population, Connecticut had 1.48% of the country's cases in the last week. Across the country, 10 states had more cases in the latest week than they did in the week before.

New London County reported 389 cases and two deaths in the latest week. A week earlier, it had reported 425 cases and three deaths. Throughout the pandemic it has reported 67,947 cases and 720 deaths.

Windham County reported 131 cases and two deaths in the latest week. A week earlier, it had reported 154 cases and no deaths. Throughout the pandemic it has reported 29,541 cases and 320 deaths.

Active shooter training in CTSoap bullets and recorded screams: How Conn. police officers train for active shooters

Within Connecticut, the worst weekly outbreaks on a per-person basis were in New Haven County with 153 cases per 100,000 per week; New London County with 147; and Middlesex County with 145. The Centers for Disease Control says high levels of community transmission begin at 100 cases per 100,000 per week.

Adding the most new cases overall were New Haven County, with 1,305 cases; Hartford County, with 1,257 cases; and Fairfield County, with 1,075. Weekly case counts rose in three counties from the previous week. The worst increases from the prior week's pace were in New Haven, Middlesex and Tolland counties.

>> See how your community has fared with recent coronavirus cases

Across Connecticut, cases fell in five counties, with the best declines in Hartford County, with 1,257 cases from 1,323 a week earlier; in Fairfield County, with 1,075 cases from 1,111; and in New London County, with 389 cases from 425.

In Connecticut, 22 people were reported dead of COVID-19 in the week ending Sunday. In the week before that, 12 people were reported dead.

A total of 898,073 people in Connecticut have tested positive for the coronavirus since the pandemic began, and 11,365 people have died from the disease, Johns Hopkins University data shows. In the United States 96,397,885 people have tested positive and 1,059,605 people have died.

>> Track coronavirus cases across the United States

USA TODAY analyzed federal hospital data as of Sunday, Oct. 2. Likely COVID patients admitted in the state:

CT hero responds to MA stabbing'Blood strewn across the floor.' CT man tried to save a woman from stabbing death

Likely COVID patients admitted in the nation:

Hospitals in 17 states reported more COVID-19 patients than a week earlier, while hospitals in 25 states had more COVID-19 patients in intensive-care beds. Hospitals in 17 states admitted more COVID-19 patients in the latest week than a week prior, the USA TODAY analysis of U.S. Health and Human Services data shows.

The USA TODAY Network is publishing localized versions of this story on its news sites across the country, generated with data from Johns Hopkins University and the Centers for Disease Control. If you have questions about the data or the story, contact Mike Stucka at mstucka@gannett.com.

Go here to see the original:

New London County reported 389 additional COVID-19 cases this week - Norwich Bulletin

Mike Stucka USA TODAY NETWORK| The Hawk Eye

Iowa reported far fewer coronavirus cases in the week ending Sunday, adding 2,042 new cases. That's down 27.6% from the previous week's tally of 2,821 new cases of the virus that causes COVID-19.

Iowa ranked 40th among the states where coronavirus was spreading the fastest on a per-person basis, a USA TODAY Network analysis of Johns Hopkins University data shows. In the latest week coronavirus cases in the United States decreased 19.4% from the week before, with 323,859 cases reported. With 0.95% of the country's population, Iowa had 0.63% of the country's cases in the last week. Across the country, 10 states had more cases in the latest week than they did in the week before.

Des Moines County reported 40 cases and two deaths in the latest week. A week earlier, it had reported 86 cases and one death. Throughout the pandemic it has reported 10,453 cases and 151 deaths.

Henry County reported 23 cases and no deaths in the latest week. A week earlier, it had reported 20 cases and no deaths. Throughout the pandemic it has reported 6,177 cases and 78 deaths.

Louisa County reported nine cases and no deaths in the latest week. A week earlier, it had reported five cases and no deaths. Throughout the pandemic it has reported 2,787 cases and 64 deaths.

Henderson County reported seven cases and no deaths in the latest week. A week earlier, it had reported 14 cases and no deaths. Throughout the pandemic it has reported 1,414 cases and 19 deaths.

Across Iowa, cases fell in 72 counties, with the best declines in Polk County, with 282 cases from 356 a week earlier; in Scott County, with 93 cases from 150; and in Des Moines County, with 40 cases from 86.

>> See how your community has fared with recent coronavirus cases

Within Iowa, the worst weekly outbreaks on a per-person basis were in Hardin County with 196 cases per 100,000 per week; Wayne County with 171; and Jefferson County with 164. The Centers for Disease Control says high levels of community transmission begin at 100 cases per 100,000 per week.

Adding the most new cases overall were Polk County, with 282 cases; Linn County, with 202 cases; and Johnson County, with 151. Weekly case counts rose in 23 counties from the previous week. The worst increases from the prior week's pace were in Muscatine, Buchanan and Hardin counties.

In Iowa, 26 people were reported dead of COVID-19 in the week ending Sunday. In the week before that, 57 people were reported dead.

A total of 856,096 people in Iowa have tested positive for the coronavirus since the pandemic began, and 10,077 people have died from the disease, Johns Hopkins University data shows. In the United States 96,397,885 people have tested positive and 1,059,605 people have died.

>> Track coronavirus cases across the United States

USA TODAY analyzed federal hospital data as of Sunday, Oct. 2. Likely COVID patients admitted in the state:

Likely COVID patients admitted in the nation:

Hospitals in 17 states reported more COVID-19 patients than a week earlier, while hospitals in 25 states had more COVID-19 patients in intensive-care beds. Hospitals in 17 states admitted more COVID-19 patients in the latest week than a week prior, the USA TODAY analysis of U.S. Health and Human Services data shows.

The USA TODAY Network is publishing localized versions of this story on its news sites across the country, generated with data from Johns Hopkins University and the Centers for Disease Control. If you have questions about the data or the story, contact Mike Stucka at mstucka@gannett.com.

Read the original post:

Des Moines County reported 40 additional COVID-19 cases this week - Burlington Hawk Eye

Should you get a new COVID booster? If so, when?

The Centers for Disease Control and Prevention on Thursday endorsed updated COVID-19 boosters, opening the way for a fall vaccination campaign that could blunt a winter surge if enough Americans roll up their sleeves. (Sept. 2) (AP Video/Angie Wang and Shelby Lum)

AP

Erie doctors have seen a lot of coughing, sneezing, sore throats and congestion in recent weeks.

Some of it is COVID-19, some of it is respiratory syncytial virus better known as RSV or other viruses that can cause cold-like symptoms, said Dr. Christopher Clark, Saint Vincent Hospital president and a family physician.

"Both RSV and the newer versions of COVID feature coughing, congestion and a sore throat, and we are seeing plenty of both," Clark said. "We usually see RSV a little later in the year, though we saw it in the summer last year. And we're heading into flu season as well."

Many local physician offices now offer a single test for COVID-19, RSV and flu. Though most people make full recoveries from these respiratory viruses without going to the hospital, Clark and other local health officials said it's important to get tested and know which virus is making you ill.

It's because COVID, RSV and flu can all cause certain people, especially older people and those with weakened immune systems, to develop serious illnesses. Also, physicians can prescribe antiviral medications once you're diagnosed.

"And with COVID, people still need to isolate for five days and wear a mask for five more if they test positive," said Charlotte Berringer, R.N., director of community health services for the Erie County Department of Health. "They don't have to isolate with the flu or RSV, but be kind to your friends and family and wear a mask if you have any respiratory symptoms."

RSV is particularly dangerous for infants younger than six months, who can develop bronchitis or pneumonia and require hospitalization. Clark said older adults with chronic illnesses are also susceptible to RSV complications.

"All these respiratory illnesses share symptoms, so it's important to get tested if you are sick," Berringer said.

Erie County's number of COVID-19 cases declined last week, but hospitalizations increased slightly as the virus shows no signs of going away as the weather gets colder and people spend more time indoors.

A total of 286 newly confirmed cases were reported in the county between Sept. 21-27, a decrease from 357 the previous week, the Pennsylvania Department of Health reported. The county's seven-day moving average of daily cases has remained between 54 and 70 since late July.

The monthly case totals from the county health department also showed the consistency this summer:

COVID-19: Case totals remain stubbornly stable in Erie County, though few get seriously ill

The amount of coronavirus found in samples taken from the Erie Wastewater Treatment Plant has declined in recent weeks, the county health department reported, indicating fewer infections than earlier this summer. All variants found in the sampling are in the BA.5 family.

COVID-19 hospitalizations rose slightly last week, from a daily average of 24.7 between Sept. 14-20 to 26.1 between Sept. 21-27. The county's 14-day moving average of daily hospitalizations has remained between 20 and 36 since late July, according to the state health department.

A majority of those patients are admitted for other reasons and later test positive for COVID, but Clark said it shows why it's important to get the new COVID-19 vaccine booster that is now available.

"COVID isn't going away," Clark said. "The fear is that we will see new strains but at this point we are dealing with the strains (BA.4 and BA.5) that this new booster covers. People should get it, and they can get the booster and their flu vaccine at the same time."

COVID-19 and flu vaccines are available at most chain pharmacies and physician offices.

Archive: New COVID-19 vaccine boosters available in Erie County

To receive COVID-19 vaccines at the LECOM Center for Health and Aging, visitlecom.eventbrite.orgor call 814-812-9851. To make a vaccine appointment at Corry Memorial, call 814-664-4641, Ext. 1234.

If you want to receive a COVID-19 or flu vaccine from your UPMC Hamot or Saint Vincent provider, call their office or visitupmc.com/coronavirus/covid-vaccineorahn.org/coronavirus/vaccine/schedule.html.

Here is a look at the county'sother COVID-19 measurementsbetween Sept. 14-20 and 21-27, according to the state health department:

Five county residents have died in September due to COVID-19 complications, compared to nine in August and six in July, the county health department reported. A total of 849 county residents has died due to COVID-19 since the pandemic started.

Contact David Bruce atdbruce@timesnews.com. Follow him on Twitter@ETNBruce.

See original here:

Coughing, congestion and sore throats: Do Erie residents have COVID-19, RSV or the flu? - GoErie.com

HONG KONG, Sept 30 (Reuters) - The Hong Kong government said on Friday it aims to ease some coronavirus curbs in an orderly way as pandemic trends in the Asia financial hub were continuing to stabilise.

From Oct. 6, some social distancing measures will be relaxed including raising the maximum number of persons per table in restaurants to 12 from eight, while banquets will be allowed to have up to 240 people attending, compared with 120 now.

Register now for FREE unlimited access to Reuters.comRegister

Reporting by Twinnie Siu and Donny Kwok; Editing by Mark Heinrich

Our Standards: The Thomson Reuters Trust Principles.

See the rest here:

Hong Kong government to further ease coronavirus measures - Reuters

The general panic caused by the coronavirus disease 2019 (COVID-19) pandemic spurred the demand for a safe and effective vaccine. Just a year after the initial report of a novel coronavirus emerging in Wuhan, China, later named the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), two vaccines were rolled out, both built on a messenger ribonucleic acid (mRNA) platform.

The question remains, are such vaccines safe during pregnancy and lactation, or will they unfavorably affect the fetus or neonate? A recent study attempts to answer this question in lactating women who received the vaccines within six months postpartum.

An mRNA COVID-19 vaccine inscribes the genetic blueprint for the virus spike protein on the host cell genomic DNA, allowing it to be translated and expressed on the cell surface. On exposure to this foreign protein, the host immune system recognizes and reacts to it, initially via innate immune responses and then by adaptive immunity. The latter includes both humoral and cellular immunity.

Humoral immunity to SARS-CoV-2 is relatively short-lived and can be overcome by strategic escape mutations in the viral genome. This was demonstrated by successive waves of COVID-19 caused by variants of concern (VOCs) of SARS-CoV-2 like the Alpha, Beta, Gamma, Delta, and now Omicron.

Still, vaccination is considered key to the long-term control of the pandemic. Even when it does not prevent breakthrough infection or reinfection, vaccination is associated with a remarkable decline in severe and critical disease, and mortality, due to the virus.

The speed at which the vaccines were developed led to the exclusion of several demographic groups from the clinical trials. This included young children and lactating mothers. At present, the vaccine is available for the latter group, despite the meager evidence on the presence of the vaccine mRNA in breast milk which could pass to the infant and potentially modulate the infants developing immune responses.

A recent study published in JAMA Pediatricsexamines this possibility in a group of 11 lactating mothers vaccinated against SARS-CoV-2 within six months of childbirth. The Pfizer/BioNTech (BNT162b2) or Moderna (mRNA-1273) vaccine was used.

The scientists reported that traces of mRNA vaccines, whether Moderna or Pfizer, were found in breast milk samples from five participants of 11. The samples had been retrieved at varying time points, with the last being 45 hours after vaccination.

The scientists measured the presence of vaccine traces in four different sample types, from whole expressed breast milk (EBM) through fat, cells, and extracellular vesicles (EVs) in the supernatant.

Cells and fat particles in EBM did not show the presence of the vaccine. Prevaccination samples did not contain any trace of the vaccine, and they faded below detection limits by 48 hours of collection.

EVs appeared to concentrate more on the vaccine than EBM. The average concentration of EVs was ~9 particles per milliliter, with each particle being 110 nm in size, on average.

This unique study is the first to produce evidence that COVID-19 mRNA vaccines are distributed to breast cells, entering breast milk in traces. It also shows how EVs in peripheral tissues package the mRNA vaccine, allowing it to be taken to distant cells. This has been a poorly examined area so far.

Earlier rat models showed low levels of mRNA vaccine in various body tissues after vaccination. These included the brain, testes, heart, and lung, showing extensive distribution within the body. The authors of the current study suggest that the vaccine is taken up into the lymphatic vessels after administration, from where it is transported to the breast cells inside lipid nanoparticles via lymph or blood.

This mRNA could then be released into the cytoplasm of the breast cells to be inserted into EVs forming within these cells. These are finally secreted, after their development is complete, into the breast milk.

The researchers point to the detection of traces of the administered vaccine in breast milk EVs, which showed the highest concentration among all EBM fractions, as evidence that, Breastfeeding after COVID-19 mRNA vaccination is safe, particularly beyond 48 hours after vaccination.

Given the small sample size, further larger studies are required. Moreover, research must be continued to show whether the traces of the vaccine in breast milk can trigger spike protein production in the neonate. This is especially important if vaccine mRNA accumulates in breast milk, as this could occur after repeated breastfeeding within 48 hours.

Safety studies to prove that the presence of mRNA is not associated with neonatal ill-effects are called for before babies less than six months old can be routinely permitted to breastfeed within 48 hours of maternal mRNA vaccination. It is also possible that the vaccine mRNA could impair the normal infant immune response to the other vaccines listed on the routine vaccination schedule for all infants during their first six months.

It is critical that lactating individuals be included in future vaccination trials to better evaluate the effect of mRNA vaccines on lactation outcomes.

See the original post here:

Is it safe to breastfeed after the COVID-19 mRNA vaccination? - News-Medical.Net

In a recent study posted to the medRxiv* preprint server, researchers assessed the superposition of aerosol and droplets in coronavirus disease 2019 (COVID-19) transmission.

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is spread through three different methods: direct contact with a fomite (an infected person or object), aerial transmission by droplets, and aerosols. The last of these, the distinction between "droplets" and "aerosols" and their respective propensity to spread infection, has been controversial but is undoubtedly significant.

Extensive research is required on the relative contributions of droplets and aerosols to infection risks or the implications for mitigation strategies.

In the present study, researchers estimated the amount of virus in particles exhaled by a SARS-CoV-2-infected person and inhaled by an uninfected person to assess the risks of aerial transmission.

When an infected individual exhales, they release virus-laden droplets into the atmosphere. The medium-sized droplets hit a person, touch something, or fall to the ground. The tiny droplets or aerosols can drift through the air for hours, cover great distances, and perhaps enter a distant person's respiratory system. By assuming that this number is proportional to the initial droplet size as volume, the team estimated the number of virions disseminated across the respiratory tract. The team compared the amounts of virions transmitted at various distances to obtain a more accurate exposure estimate. In the literature, "droplet" and "aerosol" describe whether an object poses a concern for short- or long-range aerial transmission.

The following example was employed to define terms, list presumptions, and describe the analytical process. A non-infected person, Bob, is at risk of contracting an infection from airborne contact with an infectious person, Alice.

Based on a mathematical model, Chen et al. analyzed short-range droplet transmission. According to them, there are two primary ways for short-range non-fomite transmission: large droplets that are projected at the same height directly into a person's mouth, nose, and eyes who is facing the source, and small droplets that enter the air stream and are inhaled.

Chen et al. concluded that droplets of medium size fall to the earth within a meter. Smaller droplets move with the air; larger ones move farther but will land on the ground because they descend horizontally more slowly. Furthermore, they conclude that most exposure occurs through inhaled droplets rather than deposited droplets at distances over 0.3m in the case of talking and over 0.8m in the case of coughing.

The team discovered that facing an individual at a distance of 1 m produces 17 pL of inhaled droplets for every 1 L of exhaled droplets. By first calculating what portion of that 1 L gets aerosolized using the numbers, the long-range risk can be estimated. Although environmental factors alter the diameter at which particles remain airborne, the team assumed that an inhaled particle was aerosolized when it had a diameter of less than 8 m.

The measurement with the highest measured ventilation, 3.2 air change rates per hour (ACH), was employed. The decline of aerosol danger with distance is probably considerably less pronounced in the absence of ventilation; in fact, in small enclosed spaces, the steady state may be very uniform.

The study findings quantified the relative contributions of different routes via a literature review. Medium droplets elicited the largest infection risk (measured as exposure to droplet volume), when near the infectious person out to a distance of about 1 m, according to three published studies that assessed droplets larger than 8 m, and smaller than 8 m (small droplets or aerosols), and smaller than 75 m (medium droplets).

medRxiv publishes preliminary scientific reports that are not peer-reviewed and, therefore, should not be regarded as conclusive, guide clinical practice/health-related behavior, or treated as established information.

Read the original here:

What is the aerosol and droplet risk in COVID-19 transmission? - News-Medical.Net

After being discovered in Wuhan, China, in November 2019, the novel coronavirus pandemic expanded quickly, causing significant morbidity, mortality, and financial burden worldwide [1]. Its symptoms range from asymptomatic infection to a life-threatening condition complicated by severe acute respiratory distress syndrome, thromboembolism, and multiorgan failure [2]. As severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variants have emerged, our comprehension of coronavirus disease 2019 (COVID-19) infection and management has continued to advance. An effective component of management that has dramatically helped reduce COVID-19 mortality and morbidity has been the introduction of COVID-19 vaccines [3].

The Food and Drug Administration (FDA) first issued emergency use authorization of the COVID-19 vaccine on December 11, 2020, in the United States. Since then, the number of COVID-19 vaccines approved for use has significantly increased worldwide. Along with the development of multiple COVID-19 vaccines, concerns about their side effects and contraindications have also increased. The development of COVID-19 vaccines is regulated by data safety and monitoring committees (DSMCs) composed of vaccine specialists and study sponsors. Before sanctioning the progression of a specific vaccine to the next phase, these groups evaluate the adverse events identified in each clinical study. This review article aims to provide a thorough analysis of COVID-19 vaccines approved for use in the USA, their characteristics, and their adverse effects profile.

A complete review of the medical literature was performed systematically with the keywords "COVID-19," "COVID-19 variants", "COVID-19 vaccine", and "COVID vaccine adverse effects" in PubMed, Google Scholar, and ScienceDirect databases. We also reviewed information from regulatory drug agencies and pharmaceutical companies' websites till September 4, 2022. To gather relevant content, all articles, which included literature reviews, meta-analyses, case reports, case-control cohort studies, and randomized controlled trials of vaccines, were screened and used to complete this article. Data from the Centers for Disease Control and Prevention (CDC) was also used and included in this article. We summarized and organized pertinent information for ease of understanding.

General Principles for COVID-19 Vaccine

The COVID-19 virus and its variants have surface spike protein (S-protein) which bindto the angiotensin-converting enzyme 2 (ACE2) receptors on the target cells resulting in membrane fusion. This enables the virus to penetrate the host cell and begin to replicate. The S-protein is the primary antigenic target site of COVID-19 vaccines. The antibodies produced by COVID-19 vaccines bind to the receptor binding domain of the S-protein, preventing the virus from binding to the host [4]. Based on these principles, COVID-19 vaccines evoke a substantial response against subsequent COVID-19 virus infection and offer protection by reducing the risk of severe illness, hospitalizations, and death [5,6]. COVID-19 vaccines, similar to most respiratory virus vaccines, are administered intramuscularly (IM) to evoke a strong systemic immune response [7,8]. COVID-19 vaccines that can be delivered intranasally or respiratory tract are currently under development [9].

COVID-19 Vaccines Available in the United States

Presently, four COVID-19 vaccines are approved for use in the United States by the FDA. They include two mRNA vaccines, an adjuvant recombinant vaccine and an adenoviral vaccine as seen in Table 1.

The COVID-19 vaccines effectively reduce individuals' risk of contracting the virus. In addition, research has established that individuals receiving COVID-19 vaccines have a reduced risk of COVID-19-associated morbidity and mortality [3,14].

Based on currently available data and CDC guidelines, COVID-19 vaccinations are recommended for all people aged six months and older [15,16]. mRNA COVID-19 vaccines, i.e., Pfizer-BioNTech or Moderna, are the preferred first line of COVID-19 vaccines as they have been studied extensively and have a wealth of data to support their usage [15]. In addition, Novavax is comparable to mRNA vaccines in terms of success, despite the fact that there is information on its safety and effectiveness is currently limited. The Janssen is appropriate for those without access to or with medical conditions that preclude the other three vaccines described above. Even though Janssen is the least preferred vaccine due to the potential for adverse events post-vaccination, it is still recommended to be vaccinated rather than foregoing COVID-19 vaccination altogether. More details on the Janssen vaccine are mentioned below under the section on contraindications, precautions and safety concerns.

Studies have also shown that two doses of mRNA vaccine are more effective than a single dose of Janssen [17]. For instance, Pfizer-BioNTech and Moderna have 93% and 88% effectiveness respectively after two doses in lowering COVID-19-related hospitalizations and mortality. Comparatively, Janssen is only 71% effective in lowering hospitalizations and mortality linked to COVID-19 [17,18]. Observational studies performed to compare the effectiveness of the two mRNA vaccines show no clinically meaningful difference between the two mRNA vaccines [19].

The following is the description of the old COVID-19 immunization schedule approved by the CDC before August 31, 2022. This has been discussed below in detail and can also be seen in Figure 1 and Figure 2.

The guidelines for the COVID-19 vaccines have not yet been granted FDA approval or authorization for use in children under six months. These guidelines are frequently updated by the CDC.

Pfizer-BioNTech COVID-19 (BNT162b2)

Pfizer-BioNTech COVID-19 (BNT162b2) vaccine is an mRNA-based vaccine that was developed by BioNTech and Pfizer in close collaboration [15]. This vaccine has been approved for ages six months and above [15,20]. The vaccine schedule is divided into four age groups, i.e., individuals 18 years or older, individuals aged 12 to 17 years, children aged five to 11 years, and children aged six months to four years. The duration of the primary series and the number of boosters doses required for each age group are different and therefore have been discussed below in detail.

Adults 18 years and older:In a healthy individual, the first two doses of the Pfizer-BioNTech vaccine are considered primary series, which can be given three to eight weeks apart. The individual is considered fully vaccinated two weeks after receiving the final dose in the primary series [15]. An immunocompromised individual will receivethree doses of the primary series three to four weeks apart from each other [20].A healthy individual's first booster dose is given at least five months after the last dose. The immunocompetent individuals will only qualify for a second booster vaccine if they are 50 years and older and at least four months after the first booster vaccine. However, in moderate to severely immunocompromised individuals, the first booster dose must be given at least three months after the second dose. The immunocompromised individual will receive their second booster dose four months after the first booster [15,20].

Children and teenagers age 12 to 17 years:In a healthy individual, the firsttwo doses of Pfizer-BioNTech are considered primary series, which can be given three to eight weeks apart. The individual is considered fully vaccinated two weeks after receiving the final dose in the primary series [15]. However, in a moderate to severely immunocompromised individual,three doses of the primary series need three-weekintervals between each one.In a healthy individual, only one booster dose is given at least five months from the last vaccine dose. However, in an immunocompromised patient, the first booster dose is still considered a primary dose and needs to be given within four weeks of the last vaccine [20]. The immunocompromised individual will receive their first booster in three months and the second in at least four months.

Children age five to 11 years:In a healthy individual, the first two doses of Pfizer-BioNTech are considered primary series, which can be given three to eight weeks apart. The individual is considered fully vaccinated two weeks after receiving the final dose in the primary series. However, in an immunocompromised individual, three doses of the primary series need to be given three to four weeks apart [15]. In a healthy individual, only one booster dose is given at least five monthsfrom the last dose. However, in an immunocompromised patient, the booster dose must be given three months from the last dose [20].

Children age six months to four years:In healthy children, a total of three primary doses are given. The first two doses of Pfizer-BioNTech can be given three weeks apart, and the third can be given eight weeks from the last dose. The individual is considered fully vaccinated two weeks after receiving the final dose in the primary series. The immunocompromised individuals also receive the same three doses with the same duration in the primary series as healthy individuals [15]. No booster vaccine is recommended at this age range for both immunocompetent and immunocompromised individuals [20].

Moderna COVID-19 Vaccine (mRNA-1273)

Moderna COVID-19 vaccine (mRNA-1273) is also an mRNA-based vaccine developed by the company Moderna [15]. This vaccine, similar to Pfizer-BioNTech, has been approved for ages six months and above [15,20]. This vaccine is divided into two age groups only, i.e., individuals who are 18 years or older and individuals from age six months to 17 years. The duration of the primary series and the number of boosters doses required for each age group are different and therefore have been discussed below in detail [20].

Adults 18 years and older: In a healthy individual, for the age group 18 to 49 years, the primary series consists of two doses, and for individuals aged 50 years and older, three doses are given at least four to eight weeks apart. The individual is considered fully vaccinated two weeks after receiving the final dose in the primary series. However, in an immunocompromised individual, the three doses of the primary series need to be given at four-week intervals [15]. One booster dosage is administered to healthy adults between 18 to 49 years of age; those 50 and older receive two booster doses at intervals of four to five months from the previous dose [20]. However, in an immunocompromised patient, two booster doses should be administered at least three to four months apart from the last dose.

Children and adolescents age six months to 17 years:In these healthy individuals, two doses of Moderna vaccine are considered primary series, should be given four to eight weeks apart. The individual is considered fully vaccinated two weeks after receiving the final dose in the primary series [15]. However, in an immunocompromised individual, three doses are given at four-week intervals to complete the primary series [20]. No booster vaccine is recommended for both immunocompetent and immunocompromised individuals under this age group.

Novavax COVID-19 Vaccine (NVX-CoV2373)

Novavax COVID-19 vaccine (NVX-CoV2373) is an adjuvanted recombinant protein vaccine developed by the company Novavax [15]. This vaccine has been approved for individuals 18 years and older only. The healthy individual will receive two doses of Novavax vaccine as primary series, given three to eight weeks apart [15]. The individual is considered fully vaccinated two weeks after receiving the final dose in the primary series [20]. However, in an immunocompromised individual, the two doses of the primary series must be given within three weeks. No booster vaccine is recommended for both immunocompetent and immunocompromised individuals.

Janssen COVID-19 Vaccine (Ad26.COV2.S)

Janssen COVID-19 vaccine (Ad26.COV2.S) is an adenoviral vector vaccine [15] that, like Novavax vaccine,is only approved forindividuals 18 years and older. The healthy individual will receive only one dose of Ad26.COV2.S as primary series. However, in an immunocompromised individual, the person requires a second dose of an mRNA vaccine. After receiving the second dose of the mRNA vaccine, the immunocompromised individualis considered fully vaccinated [15].A booster dose is not recommended in a healthy individual. However, in an immunocompromised individual, the first booster dose of Ad26.COV2.S is required at least two months after receiving the second dose in the primary series [20]. After that, a second booster dose of mRNA vaccine is again required at least four months after receiving the first booster dose.

As of August 31, 2022, the FDA has authorized and approved the bivalent COVID-19 vaccine booster dose. The CDC has also updated its COVID-19 vaccine schedule and guidelines, especially focusing on booster doses, as seen in Figure 3 andFigure 4. The bivalent mRNA COVID-19 vaccine booster contains the original SARS-CoV-2 strain used in monovalent vaccines plus the newer variants of SAR-CoV-2, omicron BA.4, and BA.5. The benefit of receiving the new updated bivalent vaccine is to increase vaccine effectiveness against new variants of SAR-CoV-2 as well as improving the body's immune response to new emerging variants [15,20].

This recommendation extends to both healthy and moderately or severely immunocompromised individuals over the age of 12. The two bivalent mRNA vaccines currently available are Pfizer and Moderna. To determine which bivalent vaccine is most appropriate, healthcare providers should refer to the individual's age group and primary vaccine series type.

The current recommendations are as follows:

In healthy, moderately, or severely immunocompromised individuals, the primary vaccination series has remained the same in all individuals (in the same age group). The only change is with the booster dose only. Instead of receiving multiple booster doses, CDC now recommends individuals ages 12 years and above receive only "one bivalent mRNA booster dose" after completing the primary series or any monovalent booster doses received in the past [15,20].

This new recommendation of receiving one bivalent booster dose replaces all prior monovalent mRNA booster vaccination for individuals ages 12 and above. The monovalent mRNA vaccine is not authorized as a booster dose for individuals ages 12 years and older.

Individuals ages five through 11 who received the Pfizer-BioNTech vaccine will still receive only the monovalent booster after completing the primary dose (not the bivalent). Also, all individuals who have received Novavax as a primary vaccine should receive a bivalent booster dose of either Pfizer or Moderna vaccine [15,20].

Unless otherwise noted, the CDC advises that the primary series of mRNA vaccinations be completed with the same type. For example, if a particular mRNA vaccine is in short supply or unavailable, CDC recommends delaying the second dose until the same vaccine can be obtained [21]. However, if someone receives the first dose of the mRNA vaccination but is unable to receive the second dose due to an allergic reaction or other medical issues, they are still permitted to receive Janssen 28 days after receiving the last dose of the mRNA vaccination, provided they are not also allergic to Janssen [21].

Per CDC recommendations, an alternative vaccine to the one given as part of the primary series can be administered as a booster. This is particularly relevant when an mRNA vaccination is administered as a booster to people who had Janssen as their primary series. Studies have demonstrated that this strengthens vaccine effectiveness against COVID-19 viral infection [21]. The interval for the booster dose should remain the same, as discussed above. Nonetheless, there is no significant difference when the alternate mRNA vaccine is mixed in individuals who have received either the primary Pfizer-BioNTech or Moderna vaccine.

Per CDC guidelines, non-COVID-19 vaccines can be administered simultaneously with the COVID-19 vaccine. However, both vaccines should be injected at least in different limbs (if they are associated with local reactions) or at least 1 inch apart [21].

The safety of COVID-19 vaccinations has been the subject of numerous misconceptions and myths, but in reality, most of them are relatively safe. Table 2 and Table 3 summarize contraindications and precautions associated with different COVID-19 vaccines in further detail.

A history of severe allergic responses, including anaphylaxis, to a previous COVID-19 vaccine or a vaccine ingredient is an important contraindication to future COVID-19 vaccine doses [21]. For example, adjuvants used in COVID-19 vaccines to boost the desired immune response can occasionally induce an allergic or autoimmune reaction in specific individuals. These include polysorbate in Novavax and Janssen and polyethylene glycol (PEG) in Pfizer-BioNTech and Moderna [22,26].

Anaphylaxis has an acute onset from minutes to several hours and requires immediate intervention [24,21]. Symptoms include respiratory involvement (trouble breathing, wheezing, stridor, difficulty swallowing), cardiovascular involvement (decreased blood pressure, fainting, dizziness), and skin involvement (hives, itching, mouth or face swelling) [21,24]. If anaphylaxis occurs post-vaccination, it is typically 15 to 30 minutes after the vaccine dose and warrants immediate management [21]. Management includes assessing airway, breathing, circulation, change in mental status, contacting emergency medical services (EMS), placing the patient in an upward-facing position, and immediately administering epinephrine (1:1000 dilution) via IM injection [21]. Symptoms typically improve after the first dose of epinephrine; if not, a repeat dose may be administered every five to 15 minutes while waiting for EMS to arrive [21]. Although anaphylaxis is a potentially life-threatening condition, it is a rare adverse effect with an estimated incidence of eight cases per million [27].

Per CDC, if a patient undergoes a severe allergic reaction after receiving a COVID-19 vaccine, they should not have any more doses of that same vaccine type and should be referred to an allergist for additional follow-up [21]. For example, if an allergic reaction is experienced after receiving an mRNA vaccine, the patient should not have any further doses of any type of mRNA COVID-19 vaccine [21]. After receiving the first dose of the Pfizer-BioNTech or Moderna vaccine, individuals who experiencean immediate allergic reaction may be able to receive a dose of Janssen to complete their vaccination series [22].

In a multisite US study conducted from January 2021 to March 2021, the individuals who received the first dose of mRNA vaccine and experienced severe allergic reactions were able to successfully receive a second dose of Pfizer-BioNTech or Moderna vaccines [28]. This study suggests that the reactions seen after the initial dose are not true IgE-mediated allergic reactions and are likely non-IgE mediated [28].

A general precaution prior to receiving a COVID-19 vaccine is evaluating for a history of an allergic reaction to a past COVID-19 or non-COVID-19 vaccine and other injected treatments [21]. For individuals with a history of severe allergic reactions to a COVID-19 vaccine, precautions should be taken to determine which COVID-19 vaccine type would be most appropriate for further doses [21]. For example, a polysorbate allergy is a precaution for Pfizer-BioNTech or Moderna because they contain the closely related protein PEG [21]. If an individual experiences an immediate allergic reaction to a non-COVID-19 vaccine or other injectable therapy due to either an unknown or known component of a COVID-19 vaccine, it may help to follow up with an allergist-immunologist for further testing [21].

TTS is also known as vaccine-induced thrombotic thrombocytopenia (VITT). Studies show that the Janssen vaccination led to an estimated four cases per million and 0.6 deaths per million after the initial dose [29].

Signs, Symptoms, and Management of TTS

Symptoms of TTS usually develop between seven to 14 days after vaccination and include headache, vision changes, abdominal pain, shortness of breath, trouble with bleeding or bruising, and pain in the legs or back [29,30]. If there is suspicion of VITT, blood work such as a CBC and platelet count must be obtained immediately, and imaging to identify thrombosis based on patient presentation [30]. If VITT is present, immediate consultation with a hematologist is warranted [30].

Patient Counseling After TTS Occurs

If TTS is experienced after receiving a Janssen vaccine, a subsequent dose with it is contraindicated [21]. Those who wish to complete their vaccination series should receive an mRNA booster dose at least two months after the first dose of Janssen and only if they have recovered [21]. Ultimately, the patient should discuss with their hematologist and healthcare providers to decide which mRNA vaccine is most appropriate and the optimum interval of booster administration [21]. Although the exact mechanism behind the development of TTS is unclear, it is hypothesized to be similar to heparin-induced thrombocytopenia (HIT) due to the presence of platelet factor 4 antibodies in cases of TTS [21,30]. This explains why patients should not get another dose of Janssen who have experienced a case of immune-mediated thrombosis and thrombocytopenia, such as HIT [21]. This does not include a history of other blood clotting conditions such as thrombophilia, pregnancy, or the use of birth control since they do not have an increased risk of developing TTS [21].

If an individual develops GBS within six weeks of administration of a Janssen vaccine, it is not recommended to administer another dose of it [21]. By July 2021, the Vaccine Adverse Event Reporting System (VAERS) approximated one Guillain Barre Syndrome (GBS) case per 100,000 doses [31].

Signs, Symptoms, and Management of GBS

GBS is a peripheral disorder involving nerve damage caused by ones immune system [21]. Symptoms typically occur within 42 days after a dose of Janssen, with males from ages 40-64 years most affected [21]. This can lead to walking difficulties, facial weakness, bladder or bowel dysfunction, bilateral upper and lower extremity weakness, and tingling sensations. [21]. The presence of any of these symptoms following the Janssen vaccine warrants immediate medical attention [21]. Treatment is most effective when initiated within two weeks of symptom onset and involves either plasma exchange or high-dose immunoglobulin therapy (IVIG) [32].

Patient Counseling After GBS Occurs

For those that develop GBS within six weeks after Janssen dose administration and wish to complete their vaccination series, an mRNA COVID-19 vaccine should be used for booster doses [21]. For future doses, mRNA vaccines are also recommended for those that develop GBS after six weeks of receiving a Janssen dose [21].

GBS Precautions

For individuals with a history of GBS, the administration of Janssen should be approached with caution [21]. Since using mRNA vaccines does not increase the probability of contracting GBS, Pfizer-BioNTech, Moderna, or Novavax are recommended in these situations [21].

mRNA COVID-19 vaccines and Novavax have been associated with developing myocarditis or pericarditis in young males 12 to 39 years of age post-vaccination [21,33]. However, to put it in perspective, COVID-19 infection has a greater likelihood of causing such a cardiac adverse event than vaccination. Reports of myocarditis to VAERS between December 2020 and August 2021 showed that among males, cases ranged from 52-106 per million doses of mRNA vaccines between the ages of 12 to 24 [34]. An eight-week dosage interval is now suggested between the first and second dose of mRNA or Novavax to reduce the risk of vaccine-related myocarditis for individuals aged six months to 64 years and especially for males 12 to 39 years old [21].

Signs, Symptoms, and Management of Myocarditis

Myocarditis occurs when cardiac muscle is inflamed, while pericarditis occurs when the sac around the heart is inflamed [33]. Individuals, especially young men who have received a recent COVID-19 vaccine and who are experiencing chest pain, trouble breathing, and a pounding heart or palpitations, should seek medical attention [33]. Management should consist of cardiology consultation and a cardiac work-up, an EKG, and blood tests, which include troponin level and inflammatory markers such as erythrocyte sedimentation rate (ESR) vs. C-reactive protein (CRP) [33-36].

Patient Counseling After Myocarditis Occurs

If a patient experiences myocarditis, it is advised that subsequent doses of any mRNA or Novavax COVID-19 vaccines be avoided [21]. If an individual that has developed myocarditis would like to receive another COVID-19 vaccine, they need to fully recover and be stable [21]. For subsequent doses or boosters, Janssen is recommended over mRNA or Novavax vaccines [21]. Individuals with a history of myocarditis or pericarditis unrelated to COVID-19 vaccination can get any COVID-19 vaccine that is FDA-approved after they have recovered from their condition [21].

There are seven other COVID-19 vaccines available worldwide which are listed in Table 4.

ChAdOx1 nCoV-19/AZD1222 (AstraZeneca - the University of Oxford and the Serum Institute of India)

The University of Oxford and AstraZeneca collaborated to create this vaccine. This vaccine utilizes DNA to create S-proteins as opposed to mRNA vaccines. The ChAdOx1 chimpanzee adenovirus serves as the vector for this vaccine. The genetic code for the COVID-19 S-protein will then be injected by the modified adenovirus into the nucleus of the recipient's cells, allowing it to be translated into mRNA. Later, this mRNA is translated into spike proteins that travel to the surface, where the immune system can detect them and eventually mount an immunological response. It is simple to use and store this vaccine. The vaccine does not have to remain frozen and can last long, even when refrigerated at 2C to 8C. The WHO recommends this vaccine be given in two doses IM eight to 12 weeks apart [35-37]

Ad5-Based COVID-19 Vaccine (CanSino Biologics)

This vaccine was developed by CanSinoBio and the Beijing Institute of Biotechnology as a single-dose vaccine against COVID-19 in China. This single-dose vaccine is given IM and is based on the replication of an adenovirus type 5 vector that expresses the S-protein of SARS-CoV-2. This vaccine is available in China and other countries, including Pakistan and Mexico [38]. The efficacy of this vaccine showed 57.5% and 91.7% efficacy, respectively, in preventing symptomatic and severe diseases during the phase 3 trial. Further study must be performed to check the effectiveness against different COVID-19 variants [38].

Gam-COVID-Vac/Sputnik V (Gamaleya Institute)

This vaccine was developed by the Gamaleya Research Institute of Russia. The vaccine's mechanism of action is similar to AZD1222 discussed above. Sputnik V uses double-stranded DNA for building COVID-19 spike proteins to induce an immune response. The vector used for this vaccine is also Adenovirus 26 (AD26) and Adenovirus 5 (AD5). This vaccine is given IM in two doses. The initial dose contains the AD26 vector followed by the AD5 vector given 21 days to three months apart [39,40]. The vaccine showed 91.6% efficacy in preventing symptoms of COVID-19 after the second dose. Further study needs to be performed to check the effectiveness against different COVID-19 variants [39,40].

WIV04 and HB02 (Sinopharm)

The Beijing Institute of Biological Products of Sinopharm was tasked with developing these two inactivated virus particle vaccines based on two different COVID-19 isolates found in patients in China. These two vaccines are given IM 28 days apart [41]. The vaccine showed 73% effectiveness for WIV04 and 78% effectiveness for HB02. Further study must be performed to check the efficacy against different COVID-19 variants [41]. This vaccine is available in China and other countries like the United Arab Emirates.

CoronaVac (Sinovac)

This vaccine is based on an inactive COVID-19 virus within an aluminum hydroxide as an adjuvant. This is a two-dose vaccine given IM 28 days apart [42]. This vaccine showed 83.5% efficacy in a phase 3 trial. However, other countries like Brazil and Chile have reported lower vaccine efficacy use, around 70% [42,43].

Covaxin (BBV152: Bharat Biotech & Indian Council of Medical Research)

This vaccine is based on an inactive COVID-19 virus developed by Bharat biotech and the Indian Council of Medical Research. This is a two-dose vaccine given IM 29 days apart [44]. The vaccine showed 78% efficacy in a randomized trial [44]. Further study must be performed to check the effectiveness against different COVID-19 variants.

ZyCoV-D (Zydus Cadila)

This vaccine is considered the world's first plasmid-based DNA vaccine developed by Zydus Cadila in India against the COVID-19 virus. This vaccine uses a plasmid that carries a coronavirus genome to generate S-proteins in the host cell, leading to an immune response. It is a three-dose vaccine with each dose given 28 days apart. The vaccine uses a needleless injector that delivers the vaccine with a high-pressure stream subcutaneously. The benefit of this vaccine is that it is needleless and, therefore, painless. Also, since this vaccine is plasmid-based, vector-based immunity concerns can be avoided [45]. This vaccine has shown to be 67% effective against COVID-19 infection. Further study must be performed to check the effectiveness against different COVID variants [46].

In the section, we have discussed the effectiveness of different COVID-19 vaccines against different SARS-CoV-2 variants [46-49]. This does not include studies from bivalent COVID-19 booster doses.

Delta (B.1.617.2) Variant

Several SARS-CoV-2 variants have surfaced since the COVID-19 pandemic erupted, despite vaccine efforts to confine it. Critical S-protein mutations (D614G, L452R, P681R, and T478K) have been linked to the delta variant's increased transmissibility. Another major factor in the reduced vaccine efficacy against delta variants has been theorized to be its increased affinity of the S-protein and ACE2. The table highlights the vaccine effectiveness against the delta variant. The mRNA vaccines were over 94% effective two to four weeks after completing two doses. The effectiveness goes down to around 80% at 25 weeks or more after the completion of two doses of mRNA vaccines. The vaccine effectiveness increases to over 95% when boosted with either of the mRNA vaccines.

After two doses, the AstraZeneca vaccine showed 82% effectiveness against the delta variant. This effectiveness goes down to around 43.5% at 25 weeks or more. The vaccine effectiveness increases to over 95% when boosted with either of the messenger RNA vaccines as shown in Table 5.

Omicron (B.1.1.529) Variant

According to CDC data from August 2022, BA.5 sub-lineages of the omicron variety accounted for around 88% of infections in the United States. The effectiveness of vaccines was lower for the omicron variant for all mRNA vaccines compared to the delta variant. Patients who received two doses of Pfizer-BioNTech vaccine initially had vaccine effectiveness of 65.5% around two to four weeks after completing the second dose. This effectiveness goes down to 8.8% after 25 weeks. Similarly, with the Moderna vaccine, the two doses of vaccine were initially effective at 75.1% two to four weeks after completing the second dose. This effectiveness reduces to 14.9% after 25 weeks as shown in Table 6. To combat these mutations, vaccine manufacturers are constantly developing next-generation boost doses.

For the individuals who received Pfizer-BioNTech as a primary series (two doses) and as a booster dose, the vaccine effectiveness increased to around 67% two to four weeks post booster dose. This effectiveness declined to about 45% after 10 weeks of receiving the booster dose as shown in Table 7.

The individual who received Pfizer-BioNTech as a primary course (two-dose vaccine) and then received the Moderna vaccine as a third booster dose showed the effectiveness increased to around 74% two to four weeks after receiving the booster dose, which then declined to 64% around five to nine weeks as shown in Table 8.

The individuals who received Moderna as a primary course (two-dose vaccine) and then received Moderna vaccine as a third booster dose showed effectiveness increased to around 66% two to four weeks after receiving the booster dose as shown in Table 9.No further studies were done to see the effectiveness after four weeks.

The individuals who received Moderna as a primary series (two doses) and then received Pfizer-BioNTech vaccine as a third booster dose showed the effectiveness increase to around 65% at two to four weeks post booster dose as shown in Table 10.No further studies were done to see the effectiveness after four weeks.

AstraZeneca vaccine failed to provide any protection against this variant after 20 weeks.However, for individuals who have received AstraZeneca as a primary series (two doses) and then received the Pfizer-BioNTech vaccine as a third booster dose, the vaccine effectiveness increased to around 62% at two to four weeks post booster dose. This effectiveness declined to around 40% at 10 weeks. On the other hand, individuals who have received the Moderna vaccine as a booster dose had the vaccine effectiveness increased to 70% at two to four weeks post booster dose. This effectiveness declined to around 61% at five to nine weeks as shown in Table 11 and Table 12.

We have reviewed current literature regarding COVID-19 vaccines that have already been approved in the US as well as other nations like the UK, China, and India; some other countries may also have approved them. Not all vaccines licensed elsewhere in the globe could be reviewed in this article. Vaccine side effects discussed are from currently reported data as of September 9th, 2022, which may change in the future as new data emerges.

Read the original:

A Hitchhiker's Guide to Worldwide COVID-19 Vaccinations: A Detailed Review of Monovalent and Bivalent Vaccine Schedules, COVID-19 Vaccine Side...

India Corona Update | The pace of corona virus slowed down in the country, the number of patients under treatment for infection decreased to 36,126

New Delhi: After 3,011 new cases of corona virus infection were reported in India in the last 24 hours, the total number of infected in the country increased to 4,45,97,498, while the number of patients under treatment decreased to 36,126. According to the updated data released by the Union Health Ministry at 8 am on Monday, the death toll has risen to 5,28,701 after 28 more people died due to infection in the country. In these 28 cases, 20 people are also included, whose names have been added to the list of patients who lost their lives due to the global epidemic, re-matching the death toll due to infection.

According to the data, the number of patients under treatment for corona virus infection in the country has come down to 36,126, which is 0.8 percent of the total cases. In the last 24 hours, there has been a decrease in the number of patients under treatment by 1,318. The national recovery rate of patients has increased to 98.73 percent. Significantly, on 7 August 2020, the number of corona virus infected in the country had exceeded 20 lakh, on 23 August 2020, 30 lakh and on 5 September 2020, more than 40 lakh.

The total cases of infection crossed 50 lakh on 16 September 2020, 60 lakh on 28 September 2020, 70 lakh on 11 October 2020, 80 lakh on 29 October 2020 and 90 lakh on 20 November. On 19 December 2020, these cases had exceeded one crore in the country. Last year, on May 4, the number of infected had crossed 20 million and on June 23, 2021, it crossed 30 million. On January 25 this year, the cases of infection had crossed four crores.

View post:

India Corona Update | The pace of corona virus slowed down in the country, the number of patients under treatment for infection decreased to 36126...

In a recent study posted to the medRxiv* preprint server, researchers proposed a protocol to assess the effects of coronavirus disease 2019 (COVID-19) on eating behavior and food choices.

Research suggests that some individuals infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) develop sensory symptoms like the loss of taste/smell. Sensory changes significantly affect dietary choices, impacting diet quality and energy/macronutrient intake. Yet, the effects of COVID-19 on dietary preferences remain poorly understood.

New Zealand transitioned to a minimization and protection strategy in December 2021, mandating masking and vaccination requirements in high-risk settings. This was accompanied by easing border curbs and quarantine measures for citizens returning from overseas. COVID-19 cases surged from February 2022 and peaked on March 6, 2022, at 22,025 new infections.

Early in the COVID-19 pandemic, smell/taste changes were deemed distinctive COVID-19 symptoms. Various meta-analyses have noted sensory changes as highly prevalent. However, the prevalence of sensory changes varies across regions and might be less common in infections with recent SARS-CoV-2 variants.

For instance, sensory changes have been observed in 55% of Europeans with COVID-19 to 11% of Australian COVID-19 patients. While sensory changes resolve within months of diagnosis, studies have noted long-term effects of COVID-19 on taste/smell even after recovery. Long-term taste/smell dysfunction could significantly impact the quality of life.

In the present study, researchers proposed to survey the dietary behavior of university students and provided a protocol for the same. Data from SARS-CoV-2-infected individuals would be compared to the pre-existing data available at the Sensory Neuroscience Laboratory from July 2017 to July 2021, beforewidespread SARS-CoV-2 transmission.

A retrospective cohort analysis would be implemented to compare pre-existing cohort data (pre-COVID-19) with post-COVID-19 data among university students. Post-COVID-19 data would be collected via in-person visits, online surveys, or food records. Participants would primarily be sampled from the University of Otago, New Zealand.

Eligible participants would be SARS-CoV-2-infected (PCR-confirmed) and healthy university students (aged 18 or above). Exclusion criteria will be 1) age below 18 years, 2) regular medication for a physical condition, 3) chronic sensory dysfunction, 4) diagnosis of an eating disorder, and 5) currently undertaking a weight-gain/loss dietary program.

Participant recruitment strategies involve flyers, social media, and word of mouth. All adverts would contain a link to fill in details and provide e-consent. Upon submission of the e-consent form, an online survey link will be sent automatically.

The sensory science laboratory collected the pre-COVID-19 data at the University of Otago, and consent was available from participants to use their data in the future for research purposes. The sample size will be 920, including 326 SARS-CoV-2-exposed participants. The primary outcome of the investigation will be energy intake, evaluated using a 24-hour weighted food record, which is a validated assessment of dietary intake.

Subjects will visit the laboratory to obtain food record(s) and instructions. Responses would be converted to daily energy intake. Secondary outcomes will include a healthy eating index, alcohol consumption, and the intake of fats, proteins, fibers, carbohydrates, sugars, salts, micronutrients, animal proteins, and plant-based protein.

Besides the food records, the eating behavior of the participants will be assessed using the Dutch Eating Behavior Questionnaire. The body mass index (BMI) will also be computed. Pre-COVID-19 cohort data will be used for baseline demographics.

Individuals in the post-COVID-19 cohort will complete a (baseline) survey providing information on demographics and experiences with COVID-19 and sensory dysfunction. Moreover, perceived changes in eating behavior and food preferences since before the COVID-19 pandemic will be documented.

Analysis of covariance (ANCOVA) will be used to compare total energy intake per day between cohorts by controlling for gender, age, and ethnicity. Additionally, sub-group analyses will be conducted to analyze the specific effects of public health measures in the absence of infection. Participants will be excluded from the study if they have missing/incomplete data on food records.

It is critical to understand the long-term impact of COVID-19 on nutrition and food preferences to ensure that health measures are effective against COVID-19 and future outbreaks. Further, it remains challenging to conduct controlled cohort studies given the high prevalence of undetected infections, and the proposed protocol provides an opportunity to investigate COVID-19-associated eating behavior changes.

medRxiv publishes preliminary scientific reports that are not peer-reviewed and, therefore, should not be regarded as conclusive, guide clinical practice/health-related behavior, or treated as established information.

Here is the original post:

What were the effects of COVID-19 on our food choices? - News-Medical.Net