Category: Corona Virus

Gov. Ned Lamont and ConnecticutDepartment of Public Health Commissioner Manisha Juthani held a news conference Monday to provide an update on the COVID-19 situation in Connecticut.

They encouraged vaccinations for people who are eligible, including younger age groups that have recently been approved, to receive COVID-19 vaccinations.

While its summer and people are enjoying time outdoors now, Juthani said Fall and the school year are not too far away.

So there are a few key things I want people to remember. First of all, weve got about 50 percent of our children who are 5 to 11 years old currently vaccinated, she said.

However, that might be a long time ago, and everyone, from 5 years through adulthood are eligible for a booster shot, she said.

Were going into our first school season without a mask mandate in place and were able to do that because we have these tools at our disposal, specifically vaccinesfor the entire school-age age group, she said.

State officials are also urging adults to get vaccinated and urged everyone to get up to date with what they are eligible for.

Full coverage of the COVID-19 outbreak and how it impacts you

"If you are over 50 and haven't gotten vaccinated this calendar year, 2022, go get vaccinated," Lamont said.

Juthani said the BA.4 and 5 subvariants have gone up and are the majority of the cases health officials are seeing now. She added that there is also a slight uptick in hospitizations.

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Health Officials Are Urging Vaccinations Against COVID-19 for Children, Adults - NBC Connecticut

By Melissa Patrick

All but 14 of Kentuckys 120 counties have an elevated risk of coronavirus on the latest federal risk map, and Gov. Andy Beshear cautioned that the transmission rates are likely high in those counties too.

We know there is a lot more Covid that is out there, and people need to really think about what steps they want to take, or the repercussions of steps that they might not take, Beshear said at his weekly news conference. And while the latest dominant variant isnt nearly as deadly as recent ones, It still is harming and taking lives, he said, and we need to be wary of that.

This weeks Centers for Disease Control and Preventionrisk mapsays Kentucky has 61 orange counties, indicating a high level of risk. Thats a big increase from the 37 on last weeks map. Most of this weeks orange counties are in the east and west, with a string of them down the middle of the state.

Forty-five counties are yellow, indicating a medium level of risk. Last week 44 were yellow. The rankings are based on new coronavirus cases, hospital admissions and hospital capacity.

People in yellow counties who are immunocompromised, or at high risk for severe illness from the virus, should talk to a health-care provider about whether they need to wear a mask or take other precautions, the CDC says.

The statesweekly pandemic report,released Monday, showed Kentucky had an average of 1,564 new cases a day last week, 14.3 percent more than the week before. The positive-test rate increased to 16.96% and Covid-19 deaths jumped to 62 from 38 the prior week.

Hospitalizations, while still low, are on what Beshear called a legitimate increase, increasing enough to prompt him to urge caution for the first time in a long while.

People need to be wary, the governor said. And certainly, if people are in the groups that this virus harms the most, they should definitely think about taking extra steps.

Nine out of 10 Kentuckians under 60 who have died from Covid-19 in the past year were unvaccinated, and two-thirds of Kentuckians over 60 who died from Covid-19 in the past year were unvaccinated, Health Commissioner Steven Stack said.

Speaking to how contagious the Omicron BA.5 variant is, Stack said earlier variants resulted in one person possibly infecting three or more people, while one person with BA.5 could infect 18 or more people. The good news is that even as BA.5 causes more infections, it does not appear to cause increased hospitalizations or deaths.

Stack said we are solidly at a phase in the pandemic where individuals who are at higher risk from the virus such as people 50 and older and certainly over 60, anyone with major medical problems or compromised immune systems need to take extra precautions, which involves getting that second booster. If youre generally healthy, he said. I think you might be OK to see what happens in the fall, when the FDA is expected to approve a new version of the vaccine with broader protection.

We have all got to take this seriously, Stack said. That doesnt mean we dont go on with life, but this is this is here to stay, folks. So I think we all still should continue to treat it with a healthy dose of respect.

Stack praisedToyota Motor Manufacturings decision to require masks in its Georgetown factory, noting that while this variant isnt as dangerous as prior ones, it is highly contagious and causing people to get sick and stay home from work, potentially impacting a whole operation.

I think this is important . . . and encourage other employers to consider whats appropriate in your setting, Stack said.

New vaccine approved:TheU.S. Food and Drug Administrationapproved emergency use of a new Covid-19 vaccine called Novavax on Wednesday. The vaccine that is made with more traditional technologies than thePfizerandModernamRNA vaccines.

In the next few weeks or month, youll have another option if for some reason the two mRNA vaccines were not appealing to you . . . and I would encourage you to be open to it, Stack said.

This news comes as the administration works on strategies to be ready for the pandemics next phase, including having stockpiles of tests, personal protective equipment and updated vaccines, Stein reports.

That job has become much, much harder . . . because Congress has decided that they dont want to fund that kind of effort, Jha said. And so we are now trying to put together resources to make sure that we have at least some of the new vaccines, that we have at least some tests going into the fall. We are not going to have enough.

Stack said this lack of federal funding is already limiting access to monoclonal antibodies for Covid-19, a treatment that acts much like your own antibodies and can stop symptoms of the disease from getting worse and may prevent hospitalization caused by worsening symptoms.

Hopefully, he said, this wont happen with Covid-19 vaccines, but If Congress doesnt grant more money to the administration, the administration has said unequivocally, they will unfortunately not have the resources and then that means we wont be able to just tell every citizen in every Kentucky and you can just go and at no cost to yourself get a vaccine.

So I hope theyll take action, he said. But for right now, Vaccine is abundant. So if you are eligible, please go out and get it.

More here:

CDC says 61 Kentucky counties are at high risk of Covid-19 and 45 are at medium risk; Beshear says 'be wary' of coronavirus - Winchester Sun -...

Coronavirus cases and hospitalizations are on the rise in North Texas.

Over the weekend, Dallas County's Public Health Committee moved their COVID-19 risk level from yellow to orange, which urges extreme caution.

The update comes after the Centers for Disease Control and Prevention placed Dallas, Tarrant and Collin counties in the high-risk or "red" category of COVID-19 spread on Thursday. Denton County is currently set at yellow.

The committee published a report on Saturday, saying the primary drivers of the increase in COVID-19 cases are inadequate/waning immunity and lack of masking.

Much of the population remains unvaccinated, un-boosted (have not received all recommended doses) with COVID-19 vaccine and are not up-to-date, the report states. Vaccines are our most powerful tools in protecting our residents and our economy as they prevent hospitalizations, long COVID-19, and death. Masking helps stop the spread. Individuals who received their primary series in 2021 and those who have had COVID-19 are facing significant waning immunity if they have not completed their vaccine series or been boosted.

The report states only 24% of eligible Dallas County residents have been boosted and 73% have received one vaccine.

Full coverage of the COVID-19 outbreak and how it impacts you

The Dallas County Public Health Committee said COVID-19 vaccine rates remain lower than what is needed to protect vulnerable and at-risk residents, especially children.

Data on the countys COVID-19 dashboard shows a daily average of about 570 cases over the past week. However, experts have said case counts are probably higher than what's reported as more people test themselves with at-home kits or skip testing altogether.

Hospitalizations have also increased by 45% in the last two weeks, according to the committees report.

At the high-risk level, the CDC is recommending that people wear a mask indoors, get vaccinated, increase ventilation indoors, and get tested if they have symptoms.

"As long as we do all of those things, we're going to be OK. So I don't believe that anyone needs to have an extreme amount of concern. But again, let's just be smart," said Dr. Joseph Chang, Parkland Memorial Hospital Chief Medical Officer.

Chang said that what we're seeing now is no cause for major concern yet.

"I think my concern level is greater than zero. But you know, on a scale of one to 10, it's not even close to five at this point, he told NBC 5.

According to the latest COVID-19 forecast by UT Southwestern Medical Center researchers, two omicron sub-variants, BA.4 and BA.5 make up more than 75% of samples that have been tested so far.

Researchers at UT Southwestern expect COVID hospitalizations to increase over the next several weeks. Their big concern right now is a steep rise in new patients over the age of 65. UTSW research also notes increased infection in 20 to 40-year-olds.

Chang said he is not expecting a dramatic surge in cases and hospitalizations, as seen with previous variants.

"I do not believe that we're going to have the same situation that we had with omicron and delta, and certainly not to the severity of disease that we saw. Now, we might see people get sick and they might have to stay home. But the severity is probably not going to be anywhere near what we saw before. That's the good part," he said.

Chang also stressed that getting the COVID-19 vaccine is the best way to avoid issues, especially for children, as hospitals keep an eye on the start of school in a month.

"I don't see big waves like omicron and delta again. Of course, the ultimate super spreader event is school, he said. [Kids] need to be vaccinated right away. Again, this is very basic, very simple, and very straightforward. I know there are a lot of folks with a lot of reasons why they don't want to get their kids vaccinated. But listen, it's just being smart. And if we don't do it, we're going to see some consequences.

It's still too early to say what protocols school districts will decide when that happens.

Originally posted here:

Dallas Co. Raises COVID-19 Level, Citing Waning Immunity and the Unvaccinated - NBC 5 Dallas-Fort Worth

Background: The ongoing pandemic of coronavirus disease 2019 (COVID-19) has negatively impacted respiratory health worldwide. The severity of the disease varies considerably, and patients may present with bronchitis, pneumonia, and acute respiratory distress syndrome. This study aims toquantify the parameters of the pulmonary function test (PFT) with regard to the severity of COVID-19and understand the pattern of PFT in reference to the status of selected morbidities and body mass index.

Materials and methods: This is a hospital-based, comparative, cross-sectional study. A total of 255 COVID-19 survivors underwent clinical assessment, a PFT, and a 6-minutewalk test. Participants were divided into mild, moderate, and severe disease groups. The parameters were compared between these groups. The PFT and 6-minutewalk tests were conducted using an NDD Digital computerized spirometer (NDD Meditechnik AG., Switzerland) and a fingertip pulse oximeter(Hasely Inc., India), respectively.

Results: All PFT parameters showed significant differential distribution among the severity groups (p<0.001) except for forced expiratory volume in 1 s/ forced vital capacity (FEV1/FVC) and forced expiratory flow (FEF) during 25%-75% expiration and peak expiratory flow (PEF). Among severe category participants forced vital capacity (FVC), forced expiratory volume in one second (FEV1), and FEV1/FVC, were significantly reduced as compared to mild and moderate. Severity wassignificantly affected by age >50 years. Severecategory participants were seen in 31% of normal, 58% of pre-obese, and 53% of obese participants; however, this difference was insignificant. A significant reduction in SPO2 on the 6-minutewalk test was observed in severely sick participants.

Conclusions: COVID-19 is associated with a mixed pattern of spirometry. Poor prognosis is associated with older age, obesity, and multimorbidity.

The coronavirus disease 2019 (COVID-19) pandemic, caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has affected >367 million individuals and resulted in >5 million deaths worldwide [1]. The disease primarily affects the lungs and other respiratory organs. Damage to the lungs results from a cytokine storm induced by the host's immune system. This immune response leads to acute inflammation and increased levels of inflammatory biomarkers, such as C-reactive protein, ferritin, and interleukin-6 (IL-6) [2]. Based on the widely documented lung injuries related to COVID-19, concerns are raised regarding assessing lung injury in discharged patients [3]. The severity of clinical manifestations ranges considerably, and patients present with bronchitis, pneumonia, and acute respiratory distress syndrome (ARDS). COVID-19-associated ARDS has been linked to poor prognosis [4]. A follow-up study of 81 patients with COVID-19 through computed tomography revealed a reticular pattern associated with bronchiectasis and irregular interlobular or septal thickening. These findings indicate the appearance of interstitial changes, suggesting the development of fibrosis [5].

Another follow-up study by Fumagalli et al. revealed deranged pulmonary functions in a restrictive pattern [6]. Nevertheless, Thomas et al. suggested that all spirometry parameters were normal except the changes were observed in diffusing capacity with a worse impact on those with severe disease[7]. Owing to the complex pathophysiology, the status of the lungs and degree of recovery remains unknown [8]. According to the available evidence on the COVID-19 pandemic, there is limited knowledge regarding the effects of the virus in terms of residual changes or long-term sequelae [9-12]. Notably, the pulmonary function test (PFT) and spirometry are important, reliable, and easy to perform tools for the diagnosis and management of respiratory disease in all age groups. Hence, they are used in the present study to screen residual pulmonary changes in COVID-19 survivors. Moreover, disease progression is a complex phenomenon and bi-directionally affected by protective (e.g., immune status, good nutrition) or deleterious (e.g., obesity, comorbidity) effects.

According to guidelines established by the World Health Organization, the presentation and progression of illness are categorized into the following groups: mild; moderate; and severe [13]. Moreover, it has been found that disease progression and severity are associated with the presence of comorbidities [14]. As obesity is one of the comorbidity conditions its high prevalence rate may directly or indirectly interfere with the treatment and prognosis of ARDS. This condition poses challenges due to its unique physiology in patients and, indirectly, is a risk factor for the development of chronic obstructive pulmonary disease (COPD) [15]. Hence, investigatingthe long-term sequelae of COVID-19 in survivors is urgently warranted [16]. Currently, evidence regarding the pattern of COVID-19 residual changes among survivors during the recovery phase, as well as its correlation with the comorbidity status and body mass index (BMI), is scarce [17-19].

Thus, the aim of this study was to analyze the patterns and trajectories of COVID-19 in pulmonary functions of survivors classified into different clinical categories.

This was a hospital-based, comparative, cross-sectional study. Ethical approval was obtained from the institutional ethical committee (approval number: IHEC-LOP/2020/EF0219). A total of 546 COVID-19 survivors were followed up at the Outpatient Department of the All India Institute of Medical Sciences (Bhopal, India). Of those, 255 provided written informed consent and met the inclusion criteria: age 18-65 years and discharge from hospital 2 weeks prior to inclusion in the study. Participants were enrolled between July 2021 and September 2021.

All the precautions related to the COVID-19 care protocol were implemented during this study. Clinicians performed PFTs after recording a detailed history of the patient and conducting a clinical assessment. Patient characteristics (e.g., body mass index {BMI}, comorbidity status, smoking habits, signs and symptoms, and other demographic information) were collected. Based on clinical and treatment history, and according to the World Health Organization performance scale, the enrolled COVID-19 survivors were divided into the following disease severity groups: mild; moderate; and severe. The enrolled survivors were categorized in accordance with the history of hospitalization, requirement of supplemental oxygen, and requirement for admission to the intensive care unit [13].

Clinical assessment included the 6-minute walk test (6MWT) using a fingertip pulse oximeter (Hasely Inc., India). This analysis was performed at room temperature under the supervision of a respiratory therapist. Oxygen saturation (SpO2) absolute values were categorized from 0 to 2, as per the relative capability to perform the 6MWT.

The BMI (weight/height {kg/m2}) of all enrolled survivors was also determined, and the patients were categorized as normal, obese, and pre-obese (18-21, <25, and 22-25 kg/m2, respectively) [20]. In addition, the presence of comorbidities (i.e., diabetes, hypertension, COPD, and multimorbidity) was evaluated.

PFT was performed in a sitting position using an NDD Digital computerized spirometer (NDD Meditechnik AG., Switzerland). Prior to undergoing the test, the participants were familiarized with the instrument and the procedure. PFT parameters were considered according to the maneuver-acceptable criteria established by the American Thoracic Society and the European Respiratory Society [21]. PFT parameters were recorded as best trial and percentage. PFT parameters included the following: forced vital capacity (FVC); forced expiratory volume in 1 s (FEV1); FEV1 as a percentage of the FVC; peak expiratory flow rate; forced expiratory flow rate during 25-75% of expiration (FEF25-75); and forced inspiratory vital capacity (FIVC).

Data were validated for redundancies and missing values, and they were descriptively summarized using the mean, median, and interquartile ranges (in the case of non-Gaussian distribution). Categorized PFT values were compared through an unpaired analysis of variance test to analyze the shift of categorized PFT distribution values from null parent distributions. Proportional stack diagrams were created to illustrate the effect of BMI categories on PFT values and the direction of possible interactions.

A total of 255 COVID-19 survivors were enrolled in this study (167 males and 88 females; mean age: 47.12 13.78 years). Of those, participants were classified into the mild, moderate, and severe disease groups as shown in Table 1. The distribution of the baseline characteristics of enrolled COVID-19 survivors was categorized according to disease severity presented as the mean (standard deviation) or numbers (%). The comorbidities mainly presented with diabetes and hypertensionwere found to be statistically significantlydistributed(p = <0.001), except for COPD (p=0.7). A significant distribution was also found with reference to their multimorbidity status.

All parameters exhibited a differential distribution among the disease severity groups. These differences were statistically significant, except for the FEV1/FVC ratio (p = 0.079). The mean values of FVC, FEV1, FEF25-75, PEF, FET, FIVC, and PIF parameters were lower in the disease severity group as compared to the mild and moderate groups, which suggests the restrictive pattern(Table 2).

All parameters showed a differential distribution among the disease severity groups. These differences were statistically significant, except for FEF25-75 (p = 0.2) (Table 3).

We further classified the enrolled COVID-19 survivors into binary groups by setting the cut-off value at 80% for FVC, FEV1, and the FEV1/FVC ratio. This classification represents the distribution of obstructive and restrictive changes according to the severity of the disease (Tables 4-6).

We observed an increase in the number of participants in the <80% group based on the disease severity. This may denote an association of severity with the parameters examined in this study.

We further investigated the potential effects of age and BMIon disease severity as per their category(Table 7) that suggested the presence of disease in severe form among higher age group individuals. The mean 6-minute walking distance SpO2 in all participants was above 96% except for the disease severity group who had a low 6MWDs SpO2 mean, 94.99 (3.29), and it was also statistically significant distributed (p = <0.001).

The effect of multimorbidity and BMI according to the PFT parameters of COVID-19 survivors areillustrated with the help of a stake diagram(Figures 1, 2).

Currently, there is a scarcity of large-scale studies focusing on changes in pulmonary function among COVID-19 survivors. Using spirometry, this study focused on patterns of changes in pulmonary functions in relation to morbidity and disease severity.

COVID-19 survivors aged 18-65 years were enrolled in the present study. Those in the older age group (i.e., >50 years)associated with severe disease are 76(66%) out of 115; moreover, 56 of the 131 severe cases (42%) required intensive care management. Hence, the findings were suggestive of a link between severe disease and advanced age. This association may be due to the higher rates of comorbid conditions present in older patients [22].

Our study also revealed that PFT parameters were significantly associated with disease severity. The detected changes were both obstructive and restrictive, suggesting a mixed pattern of long-term sequelae of COVID-19. Significant changes were not found in FEV1/FVC, FEF25-75, and peak expiratory flow. A similar study conducted by Fumagalli et al., involving a smaller sample size, suggested mainly restrictive changes in COVID-19 survivors [6].

In the present study, patterns of changes in PFT parameters were also studied using a binary category setting and a cut-off value of 80% [21]. Impairment of pulmonary function in the obstructive pattern (FEV1) was found in 177 (69%) participants out of 255. In the restrictive pattern (FVC), this rate was in 76% (19) of participants. In the obstructive form, 20 (48%) and 111 (85%) of the enrolled COVID-19 survivors presented mild and severe disease, respectively. In the restrictive changes, these rates were observed in 60% (25) and 91% (119) participants, respectively. This evidence indicates that the rate of restrictive changes was slightly higher than that of obstructive changes. The findings of our study are in coherence with the previously reported occurrence of progressive fibrosis as a consequence of ARDS [23].

Using computed tomography, Zhou et al. revealed that diffuse pulmonary dysfunction was common, with a high incidence of pulmonary sequelae regardless of disease severity [3]. This is attributed to diffuse alveolar damage, severe endothelial injury, widespread thrombosis with microangiopathy, alveolar septal fibrous growth, and pulmonary consolidation, as well as lower lung elasticity in critically ill patients.

According to the American Thoracic Society and the European Respiratory Society, the FEV1/FVC ratio is the most sensitive PFT parameter. In almost all COVID-19 survivors (97%) this ratio was >80%; 99% of these had severe disease [21]. This suggests that none of the enrolled COVID-19 survivors were in respiratory distress during the PFT. Alternatively, this result could be due to the fact that residual changes were slightly more restrictive than obstructive.

To verify this, we further investigated the results of the 6MWT and SpO2, which were analyzed using a score ranging from 0 to 2. We found a score of 2 and SpO2 >96%, which suggested that study participants were not in respiratory distress at the time of the study [24].

In the analysis of the PFT results, it was observed that 193 of 255 participants were hospitalized with comorbidities. The most frequent comorbidities were diabetes in 100 participants (39.21%), hypertension in 93 participants (36.47%), and multimorbidity in 61 participants (23.98%). We found a significant association of disease severity with diabetes and hypertension, but not COPD. Notably, participants with multiple comorbidities were at higher risk of severe COVID-19 versus those with single comorbidity [22].

Older participants and those with higher BMI were associated with a poor prognosis; thus, they require early and intensive care [25]. Of note, the effects of COPD and BMI were not significantly associated with pulmonary function. Importantly, there was a link between the long-term sequelae of COVID-19 and multimorbidity, particularly diabetes and hypertension.

The inferences drawn in this study were based on data derived from the disease severity groups and various PFT parameters. The participants were further classified into several groups to address the effect of possible confounders and effect modifiers. However, considering the limitations of cross-sectional studies,it may be difficult to comment with certainty. One should be cautious while drawing the causal inference for which serial measurements and adjustment through multivariate models might serve thepurpose.

Based on the present findings, we may conclude that COVID-19 is associated with a mixed pattern of spirometry. As measured by spirometry, older adults with diabetes Mellitus and hypertension are associated with deterioration in respiratory functions.We recommend that these patients must take extra precautions against COVID-19. Periodic follow-up for appropriate timely treatment and rehabilitation is advised in such patients. We recommend various multi-centric trialsregarding the role of rehabilitation programs in form of yoga/exercise in COVID-19 patients with various comorbidities.

Original post:

Patterns and Trajectories of Pulmonary Function in Coronavirus Disease 2019 Survivors: An Exploratory Study Conducted in Central India - Cureus

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COVID-19: What you need to know about the pandemic this week - World Economic Forum

GENEVA (AP) About 25 million children worldwide have missed out on routine immunizations against common diseases like diptheria, largely because the coronavirus pandemic disrupted regular health services or triggered misinformation about vaccines, according to the U.N.

In a new report published Friday, the World Health Organization and UNICEF said their figures show 25 million children last year failed to get vaccinated against diptheria, tetanus and pertussis, a marker for childhood immunization coverage, continuing a downward trend that began in 2019.

This is a red alert for child health, said Catherine Russell, UNICEFs Executive Director.

We are witnessing the largest sustained drop in childhood immunization in a generation, she said, adding that the consequences would be measured in lives lost.

Data showed the vast majority of the children who failed to get immunized were living in developing countries, namely Ethiopia, India, Indonesia, Nigeria and the Philippines. While vaccine coverage fell in every world region, the worst effects were seen in East Asia and the Pacific.

Experts said this historic backsliding in vaccination coverage was especially disturbing since it was occurring as rates of severe malnutrition were rising. Malnourished children typically have weaker immune systems and infections like measles can often prove fatal to them.

The convergence of a hunger crisis with a growing immunization gap threatens to create the conditions for a child survival crisis, the U.N. said.

Scientists said low vaccine coverage rates had already resulted in preventable outbreaks of diseases like measles and polio. In March 2020, WHO and partners asked countries to suspend their polio eradication efforts amid the accelerating COVID-19 pandemic. There have since been dozens of polio epidemics in more than 30 countries.

This is particularly tragic as tremendous progress was made in the two decades before the COVID pandemic to improve childhood vaccination rates globally, said Helen Bedford, a professor of childrens health at University College London, who was not connected to the U.N. report. She said the news was shocking but not surprising, noting that immunization services are frequently an early casualty of major social or economic disasters.

Dr. David Elliman, a consultant pediatrician at Britains Great Ormond Street Hospital for Children, said it was critical to reverse the declining vaccination trend among children.

The effects of what happens in one part of the world can ripple out to affect the whole globe, he said in a statement, noting the rapid spread of COVID-19 and more recently, monkeypox. Whether we act on the basis of ethics or enlightened self interest, we must put (children) top of our list of priorities.

___

Follow all AP stories about developments related to the pandemic at https://apnews.com/hub/coronavirus-pandemic.

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25 million kids missed routine vaccinations because of COVID - The Mercury

A recent study published in theOpen Forum Infectious Diseasesjournal evaluated the impact of the lower severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccine dosages in younger populations.

In most age groups, the SARS-CoV-2 messenger ribonucleic acid RNA (mRNA) vaccinations were significantly successful in protecting against the CoV disease 2019 (COVID-19) pandemic. According to the most recent data, vaccine efficacy (VE) of SARS-CoV-2 mRNA vaccines appears to be lower in children aged five to 11 than in adults. Besides, understanding the reason for this phenomenon is essential for creating appropriate vaccination approaches for this population moving forward.

The present work analyzed the VE of COVID-19 mRNA vaccines and the associated mechanisms in adolescents, children, and young adults, given the vaccine doses were lower in these groups compared to adults.

VE of the SARS-CoV-2 BNT162b2 vaccine in five- to 11-year-olds against COVID-19 was 91% during the two-month monitoring period in a clinical experiment before the emergence of the Omicron variant in the United States (US). Following the vaccine's approval on October 29, 2021, children were fully vaccinated by December 13, 2021, just in time with the introduction of Omicron.

However, according to preliminary information from the New York State Department of Health, VE in children aged 5 to 11 decreased from 68 to 12%, and hospitalization rates from 100 to 48%during December 13, 2021, compared to January 24, 2022. On the other hand,VE in those aged12 to 17dropped from 66 to 51%for infections and from 85 to 73%for hospitalization.

During the study period, Omicron infections in New York increased from 19% on December 13, 2021, to above99% onJanuary 24, 2022. The median period following vaccination was 51 days for children aged 5 to 11 and 211 days for thoseaged 12 to 17.

When removing the confounding effect of time after vaccination from an examination of recently vaccinated children from New York, the incidence rate ratio for infection was 1.1 for those aged five to 11 and 2.3 for 12 to 17 years at 28 to 34 days after immunization. When the analysis was limited to the Omicron period, information from the Centers for Disease Control and Prevention (CDC) demonstrated slight variation by age, with aVE of 51% in children aged 5 to 11, compared to 45% and 34%t in children aged 12 to 15 and 16 to 17, respectively.

However, during the pooled Delta- and Omicron-predominant timeframes, two-dose VE towards COVID-19-linked hospitalization for five11, 1215, and 1617 years continued at 73 to 94%. The available results indicate that BNT162b2 was less effective in younger children, yetfurther research is required to corroborate these findings.

One theory holds that the lower dosage of 10 g of BNT162b2 delivered three weeksapart was the cause of the poorefficacy in children aged 5 to 11; however, evidence on neutralizing antibodies suggeststhat this was not the case. The evidence presented at the Vaccines and Related Biological Products Advisory Committee meeting on October 26, 2021; Advisory Committee on Immunization Practices (ACIP) meeting on November 2, 2021; and Food and Drug Administration (FDA) and CDC Advisory Committee meetings posit that adolescents, children, and young adults mightattainanoptimum humoral reactionwith the existing BNT162b2 vaccine doses.

Two 30-g BNT162b2 doses administered in a 21-day interval resulted in geometric mean 50% neutralization titers of SARS-CoV-2 of 1146.5 and 1239.5 in individuals aged 16 to 25 and 12 to 15 years, respectively, one month after the second shot. Almost identical titers, 1197.6, were attained in children aged 5 to 11 years after two 10-g doses administered three weeks apart.

Children aged 9-11, 7-8, and 5-6 years acquired almost identical titers of 1191.5, 1236.1, and 1164.1 when further analyzed by age subgroup. These titers show that children and young adults have significant humoral immune reactions because they were more than threetimes higher than the peak titers attained by adults seven days followingthe second dose. As a result, it wasconceivable that doses below 10 gcould still produce significant levels of neutralizing antibodies in five to 11-year-old children.

Other causes for the decreased VE must be considered because, with the current dose, adolescents, children, and young adults produce noticeably high titers than adults. The Omicron variant reduces the efficacy of the COVID-19 vaccinations in all populations, which most likely explains a large portion of the decreased efficacy among children aged 5 to 11 years. Other possible explanations include the younger cohort's shorter time between vaccination and infection, variations in circulating viral strains among age cohorts, past SARS-CoV-2 exposure, and unidentified lower effectiveness of mRNA vaccines among younger populations.

After vaccination, T- and B-cell responses continue to develop for several months, as does immunity against severeillness. Therefore, the 51-day post-vaccination period for children aged 5 to 11 compared to 211 days for children aged 12 to 17 in New York mighthave attributed to the lower efficacy against hospitalization seen in the younger sample.

Furthermore, given the dramatic rise in Omicron occurrence over the study period, there might have been variations in the variants circulating in high, elementary, and middle schools. Besides, there was a significant SARS-CoV-2 seroprevalence in the US. Beforethe Delta variant increase, the age group of five to 11 had the highest seroprevalence in June 2021 at 42%. Previous SARS-CoV-2 exposure was linked to a decreased risk of catastrophic outcomes, but it was unclear how this may have changed the population's immune reactions.

The team noted that mRNA vaccination was a novel vaccination approach that induces both T- and B-cell responses and shows promise for producing superior vaccines against numerous pathogens, some of which are now under development. Yet, an initial trial of the two-dose BNT162b2 series found the approach was ineffective in children aged two to five. Thus, the experiment was changed to assess a three-dose series.

Factors like prior seasonal CoV exposure might have a part in the notably altered immunological response seen in older people that were not present in younger children not exposed to CoVs as much or at all. Maximizing CoV vaccination in children depends on understanding the mechanism causing BNT162b2's decreased efficacy in children.

Altering the dose intervals was one action tried to enhance immunogenicity in individuals between the ages of 12 and 39. New research has shown that spreading out the initial and second doses of mRNA vaccines increases immunogenicity while reducing adverse reactions.

On February 4, 2022, the ACIP reviewed the new information regarding extended dose intervals and published a recommendation that an eight-week gap could be ideal for some individuals aged 12 and older, particularly for males between the ages of 12 to 39. The ongoing clinical trial for BNT162b2 has been expanded to include formal evaluationof the lower 10-g dose, administered in two doses eight weeks apart for patients aged 12 to 18 and older. The team highlighted the need forstudies examining longer dosing gaps in childrenunder 12 years to see if this tactic can increase the immunogenicity and effectiveness of mRNA vaccines in younger populations.

With the present dose of the mRNA vaccines, adolescents, children, and young adults also face higher side effects in addition to reduced efficacy. The cause of COVID-19 vaccine-associated myocarditis was unknown. However, the prevalence of this uncommon event was lower after vaccination with BNT162b2 (30 g per dose) than mRNA-1273 (100 g per dose), reinforcing the idea that the myocarditis may be dose-related.

COVID-19 vaccine-related myocarditis was also more frequent after the second shot, especially with dosing intervals of four weeks. However, increasing the time between the first and second doses to eight weeks reduced the frequency of myocarditis.

The FDA Brief for October 26, 2021, meeting noted that COVID-19 vaccine-linked myocarditis was probably related to dose number and dosage. Nevertheless, the decreased myocarditis incidence after the third or booster shot relative to the reduced incidence with extended dosing intervals, implies that interval spacing, instead of dose number, might be the strategy to minimize myocarditis.

According to the study findings, the SARS-CoV-2 mRNA vaccinations demonstrated reduced efficacy in children aged 5 to 11. Neutralizing antibody titers induced by the COVID-19 vaccines in adolescents, children, and young adults illustrated that lower dosage was not responsible for the lower VE in these cohorts.

Optimizing COVID-19 vaccination approaches for younger populations in the future requires figuring out whether mRNA vaccination techniques were less effective in younger cohorts and identifying if adolescents, children, and young adults need adjusting the dosage, dosing gaps, and the number of doses.

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What is the impact of lower COVID-19 vaccine doses in younger cohorts? - News-Medical.Net

In a recent study published in Arthritis & Rheumatology, researchers examined immune reactions to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) among B cell-depleted autoimmune patients who concomitantly administered glucocorticoids.

B cell depletion is a well-established therapeutic approach in musculoskeletal and rheumatologic disorders, B cell hematologic malignancies, and various autoimmune diseases. Nevertheless, B cells are essential for triggering a protective response after an infection or vaccination. Since the 1970s, it has been established that glucocorticoids decrease T and B cell activation, preventing the development of adaptive immune reactions against infections.

According to a study by Dr. Niu and colleagues, long-term glucocorticoid use reduces the effectiveness of the CoV disease 2019 (COVID-19) vaccine and makes people more susceptible to SARS-CoV-2 infection. In addition, earlier analyses showed that patients with immune-mediated inflammatory disease who use glucocorticoids have a higher risk of COVID-19 and infection-related mortality and morbidity. Additionally, evidence suggests that COVID-19 outcomes are poorer during broad-spectrum immune suppressive therapies such as B-cell depleting medications and glucocorticoids.

In the present work, the investigators sought to determine if concurrent glucocorticoid therapy could impact COVID-19 vaccination responses that were reduced in rituximab-treated individuals with autoimmune illness.

The team observed no significant exposure to glucocorticoid medication in the present group when examining whether baseline glucocorticoid treatment could have augmented decreased immune responses to SARS-CoV-2 vaccines or infections. Consequently, only three patients received concurrent glucocorticoid therapy: one COVID-19 vaccinee and two virus-infected patients. In addition, glucocorticoid doses were modest, averaging 4.63.8 mg of prednisolone per day. Thus, it is unlikely that prior glucocorticoid usage was accountable for the defective immune reactions to SARS-CoV-2 infection and vaccination.

The use of glucocorticoids in conjunction with the infusion of rituximab was another possible source of glucocorticoids among the volunteers. This ascribes to a single injection of 25 mg prednisolone combined with the rituximab infusion.

Previous research on patients with shock and asthma episodes, where short-term systemic bolus glucocorticoids were utilized often, has not shown any evidence that such treatment affects how well patients respond to their tetanus and influenza vaccinations. Existing studies also depicted that short-term glucocorticoid therapy did not impact the immune reaction to the SARS-CoV-2 vaccine. Hence, there was no reason to believe that a single glucocorticoid dose substantially contributes to the reported decreased humoral immune reactions to SARS-CoV-2 among patients treated with rituximab.

The finding that T cell responses in rituximab-treated individuals with autoimmune disorders were preserved while B cell responses were significantly repressed indicates a specific impact of B cell depleting drugs instead of a general effect of glucocorticoids that would also affect T cell stimulation. These results and the observations made by Dr. Niu and colleagues, nevertheless, also imply that long-term, higher doses of glucocorticoids might pose a risk to B cell-depleted patients because, in the absence of B cells, immune reactions to infections and vaccinations largely rely on intact T cell reactions.

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The impact of glucocorticoid therapy on immune responses to COVID-19 vaccination or infection in rituximab-treated patients with autoimmune disorders...

The median of the national-level daily search index for Covid-19 related terms was 4, 533 (IQR (Interquartile Range)=1, 301) before theCOVID-19 outbreak (January 1 2017 to December 30 2019), and 314, 718 (IQR=445, 074) after the outbreak (December 31 2019 to March 15 2021). The median of the provincial-level search index, ranged from 63 (IQR=7) in Tibet to 1138 (IQR=302) in Guangdong before COVOD-19, and ranged from 1386 (IQR=983) in Tibet to 38, 061(IQR=45, 784) in Guangdong after the COVID-19 outbreak. The crude relative change in the median of the search index ranged from 2 099% in Tibet and 2 034% in Hainan to 3 872% in Beijing and 4 284% in Liaoning (Table 1). 89, 936 cases of SARS-COV-2 occurred nationwide (ranging from 1 case in Tibet to 68, 021 cases in Hubei) from December 31, 2020 to March 15, 2021. The number of confirmed cases outside Tibet and Hubei ranged from 18 (0.1%) in Qinghai to 2, 245 (10.6%) in Guangdong province. In conjunction with these search patterns, 13%, 76% and 11% of confirmed Covid-19 cases were reported in January 2020, February 2020 and from March 2020 to March 2021 respectively.

As shown in Table 2, there was a 10% (relative risk (RR)=1.10, 95% CI 1.071.13, p<0.0001), 11% (RR=1.11, 95% CI 1.081.14, p<0.0001) and 13% (RR=1.13, 95% CI 1.101.16, p<0.0001) annual increase in the search index before the pandemic among regions with low, middle and high HDI respectively. The difference in pre-Covid-19 trends of the search index among the three HDI groups was not statistically significant (middle vs. low, ratio of RR=1.01, p=0.6188; high vs. low, ratio of RR=1.03, p=0.2239) (Table 2, Fig.1).

Baidu search index by province and number of new confirmed cases over time. (A) Observed daily search index (log transformed) by province and HDI category over time. Aggregated search index by HDI category over time is shown in Fig. S1. (B) Daily new confirmed COVID-19 in China (cases in Hubei provinces are excluded).

During the initial wave, the search index increased by 41%, 62% and 58% on December 31, 2019 among regions with low (RR=1.41, 95% CI 1.341.49, p<0.0001), middle (RR=1.62, 95% CI 1.541.70, p<0.0001) and high (RR=1.58, 95% CI 1.481.68, p<0.0001) HDI, respectively. The immediate increase in middle and high HDI regions was statistically significantly higher than the increase in low HDI regions (middle vs. low, ratio of RR=1.15, p=0.0002; high vs. low, ratio of RR=1.12, p=0.0091).

Similarly, there was a 107-fold, 125-fold and 125-fold increase in search index between January 18 and January 25 2020, the period shortly after the official announcement of human-to-human transmission (HHT), among regions with low (RR=106.8, 95% CI 100.1114.0, p<0.0001), middle (RR=124.6, 95% CI 117.6131.9, p<0.0001) and high (RR=125.3, 95% CI 116.5134.8, p<0.0001) HDI, respectively. The immediate increase in this short period among middle and high HDI regions were statistically significantly higher than the increase in low HDI regions (middle vs. low, ratio of RR=1.16, p=0.0004; high vs. low, ratio of RR=1.17, p=0.0012). From the peak of the search index on January 25 to June 10 2020, a 10%, 11% and 11% decrease per week was observed in the search index among regions with low (RR=0.90, 95% CI 0.890.90, p<0.0001), middle (RR=0.89, 95% CI 0.880.89, p<0.0001) and high (RR=0.89, 95% CI 0.890.90, p<0.0001) HDI, respectively (Table 2).

The outbreak in Beijing was associated with a 91%, 34% and 112% increase in the search index among regions with low (RR=1.91, 95% CI 1.792.03, p<0.0001), middle (RR=1.34, 95% CI 1.261.42, p<0.0001) and high (RR=2.12, 95% CI 1.982.27, p<0.0001) HDI, respectively, in the first week (June 1117 2020) of the outbreak. Additionally, the Beijing outbreak was associated with an increase in the monthly change rate of the search index. From June 17 to October 11 2020, a 4% decrease, 2% increase and 6% decrease per month in the search index was observed among regions with low (RR=0.96, 95% CI 0.950.96, p<0.0001), middle (RR=1.02, 95% CI 1.011.02, p<0.0001) and high (RR=0.94, 95% CI 0.930.94, p<0.0001) HDI, respectively (Table 2).

The Qingdao outbreak was associated with a comparable 31%, 34% and 41% immediate increase in the search index among regions with low (RR=1.31, 95% CI 1.231.40, p<0.0001), middle (RR=1.34, 95% CI 1.261.42, p<0.0001) and high (RR=1.41, 95% CI 1.311.52, p<0.0001) HDI, respectively. In the winter wave after the Qingdao outbreak, search index increased by 1%, 2% and 2% per week among regions with low (RR=1.01, 95% CI 1.001.01, p=0.0647), middle (RR=1.02, 95% CI 1.011.02, p<0.0001) and high (RR=1.02, 95% CI 1.011.03, p=0.0002) HDI, respectively.

The Shijiazhuang outbreak in January 2021 was associated with a 100%, 167% and 145% immediate increase in search index among regions with low (RR=2.00, 95% CI 1.852.16, p<0.0001), middle (RR=2.67, 95% CI 2.502.86, p<0.0001) and high (RR=2.45, 95% CI 2.242.67, p<0.0001) HDI. In regions with low HDI (middle vs. low, ratio of RR=1.34, p<0.0001; high vs. low, the ratio of RR=1.22, p=0.0007). However, the 20% and 22% weekly decrease in search index after the Shijiazhuang outbreak among regions with middle (RR=0.80, 95% CI 0.790.80, p<0.0001) and high (RR=0.78, 95% CI 0.770.79, p<0.0001) HDI, respectively, was statistically significantly greater (p<0.0001) than the 17% monthly decrease in the region with low HDI (RR=0.83, 95% CI 0.820.84, p<0.0001). Figure2 illustrated the heterogeneity in the immediate relative change in the search index following each pre-specified exposure across the country.

Immediate relative change in search index at different exposure period (A) December 31 2019, the estimated start of the first Covid-19 wave. (B) 18 January 18 2020 (official announcement of human-to-human transmission) to Jan 25 January 2020 (shortly after the lockdown and the estimated peak of daily search index in the initial Covid-19 wave). (C) Outbreak in Beijing starting on June 11 2020. (D) Outbreak in Shijiazhuang starting on January 3 2021. Specific point estimate for relative change and the corresponding 95% CIs are provided in the supplemental materials.

The results from models where HDI or its component was coded as a continuous variable were consistent with findings from our main analysis. As shown in Table S1, the pre-pandemic trends in two provinces differing in HDI, GNPPP (Gross national product per person), education year or life expectancy by one standard deviation were similar (p>0.1). The immediate relative increase in the search index in a province with one standard higher HDI was statistically higher (initial wave: ratio of RR=1.09, p<0.0001; HHT announcement: ratio of RR=1.04 p=0.0395; Beijing outbreak: ratio of RR=1.06, p=0.0090; Qingdao outbreak: ratio of RR=1.04, p=0.0324; Shijiazhuang outbreak: ratio of RR=1.11, p<0.0001). In contrast, the gradual decrease in the search index in a province with one standarddeviation higher HDI after each exposure was either similar or greater. For each exposure, the difference associated with GNPPP, education year or life expectancy in the directions and magnitudes of both immediate and gradual effect across provinces was similar to the difference associated with HDI.

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Geographic social inequalities in information-seeking response to the COVID-19 pandemic in China: longitudinal analysis of Baidu Index | Scientific...

Since the coronavirus pandemic began, public schools have been promised a windfall of federal funding.

In Oklahoma schools have been budgeted $2.1 billion total. And that money has been scheduled to go to a wide array of programs like summer school, mental health resources and construction projects.

But more than half of the money offered by the federal government remains.

The reasons are numerous per the Oklahoma State Department of Education: supply chain issues and construction delays have delayed spending, which is given to districts through reimbursements.

Oklahoma public school district leaders are being prudent and thinking long-term strategically with how relief funds are being utilized to best serve the educational and environmental needs of Oklahoma students and educators, Oklahoma State Department of Education spokesman Rob Crissinger wrote in an email.

Uneven spending of funds is reflected across the country, per a national analysis put together by Georgetown University. A district-by-district breakdown of spending is available via Georgetowns Edunomics Lab.

Overall, it is clear that districts are making very different choices with their money, and the pace of spending appears to be slow, wrote in a national analysis earlier this year.

The deadline for spending federal money isnt for two years. School districts must spend down their CARES money by September 2024.

StateImpact Oklahoma is a partnership of Oklahomas public radio stations which relies on contributions from readers and listeners to fulfill its mission of public service to Oklahoma and beyond. Donateonline.

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Oklahoma school districts were promised billions for coronavirus relief. Here's how much they've spent - KGOU