Category: Covid-19 Vaccine

Multiple COVID-19 trends have improved in Minnesota over the past week, suggesting a peak in the latest pandemic wave ahead of what health officials hope is another mild summer for the state.

The number of federally designated counties in Minnesota at high COVID-19 risk dropped from 19 to seven, and statewide sampling this week found less evidence in wastewater of the coronavirus that causes the infectious disease. The seven-day average of new infections in Minnesota also declined from 2,138 per day on May 11 to 1,805 on May 20 although that is only based on publicly reported testing and not any at-home test results.

COVID-19 hospitalizations in Minnesota increased slightly to 416 on Thursday and included 35 people receiving intensive care. The state also reported nine more COVID-19 deaths on Friday all among seniors raising its total pandemic toll to 12,628. Both have been lagging trends during the pandemic, though, and health officials hope they will soon follow the other downturns.

Hospitalizations have been less severe in the latest wave with only 8% of the COVID-19 patients on Thursday requiring intensive care, compared with 30% at earlier points in the pandemic. More patients are being admitted for other purposes and test positive only upon routine screening.

High levels of immunity as a result of vaccinations or coronavirus infections this winter are reducing the severity of illness this spring, said Dr. Matthew Prekker, a critical care medicine specialist with Hennepin Healthcare in Minneapolis.

"The baseline risk in the population for getting so, so sick that was there before we had widely accepted vaccines is much lower now," he said. "We're also dealing with less virulent but very transmissible COVID strains ... Fortunately, we're not seeing critical illness nearly as much as we were last year."

Wastewater data was mixed last week, with the University of Minnesota showing steady or even declining viral levels in sewage samples from across the state, but the Metropolitan Wastewater Treatment Plant in St. Paul showing an increase. However, the St. Paul plant on Friday reported a 38% decline in viral load in this week's samples, matching the latest statewide wastewater trends.

Viral levels remained level or slightly higher, though, in wastewater analyzed from six plants in northeastern Minnesota. That matches with the latest regional risk data from the Centers for Disease Control and Prevention, which identified high COVID-19 levels in Koochiching, St. Louis, Pine and Carlton counties.

Freeborn, Olmsted and Winona counties in the south also maintained high-risk CDC designations, meaning that mask-wearing is recommended in indoor public places. The CDC designations, based on infection and hospital numbers, are designed to warn communities when their hospitals could be at risk of bed shortages. Most of the Twin Cities metro area remains at moderate risk, though Anoka and Carver counties are at low risk.

Minnesota's trends match with the northeastern United States, especially in New York where risk levels and case numbers are declining. The latest pandemic wave appears to be trending to the south with the CDC this week identifying an increase in high-risk counties in states such as Virginia.

COVID-19 levels have declined in Minnesota over the past two summers even as they increased in Southern states, where hot temperatures drive more people indoors and increase their risks of viral transmission.

Health officials warned of wild cards that could disrupt expectations of a mild summer, including even faster-spreading BA.4 and BA.5 variants that were discovered in South Africa and caused rapid increases in infections there. Those two variants made up 11% of the viral load found in wastewater this week in the St. Paul treatment plant, up from 7% last week.

Immunity also wanes with time, and Minnesota is reporting a decline in residents who are up to date with COVID-19 vaccinations meaning they have completed the initial series and first booster doses when they are recommended.

Only 47% of eligible Minnesotans 5 and older are up to date as of Friday, a decline from 49% last week. Last week's expansion of booster recommendations to include children 5 to 11 caused that rate to go down, because COVID-19 vaccination levels decline with age.

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COVID-19 wave appears to be in retreat as trends improve in Minnesota - Star Tribune

In a recent study posted to the medRxiv* preprint server, researchers investigated the associations between antibody levels against severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) and the risk of subsequent infection.

Immune responses after SARS-CoV-2 infection or vaccination vary over time and between individuals. Antibodies against SARS-CoV-2 nucleocapsid (N) protein are elicited in response to infection but not vaccination. Hence, the presence of anti-N antibodies is a valuable surrogate to differentiate infection-elicited antibodies from vaccine-induced antibodies.

Earlier studies observed a correlation between higher levels of antibodies against spike (S) protein or its receptor-binding domain (RBD) after two vaccine doses and enhanced protection against subsequent infection. Besides the temporal effects, the neutralizing capacity of the antibodies differs based on virulence and divergence of S proteins in emergent variants from the ancestral S protein.

Researchers evaluated the origins and consequences of variation in anti-SARS-CoV-2 antibody levels after vaccination in the current study. They quantified antibody levels of participants from two longitudinal cohorts in the United Kingdom (UK): TwinsUK and Avon longitudinal study of parents and children (ALSPAC).

Antibodies levels were determined at two time points for 9361 individuals from ALSPAC and TwinsUK cohorts during April-May 2021 (referred to as Q2, as in the calendar year quarter) and 3575 subjects from the TwinsUK cohort between November 2021 and January 2022 (Q4). Those who received more vaccine doses were older and likely enlisted in the UK Shielded Patient List than participants who received fewer doses.

The prevalence of suspected or confirmed coronavirus disease 2019 (COVID-19) cases at Q2 testing was 26% among the TwinsUK and 20% in the ALSPAC cohort. However, anti-N antibody positivity was lower at 10% in ALSPAC and 12% in TwinsUK. In Q4, SARS-CoV-2 infection prevalence was higher, with 33% suspected or confirmed cases and 17% based on anti-N antibody levels.

Within the TwinsUK cohort in Q4, the authors observed more significant and sustained antibody levels post-third dose with less variation between individuals when compared to the antibody levels of individuals with fewer vaccinations. For instance, the median level of anti-S antibodies was 13,700 binding antibody units (BAU)/ml after the third vaccination, which was 10-fold higher than the levels post-second dose (1300 BAU/ml).

Individuals with the lowest antibody levels had substantial increases in absolute levels following the third dose. TwinsUK subjects sampled two/three weeks after the third vaccination had the highest median antibody levels for up to 16 weeks. The median levels declined between two and eight weeks, and there was no further decline after that. Longer time since vaccination was associated with lower levels of antibodies for individuals sampled between 13 and 33 weeks post-second dose.

At Q2, antibody levels peaked nine weeks post-first dose among TwinsUK and ALSPAC subjects. After the second dose, antibody levels surpassed the assay limit from the second week onwards. In the TwinsUK cohort, vaccine breakthrough infections were recorded in 276 (9.2%) individuals between the first vaccination and Q4. Those who were single-vaccinated at Q2 with a subsequent breakthrough infection had lower Q2 median antibody levels (40 BAU/ml) than those who did not experience breakthrough infection (57 BAU/ml).

They noted that individuals with the lowest antibody levels at Q2 were at higher odds of experiencing a breakthrough infection in univariable (odds ratio, OR: 3.2) and multivariable (OR: 2.9) logistic regression models. Increased odds of having the lowest antibody levels after the first vaccination was observed in those on the UK Shielded Patient List in TwinsUK (OR: 4) and ALSPAC cohorts (OR: 4.1).

Individuals vaccinated with AstraZenecas AZD1222 vaccine had greater odds of having lower antibody levels after the first and second vaccination relative to Pfizers BNT162b2 vaccinees. Nevertheless, a double AZD1222 dose was not associated with lower levels of antibodies after the third vaccination. In the TwinsUK cohort, monozygotic (MZ) twins exhibited minor average intra-pair differences in anti-S antibody levels post-third dose relative to dizygotic twins. The intra-pair differences were large for non-related subjects.

The researchers found high variability in antibody responses after the first vaccination with decreasing variability after administration of second and third vaccine doses. Individuals who had low levels of antibodies post-first dose were at an elevated risk of subsequent breakthrough infection even after further rounds of vaccination.

Furthermore, increased odds of having lower levels of antibodies post-vaccination were observed for 1) individuals on the Shielded Patient List, 2) first and second-dose recipients of the AZD1222 vaccine, 3) those who reported poorer health, and 4) those who were prescribed immunosuppressants. However, there were no differences after the third vaccination between individuals who received BNT162b2 or AZD1222 for their first and second vaccination, underpinning the booster effect of the third dose.

These findings suggested that measuring anti-S antibodies induced after the first vaccine dose might serve as an early indicator for identifying those at increased risk of COVID-19 infection in the future.

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.

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Study investigates associations between antibody response to COVID-19 vaccination and the risk of subsequent infection - News-Medical.Net

Editorial for Cardiac Magnetic Resonance Imaging Findings in COVID19 VaccineRelated Myocarditis: A Pooled Analysis of 468 Patients  John Wiley

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Editorial for Cardiac Magnetic Resonance Imaging Findings in COVID19 VaccineRelated Myocarditis: A Pooled Analysis of 468 Patients - John Wiley

Sweden Recommends 5th Dose of COVID-19 Vaccine to Pregnant Women and Over-65s  The Epoch Times

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Sweden Recommends 5th Dose of COVID-19 Vaccine to Pregnant Women and Over-65s - The Epoch Times

If you follow the COVID-19 news cycle, you know that there is approval for the COVID-19 vaccine booster for children ages 5-11. What happens when a parent who was granted authority for the initial vaccine for a child in that age range and now wants to get the child their booster? Does the initial decision automatically mean the child obtains the booster? Maybe not

In a recent Pennsylvania case, mom was granted authority to choose whether to have the child obtain the initial two doses of the COVID-19 vaccine, for a child in the age range of 5-11, over dads objection. Dad filed an appeal, seeking to have the order stayed (not in effect pending the appellate decision) and part of his argument was moms ability under the order to obtain another shot for the child (presumably, an ambiguous ability that wasnt explicitly stated in the order but its written word could be interpreted that way). Dads application was denied because mom already had the child vaccinated; thus, his request was moot per the panel of judges who heard the matter. However, the panel specifically indicated that the request was moot because the two doses were complete AND the child was ineligible for a booster.

Coincidentally, the day before the decision was released, the Pfizer booster was approved for the age range. This begs the question, can mom now use the initial order to get the child a booster, and not just in this case, but in all cases to date where a parent was given sole authority to make a decision about the COVID-19 vaccine for a child. In the Pennsylvania matter, the transcript should specify the courts intent for only the two initial shots, and not the booster given that the court specifically pointed to the childs ineligibility at the time, even if the Order does not explicitly carve out the exception.

However, in other matters where it may not be so clear, did the court overshoot its intention with a broad order, such as if a court did not carve out specifics with respect to the amount of shots, or limiting the decision to the initial vaccine, or even if it simply granted sole legal custody to make a vaccination decision? On the flip side, perhaps a court in such a case anticipated that a booster would be available and wished to avoid an annual argument over the vaccine if vaccinated individuals get a yearly shot, like we do for the flu. These are the types of questions raised by the attorneys who worked on the Pennsylvania matter and are interesting to think about.

As practitioners, we should all go back and look at the wording of the COVID-19 vaccine orders received to date, and be sure to seek specific language for such orders in the future, regardless of the side you are arguing.

Another interesting aspect is how quick the vaccinating parent acts after the orders entry. A party filing an emergent appeal could be stopped in their tracks if the vaccine (even shot 1) is already complete. But if the vaccine has not been given yet, and the appellate court agrees that the trial court made a mistake + that its emergent, then the parent who disagrees with the vaccine may have another shot (pun intended).

At the end of the day, in my jaded opinion, I have to assume that the court will likely allow the booster for the same reasons it allowed the initial vaccine, absent proof that its unhealthy for children (which the FDA/CDC doesnt seem to support). The initial order sets precedent. But finding the creative argument as to why the court should stray from that order is where good representation comes in.

Like many issues over the COVID-19 pandemics impact on family law matters, only time will tell.

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COVID-19 Vaccine Parental Disputes Is There Really A Difference Between Arguing Against The Initial Shot and The Booster - JD Supra

COVID-19 vaccine effectiveness against the omicron (BA.2) variant in England  The Lancet

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COVID-19 vaccine effectiveness against the omicron (BA.2) variant in England - The Lancet

Has the US Damaged Africa's COVID-19 Vaccination Drive? by Ebere Okereke  Project Syndicate

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Has the US Damaged Africa's COVID-19 Vaccination Drive? by Ebere Okereke - Project Syndicate

A new study by a University of Arkansas information systems researcherand his colleague at the University of Waikato in New Zealand shows that COVID vaccine trials conducted in geographic locations with low infection rates had higher efficacy results, compared to trials in locations with high infection rates.

Puzzled by efficacy rates of approved COVID-19 vaccines ranging from 95% to 45%, Abhijith Anand, assistant professor in the Sam M. Walton College of Business, and Rajeev Sharma, professor at the University of Waikato in New Zealand, wondered if the prevalence of COVID-19 infection rates at the locations where pharmaceutical companies conducted trials might have had something to do with the differences in observed efficacies.

The researchers based their hunch on the fact that higher infection rates generally imply more mutant strains, which are likely to lead to more breakthrough infections and, consequently, reduce the efficacy of the vaccines observed in the trial.

A lot of important decisions were being made by legislators, politicians and even the general public based on the reported vaccine efficacy numbers, said Anand. The reported vaccine efficacy numbers varied a lot across different vaccines. We were interested in why there was a disparity.

Using data from the World Health Organization, McGill University, London School of Hygiene & Tropical Medicine Vaccine Centre, scientific publications, clinicaltrails.gov and others, Anand and Sharma tracked the pharmaceutical companies that had reported efficacy results from Phase 3 trials of their COVID-19 vaccines. The researchers then pulled all publicly available data on the pharmaceutical companies, focusing on location, conduct and efficacy results of Phase 3 trials.

The database that Sharma and Anand compiled represents the entire current publicly available global evidence on the efficacy of approved SARS-CoV-2 vaccines.

Relying on the data, the researchers examined whether there was a connection between the prevalence of COVID-19 infection rates at trial sites and the efficacy of COVID-19 vaccines. Geographic location was found to have a significant association with the observed efficacy of COVID-19 vaccines. Vaccine trials conducted in locations with a low infection rates reported higher efficacy, while trials conducted in locations with high infection rates reported lower efficacy.

The findings have important implications for shaping public policy, patient care and individual choices. Public health organizations advise individuals, organizations, medical professionals, and governmental agencies about the efficacy of vaccines based on the results of clinical trials conducted by pharmaceutical companies. That advice is often the launching point for legislation and/or policies for the public, corporations, schools, medical clinics and governmental oversight.

Most of the advice comes from well-established and respected governmental agencies such as the Centers for Disease Control, Food and Drug Administration and the World Health Organization, which also work in conjunction with pharmaceutical companies that develop and test vaccines.

The researchers argued that vaccine efficacy can be validly interpreted only in conjunction with the level of pandemic prevalence, and that Phase 3 trials should include analysis of participant samples of mutant strains, which could lead to breakthrough infection and a high level of the virus.

When efficacy results of Phase 3 trials are reported, they should include the level of pandemic prevalence at the trial locations, Anand said. That would provide more meaningful information for policy makers, as compared to the current practice of reporting efficacy results only.

The researchers study was published inPLOS ONE, a Public Library of Science publication.

Reference: Sharma R, Anand A. The effect of pandemic prevalence on the reported efficacy of SARS-CoV-2 vaccines. PLOS ONE. 2022;17(4):e0266271. doi: 10.1371/journal.pone.0266271.

This article has been republished from the following materials. Note: material may have been edited for length and content. For further information, please contact the cited source.

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COVID-19 Vaccine Trial Locations Associated With Vaccine Efficacy Results - Technology Networks

Economic Considerations in COVID19 Vaccine Hesitancy and Refusal: A Survey of the Literature*  John Wiley

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Economic Considerations in COVID19 Vaccine Hesitancy and Refusal: A Survey of the Literature* - John Wiley

The vaccine is also credited with saving more than $30 billion in health care costs and more than $40 billion in lost productivity.

Researchers have found that the COVID-19 vaccine from Pfizer and BioNTech has had significant health and economic impacts in the United States, according to data published in the Journal of Medical Economics.

In 2021, experts estimated that the vaccine prevented 8.7 million symptomatic cases of COVID-19, as well as 690,000 hospitalizations and more than 110,000 deaths. The vaccine is the most widely used COVID-19 vaccine in the United States and is also credited with saving more than $30 billion in health care costs and more than $40 billion in lost productivity.

The analyses show that the Pfizer-BioNTech COVID-19 vaccine contributed substantial public health impact in the US in 2021 and had a deep effect on the trajectory of the pandemic, said researcher Manuela Di Fusco, MSc, in a press release.

The Pfizer-BioNTech vaccine was the first COVID-19 vaccine available in the United States and was given to almost 6 in 10 Americans who were fully vaccinated in 2021, according to estimates from the CDC. In the new study, researchers used a model in addition to real-world and trial data to estimate how many symptomatic COVID-19 cases, hospitalizations, and deaths would have occurred in 2021 if the vaccine had not been available. They also estimated how much these infections would have cost the health care system and the wider economy.

Data used in the model includes information on the number of individuals vaccinated, the efficacy of the vaccine in different age groups, and the probability of catching COVID-19, developing symptoms, and being hospitalized. The impacts of long COVID-19 were also taken into account, in addition to the number of working days likely to have been lost due to short-term illness and the economic cost of premature deaths.

Not only did the researchers find health benefits from the vaccine for millions of Americans, but they also found an estimated $30.4 billion in savings in health care costs and $43.7 billion of savings in productivity losses.

[The vaccine] was estimated to prevent millions of COVID-19 symptomatic cases, thousands of hospitalizations and deaths, and generated billions in societal economic value in the US in 2021, Di Fusco said in the press release.

She added that the results, highlight the opportunity to continue widespread vaccination uptake to prevent COVID-19 related disease and generate societal benefits.

The investigators noted several limitations of the study, which could have potentially led to their findings being an underestimate. These include not factoring in the potential of the vaccine to reduce transmission, the severity of cases, and the overall impact of long COVID-19.

They also acknowledged that the findings cannot be generalized to other COVID-19 vaccine brands, indications, and populations not specifically analyzed. The model also excluded the Omicron variant, which emerged at the end of the study period.

REFERENCE

Nearly 700,000 US hospitalizations and 110,000 deaths prevented from the Pfizer-BioNTech COVID-19 vaccine, national study finds. News release. EurekAlert; May 16, 2022. Accessed May 18, 2022. https://www.eurekalert.org/news-releases/952615

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Study Finds Nearly 70,000 US Hospitalizations, 110,000 Deaths Prevented With Pfizer-BioNTech COVID-19 Vaccine - Pharmacy Times