Moderna's COVID-19 Vaccine May Be More Effective for Cancer Patients Cancer Therapy Advisor
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Moderna's COVID-19 Vaccine May Be More Effective for Cancer Patients - Cancer Therapy Advisor
UTAH (ABC4) Salt Lake Community recently lifted its COVID-19 vaccine requirement on Thursday, but some colleges in Utah are still requiring it.
University of Utah
Students who attend the University of Utah are required to be fully vaccinated against measles, mumps, rubella, and COVID-19.
Students who do not comply by either showing that they have received the vaccines or indicated a reasonable exemption will have a hold placed on their record that will prevent registration for future classes.
Utah State University
USU announced that all students would be required to be vaccinated for COVID-19 for Spring Semester 2022.
USU did however announce that for the Fall Semester 2022 students will not be required to have the vaccine.
Weber State University
Weber State University announced that it will require COVID-19 vaccinations for all students, except for concurrent enrollment students and students who qualify for an exemption, for the 2022 spring semester.
Westminster College
Westminster requires all its employees and students to be fully vaccinated or have an approved exemption.
Utah Valley University
UVU announced that the COVID-19 vaccine is required for all students for the Spring 2022 semester.
Dixie State and Southern Utah University
Both colleges have never required the COVID-19 for staff or students.
BYU and Ensign College
BYU announced they will discontinue the requirement for students and employees to report their vaccination status. The University says they still encourage vaccinations and boosters.
BYU and Ensign College have never required the vaccine for students but have always strongly encouraged it.
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Which Utah colleges still require the COVID-19 vaccine? - ABC4.com
Our key independent variable is the mean percentage of vaccine-related misinformation shared via Twitter at the U.S. state or county level. We used 55M tweets from the CoVaxxy dataset17, which were collected between January 4th and March 25th from the Twitter filtered stream API using a comprehensive list of keywords related to vaccines (see Supplementary Information). We leveraged the Carmen library29 to geolocate almost 1.67M users residing in 50 U.S. states, and a subset of approximately 1.15M users residing in over 1,300 counties. The larger set of users accounts for a total of 11M shared tweets. Following a consolidated approach in the literature25,26,27,28, we identified misinformation by considering tweets that contained links to news articles from a list of low-credibility websites compiled by a politically neutral thirdparty (see details in the Supplementary Information). We measured the prevalence of misinformation about vaccines in each region by (i)calculating the proportion of vaccine-related misinformation tweets shared by each geo-located account; and (ii)taking the average of this proportion across accounts within a specific region. The Twitter data collection was evaluated and deemed exempt from review by the Indiana University IRB (protocol 1102004860).
Our dependent variables include vaccination uptake rates at the state level and vaccine hesitancy at the state and county levels. Vaccination uptake is measured from the number of daily vaccinations administered in each state during the week of 1925 March 2021, and measurements are derived from the CDC9. Vaccine hesitancy rates are based on Facebook Symptom Surveys provided by the Delphi Group24 at Carnegie Mellon University. Vaccine hesitancy is likely to affect uptake rates, so we specify a longer time window to measure this variable, i.e., the period January 4thMarch 25th 2021. We computed hesitancy byinverting the proportion of individuals who either have already received a COVID vaccine or would definitely or probably choose to get vaccinated, if a vaccine were offered to them today. See Supplementary Information for further details.
There are no missing vaccine-hesitancy survey data at the state level. Observations are missing at the county level because Facebook survey data are available only when the number of respondents is at least 100. We use the same threshold on the minimum number of Twitter accounts geolocated in each county, resulting in a sample size of N=548 counties.
Our multivariate regression models adjust for six potential confounding factors: percentage of the population below the poverty line, percentage aged 65+, percentage of residents in each racial and ethnic group (Asian, Black, Native American, and Hispanic; White non-Hispanic is omitted), ruralurban continuum code (RUCC, county level only), number of COVID-19 deaths per thousand, and percentage Republican vote (in 10 percent units). Other covariates, including religiosity, unemployment rate, and population density, were also considered (full list in Supplementary Table S9).
We also conduct a large number of sensitivity analyses, including different specifications of the misinformation variable (with a restricted set of keywords and different thresholds for the inclusion of Twitter accounts) as well as logged versions of misinformation (to correct positive skew). These results are presented in Supplementary Information (Tables S3-S8).
We conduct multiple regression models predicting vaccination rate and vaccine hesitancy. Both dependent variables are normally distributed, making weighted least squares regression the appropriate model. Data are observed (aggregated) at the state or county level rather than at the individual level. Analytic weights are applied to give more influence to observations calculated over larger samples. The weights are inversely proportional to the variance of an observation such that the variance of the j-th observation is assumed to be 2/wj where wj is the weight. The weights are set equal to the size of the sample from which the average is calculated. We estimate weighted regression with the aweights command in Stata 16. In addition, because counties are nested hierarchically within states, we use cluster robust standard errors to correct for lack of independence between county-level observations.
We investigate Granger causality between vaccine hesitancy and misinformation by comparing two auto-regressive models. The first considers daily vaccine hesitancy rates (x) at time (t) in geographical region (r) (state or county):
$$x_{t,r} = mathop sum limits_{i}^{n} a_{i} x_{t - i,r} + epsilon_{t,r} ,$$
where (n) is the length of the time window. The second model adds daily misinformation rates per account as an exogenous variable (y):
$$x_{t,r} = mathop sum limits_{i}^{n} (a_{i} x_{t - i,r} + b_{i} y_{t - i,r} ) + epsilon^{{prime }}_{t,r} .$$
The variable (y) is said to be Granger causal30,31 on (x) if, in statistically significant terms, it reduces the error term (epsilon^{prime}_{t}), i.e., if
$$E_{{a,b}} = sumlimits_{{t,r}} {epsilon _{{t,r}} ^{2} } - sumlimits_{{t,r}}^{{}} {epsilon _{{t,r}}^{{prime 2}} } > 0,$$
meaning that misinformation rates y help forecast hesitancy rates x. We assume geographical regions to have equivalence and independence in terms of the way misinformation influences vaccine attitudes. Thus, we use the same parameters for (a_{i}) and (b_{i}) across all regions. We employ Ordinary Least Squares (using the Python statsmodels package version 0.11.1) linear regression to fit (a) and (b), standardizing the two variables and removing trends in the time series of each region. We select the value of the time window (n) that maximizes (E_{a,b}). For both counties and states, this was (n = 6)days and we present results using this value. We also tested nearby values of (n pm 2) to confirm these provide similar results. We use data points with at least 1 tweet and at least 100 survey responses for every day in the time window for the specified region.
The traditional statistic used to assess the significance of Granger Causality is the F-statistic30. However, in our case, there are several reasons why this is not appropriate. First, we have missing timewindows in some of our regions. Second, our assumptions of equivalence and independence for regions may not be accurate. For these reasons, we use a bootstrap method to estimate the expected random distribution of (E_{a,b}) with the time signal removed. To this end, we generate trial surrogates for (y) by randomly shuffling the data points. With each random reshuffled trial, we can then use the same procedure to calculate the reduction in error, which we call (E^{*}_{a,b}). The p-value of our Granger Causality analysis is then given by the proportion of trials ((N)=10,000) for which (E^{{*}{}}_{a,b} > E_{a,b}). A potential issue with Granger Causality analysis is that it may detect an underlying trend. We tested for this by linearly detrending both time series before running the Granger analysis, finding similar results.
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Huntington, WV (WOWK) Valley Health Systems is embracing National Minority Health Month and its theme to Give Your Community a Boost. The health system will use its COVID-19 Vaccine Equity Grant to ensure vaccine access in disproportionately affected communities, including racial and ethnic minority groups.
The $178,920 grant issued by the State of West Virginia will be used to focus on Cabell, Lincoln, Kanawha and Wayne counties.
Valley Health recognizes that a patients environment significantly impacts their health. Conditions like chronic lung diseases, diabetes, and obesity are associated with an increased risk of severe COVID-19 illness, and all of these conditions are prevalent in these counties.
Valley Health will offer mobile vaccination clinics and vaccine education at churches, food banks, public housing complexes, homeless shelters, recovery homes and more. Pharmacists, nurses and other healthcare professionals will administer the vaccines.
If an individual needs to travel to get their vaccine, Valley Health can provide gift cards to help with transportation costs.
The health system will also collaborate with trusted local leaders to host listening sessions in which the community can voice their concerns regarding vaccine hesitancy.
Additionally, Valley Health will seek to understand the needs of each disproportionately impacted group.
By focusing our implementation on presenting a multi-faceted approach, we can utilize this grant to provide vaccine hesitancy outreach to overcome barriers to meet the needs of individuals in our communities. This is especially important given racial, ethnic, and other disparities seen throughout the COVID-19 pandemic, and our efforts will be undertaken with a particular focus on these disparities.
Valley Health operates over 40 health centers and public health programs in southeastern West Virginia and southern Ohio. To learn more, visit the Valley Health Systems website or call your local health center.
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Valley Health to expand COVID-19 vaccine access - WOWK 13 News
Starting in August 2020, the World Bank collaborated with the World Food Programme (WFP) and implemented nine (9) rounds of the Iraq High Frequency Phone Survey (IHFPS) as part of the WFPs monthly mVAM survey. For each round, more than 1,600 adult respondents from across Iraq (nationally representative) were interviewed using mobile phones. While the first six (6) rounds of the survey were implemented between August 2020 and January 2021, the last three rounds were conducted between June and August 2021.
This brief presents findings on Covid-19 vaccination disparities and hesitancy from the last three rounds of the IHFPS. Findings from the survey suggest a low but increasing vaccination trend among adult Iraqis but also high levels of resistance to the vaccine. Concern regarding possible side effects of the vaccine is the single most cited reason why a significant number of adults in Iraq remain hesitant to the Covid-19 vaccine. The survey also revealed notable disparities in vaccination and vaccine hesitancy. Iraqis with higher levels of education, with formal public-sector jobs, men, and those in urban areas are more likely to have been vaccinated than those with lower levels of education, with informal private-sector jobs and self-employment, women, and those in rural areas. Moreover, vaccination among the elderly, who are most vulnerable, and those with higher risk of exposure poorer Iraqis that are more likely to live in large households in cramped conditions and often do informal jobs that require direct interaction with people remain significantly low.
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COVID-19 Vaccine Inequities and Hesitancy in Iraq [EN/AR] - Iraq - ReliefWeb
Throughout the COVID-19 pandemic, experts from Drexel Universitys Dornsife School of Public Health have researched disparities in testing, vaccination, health care access and other markers of the pandemic response. The latest study, this month in the American Journal of Epidemiology, harkens back to December 2020 through September 2021, when the United States first started distributing the COVID-19 vaccines, and looked at full vaccination rates in neighborhoods of 16 large U.S. cities, including Philadelphia, Austin, San Francisco, Chicago and New York City.
Researchers at Drexels Urban Health Collaborative used the CDCs Social Vulnerability Index a measure that includes socioeconomic, housing, minority status, language and other factors to assess a communitys resilience against human suffering and financial loss when faced with a crisis and looked at its association with COVID-19 vaccination in zip codes of the 16 cities. The team found wide disparities in vaccination, with neighborhoods with higher levels of social vulnerability having the lowest vaccination rates.
Shortly after the paper was published, Anthony Fauci, MD, the U.S. Presidents chief medical advisor, made a comment this week that our country is no longer in a pandemic, but a transitional phase, perhaps toward endemicity.
So, with a hopeful tone, the Drexel News Blog checked in with the papers lead author Usama Bilal, PhD, an assistant professor at Dornsife, about his teams recent findings and the current state of the pandemic locally and internationally.
We are in a better situation than one year ago, but we are still in a tough one. 362 daily deaths for a year is 132,000 deaths, which is thesame number of people that died from Alzheimers in 2019, and almost thrice the influenza/pneumonia deaths in 2019. The pandemic has also slowly moved further away towards the margin, affecting more rural and disadvantaged populations over time. Moreover, as a pandemic is a global phenomenon, it is still raging in many places, and will continue doing so at least until we achieve global vaccine equity.
We found that neighborhoods with higher levels of social vulnerability had lower likelihood of full vaccination. This pattern mirrors what we have described before with COVID-19 itself, which tends to be higher infection rates and its effect worse in those same areas. Given what we know about public health, that it affects the most vulnerable, poor and oppressed, this is not surprising. What was surprising is the degree of variability, as we found cities with much wider disparities than others.
We found that some cities in California, along with our own city of Philadelphia had a narrower gap between neighborhoods. We did not study factors driving these narrower inequalities, but we know that California has an extensive COVID-19 equity plan and that some of its cities (e.g., San Francisco) made an effort to vaccinate people in the more vulnerable neighborhoods.
Here in Philadelphia, there have been several efforts that would be great to evaluate and, if found to be effective, scale up in other locations, including the efforts of theBlack Doctors COVID-19 Consortium, thecoordinated effortsof community organizations to vaccinate Latino individuals, and some prioritization efforts towards low vaccinated zip codes in April 2021, when criteria for vaccination was more restrictive. We cannot know for sure with our data whether these efforts were the reason for Philadelphias narrower gap in vaccination, but they are definitely very important initiatives.
Many people that work in vaccines and communication were already talking about this at the beginning of the vaccination rollout, because these are issues we have seen with other interventions. If you think about the politization of mask use, vaccines have followed a similar trend.
However, I want to point out that we should not just focus on hesitancy and mistrust, but also on access. In many cities, getting an appointment to be vaccinated was challenging, vaccination sites were far away from where many people live and public transit options were scarce. There were also some immigrant populations being (incorrectly) asked for identification or insurance, which created very understandable concerns.
Public health is a collective effort, and its measures are collective by nature. Local public health departments, local and state governments, and the federal government itself, are the key agents driving public health measures. There has been a slow shift towards focusing just on personal responsibility, which is antithetical to the mission of public health. Pressuring your local governments to apply timely and adequate measures in times of high transmission, and supporting them when they do, may be a key strategy. If the last two years have taught us something, its that caring for each other is the only way out of this.
Media interested in talking with Bilal should contact Greg Richter, news manager, at gdr33@drexel.edu or 215-895-2614.
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Q+A: What Factors are Associated with Disparities in COVID-19 Vaccination Rates? - Drexel News Blog
The West Virginia Department of Health and Human Resources (DHHR) reports as of April 29, 2022, there are currently 882 active COVID-19 cases statewide. There has been one death reported since the last report, with a total of 6,856 deaths attributed to COVID-19.
DHHR has confirmed the death of a 76-year old female from Raleigh County.
We mourn the loss of this West Virginian and extend our deepest sympathies to the family, said Bill J. Crouch, DHHR Cabinet Secretary. Please schedule a COVID-19 vaccine and booster shot to protect yourself and those around you.
CURRENT ACTIVE CASES PER COUNTY: Barbour (8), Berkeley (78), Boone (11), Braxton (4), Brooke (10), Cabell (39), Calhoun (21), Clay (0), Doddridge (1), Fayette (23), Gilmer (3), Grant (5), Greenbrier (32), Hampshire (13), Hancock (12), Hardy (5), Harrison (22), Jackson (2), Jefferson (29), Kanawha (83), Lewis (6), Lincoln (14), Logan (25), Marion (32), Marshall (24), Mason (6), McDowell (10), Mercer (21), Mineral (5), Mingo (3), Monongalia (48), Monroe (10), Morgan (11), Nicholas (11), Ohio (49), Pendleton (2), Pleasants (1), Pocahontas (25), Preston (12), Putnam (27), Raleigh (63), Randolph (15), Ritchie (2), Roane (3), Summers (0), Taylor (3), Tucker (1), Tyler (0), Upshur (12), Wayne (4), Webster (0), Wetzel (8), Wirt (6), Wood (17), Wyoming (5). To find the cumulative cases per county, please visit http://www.coronavirus.wv.gov and look on the Cumulative Summary tab which is sortable by county.
Delays may be experienced with the reporting of information from the local health department to DHHR. As case surveillance continues at the local health department level, it may reveal that those tested in a certain county may not be a resident of that county, or even the state as an individual in question may have crossed the state border to be tested. Please visit http://www.coronavirus.wv.gov for more detailed information.
West Virginians ages 5 years and older are eligible for COVID-19 vaccination; after the primary series, first booster shots are recommended for those 12 and older. Second booster shots for those age 50 and over that are 4 months or greater from their first booster have been authorized by FDA and recommended by CDC, as well as for younger individuals over 12 years old with serious and chronic health conditions that lead to being considered moderately to severely immunocompromised. To learn more about COVID-19 vaccines, or to find a vaccine site near you, visit vaccinate.wv.gov or call 1-833-734-0965.
Free pop-up COVID-19 testing is available today in Barbour, Berkeley, Braxton, Cabell, Clay, Fayette, Gilmer, Grant, Greenbrier, Hampshire, Hancock, Jefferson, Lewis, Logan, Marion, Marshall, Mason, Morgan, Nicholas, Ohio, Raleigh, Randolph, Taylor, Upshur, Wayne, and Wood counties.
Barbour County
8:30 AM - 3:30 PM, Community Market, 107 South Main Street (across the street from Walgreens), Philippi, WV (optional pre-registration: https://labpass.com/en/registration?access_code=WVBBC)
1:00 PM - 5:00 PM, Junior Volunteer Fire Department, 331 Row Avenue, Junior, WV (optional pre-registration: https://unityphr.com/campaigns/wvlabs/covid)
Berkeley County
8:30 AM - 3:30 PM, Airborne Church, 172 Creative Place, Martinsburg, WV
8:30 AM - 4:00 PM, Shenandoah Community Health, 99 Tavern Road, Martinsburg, WV (optional pre-registration: https://unityphr.com/campaigns/wvlabs/covid)
9:00 AM - 3:00 PM, 891 Auto Parts Place, Martinsburg, WV (optional pre-registration: https://unityphr.com/campaigns/wvlabs/covid)
Braxton County
9:00 AM - 4:00 PM, Braxton County Memorial Hospital (parking lot), 100 Hoylman Drive, Gassaway, WV (optional pre-registration: https://labpass.com/en/registration?access_code=Braxton)
Cabell County
8:00 AM - 4:00 PM, Marshall University Campus (parking lot), 1801 6th Avenue, Huntington, WV (optional pre-registration: https://wv.getmycovidresult.com/)
8:00 AM - 4:00 PM, Cabell-Huntington Health Department (parking lot), 703 Seventh Avenue, Huntington, WV (optional pre-registration: https://wv.getmycovidresult.com/)
Clay County
8:30 AM - 3:00 PM, Lizemores Volunteer Fire Department, 13175 Clay Highway, Lizemores, WV (optional pre-registration: https://labpass.com/en/registration?access_code=WVClayCounty)
Fayette County
10:00 AM - 2:00 PM, Fayette County Health Department, 5495 Maple Lane, Fayetteville, WV
Gilmer County
8:00 AM - 3:00 PM, Minnie Hamilton Health System (parking lot), 921 Mineral Road, Glenville, WV (optional pre-registration: https://labpass.com/en/registration?access_code=WVMHCT11)
Grant County
11:00 AM - 3:00 PM, Petersburg City Parking Lot, South Main Street (across from Walgreens), Petersburg, WV (optional pre-registration: https://wv.getmycovidresult.com/)
Greenbrier County
9:30 AM - 3:00 PM, State Fair of WV, 891 Maplewood Avenue, Lewisburg, WV (optional pre-registration: https://labpass.com/en/registration?access_code=WVGBC)
Hampshire County
10:00 AM - 5:00 PM, Hampshire Memorial Hospital, 363 Sunrise Boulevard, Romney, WV (optional pre-registration: https://unityphr.com/campaigns/wvlabs/covid)
Hancock County
10:00 AM - 12:00 PM, Hancock County Health Department, 100 North Court Street, New Cumberland, WV (optional pre-registration: https://roxbylabs.dendisoftware.com/patient_registration/)
Jefferson County
9:00 AM - 5:00 PM, Hollywood Casino, 750 Hollywood Drive, Charles Town, WV (optional pre-registration: https://unityphr.com/campaigns/wvlabs/covid)
Lewis County
8:30 AM - 3:00 PM, City Parking Lot, 95 West Second Street, Weston, WV (optional pre-registration: https://labpass.com/en/registration?access_code=WVMavLewis1)
Logan County
10:00 AM - 2:00 PM, Town of Man Fire Department, Administration Building, 110 North Bridge Street, Man, WV
12:00 PM - 5:00 PM, Old 84 Lumber Building, 100 Recovery Road, Peach Creek, WV (optional pre-registration: https://wv.getmycovidresult.com/)
Marion County
10:00 AM - 6:00 PM, Dunbar School Foundation, 101 High Street, Fairmont, WV
Marshall County
11:00 AM - 5:00 PM, Benwood City Building, 430 Main Street, Benwood, WV
Mason County
8:30 AM - 3:00 PM, Krodel Park, 1186 Charleston Road, Point Pleasant, WV (optional pre-registration: https://labpass.com/en/registration?access_code=WVMavCOUNTY12)
Morgan County
8:30 AM - 3:30 PM, The Blue (of First United Methodist Church), 440 Fearnow Road, Berkeley Springs, WV (optional pre-registration: https://labpass.com/en/registration?access_code=WVMavMorgan1)
11:00 AM - 5:00 PM, War Memorial Hospital, 1 Health Way, Berkeley Springs, WV (optional pre-registration: https://unityphr.com/campaigns/wvlabs/covid)
Nicholas County
9:00 AM - 3:30 PM, Summersville Regional Medical Center, 400 Fairview Heights Road, Summersville, WV (optional pre-registration: https://labpass.com/en/registration?access_code=WVNL)
Ohio County
9:00 AM - 3:30 PM, Ohio Valley Medical Center (back parking lot at the top of 22nd Street), 2000 Eoff Street, Wheeling, WV (optional pre-registration: https://roxbylabs.dendisoftware.com/patient_registration/)
Raleigh County
9:00 AM - 4:00 PM, Beckley-Raleigh County Health Department, 1602 Harper Road, Beckley, WV (optional pre-registration: https://labpass.com/en/registration?access_code=MavBeckleyRaleigh)
Randolph County
8:30 AM - 3:30 PM, Davis Health Center, 812 Gorman Avenue, Elkins, WV (optional pre-registration: https://labpass.com/en/registration?access_code=WVRDC)
Taylor County
10:00 AM - 12:00 PM, Grafton-Taylor Health Department, 718 West Main Street (parking lot at Operations Trailer), Grafton, WV (optional pre-registration: https://wv.getmycovidresult.com/)
Upshur County
8:30 AM - 3:30 PM, Buckhannon Fire Department (parking lot), 22 South Florida Street, Buckhannon, WV (optional pre-registration: https://labpass.com/en/registration?access_code=WVUSC)
Wayne County
10:00 AM - 2:00 PM, Wayne County Health Department, 217 Kenova Avenue, Wayne, WV (optional pre-registration: https://unityphr.com/campaigns/wvlabs/covid)
Wood County
8:00 AM - 3:00 PM, Vienna Baptist Church, 3401 Grand Central Avenue, Vienna, WV (optional pre-registration: https://labpass.com/en/registration?access_code=WVMavWood1)
Please check with the testing site, DHHRs social media pages and the COVID-19 website https://dhhr.wv.gov/COVID-19/pages/testing.aspx for any last minute cancellations, and to find other free testing opportunities across West Virginia.
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COVID-19 Daily Update 4-29-2022 - West Virginia Department of Health and Human Resources
Athens, AL (35611) Today
Partly to mostly cloudy. A stray shower or thunderstorm is possible. High 81F. Winds S at 10 to 20 mph..
Partly cloudy this evening. Scattered thunderstorms developing after midnight. Low near 65F. Winds S at 10 to 15 mph. Chance of rain 70%.
Updated: April 30, 2022 @ 5:53 am
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If theres one point on which all the experts agree, it is this: The spring surge of COVID-19 in the United States, caused by the hyper-contagious BA.2 omicron subvariant, will be unlike any other phase of the pandemic thus far.
In just the last two weeks, infections have increased by more than 50%, according to the New York Times COVID data tracker, but hospitalizations due to COVID-19 have risen only slightly and daily deaths are at their lowest level since the pandemic began.
This surge feels qualitatively and quantitatively different from earlier surges in terms of the severity of disease and the mortality, says Megan Ranney, MD, MPH, an emergency medicine physician and academic dean of the School of Public Health at Brown University in Rhode Island. That is likely due to a combination of vaccines and boosters along with the fact that so many people were infected with the original omicron variant quite recently.
Yet, the United States and indeed, the global community is still in the grips of a pandemic that continues to pose substantial risks for those who are unvaccinated, the elderly, the immunocompromised, and those with certain medical conditions, such as obesity and diabetes.
AAMCNews recently spoke with several of the foremost academic experts on COVID-19 for their advice on how best to navigate this next phase of the pandemic.
While BA.2 seems to lead to less severe disease, it is not, in fact, benign especially for those who have not been vaccinated, or for those who were vaccinated but did not receive a booster shot.
If you havent been vaccinated and boosted, and certainly if youre over 50 or 60, or if you have some other significant medical issues, you should be very concerned, says Eric Topol, MD, founder and director of the Scripps Research Translational Institute in La Jolla, California. If youre fully vaccinated, including a booster, you should be pretty confident that youre not going to get very sick if you do get an infection.
But not getting very sick can still translate into flu-like symptoms including fever, body aches, sore throat, congestion, and fatigue for one or two weeks. And for a small subset of people Robert Wachter, MD, chair of the Department of Medicine at the University of California, San Francisco, puts it at 10% to 20% in unvaccinated patients and about half that in vaccinated patients a COVID-19 infection can lead to long COVID. This is a constellation of symptoms, including extreme fatigue, brain fog, and trouble breathing, that can persist for months to years.
[Plus], there has been a fair amount of research in the last six weeks about a bunch of bad outcomes a year out from a case of COVID that include heart attacks, strokes, blood clots, diabetes, and brain shrinkage, he says. The risks were higher for those hospitalized for COVID-19 but were present even in some who had a mild case of the disease.
Vaccination and a booster shot provide good protection against severe disease, studies show. Two large studies published in JAMA in January 2022 showed that three doses of an mRNA vaccine were 90% to 95% protective against severe disease or death from both the omicron and delta variants.
Anna Durbin, MD, an infectious disease physician at Johns Hopkins University School of Medicine in Baltimore, says that the first booster shot is particularly important in teaching the immune system to recognize and respond to the coronavirus. Its important to understand that when these vaccines rolled out, we were at the height of a pandemic. We wanted vaccines quickly and safely and that is what drove the primary immunization series to be two shots, three or four weeks apart. But any immunologist will tell you thats not the optimal timing for a two-shot regimen. We would have preferred to spread that out to two to three months apart, but that would have delayed authorization of the vaccines even further.
Instead, a third shot was needed several months after the first shots. By then, your immune system had calmed down from the original shots, and it was ready to rev up again, she says.
While protection against severe disease remains robust after three shots, protection against infection wanes substantially over time, in part because each new variant of virus contains more mutations that make it both more transmissible and better able to evade the bodys immune response. The BA.1 strain of omicron carries more than 50 mutations from the original coronavirus strain that originated in Wuhan, China, while the BA.2 strain contains an additional eight mutations that seem to make it about 30% more transmissible than BA.1.
About every couple of weeks, we learn that omicron has gotten a little bit smarter about how to infect people, Wachter says.
Because of mounting evidence of waning immunity after a first booster shot, the Food and Drug Administration in March authorized a second booster for anyone over 50 and for immunocompromised individuals who are at least four months past a first booster shot.
One study from Israel found that a fourth shot of the Pfizer-BioNTech COVID-19 vaccine provided protection against infection with omicron among adults 60 and over, but that protection waned quickly peaking at 4 weeks and almost disappearing by 8 weeks post-shot.
The short-lived immunity from a second booster, combined with evidence that the first booster continues to provide protection against severe disease, has led to disagreement among experts, some of whom believe that second boosters are of limited value for most individuals.
With these vaccines and with all vaccines for respiratory viruses, to be honest, our goal is not to prevent infection, Durbin says. Until I see rising cases and evidence of more severe disease, I would not recommend a [second] booster right now for most people. Durbin does hope to see a reformulated vaccine developed in time for a fall booster campaign.
Topol believes if youre eligible for a second booster, you should get one, citing three studies that show that a second booster is safe and provides greater protection against severe illness and death in those over 50.
I think its a real mistake to be discounting the importance of [second] boosters, he says. Sure, if youre living in a cave, you dont need to worry. But if youre traveling and mixing with people, and youre in an area where cases are rising, then I think it would be good to get a booster.
Wachter says that people over 60 with a high risk of a bad outcome from COVID-19 should definitely get the second booster. But younger individuals in lower risk groups have a more difficult decision to make.
The facts about the second booster that people need to understand to make that choice are that first, your immunity after that first booster wanes considerably four to six months out. Thats unquestionable. The second booster raises your immunity about to the point where you were after the first booster. Where it gets complicated is the length of protection. Do the benefits of getting the shot now outweigh the risks?
One risk is that in a month or two, just when your immunity from a second booster is waning, the United States experiences a huge surge in cases or you decide to travel or attend a large gathering. In that case, you will have squandered your immune boost just when you need it most.
Its like a coupon, Topol says. Do you want to use it now or save it for later?
Durbin fears that those who wait too long to get a second booster would have to wait to get a reformulated vaccine in the fall. My great hope is that in the fall, well have a vaccine thats different from the one weve had.
There is some good news for those who are vaccinated and boosted who also had a breakthrough omicron infection, though. They do not need [a second booster], Durbin says. They have a little bit of an edge because they were infected.
Indeed, while reinfection with BA.2 after a BA.1 infection is possible, it is rare and occurs mainly in unvaccinated individuals, according to a small Danish study.
Wachter acknowledges that the temptation to throw up ones hands at this stage of the pandemic is real. I do this for a living and its confusing to me, he says. Many of his 263,000 Twitter followers have said: You tell me what youre doing. Ill do that.
Wachter is fully vaccinated and received his second booster about two weeks ago. He is wearing an N95 mask or the equivalent in crowded indoor spaces and whenever hes around people whose vaccination status or current symptoms he does not know, such as at the grocery store or on an airplane. I would feel kind of bad if I got COVID in a place where I really could have kept myself protected, he says. But he is going out to dinner with friends and having friends over to his home.
Ranney says the value of a high-quality mask cannot be understated. This is the moment where you should expect that if youre out and about, doing indoor activities, going to restaurants and concerts without a high-quality, good-fitting mask, you should expect that if you didnt have omicron in the first wave, that youre going to catch COVID, she says. [BA.2] is that contagious.
Her lab has developed a COVID-19 risk calculator MyCOVIDRisk.app that can help you determine your risk of catching COVID-19. You enter your planned activity, how many vaccines youve gotten, your location, whether the activity is indoors or outdoors, and other factors and the app spits out your risk of catching the disease. It also gives you options to change that risk.
If youre choosing to be out and about without a mask on, there is risk, Ranney says. You just need to be aware so you can make an informed choice."
Regardless of whether you receive a second booster or not now, there will likely be another booster shot in the fall.
Durbin predicts that well have a bivalent vaccine a vaccine that is designed to fight at least two strains of the coronavirus. Moderna recently announced that its bivalent vaccine containing strains of the beta and original coronaviruses performed better than its existing vaccine.
Ranney also believes well have a bivalent vaccine but is hopeful that the fall booster incorporates some elements of the omicron strain. Its going to be too early for some of the exciting types of vaccine, like the nasal vaccines, she says. But I would suspect that what were going to get in the fall is tailored to the strains that were seeing. There is a possibility that there will be a combined COVID-flu vaccine, but thats still up in the air.
One concern among all the experts is booster fatigue particularly if there are diminishing returns for subsequent booster shots.
With each new booster, were losing more and more people, Wachter says. Im not confident that if theres a surge coming and theres a campaign that says theres a new vaccine that that will lead to a massive uptake.
The use of antivirals and other therapeutics to counter the worst effects of COVID-19 will also be critical, Topol says.
The White House announced this week that it was doubling the number of pharmacies and clinics that would carry Paxlovid, an antiviral pill that has been shown to reduce the risk of hospitalization and death in infected people by almost 90%.
We have to have complementary strategies, Topol says. We cant keep going into the booster mode; its not an ideal way to counter a virus.
Excerpt from:
BA.2, boosters, and the future of COVID-19 vaccination - AAMC
