Category: Covid-19 Vaccine

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A new randomized control trial from the United Kingdom shows that using ivermectin during COVID-19 infections provided little improvement in recovery rates in patients treated in clinics. The study appeared in the Journal of Infection.

The anti-parasitic drug has been investigated since 2020 as a potential treatment for COVID-19. Some early trials suggested the drug was able to reduce mortality rates and improve outcomes, but several of them had serious flaws, the authors noted. Subsequent trials and systematic reviews have largely disproved those earlier results.

The present, open-arm study compared outcomes among 8,811 SARS-CoV-2positive participants (median symptom duration, 5 days), who were randomized to outpatient treatment with ivermectin (2,157), standard care (3,256), and other treatments (3,398) from June 23, 2021, to July 1, 2022. All participants were followed up for 28 days.

The observed median time to first recovery was 14 days in the ivermectin group and 15 in the usual-care group. The authors said this result was statistically significant (hazard ratio 1.14; 95% confidence interval [CI], 1.07 to 1.23), but the estimated hazard ratio was less than the pre-specified meaningful effect of 1.2.

Ivermectin also did not reduce the number of hospitalizations. Use of the drug, however, was associated with a slight increase in the proportion of participants feeling fully recovered at 3, 6 and 12 months. At 6 months, 74% of respondents in the ivermectin group and 71% in the usual care group reported feeling fully recovered from the original COVID-19 illness (rate ratio 1.05; 95% CI, 1.02 to 1.08).

Overall, these findings, while evidencing a small benefit in symptom duration, do not support the use of ivermectin as treatment for COVID-19.

"Overall, these findings, while evidencing a small benefit in symptom duration, do not support the use of ivermectin as treatment for COVID-19 in the community among a largely vaccinated population at the dose and duration we used," the authors wrote.

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COVID vaccination in first half of menstrual cycle tied to temporarily longer cycles - University of Minnesota Twin Cities

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Updated COVID-19 vaccines now available for residents 65 years and older in Los Angeles County - The Eastsider

Women vaccinated against COVID-19 during the follicular phase of their period had their next cycle last 1 day longer than normal, according to a retrospective cohort analysis of menstrual cycle data.

That increase was 1.00 day (98.75% CI 0.88-1.13) when the first vaccine dose occurred in the follicular phase and 1.11 days (98.75% CI 0.93-1.29) for second doses that fell in that window leading up to ovulation, researchers led by Alison Edelman, MD, MPH, of the Oregon Health & Science University in Portland, reported in Obstetrics & Gynecology.

In this cohort of women not on hormonal contraception, there was no change in cycle length with doses given during the luteal phase, at -0.09 days for the first dose (98.75% CI -0.26 to 0.07) and 0.06 days for the second dose (98.75% CI -0.16 to 0.29), similar to a control group of unvaccinated people who also had no change in cycle length at the time either dose would have been suggested.

Additionally, people vaccinated in their follicular phase were more likely to have a clinically significant change of 8 days or more in their cycle length. This happened for 6.8% of the follicular group but only 3.3% of the luteal and 5% of the unvaccinated groups (P<0.001). Younger people from ages 18 through 29 were also more likely to have changes to their cycle (P<0.001 for both doses).

The follicular phase -- the first half of a menstrual cycle, lasting an average of 13 or 14 days until ovulation -- drives the cycle length and is "the most variable part of the cycle, whereas the luteal phase, which is post ovulation, is usually pretty set," Edelman told MedPage Today.

Edelman said that this research aids understanding of what contributes to these menstrual cycle changes on a macro level, though more research is needed to understand the micro level of what is happening with the immune system and reproductive system.

"We have a little bit of a better understanding around why this is happening and can provide folks further reassurance about getting vaccinated," Edelman said. "And if they do experience small changes in their menstrual cycle, it's temporary and it'll get back to normal."

The group had previously shown a small increase in menstrual cycle length after COVID-19 vaccination that disappeared by the second cycle post-vaccination and was on par with the impact of COVID-19 infection.

Pamela Berens, MD, an ob/gyn at the McGovern Medical School at UTHealth Houston who was also part of the first wave of research investigating the impact of the COVID-19 vaccine on menstruation although not involved in Edelman's study, told MedPage Today that the new findings were not surprising.

"It makes sense that a stressor of any particular type would impact [the follicular] phase of the cycle ... because the last 2 weeks of the cycle usually are pretty regulated," Berens said. "And so it makes sense that something that's going to impact the cycle would impact it in the follicular phase."

She noted that the clinical message is unchanged: physicians should encourage patients to get COVID vaccines whenever they are able.

Edelman said that future research could go in several directions, such as looking at the impact of other vaccines on menstrual cycles, long COVID's effect on menstruation, and specifically analyzing data from people with irregular cycles.

In total, 19,497 participants from ages 18 through 45 prospectively logged menstrual cycle data from October 2020 through November 2021 in the app Natural Cycles, which is used to track menstrual cycles to prevent or plan pregnancy without hormonal contraception. Most were younger than 35 (80.1%) and from North America (28.6%), the U.K. (31.7%), or continental Europe (33.5%).

Participants logged COVID-19 vaccines received from January through October 2021, with mRNA vaccines accounting for 63.8%. Analysis included 9,279 individuals who got the vaccine in their follicular phase and 5,532 who received their first dose in the luteal phase. An unvaccinated group of 4,686 women served as controls. To be included, individuals had to be at least three cycles post-pregnancy, post-positive pregnancy test, or post-hormonal contraception use during the whole study period. They also had to have a normal menstrual cycle length (24 to 38 days), have known geographic location, and not be menopausal.

The primary outcome was the adjusted within-individual change in days from their normal cycle, which was the average of three menstrual cycles before vaccination. For the unvaccinated control group, cycles 4 and 5 were considered the notional first and second dose vaccination cycles for comparison. The cycle length for this group was unchanged, at 0.08 days for the first dose (98.75% CI 0.10 to 0.27) and 0.17 days for the second dose (98.75% CI 0.04 to 0.38).

Many of the study's limitations were tied to the data source, authors noted. For instance, Natural Cycles users don't use hormonal contraception and are more likely to be white, living in North America or Europe, well-educated, and have lower BMIs. Plus, the data also couldn't answer the magnitude of an individual's immune response to vaccination. Additionally, the researchers couldn't use this data to account for how SARS-CoV-2 impacts menstruation.

Rachael Robertson is a writer on the MedPage Today enterprise and investigative team, also covering OB/GYN news. Her print, data, and audio stories have appeared in Everyday Health, Gizmodo, the Bronx Times, and multiple podcasts. Follow

Disclosures

This study was funded in part by the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) and the NIH Office of Research on Women's Health.

Edelman reported honoraria, travel reimbursements, or both from the American College of Obstetricians and Gynecologists (ACOG), WHO, CDC, and Gynuity. She also receives royalties from UpToDate.

Other co-authors reported honoraria and travel reimbursement from ACOG, SFP, and ABOG as well as financial ties to Borne and Elsevier. Some co-authors were employees of Natural Cycles, and the app received cost reimbursement for data processing and secure transfer.

Berens had no conflicts of interest.

Primary Source

Obstetrics & Gynecology

Source Reference: Edelman A, et al "Timing of coronavirus disease 2019 (COVID-19) vaccination and effects on menstrual cycle changes" Obstet Gynecol 2024; DOI: 10.1097/AOG.0000000000005550.

Excerpt from:

Wonky Period After COVID Vaccine May Only Happen During One Phase - Medpage Today

With seniors continuing to be disproportionallyaffected by severe COVID-19 illness, federal officials last week recommended that older Americans get another dose of the vaccine this spring, even if they got a shot in the fall.

The Centers for Disease Control and Prevention recommended that Americans 65 and older obtain another vaccine dose as long as at least four months have passed since their most recent shot.

The CDC made similar recommendationsfor older adults in 2022 and 2023 and the agency recently suggested that immunocompromised individuals six months or olderalso get an additional vaccine dose.

Here's what you need to know about the CDC's recommendation:

A. Americans65 years and older are disproportionately impacted by COVID-19, with more than half of hospitalizations connected to infection from the virusfrom October to December 2023 occurring in this age group, the CDC said.

In New York, seniors have among the highest infection rates in the stateand the highest rates of hospitalization and death, health officials said.

Dr. Mark Mulligan, director of the NYU Langone Vaccine Center, said it's been roughly six months since the CDC last recommended seniors get an updated shot a point when the body's vaccine-induced defenses tend to fade. That happens, officials said, faster in seniors than in other adults.

This is already done for some immunocompromised hosts. Why not also do it for older Americans, particularly given thatthey make up the bulk of severe disease and death,Mulligan said.

A. On Sept. 12, 2023, the CDC recommended that everyone ages six months and older get an annual update of the vaccine for 2023-2024.

It's very important for people to understand that vaccine recommendations aren't absolute, said Dr. AaronGlatt, chair of medicine and chief of infectious diseases at Mount Sinai South Nassau hospital. They don't apply to everybody evenly The CDC didn't come out and say that every single person should get this vaccine.

The ones that will benefit most, he said are the onesmost likely to die or get very sick if they get the virus.

A.The latest COVID-19 shot offers 54% increased protection for adults against becoming infected with the virus, according to a CDC report released last month.The vaccine is the same formulation as was offered last fall.

Data shows the shot provides protection against both the strain of the virusit was originally created to target and the more recent COVID lineages and mutations currently circulating nationwide.

State Health Commissioner Dr. James McDonald said the latest CDC recommendation aligns with the department in recognizing the increased risk of severe health complications, hospitalization, and death from COVID-19 in older adults.

A. To date, only 17% of the population nationwide have received their updatedCOVID shot as of last fall,although that figure is 43.3% among Americans 65 and older.

In New York State, that figure is only 11.9% while the average on Long Island is just 9%, State Health Department figures show. Meanwhile, 34.2% of New Yorkers ages 65-74 are up-to-date with their shots along with 38.9% of those 75 and older, according to department data.

We are clearly in the midst of vaccine fatigue, Mulligan said. What I'd like to suggest is this should be normalized It's an annual thing now and a regular occurrence.

Robert Brodsky is a breaking news reporter who has worked at Newsday since 2011. He is a Queens College and American University alum.

Read more from the original source:

Answering questions about CDC's recommendation to get another COVID-19 shot - Newsday

Gene therapy modifies a persons genes to treat disease,accordingto the U.S. Food and Drug Administration.

Richard Watanabe, physiology and neuroscience professor at the University of Southern California medical school,saidCOVID-19 vaccines do not alter human genes or insert modified genes.

The vaccines do notenter the nucleus of the cell where DNA is located, so they cannot influence genes,accordingto the federal Centers for Disease Control and Prevention.

At a Feb. 26, 2023,roundtablehosted by U.S. Sen. Ron Johnson, R-Wis., Dr. Robert Malone made the gene therapy claim.

The scientistcitedto Wisconsin Watchremarksby Bayer AG pharmaceuticalsexecutiveStefan Oelrich. A Bayer spokespersontoldFull Fact that Oelrich misspoke and the vaccines arent gene therapy.

The New YorkTimesand the WashingtonPosthave identified Malone as a prominent purveyor of COVID-19 vaccine misinformation.

Fact-checkershaverepeatedlydebunked the gene therapyclaims.

This fact brief is responsive to conversations such asthis one.

Sources

Food and Drug Administration:What is Gene Therapy?

Google Docs:Richard Watanabe email

Centers for Disease Control:Understanding How COVID-19 Vaccines Work

Rumble:What Are Federal Health Agencies and the COVID Cartel Hiding? | Feb. 26

Google Docs:Robert Malone 2/28/24 email

Rumble:Head of Pharma at Bayer admits that the mRNA vaccines are gene therapy

Full Fact:Bayer executive wrongly said mRNA vaccines are gene therapy

AP News:No, COVID-19 vaccines arent gene therapy

PolitiFact:Joe Rogan falsely says mRNA vaccines are gene therapy

Reuters:mRNA vaccines are distinct from gene therapy, which alters recipients genes

Washington Post:A vaccine scientists discredited claims have bolstered a movement of misinformation

New York Times:Robert Malone Spreads Falsehoods About Vaccines. He Also Says He Invented Some.

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Are COVID-19 vaccines gene therapy? - WisconsinWatch.org

We engaged in in-depth interviews with pregnant women to delve into their knowledge, attitudes, acceptance, and refusal of vaccination. The valuable insights obtained from these interviews were instrumental in shaping the authentic data used to construct a questionnaire.

In our study, 85.3% of the pregnant women were vaccinated before becoming pregnant and understood the potential severity of COVID-19. Nevertheless, once pregnant, 50% of this subgroup had no confidence in the vaccination. They were concerned about the dangers of the vaccine to themselves and their unborn children, especially miscarriage and premature birth. This concern was evident despite their being aware that the vaccine can reduce the severity of the disease.

Our research also found that the pregnant womens level of immunity to COVID-19 did not affect their vaccination decisions. The effectiveness of vaccines varies depending on the vaccine type and evolves over time within the pregnant population. The variations in immunity can be influenced by factors such as maternal age and underlying diseases, body mass index, and gestational age24. Nevertheless, pregnant women continue to express concerns about their immunity following previous injections and are hesitant to receive any further vaccinations during pregnancy.

Even if they knew their immunity level, they still decided not to get vaccinated because they were concerned about possible harm to the unborn baby, miscarriage or preterm delivery. This attitude must be adjusted during the COVID-19 pandemic. Several studies have shown that vaccination against COVID-19 before and during pregnancy is safe, effective and beneficial to both the mother and child. The benefits of getting a COVID-19 vaccination during pregnancy far outweigh any potential adverse consequences23,25,26,27,28.

No COVID-19 vaccine contains a live virus, so the vaccines do not cause COVID-19 infection in recipients, including pregnant women and their foetuses23,25,26,27,28. However, our investigation found that most respondents were uncertain whether the vaccine was safe for themselves and their unborn children. The women were unsure whether the vaccine would help prevent infection in their unborn babies. Most also believed that multiple vaccinations would harm their unborn children. This lack of information made it very challenging for them to decide whether to be vaccinated while pregnant.

Regarding the safety of mRNA COVID-19 vaccines (Moderna and Pfizer-BioNTech), no problems have been found for women vaccinated with them before or during pregnancy or for their unborn children23,25,26,27,28. Data from studies in the United States, Europe and Canada show that their use during pregnancy is not associated with an increased risk of complications, such as preterm birth, miscarriage and postpartum haemorrhage21,26,29. There is no increased risk of miscarriage in pregnant women administered an mRNA COVID-19 vaccine before or during early pregnancy (before 20 gestational weeks)25,26,28,29. A study from Chicago found that COVID-19 vaccination in pregnant women before and during the first trimester was not associated with a risk of congenital malformations30.

The administration of 2 primary doses of a COVID-19 mRNA vaccine to mothers during their pregnancy helped protect babies younger than 6months from being hospitalised due to COVID-19 infection. In our investigation, the majority (84%) of infants hospitalised with an infection were born to women not vaccinated during pregnancy31.

Our research found that the type and number of vaccinations influenced vaccination decisions. In Thailand, the Pfizer-BioNTech and Moderna COVID-19 vaccines are more popular than the other COVID-19 vaccines available in the country, and these 2 vaccines have been reported to be safe in pregnant women23. However, some vaccination centres in Thailand only provide 1 type of vaccine. Consequently, people seeking vaccination may find that their preferred vaccine is unavailable. If an alternative vaccine can be provided by allowing pregnant women to select the vaccine themselves, it would likely increase the vaccination rate among pregnant women.

In addition, our research found that vaccination decisions are influenced by social media news about the dangers to mothers and unborn children, including death and disability. Most of the pregnant women in our study rejected vaccination because they were uncertain whether vaccination would increase their foetuses immunity. Recent research has revealed the role of social media in disseminating information and potentially influencing peoples attitudes towards vaccination. Studies have also shown the positive potential of social media in public health interventions and overcoming vaccination hesitancy among mothers32,33,34,35. Therefore, there should be thorough scrutiny of the various roles of social media in disseminating information to the public and influencing individual behaviour in the context of public health activities. This approach will give pregnant women a correct understanding of COVID-19 vaccines.

Vaccination certifications also play a key role in pregnant womens vaccination decisions. Attending workplaces or meetings involving large groups of people puts individuals at risk of contracting COVID-19. Therefore, most public and private organisations require employees attending workplaces to be vaccinated to the levels recommended by the Thai Ministry of Health. Employers may also require certification of COVID-19 vaccination status. These restrictive policies pressurise pregnant women to get vaccinated even if they disagree with having a vaccination.

WHO has commented that COVID-19 is a health emergency that does not give governments many choices in quickly returning the situation to normal. Regarding calls for the widespread use of COVID-19 vaccination certificates, WHO recognises that introducing such certificates is risky and may result in harm. The general use of the certificates may cause deviations from their initial objectives: to ensure continuity of care and to provide proof of vaccination status. Legal or ethical considerations may be raised by further potential uses for vaccination certificates, for example, public health surveillance, pharmacovigilance, research, and exemptions to public health and social measures. WHO cites legal obligations to protect patient data and the need to respect human rights and fundamental freedoms. To this end, WHO has recommended that data protection measures be in place before adopting digital vaccination certificates. It has also stressed that vaccination certificates must not be considered a substitute for health surveillance36.

Our study presented both similar and different results from the previous study about attitudes, acceptance and rejection of COVID-19 vaccination among breastfeeding women34. Both pregnant and breastfeeding women believed that vaccines can reduce infection and disease severity. The womens COVID-19 immunity levels did not affect their acceptance or rejection of vaccination and some mothers rejected vaccination because of concerns about possible harm to them or their newborns. The safety of COVID-19 vaccination to the unborn and newborn babies and mothers is the main concerning of both pregnant and breastfeeding women. However the different results of pregnant women from breastfeeding women were the effect of social media messages and vaccination certifications to their decision. Pregnant women had more concern about those issue than breastfeeding women. Most of pregnant women were still working and COVID-19 vaccination certifications were important to their works. While breastfeeding women have a right for stop working up to 90days, therefore vaccination certification is not required.

To enhance COVID-19 vaccination rates during pregnancy, it is essential to address the significant decline in pregnant women's confidence in vaccination. Targeted strategies involve implementing comprehensive education and communication campaigns to dispel misinformation and underscore the safety and benefits of vaccination for both mothers and unborn children. Specific measures include developing focused educational initiatives, employing communication strategies to counter social media influence, improving information accessibility about vaccine types, establishing clear certification guidelines for safety, and tailoring messaging to address concerns about potential harm to unborn babies. These efforts aim to increase vaccination acceptance among pregnant women, contributing to improved maternal and fetal health outcomes.

Our study is affected by some limitation. The study design was prospective cross-sectional study which represented the real situation of COVID-19 outbreak during that time. The study is limited by the exclusive recruitment of the sample from Siriraj Hospital. Despite this, it's crucial to recognize that Siriraj Hospital, functioning as both a medical school and a referral center in Bangkok, draws patients from diverse regions of Thailand seeking advanced prenatal care. The selection of 400 pregnant women aimed to represent a varied demographic from different parts of the country. Although participants were not randomly chosen and were exclusively from Siriraj Hospital, the study intended to capture the extensive demographics and geographic diversity inherent in the hospital's patient population. Most of pregnant women (85.3%) had a history of COVID-19 vaccination which would affect the decision making for repeated vaccination. Their actual attitude may be affected by the severity of disease and availability of database of COVID-19 vaccination during pregnancy at that time.

The strength of our study is the less of socially desirable bias. In phase I, participant was in-depth interviewed in a close area by only single interviewer and in phase III, pregnant women response questionnaire in a closed place. The respondent can present the actual attitude, acceptance or rejection of COVID-19 vaccination.

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A qualitative study of pregnant women's perceptions and decision-making regarding COVID-19 vaccination in Thailand ... - Nature.com

March 01, 2024

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The latest COVID-19 vaccines reduce the risk for hospitalization or visits to an ED or urgent care by around 50%, according to interim data published in MMWR.

This seasons influenza vaccines were similarly protective against hospitalization among children and adults, early estimates published in MMWR showed.

The updated, monovalent COVID-19 vaccines recommended by the CDC in September target omicron XBB subvariants of SARS-CoV-2.

Although studies have found that updated COVID-19 vaccines elicit broadly cross-protective neutralizing antibodies, including against XBB lineages and JN.1 currently the predominant omicron lineage the pace and frequency with which new SARS-CoV-2 lineages have displaced predecessors underscores the need for ongoing monitoring of COVID-19 vaccine effectiveness (VE) and for periodic COVID-19 antigen updates, Jennifer DeCuir, MD, PhD, from the CDCs Coronavirus and Other Respiratory Diseases Division, and colleagues wrote in MMWR.

DeCuir and colleagues analyzed data on 128,825 people who had a medical encounter (ME) or were hospitalized for COVID-19 at one of 369 EDs and 229 hospitals in eight states in the Methods for Virtual SARS-CoV-2, Influenza and Other Respiratory Viruses Network (VISION). Of these, 17,229 received a positive test for SARS-CoV-2 and 111,569 received a negative test.

Among VISION MEs and hospitalizations, 8% of people with a positive SARS-CoV-2 test had received an updated COVID-19 vaccine and 12% of people with a negative SARS-CoV-2 test had received the updated vaccine.

Overall, VE against COVID-19-associated ME or hospitalization was 51% (95% CI = 47%-54%) in the first 7 to 59 days after receiving an updated vaccine dose and 39% (95% CI = 33%-45%) in the 60 to 119 days after an updated vaccine dose.

Another study published in MMWR showed that the 2023-2024 influenza vaccines have VEs that are relatively similar to previous vaccines.

These interim estimates indicate that receipt of a 2023-2024 influenza vaccination reduced the risk for medically attended influenza-associated outpatient visits and hospitalization among children and adolescents and among adults, including those older than age 65 years, consistent with results from previous years, Aaron M. Frutos, PhD, from the CDCs Influenza Division, and colleagues wrote.

Frutos and colleagues analyzed data from four CDC-affiliated VE networks of health care facilities in 22 states on people who received outpatient medical care or were hospitalized for acute respiratory illness (ARI). It was the first time that interim influenza VE data were available at the same time for both adults and children from four different vaccine effectiveness networks.

They estimated that interim VE against any influenza-associated ARI among adults ranged from 33% to 49% in outpatient settings and 41% to 44% against influenza-associated hospitalization. Among children, interim VE against influenza was 59% to 61% in outpatient settings and 52% to 61% against influenza-associated hospitalization.

A second study of 2023-2024 influenza vaccine effectiveness by Sophie Zhu, PhD, an investigator in the CDCs Epidemic Intelligence Service, and colleagues found similar VE rates based on nearly 680,000 people in California who had an influenza test between Oct. 1, 2023, and Jan. 31, 2024.

Zhu and colleagues found that 28% of people who received an influenza test had received an influenza vaccine, including 18% of people who tested positive and 29% of people who tested negative.

Overall, they found that adjusted VE was 45% against receiving a positive influenza test, with VE highest among people aged younger than 18 years at 56%, and that it declined among older age groups 48% among adults aged 18 to 49 years, 36% among people aged 50 to 64 years and 30% among people aged older than 65 years.

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Disclosures: DeCuir, Frutos and Zhu report no relevant financial disclosures. Please see the studies for all other authors relevant financial disclosures.

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Latest COVID-19 vaccines reduce hospitalization risk by around half - Healio

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Health initiatives in rural areas need to be geographically tailored, culturally anchored, and locally driven, academics argue.

The group of University of Otago and University of Waikato researchers studied health providers in rural Mori and Pasifika communities during the COVID-19 vaccination rollout. They uncovered the challenges they faced but also found ways to ensure the effectiveness of any future health promotion programs.

Rural residents in Aotearoa New Zealand are known to have worse health outcomes than their urban counterparts, and were identified as an at-risk population during the pandemic. Despite this, disparities have been found between rural and urban vaccination rates.

The study, published in the Journal of Primary Health Care, aimed to gain insight into factors contributing to this disparity by exploring the experiences of those "on the ground" during the pandemic response.

Lead author Associate Professor Kati Blattner, of Otago's Department of General Practice and Rural Health and Va'a O Tautai, Center for Pacific Health, says common issues were identified.

"The rural vaccine rollout was developed without consideration of the rural context or effective engagement with rural health providers. Challenges multiplied on rural roads with geographical distance, small low-density populations, dire workforce shortages and limited infrastructure including phone and internet connectivity," she says.

Realizing misalignment with their context was hindering progress, rural health providers took ownership of the rollout, entrusting established ways of working and engaging their communities and external Mori or Pasifika networks, enabling innovative local solutions to arise.

"We found three overarching factors influencing the vaccine rollout rurally: geographical tailoring, cultural anchoring, and local control," Dr. Blattner says.

The interaction between these three factors was as important as the role played by each one.

"Rural places are not miniature citiesthe smaller and more remote the community, the more important that health services are integrated, which requires bundled rather than fragmented administrative and regulatory frameworks and resources.

"Bundling requires a move away from siloed funding for strands of activity to a whole-of-service, community-led approach.

"Successful rural vaccine rollouts should not be built on specific immunization programs, but rather on strong, resilient rural health services."

However, despite demonstrating capability for rolling out a national initiative while continuing to operate their services as usual, Dr. Blattner says no sustained investment in rural health services was forthcoming.

"We hope the voices of the health workers and their communities covered by the research are represented loudly enough that this will lead to a better understanding of their rural context and their health services for those based centrally, particularly policy makers and program funders.

"New Zealand needs sustained investment in rural health services, which are designed for rural contexts and capable of meeting the needs of diverse rural communities."

More information: Katharina Blattner et al, He Aroka Urut. Rural health provider perspectives of the COVID-19 vaccination rollout in rural Aotearoa New Zealand with a focus on Mori and Pasifika communities: a qualitative study, Journal of Primary Health Care (2024). DOI: 10.1071/HC23171

Journal information: Journal of Primary Health Care

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Study provides rural perspective on COVID-19 vaccination rollout - Medical Xpress

In a study yesterday in Clinical Infectious Diseases, Centers for Disease Control and Prevention (CDC) and Epic Systems researchers reveal that, among US adults at risk for severe COVID-19 in the Epic Cosmos database, the lowest rate of hospitalization was among those recorded as receiving three or more mRNA COVID vaccine doses plus Paxlovid (nirmatrelvir-ritonavir).

The researchers used electronic health data from April to August 2022 to calculate adjusted hazard ratios (aHRs) for hospitalization among outpatients who had mild to moderate confirmed COVID-19.

In total, 731,349 patients eligible for treatment with Paxlovid were included in the study, of whom 5,296 (0.72%) were hospitalized within 30 days of their COVID-19 diagnosis. Among the patients, 177,757 (24.3%) were unvaccinated, 157,011 (21.5%) received two doses of mRNA vaccines, 330,448 (45.2%) received three or more mRNA vaccine doses, and 66,133 (9.0%) were categorized in the "other vaccination" category.

Of unvaccinated patients, 20.2% received Paxlovid compared to 27.0% of patients who received two mRNA doses, and 33.0% of those who had received three or more mRNA vaccine doses.

The rate of hospitalization after receipt of Paxlovid was 19.7 per 100,000 person-days for those unvaccinated, 16.4 per 100,000 person-days for those with two mRNA vaccine doses, and 14.2 per 100,000 person-days for those with three or more mRNA vaccine doses.

The authors found a 78% reduction in risk of hospitalization among patients who had three doses of vaccine as well as Paxlovid (aHR, 0.22; 95% confidence interval [CI], 0.19 to 0.24.) Two vaccine doses and no Paxlovid was associated with an aHR of 0.74 (95% CI, 0.67 to 0.80), and three doses and no Paxlovid were linked to an aHR of 0.51 (95% CI, 0.47 to 0.55). Among unvaccinated patients who took Paxlovid, the aHR for hospitalization was 0.47 (95% CI, 0.40 to 0.55).

"Although we found evidence of substantial protection against hospitalization by nirmatrelvir-ritonavir, the absolute reduction in hospitalizations was modest," the authors concluded. "As an increasing proportion of the population has a degree of immunity from infection or vaccination and as pathogenicity has changed, overall hospitalization rates are lower than earlier in the pandemic."

Although we found evidence of substantial protection against hospitalization by nirmatrelvir-ritonavir, the absolute reduction in hospitalizations was modest.

The authors said Paxlovid still offers the greatest benefit to people at the highest risk of severe COVID-19 outcomes.

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COVID-19 vaccines plus Paxlovid tied to low rates of hospitalization - University of Minnesota Twin Cities

Americans should expect yet another update of the Covid-19 vaccine this fall at about the same time as flu shots are available, the top US public health official said Monday.

Researchers are working on selecting a strain for the upcoming version, and will probably wait until May to pick one to target with vaccines, <-bsp-bb-link state="{"bbHref":"bbg://securities/0247409Z%20US%20Equity","_id":"0000018e-0b97-d64e-af9e-cfdf92000000","_type":"0000016b-944a-dc2b-ab6b-d57ba1cc0000"}">Centers for Disease Control and Prevention Director <-bsp-person state="{"_id":"0000018e-0b97-d64e-af9e-cfdf92000001","_type":"00000160-6f41-dae1-adf0-6ff519590003"}">Mandy Cohen said in an interview at Bloombergs offices in Washington.

CDC Director Mandy Cohen speaks with Bloombergs Riley Griffin in Washington.

Source: Bloomberg

Cohen took the helm at the CDC in July, just weeks after the US ended the emergency declaration that gave the agency special powers to address the ...

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Updated Covid Shot Expected This Fall, CDC's Cohen Says (1) - Bloomberg Law