Category: Covid-19 Vaccine

Interrupting treatment of immunosuppressing medicines for two weeks can significantly improve antibody immunity provided by COVID-19 booster vaccines.

A major study has shown that people with inflammatory conditions are able to improve the antibody response from a COVID-19 booster vaccination by interrupting their treatment of methotrexate for two weeks immediately after having the vaccine.

The findings of the study show that the antibody response to the vaccine was double at four weeks and was one and a half times greater at 26 weeks, when compared to those who continued with their treatment as usual. This improved antibody response was found to last for six months.

These findings will be useful for national immunisation advisory committees, and other specialist societies formulating recommendations on the timing of vaccination in those treated with or starting medicines that turn down the immune system.

Co-Lead Investigator Professor Rosemary Boyton, from Imperials Department of Infectious Disease, said: This study shows that a simple intervention like interrupting methotrexate for two weeks immediately after the COVID-19 booster vaccine dose improved subsequent antibody responses and that this effect was sustained at 26 weeks.

"Further important research is in progress to understand better how this simple intervention impacts on vaccine induced antibody (B cell) and cellular (T cell) immune memory and cross-protection against current and emerging variants of concern.

Methotrexate is an immunosuppressant medication. It slows down the bodys immune system to help reduce swelling and is prescribed to manage conditions such as rheumatoid arthritis, psoriasis and Crohns disease.

While methotrexate is effective at controlling these conditions and has emerged as first line therapy for many illnesses, it reduces the bodys ability to fight infections and the ability to generate a strong response to flu and pneumonia vaccines, including those against COVID-19.

The Vaccine Response On Off Methotrexate (VROOM) trial recruited 383 participants that were taking methotrexate and had clinically stable rheumatoid arthritis or psoriasis. They found that in the people who stopped using immunosuppressing medication for two weeks, the level of antibody response was one and a half times greater at 6 months compared to the group who continued their treatment.

Patients who interrupted treatment reported experiencing more flare-ups of their inflammatory conditions in the next few weeks, but most flares were self-managed, and most didnt need help from a healthcare provider.

Chief Investigator, Professor Abhishek at the University of Nottingham and Honorary Consultant Rheumatologist at Nottingham University Hospitals NHS Trust, said: COVID-19 has not gone away, and with the emergence of new variants, and vaccine hesitancy among patients, it is important to optimise durable protection in people who are susceptible to COVID-19. Evidence from our trial will help patients and clinicians make informed choices about the risks and benefits of interrupting methotrexate treatment around the time of vaccination against COVID-19.

The study was carried out in collaboration with colleagues from the University of Manchester, Imperial College London, the University of Oxford, Queen Mary University London, UK Health Security Agency (formerly Public Health England) and participating NHS hospitals. The study was managed by the Oxford Clinical Trials Research Unit (OCTRU).

The trial is funded by a National Institute for Health and Care Research (NIHR) and Medical Research Council (MRC) partnership.

This article has been adapted from a press release from the University of Nottingham.

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Immunosuppressing medicine can be interrupted to boost COVID-19 vaccine response - Imperial College London

Doctors in Singapore are calling on people to vaccinate and to put on a face mask to reduce the usual year-end increase in acute respiratory infections, including COVID-19, influenza and the common cold.

Both Healthway Medical, the largest general practice chain with more than 120 clinics, and Parkway Shenton with 55 GP clinics, say they have seen a 30% increase in respiratory infections, according to a report by The Straits Times on December 12.

Raffles Medical with 43 GP clinics has also noticed an increase in such ailments, the report added.

The latest Ministry of Health (MOH) data for the week ending December 2 showed an average of 2,970 cases a day at Singapores 25 polyclinics against a five-year median of 2,009 daily cases for 2018 to 2022 for this time of the year.

While this is lower than the 3,000 to 3,500 a day in the pre-pandemic years, it comes on the back of almost three years of low infection rates due to precautions taken against COVID-19. In 2020 and 2021, polyclinics were seeing fewer than 1,000 cases a day in early December.

Polyclinics treat about 20% of acute cases in the primary care setting, with the 1,800 GP clinics handling the rest.

For the same week, more than 32,000 people were diagnosed with COVID-19 about 460 were hospitalised and nine needed intensive care, adding significantly to the bed crunch at public hospitals.

Professor Hsu Li Yang, an infectious diseases expert at the National University of Singapores Saw Swee Hock School of Public Health, said: During this holiday season, as upper respiratory tract infections including COVID-19 cases rise, it is important to be mindful of others. Wear a mask in crowded places, stay home if unwell, and get the latest flu jab as well as a COVID-19 booster to avoid disrupting your travel plans. Doctor Jonathan Tan, a family physician at Healthway, added: We usually see more respiratory infections during the year-end. However, this year we are seeing an even larger increase in the number of upper respiratory tract infections.

Fortunately, the majority of cases are mild and can be treated in an outpatient setting, he said. He too advised staying updated with Influenza and COVID-19 vaccinations and to mask up, especially in crowded places, as this can reduce the chances of catching air-borne bugs.

COVID-19 vaccines are free in Singapore, as is the Influenza vaccine for those who have signed up for Healthier SG, the national scheme introduced in 2023 to encourage people to stick to one family doctor who can provide preventive care to keep them healthy.

The actual number of people with Influenza is relatively low, with the majority suffering from the common cold.

The MOH, which tracks Influenza infections to spot possible pandemics, said: The proportion of patients with Influenza-like illness among the polyclinic attendances for acute respiratory infection is 0.5%. Out of this small number with Influenza-like illness, only 11.5% tested positive for the flu virus over the past four weeks.

Dr. Tan said people who feel sick should promptly test for COVID-19 at home. If they test positive, there is the option of taking antiviral medications such as Tamiflu. This will reduce the severity of symptoms.

Doctor Edwin Chng, Parkway Shentons medical director, said: Those with risk factors, including the elderly and immunocompromised people, should see a doctor for proper assessment. He said people should practise good hygiene which most people were doing during the pandemic years such as hand washing and not touching their face with their hands, as this could spread diseases like the common cold, COVID-19 and the flu.

Doctor Chng Shih Kiat, medical director at Raffles Medical, said some patients seen at its clinics needed to be prescribed antivirals, though the majority of patients had relatively mild symptoms.

To avoid getting sick, he advised people to stay healthy and eat a balanced diet with an adequate intake of fruits and vegetables.

It is also important to get ample rest and stay hydrated. Exercise regularly, but do not over-exert with overzealous exercise routines. When travelling, wear a mask, especially in crowded places, the broadsheet had Dr. Chng as saying.

Link:

Doctors advise Singaporeans to vaccinate, put on face masks amidst COVID-19 wave - The Hindu

Amsterdam (Precision Vaccinations News)

The European Commission (EC), the Heads of Medicines Agencies (HMA), and the European Medicines Agency (EMA) today published the first version of the Union List of critical medicines, which includes vaccines.

As of December 12, 2023, the List contains more than 200 active substances of medicines for human use, considered critical for healthcare systems, for which continuity of supply is a priority and shortages should be avoided.

The List reflects the outcome of the review of 600 active substances taken from six national lists of critical medicines andwill be expanded in 2024 andupdated yearly.

Inclusion in the List does not mean that the medicinewill likely experience a shortage soone. It implies that preventing shortages is particularly important as a shortage could cause significant harm to patients and pose essential challenges to health systems.

A medicine or vaccine is considered critical if used in serious diseases and cannot be easily replaced by other products in case of a shortage.

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Europe's Initial Critical Medicines and Vaccine List Announced - Precision Vaccinations

Published: Dec. 13, 2023 at 8:01 a.m. ET

By Will Feuer

Shares of Moderna and other makers of Covid-19 vaccines were dragged lower after rival Pfizer warned that it expects revenue from its Covid-19 products to fall next year.

Moderna shares were down nearly 5% at $74.51 in premarket trading, following Pfizer shares, which were more than 6% lower. Shares of Moderna have already fallen...

By Will Feuer

Shares of Moderna and other makers of Covid-19 vaccines were dragged lower after rival Pfizer warned that it expects revenue from its Covid-19 products to fall next year.

Moderna shares were down nearly 5% at $74.51 in premarket trading, following Pfizer shares, which were more than 6% lower. Shares of Moderna have already fallen nearly 57% this year.

American depositary receipts tied to shares of Germany-based BioNTech, which has partnered with Pfizer on its Covid-19 vaccine, fell about 4% to $95.00 in the premarket session. The stock is down about 34% this year.

Shares of Novavax also fell about 1% to $5.25 in premarket trading, adding to a decline of about 48% this year.

Earlier Wednesday, Pfizer issued revenue and earnings outlook for next year that fell below Wall Street analysts' expectations. The miss was largely driven by declining sales of the company's Covid-19 vaccine and its Paxlovid treatment.

Write to Will Feuer at Will.Feuer@wsj.com

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Moderna Shares, Other Covid Vaccine Makers Hit by Warning From Pfizer - MarketWatch

Rare blood clots tied to some early COVID-19 vaccines that are no longer in use may have been the result of two out-of-control immune reactions happening at once.

One of these immune reactions was already known, but the second, reported Oct. 26 in the journal Blood, is a new discovery.

The finding could help to explain how other clotting conditions develop and point to better treatments, as well as suggest ways to make vaccines safer for people who are prone to the side effect.

"Understanding how a drug causes an adverse event allows us to design new approaches to make those treatments safer," said Ishac Nazy, an associate professor of medicine at McMaster University in Canada who studies the vaccine-related clotting disorder but was not involved in the current research.

The vaccine-related clotting disorder, known as vaccine-induced immune thrombotic thrombocytopenia (VITT), was rare and linked to two shots: the Johnson & Johnson (J&J) and AstraZeneca COVID-19 vaccines. Both shots contained common-cold viruses called adenoviruses that were tweaked so that they couldn't infect cells. Instead, the modified viruses carried DNA instructions for part of SARS-CoV-2, the coronavirus that causes COVID-19, into the body.

VITT was a sobering side effect of what many public health experts had hoped would be a promising technology. Unlike the Moderna and Pfizer-BioNTech COVID-19 shots, which contain RNA, the J&J and AstraZeneca vaccines did not need ultracold storage, making them more accessible where cold-chain storage is unreliable. Adenovirus-based vaccines have been investigated for other diseases, but very few have achieved approval. Exceptions are an adenovirus-based Ebola vaccine approved in China and another approved by the European Union, both used only in at-risk individuals.

Soon after rolling out the J&J and AstraZeneca vaccines, doctors began reporting cases of clotting that looked a lot like a previously known disorder called Heparin-induced thrombocytopenia (HIT). About 20 to 30 years ago, HIT affected 3.5% of patients who had knee or hip replacements, said Dr. Andreas Greinacher, a physician who specializes in clotting disorders at the Greifswald University Hospital in Germany and was not involved in the new research. In these patients, heparin, a blood thinner normally given to prevent blood clots, actually triggered runaway clotting instead.

The adenovirus-based COVID vaccines were triggering the same condition as HIT, though scientists gave it a new acronym to reflect the different origin. Researchers reported that about 1 in 50,000 people under 50 who received the vaccine were affected, as well as about 1 in 100,000 of those 50 and older.

Neither vaccine is currently administered in the U.S. (AstraZeneca's shot was never used in the country, and J&J's vaccine was authorized but then retired due to the clotting issue and availability of better vaccines.) However, learning what triggers VITT could still be useful.

Today, HIT is rare because doctors now understand what causes it and can prescribe different, safer versions of heparin, Greinacher told Live Science. Similarly, he said, studying the mechanisms behind HIT and VITT could make adenovirus vaccines safer.

"Our big aim currently is to find which factor in the vaccines is triggering it," Greinacher said. "If you know the factor, I'm certain there are very smart biotechnologists who can modify the adenovirus vector so this factor is no longer present."

When VITT was first observed in patients getting COVID-19 vaccines in February 2021, scientists soon discovered that it had to do with PF4, a chemical signal released by platelets, the blood cells that form clots.

In rare cases after vaccination with an adenovirus-based vaccine, the body would make antibodies to PF4. These antibodies would latch onto PF4 and form clumps that could then bind to receptors called Fc on other platelets. This would activate the platelets and lead to a runaway clotting response.

The new Blood study found that PF4 alone also activates a second set of receptors that cause platelets to accumulate, likely a second reason why clotting goes haywire in this disorder.

There is still a long way to go, Nazy told Live Science, whose team first reported in 2021 how antibodies against PF4 were causing VITT. The new research suggests that there are actually two different ways that PF4 acts in VITT, he said. These two pathways are not exclusive and may work in tandem.

In the new study, researchers tested blood from healthy individuals and people with VITT to trace the cascade of signals that leads to the overactive clotting. They found that the PF4 activates a receptor called c-Mpl on platelets, which causes them to clump together. This is in addition to the mechanism discovered in 2021, in which complexes of PF4 and PF4 antibodies activate platelets' Fc receptors.

"What we have shown is that as well as that antibody trigger, you've also got PF4 itself binding to platelets and activating them, providing a double whammy," Phillip Nicolson, an associate clinical professor of cardiovascular medicine at the University of Birmingham in the U.K. and the leader of the new study, told Live Science. "That may be why [the clotting] happens to a harmful degree."

Scientists have a few clues as to why adenovirus vaccines can trigger this response. PF4 carries a positive electrical charge on its surface, while adenoviruses are highly negatively charged, Nicolson said, so they may bind together easily. But even that is not confirmed, Nazy said, and has mostly been shown with computer modeling rather than with real molecules.

In rare cases, unusual clotting happens without vaccination or treatment with heparin. A recent paper published in the The New England Journal of Medicine, and co-authored by Nazy, found that in at least two of these unexplained clotting cases, the clotting disorder occurred after typical adenovirus infections. In many cases, the connection between unexplained clotting and a viral infection may be missed. And it's still a mystery why very few people are susceptible to these clotting conditions.

"That's the part we need to understand to prevent the disease from even happening," Nazy said.

Ever wonder why some people build muscle more easily than others or why freckles come out in the sun? Send us your questions about how the human body works to community@livescience.com with the subject line "Health Desk Q," and you may see your question answered on the website!

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Rare clotting effect of early COVID shots finally explained what could that mean for future vaccines? - Livescience.com

Alejandra O'Connell-Domenech and The Hill

4 days ago

(The Hill) Nearly 60 percent of Americans living in the Midwest and surrounding states say they will not get the new COVID-19 vaccine this year, according to a survey from Emerson College Polling.

The Food and Drug Administration (FDA) approved an updated new COVID-19 booster in September, targeting currently circulating variants of the disease.

But more than three years since the onset of the pandemic, fewer Americans are opting to get booster shots. Only 16 percent of U.S. adults have gotten the newest vaccine, according to the Centers for Disease Control and Prevention (CDC).

The Emerson College survey found Americans overall are split down the middle on whether to get the updated vaccine.

Americans in Minnesota, Illinois, Colorado and Iowa alignedwith national attitudes toward the new shot with about half of the residents in each state saying they would probably forgo the new vaccine.

Wyoming has the largest percentage of residents who willmost likely skip the new shot, with 74 percent of survey respondents saying as much.

Over 65 percent of residents in North Dakota, Oklahoma, Kentucky, West Virginia and Idaho also say they will probably not get the booster, according to survey findings.

Many of the states with large percentages of residents who said they wont get the new vaccine also hold negative opinions about the public health information available in their state.

In Wyoming and Idaho, 37 percent of survey respondents said their states government agencies have a poor quality of public health information, according to the poll.

These findings should be a wake-up call to health communicators, as we can no longer rely on mandates and must engage people in real conversations to encourage them to vaccinate themselves and their families, said Kenneth Rabin, a scholar at the CUNY Graduate School of Public Health and Health Policy that commissioned the survey.

Health experts are urging all Americans over the age of six months to get the updated vaccine to protect themselves from the virus as the country heads into peak respiratory illness season.

Heres the bottom line: COVID-19 vaccine uptake is lower than wed like to see, and most people will be without the added protection that can reduce the severity of COVID-19, the CDC said in an update on the virus last month.

Over 1,500 registered voters took part in Emerson College Polling national survey which was conducted between Oct. 16-17. About 500 residents in 22 states also took part inthe schools statewide surveys, which were conducted between Oct.1-4.

The margin of error for each survey ranges between 3.98 percent and 4.6 percent.

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Most people in Americas Heartland will forgo updated COVID vaccines: Survey - KSN-TV

Published on December 04, 2023

Most health insurance plans will cover COVID-19 and flu vaccines at no cost to the individual. Individuals without health insurance or those with plans that do not cover COVID-19 vaccines can get them at no cost at Metro Health clinics or area pharmacies participating in the CDC's Bridge Access Program. This program will continue next year and ends on December 31, 2024. Visit vaccines.gov to look up sites participating in the Bridge Access Program.

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COVID-19 Vaccination Update - City of San Antonio - City of San Antonio

Area medical providers and pharmacies are offering an assortment of vaccinations to help protect people from respiratory illnesses. CHDI, 200 South Evans, offers walk-in flu, COVID-19, and RSV vaccinations from 8 a.m. to 5:30 p.m. They are limited to established patients of the clinic. The flu vaccine is offered free of charge, the COVID-19 vaccine is free and funded through []

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Clinics, pharmacies offering RSV, flu, COVID-19 vaccinations - Uvalde Leader-News

(Precision Vaccinations News)

The U.S.CDC's Weekly COVID-19 Vaccination Dashboardestimates vaccinations and intent for vaccination using various data sources, including surveys, healthcare claims, electronic medical records, and immunization information systemsdata.

As of December 6, 2023, category highlights include the following data:

As of November 25, 2023, 6.9% (95% Confidence Interval: 6.0%-7.9%) of children were reported to be up-to-date with the 2023-24 COVID-19 vaccine.

About17.3%of children had a parent who reported they planned to get their child vaccinated. Additional COVID-19 vaccination data for children by demographic characteristics at the national level and overall estimates by jurisdiction areavailable at this CDC link.

For pregnant women,8.9% hadreceived the updated 2023-24 COVID-19 vaccine.

Vaccination coverage was highest among non-Hispanic Asian (15.2%) womenand lowest among non-Hispanic Black (2.7%) pregnant women.

And for adults, about 16%reported having received an updated 2023-24 COVID-19 vaccine since September 14, 2023.Vaccination coverage increased by age and was highest among adults 65 and older [33.3%, (31.2%-35.3%)].

From a geography perspective, the District of Columbia reported the most significant number of vaccinated adults,with about 30.7%.

COVID-19 vaccination coverage estimates among alladultsare based on CDC's National Immunization SurveyAdult COVID Module data.

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Who Received an Updated COVID-19 Vaccine? Precision Vaccinations News - Precision Vaccinations

A New Era of Vaccination: Protein-Based COVID-19 Vaccines

The COVID-19 pandemic has stressed the significance of vaccines in the global fight against infectious diseases. In response, Novavax Inc., a leading biotechnology company, has developed an innovative protein-based COVID-19 vaccine, Nuvaxovid XBB 1.5, which has now been authorized for use in Canada, the United States, the European Union, and by the World Health Organization, for individuals aged 12 years and older.

The protein-based vaccine platform has been recognized for its proven safety record, having been used in several vaccine formulas over the years. Dr. Walker, a renowned health expert, has underscored the significant safety track record of these vaccines, emphasizing their importance in the fight against COVID-19.

Protein-based vaccines, unlike mRNA vaccines, use harmless pieces of the virus to trigger an immune response and build immunity. Novavaxs vaccine stimulates both arms of the immune system and incites functional immune responses against various COVID-19 variants. Furthermore, it utilizes Novavaxs patented Matrix M adjuvant, which boosts the immune system response, making it broader and more durable.

Common side effects of Novavaxs vaccine include headache, nausea, muscle pain, and fatigue. However, these are temporary and typically resolve within a few days. The vaccine is a ready-to-use liquid formulation and is stored at a temperature of 2 to 8C, making it a practical choice for mass vaccination programs worldwide.

While protein-based vaccines have proven their efficacy and safety, the introduction of RNA-based vaccines has marked a significant advancement in vaccine development. The newly authorized ARCT-154, an RNA-based COVID-19 vaccine authorized in Japan, uses a form of RNA capable of self-replication inside cells, providing a potent defense against various infectious diseases and cancers.

Despite the potential advantages of RNA-based vaccines, they come with their own set of challenges. The longer sequences in self-amplifying RNA (saRNA) vaccines add complexity to the manufacturing process, and the intricacies of interacting with the immune system pose challenges. On the other hand, protein-based vaccines, such as Novavaxs, have a more established safety record and are relatively simpler to produce.

The development of nucleocapsid (N) protein-based COVID-19 vaccines is an exciting area of research. These vaccines target the N sequences of the virus, which are prone to mutation, and could potentially lead to the development of broad-spectrum vaccines. However, the mutability of N sequences also presents challenges, particularly in terms of the development of cross-reactive vaccines due to escape mutations.

As we continue to battle the COVID-19 pandemic, the importance of vaccination cannot be overstated. Whether you opt for a protein-based or RNA-based vaccine, getting vaccinated is crucial to protect not only yourself but also those around you, particularly as we prepare for the winter season and the potential resurgence of respiratory illnesses.

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Protein-Based COVID-19 Vaccines: A New Era of Vaccination | Novavax Inc. - Medriva