Category: Covid-19

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New COVID-19 Vaccine Recommendations: What They Mean for You | Time
April 24, 2023

In an Apr. 19 meeting, the vaccine committee of the U.S. Centers for Disease Control and Prevention (CDC) recommended that people ages 65 and older get a second bivalent mRNA booster. The panel also recommended additional boosters for people with weakened immune systems.

As a result of the new recommendations, the bivalent booster, which targets both the original and Omicron BA.4/5 viruses, also becomes the only mRNA COVID-19 vaccine available in the U.S., replacing the original shots that targeted only the original SARS-CoV-2 virus and were used to immunize people with their primary series of shots.

The updated guidelines are part of the CDCs effort to streamline a confusing COVID-19 vaccine regimen. Currently, it includes different formulations of mRNA vaccines from both Pfizer-BioNTech and Moderna. Under the latest guidelines, these will now all target the same viral strain, differing only by dosage for different age groups.

The committee also supported simplifying the currently complicated vaccination timelines for most healthy Americans ages six and older with a booster once a year, similar to the annual flu shot. That means that most peoples next COVID-19 shotlikely a bivalent shotwould probably come in the fall.

The U.S. Food and Drug Administration (FDA)s vaccine committee will meet in June to decide which strain or strains should be included in that shot. While the specific formulation of the vaccine may change, its not likely that the simplified dosing schedule will change.

The panel also allowed for some flexibility in the timing and frequency of the bivalent booster dose, especially for young children, older people, and people with weakened immune systems. For all of these groups, the committee supported giving doctors discretion in deciding whether additional dosesbeyond the single booster recommended for most healthy peopleshould be used.

The schedule remains slightly more complicated for younger children, since the two mRNA vaccine brands have varying doses based on age groups. For healthy children ages six months to four years, the committees updated recommendations advise at least two total doses, with at least one of them being a bivalent shot. Until now, children in this age group got two shots of Modernas original vaccine and a bivalent booster, while kids getting Pfizer-BioNTech received either two or three shots of the original, depending on their age, and a bivalent booster. Now, regardless of where they are in their primary vaccination series, the new recommendations could mean getting fewer total doses.

For five year olds, the recommendations are slightly different, since Pfizer-BioNTech and Moderna used different age cutoffs for their studies. Five year olds getting Moderna shots now need at least two doses, with a least one of them being a bivalent shot. Five year olds getting Pfizer-BioNTech vaccine only need one dose of the bivalent shot. (To make the changes easier to understand, the CDC says it will publish charts on its website for parents and doctors detailing the new vaccination regimen for all young children.)

These recommendations will remain in place until FDA and CDC experts meet again in June.

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XBB.1.16 Arcturus Is New Covid-19 Variant Under … – Forbes
April 24, 2023

The spread of the XBB.1.16 Covid-19 Omicron subvariant has fueled a Covid-19 surge and the return of ... [+] face mask mandates in India. (Photo by Sunil Ghosh /Hindustan Times via Getty Images)

Guess what? Theres yet another Covid-19 coronavirus variant spreading around the world and in the U.S. This one has the oh-so-easy-to-remember name XBB.1.16 because when has the name of another Omicron subvariant started with the letters XBB, right? On March 22, the World Health Organization (WHO) classified the XBB.1.16 as a new variant under monitoring (VUM), which isnt as serious as a variant of interest (VOI) which isnt as serious as a variant of concern (VOC). Nevertheless, a VUM could always eventually become a VOI or even a VOC. And the spread of the XBB.1.16 seems to have already fueled whats been called by Business Today a massive surge of Covid-19 cases in India and sparked the return of face mask mandates there. These days the term massive surge isnt great to hear unless you are talking about chocolate or sex. So the big question is how concerned should you be about this new subvariant that some have unofficially dubbed the Arcturus subvariant?

Well, Acturus-lly, the XBB.1.16 has gone from being about 0.21 percent of all Covid-19 cases worldwide in late February to an estimated 3.96% a month later. In the U.S,, the XBB.1.16 accounted for an estimated 7.2% of all Covid-19 samples from April 9 to April 15, according to the Centers for Disease Control and Prevention (CDC). Thats up from 3.9% the week before and 2.1% the week prior to that. XBB.1.5 is still the alpha-dog of variants in the U.S., accounting for an estimated 78.0% of all COvid-19 samples. But the XBB.1.16 has already overtaken all the other XBBs to reach second place in the U.S. and seems to have XBB.1.5 in its sights, metaphorically, of course, since we dont want to imply that the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has eyes.

So it does look like the XBB.1.16 has a growth advantage over other existing SARS-CoV-2 variants and subvariant. A growth advantage may sound like a good thing when you are using the term to describe yourself or certain parts of yourself. But its a much more ominous term when being used to describe a still dangerous pathogen like the SARS-CoV-2. In this case, its when a given variant or subvariant has characteristics that makes it better able to spread than others.

During a March 29 press conference, Maria Van Kerkhove, PhD, the WHOs Technical Lead on Covid-19, did indicate that the XBB.1.16 is actually very similar in profile to XBB.1.5. It has one additional mutational mutation in the spike protein which in lab studies shows increase infectivity, as well as potential increased pathogenicity. These arent positive terms. If a date describes you as having increased pathogenicity, you are unlikely to have a second date with him or her because it means increased disease-causing capabilities. Increased infectivity means that the XBB.1.16 may be more likely to infect you than other variants and subvariants. Potential increased pathogenicity suggests that the XBB.1.16 could potentially, maybe, perhaps, possibly cause more severe Covid-19 than other existing variants and subvariants. But the jury is still out on this latter issue. Van Kerkhove added, This is one to watch. It has been in circulation for a few months.

This is why the WHO has categorized the XBB.1.16 as a VUM three months after it was first detected on January 23. This is not an everyone has VUM situation as there are only six other variants and subvariants currently on the WHO VUM list. The WHOs formal working definition of a VUM is one with genetic changes that are suspected to affect virus characteristics and early signals of growth advantage relative to other circulating variants (e.g. growth advantage which can occur globally or in only one WHO region), but for which evidence of phenotypic or epidemiological impact remains unclear, requiring enhanced monitoring and reassessment pending new evidence. It would become a VOI if its already demonstrated a clear growth advantage over other circulating variants in more than one WHO region with increasing relative prevalence alongside increasing number of cases over time, or other apparent epidemiological impacts to suggest an emerging risk to global public health. XBB.1.5 is the only WHO VOI right now. A subvariant would become a VOC if it either showed that it causes more severe disease, significantly affects the ability of health systems to provide care to patients, or is able to evade protection against severe Covid-19 from vaccination. The WHO VOC list is currently like the list of A-list celebrities wearing leg warmers, empty.

That doesnt mean that the XBB.1.16 shouldnt raise any concern. The XBB.1.16 has already appeared in at least 29 countries, according to the WHO. As mentioned earlier, its been making its mark on India. The April 14 Business Today article indicated that India had reported 11,109 cases in the last 24 hours, as per the health ministry data on Friday. It also mentioned that India has 49,622 active Covid-19 cases and a fatality rate of 1.19%. This was the fifth consecutive day that India had reported a rise in Covid-19 cases.

Could the XBB.1.16 fuel surges in other countries like Singapore, the U.K., Australia, and the U.S. Well, Mike Honey, who is the Technical Lead for Manga Solutions based in Melbourne, Australia, provided on Twitter this animated map showing the spread of the Acturus variant around the world:

Now, Honey used the name Arcturus. But, remember, that name aint official, just like Kraken and Orthus names of earlier emerging subvariants werent official either. Its just that the continued use of letter and number combos that sound more like Star Wars droids has made it more difficult for the general public to keep track of these different Omicron subvariants. Thats prompted folks on social media to create and use their own unofficial nicknames, to grin and bear it in a way. Arcturus is actually a Latinized version of the ancient Greek name Arktouros, which means Guardian of the Bear, because who wouldnt want a bear to be guarded, right?

Speaking of bear, has this new subvariant brought to bear another Covid-19 surge in the U.S. yet? Well, it may be that one can bearly tell these days because so many folks seem to have abandoned getting officially tested for Covid-19. When people are home testing and not telling others their results or not getting tested at all, the reported Covid-19 cases probably dont really reflect whats really going on with the pandemic. The CDC numbers still show a downward trend in cases since mid-January with 101,437 reported Covid-19 cases for the week ending April 12. But as they say, who the bleep knows. Plus, reported cases always lag whats happening right now since it takes time for people to get tested and public health officials to learn of these cases.

All of this is a reminder that although many political leaders seem to want to shove Covid-19 under the metaphorical rug and act as if its not a problem anymore, the virus certainly hasnt agreed to simply go away. It is still important to keep track of what variants and subvariants continue to emerge and what problems they may bring.

There have been anecdotes of more people reporting conjunctivitis symptoms with XBB.1.16 infections. Conjunctivitis, which is popularly (or maybe unpopularly) known as pink eye, is when your conjunctiva gets inflamed and swollen. The conjunctiva is the thin layer of tissue that covers the white part of your eye and the inside of your eyelids. Tatiana Prowell, MD, an Associate Professor of Oncology at Johns Hopkins School of Medicine, warned on Twitter that the red, itchy, or sticky eye symptoms associated with such a viral conjunctivitis could be mistaken for allergies:

Keep in mind, though, that anecdotes are not the same as official data and well-constructed medical studies. So, its not clear yet how common conjunctivitis may be for those who get infected with the XBB.1.16 and what other symptoms and problems may emerge. In other words, its not clear yet what Arcturus may actually bring to bear, so to speak. Whats clear, though, is that this new subvariant does indeed bear close watching.

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XBB.1.16 Arcturus Is New Covid-19 Variant Under ... - Forbes

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