Category: Vaccine

Recent data shows low vaccination rates ahead of the holiday season and new year.

Recent data analyzed by the Boston Public Health Commission (BPHC) shows low vaccination rates and an increase in cases of respiratory viral illness in Boston. BPHC recommends people protect themselves and their communities from getting sick, especially as they travel and gather with loved ones.

According to data from the Massachusetts Department of Public Health (DPH), twice as many people have been hospitalized with the flu or COVID-19 in Boston compared to October.1 BPHC also measures virus levels in wastewater in Boston to track transmission of infection and has noted significant increases in the amount of COVID-19, Flu, and RSV. Compared to two weeks ago, the amount of COVID-19 in wastewater across the city of Boston is 23% higher, the flu virus is 23% higher, and RSV is 34% higher.

Staying up to date on vaccines for respiratory viruses, such as COVID-19, flu and RSV is an important strategy to reduce the risk of severe illness and hospitalization. Using DPH data, BPHC found only 15.7% of people in Boston have received the updatedCOVID-19 vaccine. The data also show only 33.8% of people in Boston have received a flu vaccine this season.2

Vaccination is the best way to prevent severe illness and hospitalization from COVID-19, flu and RSV, and it is not too late to protect yourself this season, said Dr. Bisola Ojikutu, Commissioner of Public Health and Executive Director of the Boston Public Health Commission. We encourage residents to take advantage of opportunities for free walk-in COVID-19 vaccination and testing as well as flu shots.

To make it easier for people to get vaccinated ahead of the holidays, BPHC is holding a vaccine event at the Bruce C. Bolling Municipal Building in Roxbury on Friday and Saturday, December 22 and 23. With a winter wonderland theme to kick off the holidays, the vaccine event will offer free COVID-19 and flu immunizations, giveaways, face painting, treats, and an opportunity to meet Santa. (See flyer below + translations.) For RSV vaccination, people shouldreach out to their healthcare provider to determine eligibility.

Standing COVID-19 and flu vaccine clinics remain at the Bruce C. Bolling Building and Boston City Hall:

Follow the recommended respiratory virus safety steps to reduce your risk:

Older adults, adults aged 60 and older, children younger than 5 years old, pregnant people, and people with chronic medical conditions are among those at higher risk for severe illness, hospitalization, and death.

BPHC has several resources to help people stay healthy ahead of the holidays, including COVID-19 test kits and health education materials in 12 languages. Visit boston.gov/bphc-infectiousdisease to learn more.

1 Over the past 30 days there have been 43.3 new adult COVID-19 hospitalizations per 100,000 in Boston. This is a slight increase compared to the month of October 2023 when we had 38.4 new hospitalizations per 100,000. There have been 73.6 influenza hospitalizations per 100,000 in Boston. This is a large increase compared to the month of October when we had 17.8 influenza hospitalizations per 100,000.

2 Based on DPH data, the current COVID-19 vaccination rate for Boston residents is 15.6% from 7/2/2023 to 12/9/2023. The flu vaccination rate for Boston residents is 33.8%.

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BPHC Encourages Vaccination As Respiratory Virus Cases And Hospitalizations Rise - Boston.gov

image:

Humans mount convergent H1N1-H3N2 neutralizing antibody responses to influenza virus. Panels are derived from structures reported by Simmons et al., (PDB 7TRH, 7RRI and 3UBE by Xu et al., for the model of receptor engagement).

Credit: Kevin McCarthy (CC-BY 4.0, https://creativecommons.org/licenses/by/4.0/)

Researchers have identified a previously unrecognized class of antibodiesimmune system proteins that protect against diseasethat appear capable of neutralizing multiple forms of flu virus. These findings, which could contribute to development of more broadly protective flu vaccines, will publish December 21st by Holly Simmons of the University of Pittsburgh School of Medicine, US, and colleagues in the open access journal PLOS Biology.

A flu vaccine prompts the immune system to make antibodies that can bind to a viral protein called hemagglutinin on the outside of an invading flu virus, blocking it from entering a persons cells. Different antibodies bind to different parts of hemagglutinin in different ways, and hemagglutinin itself evolves over time, resulting in the emergence of new flu strains that can evade old antibodies. New flu vaccines are offered each year based on predictions of whatever the most dominant strains will be.

Extensive research efforts are paving the way to development of flu vaccines that are better at protecting against multiple strains at once. Many scientists are focused on antibodies that can simultaneously protect against flu subtypes known as H1 and H3, which come in multiple strains and are responsible for widespread infection.

Simmons and colleagues homed in on a particular challenge in this endeavora small change found in some H1 strains in the sequence of building blocks that makes up hemagglutinin. Certain antibodies capable of neutralizing H3 can also neutralize H1, but not if its hemagglutinin has this change, known as the 133a insertion.

Now, in a series of experiments conducted with blood samples from patients, the researchers have identified a novel class of antibodies capable of neutralizing both certain H3 strains and certain H1 strains with or without the 133a insertion. Distinct molecular characteristics set these antibodies apart from other antibodies capable of cross-neutralizing H1 and H3 strains via other means.

This research expands the list of antibodies that could potentially contribute to development of a flu virus that achieves broader protection through an assortment of molecular mechanisms. It also adds to growing evidence supporting a move away from flu vaccines grown in chicken eggscurrently the most common manufacturing approach.

The authors add, We need annual influenza virus vaccines to keep pace with continuing viral evolution. Our work suggests that the barriers to eliciting more broadly protective immunity may be surprisingly low. Given the right series of influenza virus exposures/vaccinations, it is possible to for humans to mount robust antibody responses that neutralize divergent H1N1 and H3N2 viruses, opening new avenues to design improved vaccines.

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In your coverage, please use this URL to provide access to the freely available paper in PLOS Biology: http://journals.plos.org/plosbiology/article?id=10.1371/journal.pbio.3002415

Citation: Simmons HC, Watanabe A, Oguin III TH, Van Itallie ES, Wiehe KJ, Sempowski GD, et al. (2023) A new class of antibodies that overcomes a steric barrier to cross-group neutralization of influenza viruses. PLoS Biol 21(12): e3002415. https://doi.org/10.1371/journal.pbio.3002415

Author Countries: United States

Funding: The research was supported by National Institute of Allergy and Infectious Diseases Program Project Grant P01 AI089618 (to G.H.K.) and funds from the University of Pittsburgh Center for Vaccine Research (to K.R.M).The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

Experimental study

Cells

Competing interests: The authors have declared that no competing interests exist

Disclaimer: AAAS and EurekAlert! are not responsible for the accuracy of news releases posted to EurekAlert! by contributing institutions or for the use of any information through the EurekAlert system.

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New type of antibody shows promise against multiple forms of flu virus - EurekAlert

COVID-19 antigen home tests indicating a positive result are photographed in New York, April 5, 2023. (AP Photo/Patrick Sison, File)

HUNT VALLEY, Md. (TND)

Just a couple years ago, the idea of that statement threw much of society into panic and confusion.

Am I at risk? Should I get tested? Should I travel? Should I wear a mask? Have I gotten the latest vaccine?

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But this year, COVID-19 seems to be getting grouped in with the other seasonal respiratory viruses, like influenza and respiratory syncytial virus (RSV).

As we head into the winter months and holiday season, cases of all three viruses are increasing. According to the most recent Centers for Disease Control and Prevention (CDC) data, in the past four weeks, hospitalizations across all groups increased by 200% for influenza, 60% for RSV and 51% for COVID-19.

Theres also talk of a new coronavirus subvariant JN.1. Its now the fastest growing strain in the U.S., making up 20% of new COVID-19 infections. In the Northeast, its the dominant variant.

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JN.1 is another descendant of the Omicron strain weve been seeing since 2022, and so far, theres no evidence it causes any more severity in infections than the other strains did.

The CDC has said COVID symptoms these days typically depend more on someones level of immunity than the variant itself.

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And, according to an article published in Nature Reviews Microbiology, were fairly immune, whether we got vaccinated or infected, or both. Researchers say this has resulted in a vastly decreased overall risk of severe disease.

The government unleashed access to vaccines and evidence-based treatments to prevent deaths and severe illnesses. Scientists say now, in the era of vaccine availability and dominant (less severe) Omicron subvariants, managing COVID-19 looks a lot different than it did in the past three years.

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One things for sure: individual Americans are managing the virus differently.

While the majority of U.S. adults say they plan on getting the latest COVID-19 vaccine, that majority is just 57%, according to a POLITICO/Morning Consult poll in September. Forty-three percent say they probably or definitely will not get the booster.

Gallup has been tracking attitudes toward COVID-19 since the pandemic began. Each time theres a surge in cases, Americans feel a little more concerned about getting infected and take more precaution.

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But overall, a new high 44% of people say the pandemic is over. In July 2022, that number was 33%, and in November 2021, it was just 18%.

Forty-two percent of people say their life is completely back to normal up significantly from even mid-2022, when just 21% of people said their lives were back to normal.

When it comes to wearing face masks, 55% say they never wear a mask outside the house anymore. In July 2020, 53% said they always wore a mask outside, and less than 1% said they never wore one.

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Spring of this year marked the lowest levels of COVID hospitalizations and deaths since the start of the pandemic. With that milestone, masks came off and many employees returned to their offices.

The federal public health emergency also closed out in May, meaning the healthcare system was back to normal, covering people with insurance. The CDC stopped collecting data on positive Covid tests; mask and vaccine mandates expired (or were outlawed in certain states); and travel restrictions eased up.

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These days, although cases are on the rise, the CDC is mostly focused on recommending people get the most updated vaccinations for all the seasonal viruses, so getting your COVID shot is much like getting your flu shot.

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The agency still wants healthcare providers to counsel patients about testing and other preventive measures like covering coughs/sneezes, staying home when sick, improving ventilation at home or work and washing hands.

But thats a far cry from the most stringent CDC guidelines when the pandemic was at its peak: social distancing, N-95 masking, working from home and taking numerous Covid tests to travel by air.

The agency went from recommending people quarantine for two weeks if theyd been infected to simply isolating for five days recommendations that run parallel to other illnesses, like influenza.

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Although the elderly and immunocompromised still face enhanced risks if they get infected, for large swaths of the population, weve returned to normal, maskless day-to-day life.

As scientists warned, COVID is here to stay, but it now joins the slew of other seasonal viruses, and, like the flu, Americans can assess their own personal risk and determine their precautionary plan.

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While it didnt seem possible in the darkest days of the pandemic May 2020 or January 2021 many health officials consider COVID-19 endemic, meaning its patterns are predictable and steady in designated regions. While some health officials disagree over whether Covid-19 has hit that point, and neither the CDC nor World Health Organization (WHO) has officially declared it so, societal norms have changed.

Like Dr. William Schaffner, infectious disease expert at Vanderbilt University Medical Center, told WebMD: People are behaving endemically.

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COVID-19 cases are up, but panic is low - KEYE TV CBS Austin

The World Health Organisation (WHO) has added the second malaria vaccine to its list of prequalified vaccines. The vaccine, R21/ Matrix-M malaria vaccine , was recommended by the WHO for malaria treatment in October 2023. The R21 vaccine is the second malaria vaccine prequalified by the WHO, following the RTS, S/AS01 vaccine which obtained prequalification status in July 2022. What does it mean to be a prequalified vaccine? As per the information available on the official website of the WHO, if a vaccine has undergone thorough evaluation of relevant data, testing of samples and WHO inspection of relevant manufacturing sites and the outcome is positive it is included in the WHO List of Prequalified Vaccines. Vitamin B12 deficiency signs that are mostly ignored The R21 vaccine has been developed by Oxford University and manufactured by Serum Institute of India. "Today marks a huge stride in global health as we welcome the prequalification of R21/Matrix-M, the second malaria vaccine recommended for children in malaria endemic areas. This achievement underscores our relentless commitment to wiping out malaria which remains a formidable foe causing child suffering and death. This is another step toward ensuring a healthier, more resilient future for those who have lived for too long in fear of what malaria could do to their children. Together with our partners we are united in the pursuit of a malaria-free future, where every life is shielded from the threat of this disease," Dr Kate OBrien, Director of WHO's Department of Immunization, Vaccines and Biologicals has said. In 2022, a total of 608 000 malaria deaths were recorded globally "Malaria, a mosquito-borne disease, places a particularly high burden on children in the African Region, where nearly half a million children die from the disease each year. Globally, in 2022, there were an estimated 249 million malaria cases and 608,000 malaria deaths across 85 countries," the WHO says. Malaria is a life-threatening infectious disease caused by the Plasmodium parasites transmitted to humans through the bites of infected female Anopheles mosquitoes. There are several species of Plasmodium, with P. falciparum being the most deadly. Once bitten, the parasites enter the bloodstream and travel to the liver, where they mature and multiply before re-entering the bloodstream to infect red blood cells.

COVID variant JN.1 has minimum symptoms

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Second malaria vaccine prequalified by WHO: Know what this means - IndiaTimes

Kate O'Brien, Director of the Department of Immunization, Vaccines and Biologicals at WHO

Despite multiple health-related crises, the year 2023 will be remembered as a triumph in global health, with countries coming together to stamp out infectious diseases through dedicated efforts and collaborative action. As the World Health Organization (WHO),celebrated its 75th year in April 2023, a spirit of unity prevailed, reminding us that together, we can provide everyone with the best chance for a healthy life.

On May 5, 2023, WHO Director-General, Dr Tedros Adhanom Ghebreyesus, declared the end of the COVID-19 global health emergency. This momentous occasion highlighted the innovation of vaccine researchers, the grit and resolve of vaccine delivery programmes around the world, political commitment by government leaders, and the incredible dedication of health and care workers.

"The Big Catch-up" initiative announced earlier in the year by WHO and key partners marked a coordinated effort to reverse the historic declines in childhood vaccination resulting from the pandemic and resume the hard-fought gains that will put communities and countries on the path to the Immunization Agenda 2030 (IA2030) goals which have been committed to at the World Health Assembly. Promising signs of recovery in childhood immunization levels were apparent though unevenly felt across countries, offering hope for being able to reach a future where no child dies of a vaccine-preventable disease.

The MVIP is a model public-private partnership and a WHO flagship programme that has been implemented by colleagues at all levels of the Organization, with significant contributions by international and country-level partners. Last week, the WHO

MVIP team, received the Director-Generals Award for Excellence for Exceptional Contribution to the Organization by the 3-level Team for Malaria Vaccine Implementation. Congratulations to WHO colleagues and partners, who were central to the success of the programme. We look forward to further collaboration with partners in 2024 and beyond to support the malaria vaccine introductions into country vaccine and malaria control programmes, so more children can benefit.

Malaria is not the only vaccine news. The dengue vaccine, "Qdenga", holds the potential to protect youth from a significant public health threat and SAGE provided recommendations on its use and rollout. Additionally, a new Men5CV vaccine against meningitis is set to make a positive impact in the African meningitis belt.In the fight against cervical cancer, there's reason for optimism with substantial progress on HPV vaccination. The endorsement of the single-dose recommendation by WHO and its adoption by 30 additional countries, including high-cervical-cancer-burden countries like Bangladesh, Indonesia, and Nigeria, brings us closer to the 2030 goal of widespread availability of HPV vaccines for all girls worldwide.

Despite these incredible achievements, the world acknowledges the urgent need for more work in preventing outbreaks of vaccine-preventable diseases. Under the inspiring banner of "The Big Catch-Up," countries are actively reestablishing the performance and coverage of childhood routine vaccination programs to prevent unnecessary outbreaks of diseases like measles, yellow fever, diphtheria, polio, and pertussis.Sustained investments in immunization, often the foundation of a primary health care approach, integrated fully into national health plans, and equitable access to vaccines are crucial for the continued success of these efforts.

As we come to the end of this remarkable year, I want to extend my heartfelt appreciation for your unwavering dedication and tireless efforts in advancing vaccine development and deployment through immunization programmes worldwide. Together, we have achieved remarkable milestones, overcoming numerous challenges, and making a significant impact on the lives of people, and on the publics health. It is through your hard work and collaboration that we have made such tremendous progress in protecting the health and well-being of individuals across the globe. Your unwavering commitment to research and development has resulted in breakthroughs, such as the development of new vaccines and improved delivery mechanisms. These advancements have not only expanded the scope of protection but also enhanced accessibility, ensuring that even the most marginalized communities receive the care that is their right. Looking forward to January 2024, when the second Progress Report on the IA 2030 will be presented to the Executive Board of the WHO, there's a strong commitment to advocating for a world where vaccines are available and accessible to all, regardless of birth, geography, or economy.Together, we can strive for even greater success in immunization coverage, equity, and innovation. Let us continue to strengthen partnerships, foster collaboration, and share knowledge to overcome the remaining challenges and ensure that no one is left behind.

The 50th anniversary of the Expanded Programme on Immunization (EPI) in 2024, will be an opportunity not just to reflect on past achievements but perhaps more importantly to set ambitious goals for the future. The upbeat spirit of progress and collaboration is driving us toward a world where immunization remains a cornerstone of global health efforts, ensuring a brighter and healthier future for all.By working together, we can confront emerging threats, adapt to changing circumstances, and ensure resilient immunization programmes that we know form the foundation of emergency responses to infectious disease threats.

As we bid farewell to 2023, let us celebrate our collective accomplishments, but also recognize that our work is far from over. Your dedication and passion inspire us all to ensure sustainable immunization programs that benefit generations to come. Together, we can make a profound difference in the health and well-being of communities worldwide. Wishing you all a holiday season of peace, of reflection, and time with those you love. Looking forward to a New Year which brings greater equity, greater humanism, and greater commitment to our shared planet.

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Message by the Director of the Department of Immunization, Vaccines and Biologicals at WHO - November/December ... - World Health Organization

A groundbreaking study led by researchers at the University of Pittsburgh School of Medicine has unveiled a previously unknown class of antibodies with the potential to neutralize various forms of the flu virus.

The findings, published in the open-access journal PLOS Biology on Thursday, mark a significant step toward the development of more universally protective flu vaccines.

Traditional flu vaccines stimulate the immune system to produce antibodies targeting a viral protein called hemagglutinin on the surface of invading flu viruses. However, the ever-changing nature of hemagglutinin presents a challenge as the protein evolves over time, giving rise to new flu strains that can elude existing antibodies. The current approach involves annual vaccine updates based on predictions about the most dominant strains expected for the upcoming flu season.

In the pursuit of flu vaccines capable of providing broader protection across multiple strains, researchers have focused on antibodies that can simultaneously neutralize various flu subtypes, such as H1 and H3, known for causing widespread infections.

The team, led by Holly Simmons, addressed a specific hurdle in this endeavorthe 133a insertion, a subtle alteration found in some H1 strains in the hemagglutinin sequence. While certain antibodies could neutralize both H1 and H3, this ability was compromised when the H1 strain possessed the 133a insertion.

Conducting experiments with patient blood samples, the researchers identified a novel class of antibodies that demonstrated the capability to neutralize specific H3 strains and H1 strains, regardless of the presence of the 133a insertion. Distinct molecular characteristics distinguished these antibodies from others that cross-neutralize H1 and H3 strains through alternative mechanisms.

The discovery expands the repertoire of antibodies with potential contributions to the development of broadly protective flu vaccines and challenges the prevailing manufacturing approach for flu vaccines, which predominantly relies on chicken eggs.

The researchers emphasize the significance of their findings, stating, "We need annual influenza virus vaccines to keep pace with continuing viral evolution. Our work suggests that the barriers to eliciting more broadly protective immunity may be surprisingly low. Given the right series of influenza virus exposures/vaccinations, it is possible for humans to mount robust antibody responses that neutralize divergent H1N1 and H3N2 viruses, opening new avenues to design improved vaccines."

This breakthrough offers hope for a future where flu vaccines could provide enhanced and lasting protection against the ever-evolving influenza virus.

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Flu viruses may be combated with new antibody, study finds - The Jerusalem Post

By Alexa Lardieri U.S. Deputy Health Editor Dailymail.Com 19:12 21 Dec 2023, updated 19:15 21 Dec 2023

Seniors in the US could be facing a 'great risk of serious illness' due to their low vaccination rates and health officials stress there is 'an urgent need' to protect the vulnerable population from anoutbreak of respiratory viruses.

ACenters for Disease Controland Prevention report today found that as of December 10, just one-third of residents were up to date with their Covid vaccine and just 10 percent had received a vaccine for RSV.

A higher share - 72 percent - have received their flu vaccine.

Older residents in nursing homes are at heightened risk of severe illness and death from any one of the three viruses due to their weakened immune systems.

During the 2021-2022 flu season, the death rate for people 65 years and older was around 7.4 per 100,000 population, compared to 0.1 per 100,000 people among those aged 18 to 49 years.

Health experts have warned America is battling one of the worst winter cold seasons they've seen as cases of Covid-19, flu and respiratory syncytial virus (RSV) continue to climb and put pressure on hospitals.

The CDC has been warning the rise in illnesses could put a strain on the healthcare system, meaning 'patients with other serious health conditions may face delays in receiving care.'

The US is already seeing crowding among hospital beds for pediatric patients.

The CDC said: 'In some parts of the country, hospital beds for children are already nearly as full as they were this time last year.

'If these trends continue, the situation at the end of this month could again strain emergency departments and hospitals.'

The low rates of RSV vaccination could partly be because this is the first year a shot has been approved by the Food and Drug Administration for the virus for Americans over 60 years old.

Challenges to implementing the roll out and administration of the new vaccine, along with limited time to train providers may also be a driving force behind the low coverage.

The CDC said it will be important moving forward to educate staff and residents about RSV and its vaccine.

Overall, the health agency also said vaccine fatigue, vaccine hesitancy and inaccurate health information could also be driving low numbers.

Access to vaccines in underserved areas or among vulnerable populations, as well as cost and payment barriers, is also a contributing factor.

Vaccination rates varied across the US, with some regions having more coverage than others.

For all vaccines, North and South Dakota consistently reported the highest coverage of all three.

For Covid vaccines, Vermont, New Hampshire, Minnesota, Iowa, Alaska and Hawaii had highest rates, with between 45 and 60 percent of residents vaccinated.

The lowest rates - between 15 and 30 percent - were seen in 15 states, including Nevada, Arizona, Texas, Florida, Alabama and Tennessee.

For the flu, residents in elderly care homes with vaccination rates above 75 percent were observed in two dozen states, including Utah, Colorado, Wyoming, Nebraska, Kansas, New York, Pennsylvania and Arkansas.

The lowest rate - vaccination of between 30 and 45 percent of residents - was seen only in Arizona.

RSV coverage was the lowest and nearly three dozen states reported between one and 15 percent of residents vaccinated.

States where rates were the lowest included Washington, Oregon, Oklahoma, Maine, Ohio, Mississippi, New York, New Jersey and Maryland.

Rates were highest - between 30 and 45 percent - in just Alaska and Hawaii.

The low rates of vaccination are concerning as the number of respiratory illnesses spread across the US this winter.

Overall rates of respiratory illness have reached high or very high levels in 14 states and hospitalizations for these illnesses has been on the rise for eight weeks, hitting 5.3 percent of all hospitalizations for the week ending December 9.

The number of Covid hospitalizations has also been on the rise for five weeks, hitting 23,400 during the week ending December 9.

Test positivity has generally gone up as well over the five weeks, hitting 11 percent for the same week.

The increase in cases is likely due to the JN.1 variant, which experts believe could be more infectious.

The CDC recently announced it was tracking the mutation and the World Health Organization announced it was deemed a 'variant of interest.'

The agency said it is currently the fastest-growing variant in the country, and its presence will continue to increase.

The new variant was first detected in the US in September.

Due to its rapid spread, the CDC believes it is either more transmissible or better at evading the human immune system.

Still, there is no evidence the variant poses an increased risk to people and no indication it is more severe than previous variants.

Additionally, experts say the current Covid vaccine provides protection.

The World Health Organization has classified the new Covid-19 variant, JN.1, as a variant of interest (VOI) separately from its parent lineage BA.2.86.

The Centers for Disease Control and Prevention said it appears to be more transmissible or better at evading immune systems, but there is no evidence it presents an increased risk to public health.

The variant was first detected in the US in September and has only a single change from its parent strain.

The WHO declared the global public health risk posed by JN.1 as low, but said the onset of the winter cold and flu season, coupled with the rise of the more transmissible Covid variant, could increase the burden of respiratory infections in many countries.

The health organization said it is continuously monitoring the strain and will update the risk evaluation as needed.

Additionally, it advised that current Covid vaccines are effective at protecting against severe disease and death from the JN.1 mutation.

While multiple viruses circulate this winter, the WHO recommended washing your hands frequently, covering your nose and mouth when coughing and sneezing, staying current on vaccinations, isolating if sick and wearing a mask in crowded spaces.

It also encouraged people to social distance from others and get tested if you develop cold, flu or Covid symptoms.

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Is US on track for an explosive outbreak in care homes this winter? CDC report shows as little as 10% of elder - Daily Mail

The program is estimated to have averted at least 2.7 million deaths, the World Health Organization said Tuesday. In other covid news, subvariant JN.1 is on the move, and fast.

CIDRAP: COVAX Winds Down With COVID Vaccine Shift To Regular Programs The World Health Organization (WHO) today announced that COVAX, a program formed in 2020 to increase equitable distribution of COVID-19 vaccines, will close on December 31 as distribution shifts to regular immunization programs. COVAX was jointly led by Gavi, the Vaccine Alliance, UNICEF, and the WHO. So far, it has distributed nearly 2 billion doses to 146 economies, the WHO said in a statement. The groups estimate that the vaccines distrusted through COVAX averted 2.7 million deaths and helped lower-income countries achieve 57% two-dose coverage, compared to the 67% global average. (Schnirring, 12/19)

Biz Community: 3 Lessons From Covax As The Organization Draws To A Close As an emergency solution launched amid the pandemic, Covax faced many challenges. Without having any cash reserves up front, it was initially limited in its ability to sign early contracts with manufacturers, and while it was able to ship doses to 100 economies in the first six weeks of the global roll-out, export bans and other factors meant that large-volume deliveries were only received in the third quarter of 2021. While Covax was unable to completely overcome the tragic vaccine inequity that characterized the global response, it significantly alleviated the suffering caused by Covid-19 in the Global South. (12/20)

More on the spread of covid

Reuters: WHO Says JN.1 COVID Strain A 'Variant Of Interest', Poses Low Risk While there might be more cases with the variant, JN.1 doesn't pose a greater risk, said Andrew Pekosz, a virologist at the Johns Hopkins Bloomberg School of Public Health. JN.1 was previously classified a variant of interest as part of its parent lineage BA.2.86, but WHO has now classified it as a separate variant of interest. (Roy, 12/19)

The Atlantic: Winter Illness This Year Is A Different Kind Of Ugly Earlier this month, Taison Bell walked into the intensive-care unit at UVA Health and discovered that half of the patients under his care could no longer breathe on their own. All of them had been put on ventilators or high-flow oxygen. It was early 2022 the last time I saw that, Bell, an infectious-disease and critical-care physician at the hospital, told meright around the time that the original Omicron variant was ripping through the region and shattering COVID-case records. This time, though, the coronavirus, flu, and RSV were coming together to fill UVAs wardsall at the same time, Bell said. (Wu, 12/19)

Bloomberg: US Workers Overuse Cold Medicine Due To Office Sick Shaming Fear At the height of the pandemic, Meg McNamaras employer sent her home with symptoms that looked a lot like Covid, but she knew better. A negative Covid test proved that the 37-year-olds coughs and red eyes were just her usual allergies. Determined to not be wrongly accused again, the New York-based physicians assistant turned to over-the-counter medication. She started popping Benadryl every morning to mask her symptoms, but that caused other problems. (LaPara andBrown, 12/20)

AP: States Are Trashing Troves Of Masks And Pandemic Gear As Huge, Costly Stockpiles Linger And Expire With expiration dates passing and few requests to tap into the stockpile, Ohio auctioned off 393,000 gowns for just $2,451 and ended up throwing away another 7.2 million, along with expired masks, gloves and other materials. The now expiring supplies had cost about $29 million in federal money. A similar reckoning is happening around the country. Items are aging, and as a deadline to allocate federal COVID-19 cash approaches next year, states must decide how much to invest in maintaining warehouses and supply stockpiles. (Peltz and Lieb, 12/20)

CIDRAP: Study Spotlights Persistent Daily Headaches After COVID-19 A study based on patients in 11 South American countries shows that new daily persistent headache (NDPH) can be a clinical symptom after COVID. "Persistent headache, with a prevalence ranging from 8 to 15% in the first six months after COVID-19 remission, is a frequent symptom," the authors of the study write. "However, limited knowledge exists regarding the clinical spectrum and predisposing factors." The mean age was 40 years, and most participants were women (81.5%), with university education (76.2%). More than 90% described their COVID-19 infections as mild to moderate. (Soucheray, 12/19)

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Global Vaccine Program COVAX Will End Dec. 31; Gave Out Nearly 2B Doses - KFF Health News - Kaiser Health News

December 21, 2023

4 min read

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On Dec. 14, the CDC issued an urgent warning calling for health care providers to increase vaccination coverage for COVID-19, influenza and respiratory syncytial virus.

Data released around the time of the warning showed dangerously low vaccination coverage and high hospitalization rates for the three respiratory illnesses.

With the holidays around the corner and millions of Americans estimated to have travel plans, there is cause for concern over greater risk of severe disease, which could lead to increased strain on the health care system.

Healio spoke with National Foundation for Infectious Diseases (NFID) Medical Director Robert H. Hopkins, Jr., MD, about the CDC warning and if it is too late for vaccination ahead of the holidays.

Healio: What do the data show in terms of vaccinations?

Hopkins: Based on CDC data through Friday, Dec. 15, 2023:

Far too few in the U.S. population have received the 2023-2024 COVID-19 vaccine, with the lowest rate (7.8%) in children and the highest rate (37.4%) in adults aged 65 years and older.

Influenza vaccination rates are also unacceptably low 43.3% in children to 69.3% in adults 65 years and older.

RSV vaccines are available for the first time this year for pregnant women (at 32-36 weeks gestation) and for adults aged 60 years and older. Only approximately 17% of adults aged 60 years and older have received the vaccine.

Healio: Can you summarize the CDC warning? Have they issued a warning like this before around this time of year?

The CDC Health Alert on Dec. 14, 2023, highlighted the convergence of several important issues of concern with three messages:

First, a rapid increase in influenza and COVID-19 disease at the same time as we have ongoing high levels of RSV disease. These increases have the potential to strain and/or disrupt our health care system.

Second, although we have safe and effective vaccines available to prevent all three of these diseases, vaccination rates are low and this means that more children, adolescents and adults are at risk for severe disease.

Third, a request that health care professionals redouble their efforts to vaccinate the majority of our population who are yet to be vaccinated, use effective testing strategies, and use antivirals in persons in whom their use is indicated.

The CDC issues health alerts when issues of public health concern need widespread dissemination to health care, public health professionals and the public.

Healio: Is it too late to get vaccinated to have protection over the holidays?

Hopkins: All these vaccines are safe and effective tools that have been demonstrated to reduce the risk for severe disease (due to the specific disease vaccinated against), but it takes up to 2 weeks to develop immunity following vaccination.

That said, it is not too late to be vaccinated for those who have not yet done so. And, if you are unvaccinated and have had influenza, you should still be vaccinated after you recover to reduce your risk for another strain of influenza later in the season.

The unfortunate particularly unfortunate because we have tools at hand to prevent and treat these diseases combination of high rates of disease from all three of these viruses and low vaccination rates poses a risk that hospitals and medical facilities may be overwhelmed with demands for patient care. The goal is to prevent crises in health care access similar to those that occurred in the first year of the COVID-19 pandemic.

In addition to strongly encouraging vaccination for those who are not vaccinated, other steps can also help staying home when ill, wearing a mask when exposed to others, covering coughs with your sleeve and not your hands, avoiding touching your nose and face, improving indoor air quality and hand-washing. All of these can reduce respiratory virus transmission and the risk for illness. The NFID video, Are You That Person, summarizes steps we can all take to help protect against influenza.

Healio: Should the CDC have issued this alert earlier?

Hopkins: The calculus on when to release a health alert is not simple. The CDC has posted data for weeks on its website and has raised the concern about vaccination rates since early this fall. The CDC has also been monitoring and posting concerns about the newer COVID-19 variants on their website. The Health Alert Network (HAN) also noted a recent increase in reports of multisystem inflammatory syndrome in children among children hospitalized with COVID-19 in recent weeks. The HAN also emphasized that health care providers use appropriate tools to test for respiratory viruses and to use available antivirals against influenza and COVID-19 in persons at risk for severe disease.

For all who are listening, I strongly recommend that anyone age 6 months and older get vaccinated against COVID-19 with the 2023-2024 vaccine and get an annual influenza vaccination. Pregnant women and families expecting new babies should ask about RSV protection for their infants. Adults aged 60 years and older, particularly those with chronic health conditions and who are in residential care, should seek RSV vaccination if they have not already done so. I would like to see everyone in our communities across our country to have the protections I have provided for my family and for my patients.

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Q&A: Is it too late to get vaccinated for protection over the holidays? - Healio

A new COVID-19 variant is now estimated to make up about 20% of COVID-19 cases in the United States.

The World Health Organization (WHO) recently named the strain, JN.1, a variant of concern - meaning that the global body is monitoring the variant closely but hasn't yet added it to its "watchlist" of high-risk strains. Still, the WHO warns the fast-spreading variant could lead to an uptick in cases during winter months as people spend more time indoors at family and group gatherings.

In California, the proportion of people testing positive for COVID-19 has been on a steady rise since November, coinciding with flu season.

We recently spoke with three UC San Francisco COVID-19 experts, Vivek Jain, MD, MAS; George Rutherford, MD, and Peter Chin-Hong, MD, to get the rundown on this COVID-19 season and the latest variant.

Chin-Hong: The symptoms of JN.1 are thought to be similar those of other members of the Omicron family of COVID-19 variants: Typically, illness starts with a sore throat, followed by congestion and a dry cough.

People may also experience other symptoms such as a runny nose, fatigue, headache, muscle aches, fever, diarrhea and an altered sense of smell. But probably what is more important than the symptoms is who has it: A patient who is older than 75 or is immunocompromised and who has not been recently vaccinated against COVID-19 may experience more serious symptoms like difficulty breathing. Folks like these can get very ill.

Chin-Hong: There is no evidence that the new variant causes more serious disease, hospitalizations or a higher fatality rate than other Omicron variants.

Chin-Hong: Yes. Although the vaccine was developed against another Omicron strain (XBB.1.5), studies have shown that the new COVID-19 vaccine generates a robust immune response to JN.1. I have full confidence in the new formulation of the COVID-19 vaccine for the variants that are circulating right now.

Chin-Hong: Yes, the current slate of COVID-19 antivirals such as Paxlovid and - for hospitalized COVID-19 patients, remdesivir - are also very effective against JN.1. Remember, it's important to take Paxlovid as soon as possible after showing symptoms of COVID-19, ideally within the first five days. You'll need a prescription for both these medications.

Jain: Broadly, everyone 6 months and older should get the new 2023-2024 COVID-19 vaccine. COVID-19 vaccines are very safe and lower peoples' risk of death and hospitalization, especially those who are older or who have medical conditions.

Jain: Yes, if that's convenient. It's also okay to space them slightly apart.

If you're 60 and over or in weeks 32 to 36 of pregnancy, you may also qualify for the new RSV vaccines.

Jain: Everyone should strongly consider staying up to date with annual COVID-19 vaccines. People should talk with their health care providers and consider factors like age, and medical conditions, including whether they are immunosuppressed, live with other people at high risk for serious COVID-19 and their COVID-19 history.

Rutherford: Yes. COVID-19 was the eighth leading cause of death in the U.S. between 2021 and 2022. It's the number one vaccine-preventable cause of death among children in the U.S.

Jain: Yes, health insurance and pharmacies will cover the cost of the new COVID-19 vaccines. People without insurance or who might face a difficult co-payment should contact their local health department for places to get free COVID-19 vaccinations. You can also check the federal government's Bridge Access Program for free COVID-19 vaccines at thousands of locations nationwide.

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Covid variant JN.1 is on Rise. Here's What to Know - Mirage News