Category: Vaccine

A child receives a measles vaccination at a clinic in Harare, Zimbabwe, where a 2022 outbreak saw some 700 children die from the highly infectious childhood disease. Tsvangirayi Mukwazhi/AP hide caption

A child receives a measles vaccination at a clinic in Harare, Zimbabwe, where a 2022 outbreak saw some 700 children die from the highly infectious childhood disease.

Measles is on the rise around the world, and even experts who saw it coming say the increase is "staggering."

The World Health Organization said in December that its European region (which extends into parts of western and central Asia) saw an "alarming" increase in measles cases from under a thousand in 2022 to more than 30,000 last year.

John Vertefeuille, director of the U.S. Centers for Disease Control and Prevention's Global Immunization Division, said in a statement that the numbers are "staggering."

The WHO's most recent global numbers, released in November, reveal that measles cases increased worldwide by 18% to about 9 million, and deaths rose 43% to 136,000, in 2022 compared to 2021. Some 32 countries had large, disruptive outbreaks in 2022, and that number ticked up to 51 in 2023, Dr. Natasha Crowcroft, WHO's senior technical adviser for measles and rubella control, told NPR.

The worrying uptick in measles outbreaks and deaths is, "unfortunately, not unexpected given the declining vaccination rates we've seen in the past few years," noted John Vertefeuille of the CDC in his statement. "Urgent, targeted efforts are critical to prevent measles disease and deaths."

Measles is one of the most contagious infectious diseases, and also one of the most preventable: two doses of vaccine in childhood is 97% protective. WHO estimates that some 61 million doses were missed or delayed in 2021. In 2022, about 83% of the world's children received one dose of measles vaccine by their first birthday the lowest proportion since 2008, when the rate was also 83%.

"We're going to see outbreaks any time we have an accumulation of people who haven't been vaccinated," says Cyndi Hatcher, unit lead for measles elimination in the African Region at the CDC. "When you have immunization disruptions, measles is always going to be one of the first epidemics that you see."

Low-income countries continue to have the lowest vaccination rates five sub-Saharan African countries have rates below 50% for the first dose.

"Measles is called the inequity virus for good reason. It is the disease that will find and attack those who aren't protected," says Dr. Kate O'Brien, WHO director for immunization, vaccine and biologicals.

In Ethiopia, for example, conflict and weaknesses in the rural health system have taken a toll on vaccination rates, says Dr. Ngozi Kennedy, UNICEF's Ethiopia health manager.

"We have a lot of pastoral communities that are often on the move so they may not know how to, or may not be able to, get to health centers for the vaccine. Also, as a result of the protracted conflicts, services are often disrupted with populations and even some health-care workers being displaced," she says.

Children who don't get their vaccines on schedule are at risk of death and serious illness, particularly children under age 5 who are at highest risk for severe complications including pneumonia, encephalitis (brain swelling) and death. Measles can also put children at higher risk for other potentially fatal childhood diseases such as diarrheal diseases and meningitis because the virus can cause the immune system to forget its learned defenses against other pathogens.

"I think that people may have forgotten how dangerous measles can be if they haven't seen cases before," Hatcher says.

But global health experts didn't forget, and many predicted that outbreaks would be coming.

"During the pandemic, when everything was locked down, there wasn't much measles being spread ... because no one was going anywhere," says WHO measles and rubella senior technical adviser Dr. Natasha Crowcroft. "It's the usual human thing that no one does anything until the problem starts. It's really hard to sell prevention."

Last year a coalition including the Bill & Melinda Gates Foundation and Gavi, the Vaccine Alliance, launched "The Big Catch-Up" an effort to get vaccination rates back up to at least their pre-pandemic levels. (Editor's note: The Gates Foundation is one of the funders of NPR and this blog.)

Kennedy says efforts continue in Ethiopia to shore up vaccination rates. Health workers there have begun to track childhood immunizations electronically in hopes of keeping more children current, and the country has prioritized 14 "equity zones" to catch kids up on their shots.

But the CDC's Cyndi Hatcher says much more needs to be done.

"I think we need to be very honest with ourselves at the global level," she says. "Are we truly committed to making [measles] a public health priority and do we have the resources that we need to make full immunization a reality at the global level, the regional level but especially at the country and community level?"

Fran Kritz is a health policy reporter based in Washington, D.C., and a regular contributor to NPR. She also reports for the Washington Post and Verywell Health. Find her on X (Twitter): @fkritz

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Measles numbers are 'staggering.' Can this outbreak be brought under control? : Goats and Soda - NPR

This week, I address pushback I received on my Novartis-MorphoSys column. But first, a preview of the expected readout from Gritstone Bios neoantigen cancer vaccine study.

Before the end of the quarter, Gritstone Bio will release preliminary results from a randomized, Phase 2 clinical trial investigating a personalized therapeutic cancer vaccine in microsatellite-stable colon cancer, a type of immunologically cold tumor that is resistant to immunotherapies like PD-1/PD-L1 inhibitors.

The Gritstone vaccine is designed to train a patients own T cells to recognize and kill cancer cells by targeting mutated cancer proteins, called neoantigens, that are unique to a patients own tumor. Its a relatively new approach for cancer vaccines made possible by powerful and relatively inexpensive genomic sequencing of tumors that is intended to overcome all the previous failures in the field. Gritstones effort is also similar to one being used by Moderna and Merck that has reported encouraging results in melanoma and is now being investigated in a Phase 3 study.

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Gritstone Bio's cancer vaccine test, and more on Novartis' deal - STAT

In 2000, thanks to an effective vaccine with high uptake, the U.S. achieved a rare public health victory: zero cases of endemic measles transmission. But measles has persisted, with repeated outbreaks over the years, and it is having a big comeback. In the U.S., 23 cases of measles were reported over less than eight weeks in December and January, including seven cases brought in by international travelers and two outbreaks each involving more than five people. There was a thirtyfold increase in measles cases in Europe in 2023, with tens of thousands of hospitalizations and five deaths.

There was a thirtyfold increase of measles cases in Europe in 2023, with tens of thousands of hospitalizations and five deaths.

How did it get this bad? On top of pre-existing vaccine hesitancy and a thriving machine of misinformation and disinformation spread easily on social media, the Covid-19 pandemic led to supply chain and delivery interruptions and decreased access to routine primary and preventive care. Health budgets and personnel normally devoted to things such as community vaccination efforts were tied up in pandemic-related efforts. And in places where much of the care shifted to telehealth, that convenience also removed the opportunity to administer vaccines in the course of routine in-person visits.

Exemptions from vaccination play a significant role in outbreaks of preventable diseases like measles. While all states allow exemptions for medical reasons, and most allow religious exemptions, the area of greatest growth is in nonmedical, nonreligious, or personal, exemptions, which open the door for outbreaks.

Measles is a pretty terrible virus. Of those who become infected, 1 in 5 will need hospitalization, 1 in 20 will develop pneumonia and 1 in 1,000 will develop encephalitis (inflammation of the brain), and as many as 1 to 3 in 1,000 will die from these complications. Measles infection is dangerous during pregnancy, leading to miscarriage, low birth weight and preterm labor. It also has a terrifying late-term complication, subacute sclerosing panencephalitis, a fatal condition that can strike as late as a decade after the initial infection.

Measles is also highly contagious one person with measles can transmit the disease to 90% of the incompletely vaccinated or immunocompromised they come into close contact with. To prevent outbreaks of the virus, 95% of people in a community need to be vaccinated against it. When we have a suspected or confirmed case in the hospital, the patient is placed in an isolation room that meets specific ventilation requirements and can be accessed only by those who are wearing N95 respirators and are immunized against the virus.

But out in the world, that same person can spread disease rapidly to those around them, especially in places where there are pockets of unvaccinated people and very young children (who wont have completed the vaccine series yet). On Friday, a measles case in an infant was confirmed in San Diego, and according to the public notice announcing the case, the infected infant was taken to a restaurant, a park, a pediatricians office and then an emergency department. Others were potentially exposed at each of those locations.

High vaccination rates, such as those that once eradicated measles in our country, can mean a loss of generational memory of thediseases we defeated. At its peak in the 1950s, there were 3 million to 4 million cases of measles every year; it was transparently bad. As the disease disappeared, its specter did, too, meaning purported harms of vaccines, particularly for those receiving readily available misinformation or disinformation, seemed to be riskier than the forgotten disease. We need to raise the collective consciousness about the consequences of nonvaccination and the very serious nature of outbreaks to boost vaccination rates.

High vaccination rates, such as those that once eradicated measles in our country, can mean a loss of generational memory of the diseases we defeated.

Disturbingly, things appear to be trending in the wrong direction. Mississippi has had one of the highest vaccination rates in the country, with 99% of children fully vaccinated. In 1979, the states Supreme Court struck down religious exemptions to school immunization requirements because the overriding and compelling public interest of protecting children from the horrors of diseases against which means of immunization are known and have long been practiced successfully. For 40 years, Mississippi hasnt had a single case of measles that originated within the state. (But in August, a religious exemption was granted, and health officials expect that remarkable record will end.)

Ten states have now reached exemption rates that make it impossible for them to reach their needed vaccination goals against measles. That is, even if 100% of the nonexempt children in a state get vaccinated, it will still be impossible for the state to reach an overall 95% vaccination rate against the virus.

There are a variety of approaches states have implemented to allow exemptions but ensure they remain relatively rare, leaving room for herd immunity. They include strengthening requirements for exemptions, incorporating parental education about the risks of not vaccinating into the process and ensuring transparency about high rates of exemptions in schools and programs. Some states have special provisions that exclude unvaccinated children from school or prohibit exemptions during active outbreaks.

Limiting exemptions must be paired with increasing vaccine and vaccine information accessibility. This includes continuing to expand where and how vaccines can be received, including pharmacist prescribing and administration and schools and child care centers, ongoing widespread community educational efforts and dissemination of in-depth and reliable information about vaccines.

Classic symptoms of the infection include the 3 Cs: cough, coryza (runny nose) and conjunctivitis.

Early recognition of measles is also important. Classic symptoms of the infection include the 3 Cs: cough, coryza (runny nose) and conjunctivitis; high fever; blue-white spots inside the mouth (called Koplik spots); and a characteristic rash. Quickly seeking medical attentionwhen cases are suspected allows testing, confirmation of the diagnosis and prevention of further spread. Some people, including infants, those who are immunocompromised and pregnant women, are eligible to receive immune globulin to prevent illness after theyre exposed to someone with measles. Confirming whos been exposed to a verified case allows people in these groups to get medical attention early enough for that preventive treatment.

Parents with young children should make sure theyre up to date on any immunizations that may have been skipped or delayed during the pandemic. Because the majority of cases and outbreaks start with those returning from travel abroad, a planned trip abroad is an especially good time for families to review their routine vaccination status.

Right now, staying safe from measles is complicated by the layered challenges of pre-pandemic vaccine skepticism, pandemic-era setbacks and increased world travel. Itll take a concerted effort to take us back to the kinds of success we achieved two decades ago.

Esther Choo, M.D. M.P.H., is an emergency medicine physician, health policy researcher and founding member of Equity Quotient, a company that advises organizations on building cultures of equity. She has provided commentary on the pandemic and other health care topics through appearances on MSNBC, CNN, the BBC and Yahoo! Finance and editorials published in The Lancet, the British Medical Journal, The Washington Post, NBC Think and USA Today.

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Measles is making a comeback in the U.S. Whats causing its resurgence? - MSNBC

PORT OF SPAIN, Trinidad, CMC The Ministry of Health in Trinidad and Tobago has been ordered by a court to pay legal costs to a civil and human rights group that brought a lawsuit against it for information on the adverse reports of coronavirus (COVID-19) vaccines.

The action was filed against the ministry by Umar Abdullah, the leader of First Wave Movement.

High Court Judge Justice Frank Seepersad said the information sought by Abdullah was important in the public's interest and should have been provided by the ministry.

He said that it was important for citizens to know the possible risks associated with the vaccines so that they can make informed decisions in deciding to subject themselves to the jab.

The Ministry of Health did not put in an appearance at the February 6 hearing although the State had been served with the court's previous orders when leave was granted for the claim.

The ministry was ordered to pay TT$17,500 in costs because only some of the information sought by Abdullah was provided after he filed his lawsuit.

On October 10, 2023, Abdullah said he embarked on a project to get information on COVID-19 vaccines and asked for the total number of adverse reports of the vaccines; a list of all the reports identifying specific concerns for example, blood clots, headaches, stroke and heart attack ; the number of people who died because of the vaccine; and copies of all reports sent to vaccine manufacturers, the Pan-American Health Organization (PAHO) and the World Health Organization (WHO).

He said during the COVID-19 pandemic Health Minister Terrence Deyalsingh said the ministry's system to address the reporting of adverse events of COVID-19 vaccines was the online Events Supposedly Attributable to Vaccines and Immunisations (ESAVI).

On January 16, the ministry, in its response, said the total number of adverse reports made to ESAVI up to August 10, 2023, was 50.

It also provided a breakdown of the signs and symptoms.

There were also zero deaths as a result of the vaccine.

They included body pain, nerve pain, weakness, heavy, irregular, longer menstrual periods and later periods; pronounced pre-menstrual symptoms; heart palpitations; severe coughing; increased pulse and blood pressure; pain at the injection point; twitching of the face; muscle spasms and pain; joint pain; tingling of the hands and feet; fevers; shortness of breath; and headaches.

An epileptic patient reported increased seizures.

The ministry said it did not have the number of people who recovered from any adverse effect nor did it have reports sent to the manufacturers, PAHO, or the WHO.

Follow The Gleaner on X, formerly Twitter, and Instagram @JamaicaGleaner and on Facebook @GleanerJamaica. Send us a message on WhatsApp at 1-876-499-0169 or email us at onlinefeedback@gleanerjm.com or editors@gleanerjm.com.

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Court orders Trinidad's health ministry to pay legal costs in COVID-19 vaccine information case - Jamaica Gleaner

CLAIM

Study shows myocarditis from COVID-19 vaccination carries serious risk of death

DETAILS

Misrepresents a complex reality: It is mandatory for healthcare workers to report serious adverse events to VAERS regardless of the cause. The studys observation that the majority of VAERS reports were related to hospitalization and death may well have been due to this reporting policy. Multiple studies have shown that the majority of people who develop vaccine-associated myocarditis fully recover without complications. Misleading: Numerous studies have shown that the benefits of COVID-19 vaccines outweigh their risks. It is COVID-19 that is associated with a greater risk of heart problems, blood clotting disorders, and other complications.

KEY TAKE AWAY

Studies have shown that people vaccinated against COVID-19 are less likely to develop severe disease, require hospitalization, and die from COVID-19 compared to unvaccinated people. While COVID-19 vaccines are associated with a slightly elevated risk of myocarditis and a particular blood clotting disorder, it is COVID-19 that is associated with a greater risk of these illnesses and other complications. On balance, the evidence gathered so far by studies shows that the benefits of COVID-19 vaccination outweigh the risks, not the other way around.

It cited the studys conclusion stating that COVID-19 vaccination is strongly associated with a serious adverse safety signal of myocarditis, particularly in children and young adults resulting in hospitalization and death.

Similar claims also appeared in the Washington Times and on X (formerly Twitter). Overall, they received more than 6,800 engagements on social media platforms, including Facebook and X/Twitter.

As we will explain below, the article repeats a host of already-refuted claims and inaccurately portrays the risk of myocarditis posed by COVID-19 vaccination. The study that it relies on also contains important limitations and doesnt provide reliable evidence for its claims.

The study in Therapeutic Advances in Drug Safety was authored by computational biologist Jessica Rose, masters student Nicolas Hulscher, and cardiologist Peter McCullough.

Both Rose and McCullough have previously spread vaccine misinformation. Hulscher, according to his LinkedIn profile, is a masters student in epidemiology at the University of Michigan Ann Arbor. Notably, Hulscher and McCullough co-authored a preprint that claimed 76% of deaths in vaccinated people were due to COVID-19 vaccines. Health Feedback covered the preprints questionable methods and conclusions here.

The stated aim of the study was to determine possible links between COVID-19 vaccination and myocarditis, using reports in the U.S. Vaccine Adverse Event Reporting System (VAERS), particularly associations between age, gender, and dose of vaccine.

Its worth noting that the link between myocarditis and COVID-19 mRNA vaccines was already identified by studies published in 2021. These studies showed that it is young males, particularly adolescents and young adults typically below the age of 30, who are most likely to develop myocarditis, and that myocarditis is most likely to occur after the second dose[1-3].

And myocarditis has since been acknowledged by public health agencies in Europe, the U.S., Australia, and elsewhere, as a potential side effect of COVID-19 mRNA vaccination, particularly in young males.

Rose et al. reported the same trends observed in earlier studies, demonstrated by the following three statements:

This side effect was mostly reported in young individuals, especially males. Myocarditis was more likely following a second dose of vaccine. individuals under the age of 30 were more prone to acquire myocarditis from COVID-19 vaccination compared to those aged 30 and above

It also reported that there were a total of 3,078 reports, or 0.3% of all adverse events, related to myocarditis.

One of the red flags in the study shows up in the authors classification of these events as COVID-19 vaccine-related, despite the fact that VAERS reports alone are insufficient to establish that a case of myocarditis was caused by the vaccine. The same red flag appears in the authors claim that deaths reported to VAERS were also caused by the COVID-19 vaccines.

This is not to say that VAERS reports have no place in determining whether an adverse event could be caused by a vaccine. In fact, VAERS reports were among the data that clued the CDC into the association between myocarditis and COVID-19 mRNA vaccines. But this was only accomplished after additional investigation into the reported cases and statistical analyses.

The authors also postulated that myocarditis cases could present as sudden deaththe language echoing the died suddenly dog whistle used by opponents of COVID-19 vaccination.

To do this, they cited two VAERS reports. One was a 33-year-old male whose death was attributed to myocarditis following an autopsy, and who received his last vaccine dose nearly two years ago.

The other was a 15-year-old male who became significantly ill four days before he diedrendering the authors interpretation of this as a sudden death debatableand whose cause of death was attributed to myocarditis of unknown cause. According to the VAERS report, he received his last vaccine dose roughly a year ago.

However, neither of the cases above are consistent with the pattern of vaccine-induced myocarditis. Studies have observed that the onset of myocarditis symptoms typically begin within the first week after vaccination[2,4], although a range of up to a month has also been observed[5]. The U.S. Centers for Disease Control states that myocarditis due to COVID-19 vaccination most frequently occurs within seven days of vaccination.

Given the very long period of time that had passed since their last vaccine dose and the fact that myocarditis can be caused by multiple things, not just COVID-19 vaccines, the authors seem to have jumped to conclusions in attributing both deaths to COVID-19 vaccination without additional information.

Rose et al. also alleged that myocarditis after vaccination entailed a serious risk of hospitalization and death, based on their finding that 76% of cases resulted in emergency care and hospitalization.

However, this fails to acknowledge that reporting serious adverse events after COVID-19 vaccination, regardless of whether the vaccine caused the adverse event, is mandatory. Per the VAERS website, serious adverse events include Inpatient hospitalization or prolongation of existing hospitalization and death.

The potential skew in reports brought about by this policy, however, wasnt accounted for by the authors.

Contrary to the conclusions of Rose et al., several studies that examined the severity of vaccine-induced myocarditis have found that the majority of patients fully recover without any complications[4,6,7].

Finally, the authors misrepresented a few studies it cited to support its claims. For example, it cited a study by Swank et al. as finding circulating Spike protein among the vaccinated with post-acute sequelae for up to 1 year.

We reached out to the studys corresponding author, David Walt, a professor of pathology at Brigham and Womens Hospital and a core faculty member at Harvards Wyss Institute. In an email, Walt stated that this incorrectly described the studys findings, which was about long COVID patients, not vaccinated people.

He also pointed out that their findings had been mischaracterized by Rose et al., stating It is NOT the full spike protein [detected in vaccinated people], as stated. We found that the S1 fragment of the spike protein is detectable for 3 to 7 days post-vaccination and is undetectable after that.

He clarified that it was in long COVID patients that the spike protein was detected. This is NOT caused by vaccination, but by infection, he said.

He stated that vaccine-induced myocarditis is very rare and that the levels of these proteins (S1 and spike) we are detecting in all our studies are very low. Our test is ultrasensitive. The levels are not at the concentration that would cause systemic inflammation.

The claims in the article are exaggerations, he said.

The claim in the Blaze article that the vaccines never stopped transmission is a refrain that is echoed time and time again by those who oppose COVID-19 vaccination. As Health Feedback explained previously, the claim is an example of the nirvana fallacy, in which a solution is rejected simply because it doesnt work perfectly.

Such an expectation is unrealistic as no vaccine exists that works 100% of the time.

Multiple studies have shown that the COVID-19 vaccines reduce the likelihood of an infected person transmitting the virus to others, such as between people living in the same household[8-13]. The vaccines did so with varying degrees of effectiveness, depending on factors like the variant and the amount of time that had elapsed since the last vaccine dose. Although imperfect, they did reduce transmission.

Secondly, while Sweden, Norway, and Finland did suspend the use of the Moderna COVID-19 vaccine for young men, this can in no way be interpreted to mean Europeans [] have spared their children from the novel vaccines. For one, Sweden, Norway, and Finland dont restrict the use of other COVID-19 vaccines, such as the Pfizer-BioNTech COVID-19 mRNA vaccine. And many other European countries have placed no age restrictions on COVID-19 vaccination in the first place.

The Blaze article relied on the study by Rose et al. to suggest that the risks of the COVID-19 vaccines are greater than its benefits. However, as the study didnt undertake any examination of the benefits of COVID-19 vaccination nor did it make a risk-benefit assessment, it is unequipped to support the suggestion made by The Blaze.

Firstly, studies have shown that people vaccinated against COVID-19 are less likely to develop severe disease, to require hospitalization, and die compared to unvaccinated people[14-16]. Thus, getting vaccinated reduces the risk of COVID-19 complications, which is the primary goal of vaccination.

Secondly, while COVID-19 vaccines are associated with a slightly elevated risk of myocarditis and a particular blood clotting disorder, studies have found that the risk of heart complications, including myocarditis, associated with COVID-19 is greater than that of COVID-19 vaccines[17,18].

Indeed, the incidence of post-vaccine myocarditis has been estimated to be as high as 35.9 per 100,000 people. In contrast, that of post-COVID-19 myocarditis is 64.9 per 100,000 people[19].

The American Heart Association considers the benefits of the COVID-19 vaccines to outweigh their risks. An expert consensus by the American College of Cardiology also found that a very favorable benefit-to-risk ratio exists with the COVID-19 vaccine for all age and sex groups evaluated thus far[20].

Figure 1 There is a favorable benefit-to-risk ratio for COVID-19 mRNA vaccine recipients at highest risk for post-vaccination myocarditis[20].

COVID-19 is also associated with a greater risk of developing other health problems, such as blood clotting disorders[21,22] and neurological problems like fatigue and brain fog[23-25].

Finally, studies so far havent shown that COVID-19 vaccination is associated with a greater risk of all-cause deaths. A CDC study examining the period between December 2020 and July 2021 found a lower non-COVID-19 mortality in vaccinated people compared to unvaccinated people[26]. Another study in more than 520,000 people found that the all-cause mortality was 37% lower in the vaccinated group[27].

On balance, the evidence gathered so far by studies runs counter to the claim made in the Blaze article, showing that the benefits of COVID-19 vaccination outweigh the risks, not the other way around.

The study by Rose et al., used by The Blaze to suggest that myocarditis linked to COVID-19 vaccines carries serious risks, contains important limitations and comes to conclusions that cannot be substantiated by the data it collected. It also grossly misinterpreted at least one study it cited to support its conclusions.

Multiple published studies have shown that the clinical course of COVID-19 vaccine-induced myocarditis is mild for the majority, and contrary to the claims by Rose et al. and The Blaze, dont entail serious risks of hospitalization and death. Studies have also shown that it is COVID-19not COVID-19 vaccinesthat is associated with a greater risk of cardiovascular diseases and other complications. Reliable scientific studies show that the benefits of COVID-19 vaccination outweigh the risks.

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Claim that myocarditis from COVID-19 vaccines carries serious risk of death is based on flawed study - Health Feedback

The French drug safety body has presented its work in mapping the extent of side effects after vaccination against Covid-19 in France, three years after the first vaccine was given.

The Rseau franais des centres de pharmacovigilance (RFCRPV) looked at 200,000 reports of post-vaccination side effects flagged by health professionals and members of the public over a span of three years, comprising over 157 million vaccinations.

This presented an unprecedented challenge to the drug safety body, largely due to the scale and timeframe of the vaccine rollout.

In theory there was nothing new about it, RFCRPV vice-president Dr Aurlie Grandvuillemin told Sciences et Avenir.

However, in terms of tracking a treatment that was administered in such a short space of time to such a large number of people, it was completely unprecedented.

The RFCRPV had to determine if the reports of side effects were related to the Covid vaccines while looking for any other effects that may not have been observed during the vaccines clinical trials.

Of the 200,000 side effects in the study, 25% (50,000) were classified as severe, said national medicines safety agency, l'Agence nationale de scurit du mdicament et des produits de sant (ANSM).

Blood clots - Rare risk

The RFCRPV issued an alert in spring 2021 about the small-but-possible risk of blood clotting events (thrombosis) following a Covid jab.

We were receiving a number of reports for patients with or without prior risk factors, vaccinated by Pfizer, Moderna or AstraZeneca," said Dr Grandvuillemin. So something was potentially going on.

Later investigations showed no statistical excess risk for vaccines using messenger RNA technology (Pfizer/BioNTech, and Moderna). However, a statistical risk (1 per 100,000 people) was found for the AstraZeneca vaccine, particularly in the under-55s.

At the time, the health authorities recorded 30 cases of thrombosis in France, after four million doses of the AstraZeneca vaccine had been given. Nine people died from a thrombosis-related case.

Heart problems - Very low risk

Also in 2021, RFCRPV centres received increased reports of patients with inflammation of the heart (myocarditis) and the membrane around the heart (pericarditis).

They had been vaccinated with messengerRNA (mRNA) vaccines (Pfizer/BioNTech, and Moderna).

However, in July, the ANSM said that a link had been confirmed, but that it remained very rare, and did not call into question the benefit/risk ratio of the vaccine. This meant that the risks of vaccination were considered much lower than the benefits.

The Assurance Maladie came to a similar conclusion in 2022.

It said that vaccination with Comirnaty (Pfizer-BioNTech) and Spikevax (Moderna) increases the risk of myocarditis and pericarditis in the seven days following vaccination, especially in men aged under 30. However, the risk was low, given the high number of doses administered.

Menstrual disturbances - 20% risk after first dose

Reports of this side effect have been attracting medical interest since the end of 2021.

A recent study by the ANSM showed that there is a 20% risk of heavy menstrual bleeding between one and three months after the injection of a first dose of an mRNA Covid-19 vaccine.

The data shared shows that eight women were affected for every million patients vaccinated.

The European Medicines Agency added the side effect to the official list of risks for mRNA vaccines in October 2022, after the assessment of RFCRPV data. It was also added to the side effects leaflet enclosed within the vaccine packages.

Read more: Covid vaccine disturbs menstruation for some women, finds French study

"In some cases it is extremely complex and we have to work with almost impossible cases in which we cannot rule either way: a link cannot be established, but cannot be ruled out either, Dr Grandvuillemin told Sciences et Avenir.

Such cases include:

Pain in the extremities, insomnia, malaise, and lymph node problems: Infrequent (between 1 and 10 cases per 1,000 injections).

Skin rashes, swelling, or temporary facial paralysis: Rare (between 1 and 10 cases per 10,000 injections).

Severe allergic reactions (anaphylaxis): Very rare (less than one case per 100,000 injections).

Nonetheless, the RFCRPV sought to reiterate that vaccination had saved lives.

A World Health Organization (WHO) study from April 2023 estimated that between December 2020 and April 2023, the vaccine had directly prevented just over one million deaths in Europe, with 96% of these people aged over 60.

The latest vaccination campaign in France began in October 2023, and particularly focused on the most at-risk, vulnerable groups.

People can also get their flu vaccination at the same time as their Covid jab.

In its latest report, health authority Sant publique France said that most indicators of Covid-19 are dropping, or at a weak level, but indicators of flu are currently rising and are at epidemic levels.

Flu vaccination campaign extended due to rise in cases in France

See: big rise in flu cases and hospitalisations in France

Doctors concerned over low take-up of Covid and flu vaccines in France

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How safe were Covid vaccines? Side effects studied by French drug body - The Connexion

Researchers have found that getting a vaccine booster shot in a different arm from the one you got the first in may improve the bodys immune response up to four-fold. While they exclusively studied responses to the COVID-19 vaccine, they suspect this effect may be seen with other multidose vaccines.

When you get a vaccine, do you have a preferred arm that you present to the health professional administering it? Many opt to have vaccines, including booster shots, injected into the same arm, usually to prevent the muscle ache or heaviness that follows from affecting the use of their dominant arm or hand.

Historically, the choice of arm was not thought to matter to vaccine effectiveness. However, a new study by researchers at Oregon Health and Science University (OHSU) has found that when it comes to multidose vaccines, people who have one dose in one arm and the second in the other have an improved immune response.

This question hasnt really been extensively studied, so we decided to check it out, said Marcel Curlin, the studys corresponding author. It turned out to be one of the more significant things weve found, and its probably not limited to just COVID vaccines. We may be seeing an important immunologic function.

The researchers recruited 947 OHSU employees who agreed to receive two-dose vaccinations against the SARS-CoV-2 virus early in the pandemic. They were randomized to get the second (booster) dose in the same or the opposite arm as the first dose. Blood samples were collected at various times after boosting and tested for antibody response.

While both groups had a similar antibody response at week two, those whod had contralateral shots that is, a shot in each arm showed a substantial increase in the magnitude and breadth of their antibody response by weeks three and four that progressively increased over time to up to a four-fold increase.

Additionally, the researchers found a heightened immune response to the original SARS-CoV-2 strain and an even stronger response to the Omicron variant that emerged approximately a year after the second vaccine was given.

Although the researchers cant explain this effect, they speculate that injecting a vaccine into each arm produces a new immune response in the corresponding lymph nodes.

By switching arms, you basically have [immune] memory formation in two locations instead of one, Curlin said.

Although the current study focused on SARS-CoV-2, the researchers say that the improved immune response seen with contralateral injections might apply to other multidose vaccinations. Further research will determine if thats the case, especially in children. But at this stage, theyre not advocating for a change in practice based on the results of this study.

The study was published in The Journal of Clinical Investigation.

Source: OHSU

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Getting vaccines in different arms improves effectiveness, study finds - New Atlas

I STILL have my immunisation card from my childhood days, thanks to my mom. My parents understood that immunisation was serious business. In the workplace, not much is said about taking advantage of vaccines in preserving health.

Vaccines are among the most cost-effective and impactful tools for preserving health, and vaccination is a key strategy in preventive medicine. The American College of Preventive Medicine defines preventive medicine as promoting preventive health to improve well-being by preventing disease, disability and death. Because we spend a lot of time at work, the workplace presents an opportunity for preventive medicine, including vaccine-preventable diseases.

Some employers support workplace immunisation programmes as part of health promotion for staff. About one in 10 working-age persons gets the flu each year. A worker with the flu could lose more than three workdays. However, whereas the benefits of the flu vaccine in decreasing infections, hospitalisations, and deaths among the elderly and persons with chronic illnesses are well documented, we question whether there are health and economic benefits of immunisation programmes that also target working-age persons with no medical conditions.

For low- and middle-income countries like Jamaica, cost-benefit considerations could start with looking at the possible worst-case scenario. Studies of this issue are mainly carried out in high-income countries, primarily the US, with highly privatised healthcare, which is different from countries in which health systems are fully or partially nationalised. A conservative approach considers costs related to workdays, vaccines, doctors visits, medications, and hospitalisation regardless of who pays insurer, employer and/or worker. One such study was published in the highly regarded Journal of the American Medical Association.

Conducted across two influenza seasons among 18-64-year-olds with no medical conditions, this study yielded invaluable insights. They found that the flu vaccine decreased illness and absenteeism by a third and decreased doctors visits by 42 per cent compared to unvaccinated workers. Benefits were observed during the flu season when there was a good match between the flu vaccine and circulating flu strains. The year without a good match showed no protection. They concluded that there was no economic benefit from a workplace flu vaccine programme for most years for working-age adults with no chronic medical conditions.

This may be just where we would want to start a conversation about the cost-benefit impact of immunisation programmes delivered in workplaces across Jamaica. Chronic medical conditions are a growing concern affecting all age groups and associated with increased vulnerability to infectious diseases.

A benefit of vaccination is reducing the spread of infections. The negative impact of vaccine-preventable diseases on quality of life and productivity, even after recovery, should be considered. These factors are likely to tip the equation in favour of a positive return on investment.

A systematic review of studies on this issue published in the European Journal of Public Health in 2023 lends support. A collaboration between French scientists and Malakoff-Humanis, a private insurance group in France, highlighted that 40 per cent of randomised clinical trials (RCTs), the gold standard for health research, showed positive cost-benefit ratios or what they termed positive return-on-prevention (ROP). Only 15 per cent of RCTs reviewed showed a negative ROP; others were neutral or inconclusive. In countries like Jamaica, where government-supported health services are widely available, immunisation programmes delivered in the workplace setting through private-public partnerships are likely to have positive return-on-prevention.

To foster vaccine uptake by workers, the Community Preventive Services Task Force in the US recommends that employers implement occupational health services, schedule reminders, reduce out-of-pocket costs by covering vaccine costs, and include immunisations in health plans. In Jamaica, health insurance typically does not cover immunisations unless employers request special arrangements. Organisations could prioritise vaccines for staff and their dependents that address the most pressing public health needs of our time. For example, the vaccine against human papillomavirus (HPV) is effective in preventing cancer of the cervix and may be appropriate for younger staff and dependents. Cervical cancer is the second leading cause of cancer-related deaths among women in Jamaica. Additionally, promoting the annual flu vaccine, as well as catch-up vaccines for adults with incomplete immunisation, including against measles, would be timely in light of rising cases of vaccine-preventable diseases globally.

Yohann White is a medical doctor and certified infection prevention and control professional. Send feedback to yohann.white@caribewellness.com or editorial@gleanerjm.com

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Return on investment of preventive medicine in the workplace - Jamaica Gleaner

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Research Roundup: Covid Vaccine In Pregnancy; Infection Reduction; Insomnia; Acute Flaccid Myelitis - KFF Health ... - Kaiser Health News

As outbreaks of measles spread throughout the world, anti-vaccine activists arent just urging people not to get vaccinated theyre taking a page from a well-worn playbook, falsely downplaying the dangers from the highly contagious respiratory disease.

The truth is, measles is not a super severe serious illness when youre a child, Mary Holland, president of the countrys best-funded anti-vaccine organization, Childrens Health Defense, said last week on the groups online morning show. Childrens Health Defense was founded by Robert F. Kennedy Jr., who took a leave from the organization in April to run for president.

Holland, a lawyer, called government responses to recent outbreaks fearmongering and crying wolf.

Its a couple days of spots and then you move on, she said.

But national health agencies warn the fear of measles is well-founded.

Measles a disease so contagious it acts as a bellwether for threats from other infectious diseases is marked by fever, flu-like symptoms and an itchy rash, and sometimes comes with dire complications including pneumonia, seizures and brain damage. For every 1,000 cases of measles, about 200 children may be hospitalized, 50 may get pneumonia, one child may develop brain swelling along with deafness or disability, and between one and three may die.

Despite the availability of an incredibly effective vaccine, the disease is spreading worldwide. The reasons behind the surge are complex. For countries in Africa, the Middle East and Southeast Asia, there are issues of access; childhood vaccine campaigns suffered when Covid weakened already-stretched public health systems. Europe, the U.K. and the U.S. experienced similar, if smaller-scale, disruptions to their childhood vaccine programs during Covid. Rising vaccine skepticism plays a smaller but significant part.

Last month, the World Health Organization announced an alarming 45-fold increase in measles in Europe from 2022 to 2023, while health officials in the U.K. declared a national incident stemming from an outbreak of hundreds of cases in the West Midlands, warning of a likely spread to other regions. U.K. officials attribute the rise to a drop in vaccine uptake.

Across the U.S., state and regional health agencies have been announcing cases of measles in their communities. The Centers for Disease Control and Prevention issued an advisory last week for providers to stay alert for measles cases, citing 23 confirmed cases since Dec. 1, mostly among unvaccinated children.

Anti-vaccine activists and influencers are unfazed.

Mother and wellness influencers with tens of thousands of followers on Instagram have reacted to the recent outbreaks with posts warning their audience not to buy into the hype. As the news tries to fear-monger about the measles outbreak, one home birth advocate posted, remember that the vaccine is more dangerous than the actual illness. (This is false.)

Other mom influencers posted memes tapping into nostalgia for a time when some parents intentionally exposed their young children to measles, mumps and rubella with parties, as the diseases were considered serious, but less harmful for young children. These planned contaminations largely ended with the availability of vaccines, which offered the preferable opportunity to avoid the diseases in childhood and beyond.

Before a measles vaccine became available in 1963, the U.S. saw an estimated millions of cases per year, tens of thousands of related hospitalizations, and hundreds of deaths, according to the CDC. At the time, compared to polio and smallpox, measles was considered a milder disease, but riding a wave of success from those immunization efforts, the federal government launched a vaccine push to eradicate measles and by 1969, cases had fallen dramatically.

While pockets of distrust for vaccines have existed as long as vaccines themselves, certain events most notably the publication of since-discredited research by disgraced doctor Andrew Wakefield supercharged the anti-vaccine movement and have powered the enduring and false belief that vaccines lead to autism and other maladies.

The tactic of minimizing the threat of vaccine-preventable illnesses is nothing new. Anti-vaccine activists in the 1800s dismissed the dangers of smallpox as senseless panic ginned up by doctors and health officials. And during Covid a disease that claimed over 1 million American lives activists claimed through debunked documentaries and conspiracy-theory-laden books that the vaccines were more dangerous than the disease.

In 2019, as measles surged through the U.S. at a rate not seen in decades, then-President Donald Trump reversed his previously hesitant stance to urge parents to get their children vaccinated. In response, weeks later, the second best-funded anti-vaccine organization, the Informed Consent Action Network, released Measles for Dumbies, a video guide for how to identify, understand and refute mainstream misinformation, about what Del Bigtree, the groups executive director and now director of communications for the Kennedy campaign, called a benign childhood disease.

By December 2019, a measles outbreak in Samoa where anti-vaccine activists including Kennedy had advocated against measles-mumps-rubella vaccines had killed dozens of children and babies, underscoring the consequences of low vaccination rates. Kennedy told NBC News last year that he discounts the official cause of those deaths, believing despite evidence to the contrary that the vaccine, not measles, was to blame.

Kennedy has made light of measles for years. In 2021, at an Amish country fair in Lancaster, Pennsylvania, he praised low vaccine rates and warned the audience that the government was coming for the Amish.

I am a measles survivor, Kennedy said sarcastically as the crowd roared with laughter. It was extraordinary. Im very, very lucky to have lived through that nightmare because we had to stay at home and watch TV the whole week with all of my brothers and sisters. It was horrible.

What is the cure for measles? he continued. Chicken soup and Vitamin A. Neither of those things can be patented.

Kennedy went on to suggest that pharmaceutical companies were ignoring harms from the measles-mumps-rubella vaccine a claim without evidence to make permanent customers of injured children.

Asked for a comment, Stefanie Spear, the Kennedy campaigns press secretary, said in an email: The reason Mr. Kennedy was making light of measles infection is because his generation considered it a routine childhood illness.

Spear added that measles deaths were relatively rare before the vaccine was invented. Virtually every one of our grandparents who were alive before 1960 caught the measles and survived it, she said. We would not be having this conversation if our grandparents had died from measles.

Nostalgic stories like Kennedys remain one of the anti-vaccine movements go-to modern talking points, illustrated most often by a piece of pop culture posing as evidence a 50-year-old episode of The Brady Bunch. The clip, in which the Brady children contract and recover from measles with little fanfare or seeming concern from their sitcom parents, went so viral in 2019 that a former star from the show spoke out against it. The clip is going around again in anti-vaccine circles.

Its a campaign fueled by selective memory, and one with senseless consequences, said Dr. Paul Offit, the director of the Vaccine Education Center at Childrens Hospital of Philadelphia and a frequent target of the anti-vaccine movement.

Most everybody who was born before a vaccine was available had measles. I had measles as did all my friends. I lived, but not everybody did, Offit said. It is galling that people think if they dont see somebody die right next to them then it never happened.

Offit mentioned the 1991 measles outbreak in Philadelphia that started in a church community. By the time health officials had it contained, 1,400 people, mostly unvaccinated preschoolers, had been infected. Nine children died.

Measles means suffering, hospitalizations, ICU admissions and the occasional death, Offit said. Kids with measles are sick. Its a miserable illness.

Less talked about, Offit said, is an extremely rare condition, subacute sclerosing panencephalitis, or SSPE, a fatal disorder of the brain that can manifest about seven years after a measles infection.

This is a preventable illness, Offit said. "We could eliminate this virus from the world if we wanted to.

Elimination would rely on vaccines, which are widely available, safe, effective, and under constant threat by a growing anti-vaccine movement.

Brandy Zadrozny is a senior reporter for NBC News. She covers misinformation, extremism and the internet.

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How the anti-vaccine movement is downplaying the danger of measles - NBC News