Millions of Americans are immunosuppressed or immune-compromised. That is, they take drugs to make sure that a transplanted organ is not rejected or to tamp down the overactive immunity that produces rheumatoid arthritis and lupus; or, alternatively, they have illnesses that undermine their ability to defend against pathogens. A handful of research papers published over the past few months all find the same result: When these patients receive Covid vaccines, their bodies don’t create as many defensive antibodies as those of healthy people. Some have contracted the disease despite being fully vaccinated—meaning that, to protect themselves, they must continue to behave as though their vaccinations never occurred.
As a result, some are seeking extra vaccinations, arranging for third doses that they hope will act like booster shots. A study published Monday in the Annals of Internal Medicine by a team at Johns Hopkins University School of Medicine documents the experience of 30 people living with organ transplants who sought out a third shot in hopes of boosting their immune responses. After their second shots, none of the 30 had high antibody levels; in fact, only six showed any antibody response at all. After the third shot, 14 out of 30 saw some improvement, and 12 of 30 had antibody levels that the researchers considered protective.
The UK has four vaccines approved for use: Pfizer-BioNTech, Oxford-AstraZeneca, Moderna and Janssen; three of which require two doses for maximum protection.
The campaign to reach as many people as quickly as possible was boosted by a shift in policy in early January – to prioritise the first dose of a vaccine, with a second dose up to 12 weeks later, a bigger gap than originally planned.
Progress made in the UK so far means the country continues to be among those with the highest vaccination rates globally.
NEW YORK (AP) — A new analysis of blood samples from 24,000 Americans taken early last year is the latest and largest study to suggest that the new coronavirus popped up in the U.S. in December 2019 — weeks before cases were first recognized by health officials.
The analysis is not definitive, and some experts remain skeptical, but federal health officials are increasingly accepting a timeline in which small numbers of COVID-19 infections may have occurred in the U.S. before the world ever became aware of a dangerous new virus erupting in China.
The pandemic coronavirus emerged in Wuhan, China in late 2019. Officially, the first U.S. infection to be identified was a traveler — a Washington state man who returned from Wuhan on Jan. 15 and sought help at a clinic on Jan. 19.
CDC officials initially said the spark that started the U.S. outbreak arrived during a three-week window from mid-January to early February. But research since then — including some done by the CDC — has suggested a small number of infections occurred earlier.
The good news? Vaccines still sharply reduce the risk of being admitted to hospital with the Delta variant. The Scottish study found that the Pfizer/BioNTech vaccine provided 79% protection, two weeks on from the second dose, while the Oxford/AstraZeneca vaccine offered 60% protection. That lower rate may be due to the fact that it takes longer for immunity to develop with the Oxford/AstraZeneca vaccine, researchers said.
However, research released shortly after by Public Health England was even more promising. It found that the Pfizer/BioNTech vaccine provides 96% protection from hospitalization after two doses, while the Oxford/AstraZeneca is 92% effective at preventing hospitalization after both shots. The conclusion? It’s yet more evidence of the importance of making sure as many people as possible get vaccinated, and that they get both shots.
The Illinois program gives people recovering from covid-19 a take-home kit that includes a pulse oximeter, a disposable Bluetooth-enabled sensor patch, and a paired smartphone. The software takes data from the wearable patch and uses machine learning to develop a profile of each person’s vital signs. The monitoring system alerts clinicians remotely when a patient’s vitals— such as heart rate—shift away from their usual levels.
Typically, patients recovering from covid might get sent home with a pulse oximeter. PhysIQ’s developers say their system is much more sensitive because it uses AI to understand each patient’s body, and its creators claim it is much more likely to anticipate important changes.
“It’s an enormous benefit,” says Terry Vanden Hoek, the chief medical officer and head of emergency medicine at University of Illinois Health, which is hosting the pilot. Working with covid cases is hard, he says: “When you work in the emergency department it’s sad to see patients who waited too long to come in for help. They would require intensive care on a ventilator. You couldn’t help but ask, ‘If we could have warned them four days before, could we have prevented all this?’”
The contribution of natural immunity should speed up the timeline for returning fully to normal. With more than 8 in 10 adults protected from either contracting or transmitting the virus, it can’t readily propagate by jumping around in the population. In public health, we call that herd immunity, defined broadly on the Johns Hopkins Covid information webpage as “when most of a population is immune.” It’s not eradication, but it’s powerful.
Without accounting for natural immunity, we are far from Anthony Fauci’s stated target of 70% to 85% of the population becoming immune through full vaccination. But the effect of natural immunity is all around us. The plummeting case numbers in late April and May weren’t the result of vaccination alone, and they came amid a loosening of both restrictions and behavior.
Researchers from the Cleveland Clinic published a study this week of 1,359 people previously infected with Covid who were unvaccinated. None of the subjects subsequently became infected, leading the researchers to conclude that “individuals who have had SARS-CoV-2 infection are unlikely to benefit from COVID-19 vaccination.”
One of the most persistent falsehoods of the COVID pandemic has been the claim that Florida has been “hiding” data. This idea has been advanced primarily by Rebekah Jones, a former Florida Department of Health employee, who, having at first expressed only some modest political disagreements with the way in which Florida responded to COVID, has over time become a fountain of misinformation.
To understand what is happening here, one needs to go back to the beginning. Over the past 15 months, Florida has published a truly remarkable amount of COVID-related data. At the heart of this trove has been a well-maintained list of literally every documented case of COVID — listed by county, age, and gender, and replete with information about whether the patient had recently traveled, had visited the ER, had been hospitalized, and had had any known contact with other Floridians. To my knowledge, Florida has been the only state in the union that has published this kind of data.
To this day, you can download Florida’s case-line data and see 21 cases of COVID that, despite having been identified between March 2020 and December 2020, feature a December 2019 “Event Date.” To anyone who understands data, these results are clearly the product of the system having assigned a non-null default value when no data has been entered. To the Miami Herald, however, these results hinted at scandal. Even now, when its reporters know beyond any doubt that their initial instincts were wrong, the Herald continues to tell its readers that these entries serve as “evidence of community spread potentially months earlier than previously reported.” This is not true.
In gain-of-function research, a microbiologist can increase the lethality of a coronavirus enormously by splicing a special sequence into its genome at a prime location. Doing this leaves no trace of manipulation. But it alters the virus spike protein, rendering it easier for the virus to inject genetic material into the victim cell. Since 1992 there have been at least 11 separate experiments adding a special sequence to the same location. The end result has always been supercharged viruses.
A genome is a blueprint for the factory of a cell to make proteins. The language is made up of three-letter “words,” 64 in total, that represent the 20 different amino acids. For example, there are six different words for the amino acid arginine, the one that is often used in supercharging viruses. Every cell has a different preference for which word it likes to use most.
In the case of the gain-of-function supercharge, other sequences could have been spliced into this same site. Instead of a CGG-CGG (known as “double CGG”) that tells the protein factory to make two arginine amino acids in a row, you’ll obtain equal lethality by splicing any one of 35 of the other two-word combinations for double arginine. If the insertion takes place naturally, say through recombination, then one of those 35 other sequences is far more likely to appear; CGG is rarely used in the class of coronaviruses that can recombine with CoV-2.
In fact, in the entire class of coronaviruses that includes CoV-2, the CGG-CGG combination has never been found naturally. That means the common method of viruses picking up new skills, called recombination, cannot operate here. A virus simply cannot pick up a sequence from another virus if that sequence isn’t present in any other virus.
One success story took place in Philadelphia, thanks to an effective collaboration between two health systems and Black community leaders. Recognizing that the largely online signup process was hard for older people or those without internet access, Penn Medicine and Mercy Catholic Medical Center created a text-message-based signup system as well as a 24/7 interactive voice recording option that could be used from a land line, with doctors answering patients’ questions before appointments. Working with community leaders, the program held its first clinic at a church and vaccinated 550 people.
In Alabama, for example, National Guard mobile vaccination units were set up with the ultra-cold freezers needed to transport and store mRNA-based covid-19 vaccines. “Why not, when this particular push is over, leave those freezer units with the federally qualified health centers that are already in those communities?” McClure says. “You’re starting to build the infrastructure for being able to deliver vaccination on a consistent basis.”