State Surgeon General Dr. Joseph A. Ladapo Issues New mRNA COVID-19 Vaccine Guidance

Link: https://content.govdelivery.com/accounts/FLDOH/bulletins/3312697

Guidance: https://floridahealthcovid19.gov/wp-content/uploads/2022/10/20221007-guidance-mrna-covid19-vaccines-doc.pdf?utm_medium=email&utm_source=govdelivery

Analysis: https://floridahealthcovid19.gov/wp-content/uploads/2022/10/20221007-guidance-mrna-covid19-vaccines-analysis.pdf?utm_medium=email&utm_source=govdelivery

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Today, State Surgeon General Dr. Joseph A. Ladapo has announced new guidance regarding mRNA vaccines. The Florida Department of Health (Department) conducted an analysis through a self-controlled case series, which is a technique originally developed to evaluate vaccine safety.

This analysis found that there is an 84% increase in the relative incidence of cardiac-related death among males 18-39 years old within 28 days following mRNA vaccination. With a high level of global immunity to COVID-19, the benefit of vaccination is likely outweighed by this abnormally high risk of cardiac-related death among men in this age group. Non-mRNA vaccines were not found to have these increased risks.

As such, the State Surgeon General recommends against males aged 18 to 39 from receiving mRNA COVID-19 vaccines. Those with preexisting cardiac conditions, such as myocarditis and pericarditis, should take particular caution when making this decision.

Author(s): Joseph A. Ladapo

Publication Date: 7 Oct 2022

Publication Site: Florida Dept of Health

KFF COVID-19 Vaccine Monitor: September 2022

Link: https://www.kff.org/coronavirus-covid-19/poll-finding/kff-covid-19-vaccine-monitor-september-2022/

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Overall adult vaccination rates have been relatively steady over the past year. The latest COVID-19 Vaccine Monitor finds that nearly eight in ten adults (77%) say they have gotten at least one dose of a COVID-19 vaccine, including about half who say they are fully vaccinated and also received at least one booster dose (47%), about a quarter who have been fully vaccinated but have not gotten a booster (26%), and a small share who are partially vaccinated (3%). Twenty-three percent remain unvaccinated, the vast majority of whom say they will “definitely not” get the COVID-19 vaccine (88% of unvaccinated, or 21% of all adults). For the latest breakdown of self-reported vaccination rates by demographic group, see the Vaccine Monitor Dashboard.

In late August, the Food and Drug Administration authorized the use of new, updated COVID-19 vaccine boosters that target both the new omicron variants and the original strain of the virus. The bivalent boosters (one by Moderna and one by Pfizer) are now authorized for use by those ages 12 and older who have gotten an initial series of a COVID-19 vaccine, including those who have already received one or more boosters.

Awareness of the new boosters is modest, with about half of adults saying they have heard “a lot” (17%) or “some” (33%) about updated booster, 31% saying they have heard “a little,” and one in five saying they have heard “nothing at all” about the new booster doses.

Older adults and Democrats are somewhat more likely than their counterparts to say they have heard at least “some” about the new boosters, but fewer than a quarter across these groups report hearing “a lot” about the new shots.

Author(s): Grace Sparks Follow @gracesparks on Twitter , Lunna Lopes , Liz Hamel Follow @lizhamel on Twitter , Alex Montero , Marley Presiado , and Mollyann Brodie Follow @Mollybrodie on Twitter

Publication Date: 30 Sept 2022

Publication Site: Kaiser Family Foundation

Most Americans don’t plan to get a flu shot this season — lots of them say they’ll mask to avoid germs instead

Link: https://www.cnbc.com/2022/10/04/fewer-americans-plan-to-get-a-flu-shot-this-season-2022.html

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Only 49% of U.S. adults plan to get their flu shot this flu season, according to a survey conducted by the National Foundation for Infectious Diseases (NFID). Even 1 in 5 of those who are at higher risk for influenza-related complications say they won’t get vaccinated.

People who are more likely to have severe outcomes from a flu infection include those over the age of 65, pregnant people, children younger than five years old, and individuals with underlying conditions, according to the Centers for Disease Control and Prevention.

….

Most Americans agree. Nearly 70% believe that getting an annual flu vaccination is the best way to prevent influenza-related deaths and hospitalizations, the NFID found. And yet many people remain hesitant to get their vaccine.

Instead, more U.S. adults are gravitating towards masking as a form of protection against the flu. A higher percentage of Americans (58%) plan to mask at least sometimes this flu season than intend to get vaccinated.

Author(s): Renée Onque

Publication Date: 4 Oct 2022

Publication Site: CNBC

Polio Is Back in the US and UK. Here’s How That Happened

Link: https://www.wired.com/story/polio-is-back-in-the-us-and-uk-heres-how-that-happened/

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Start with the vaccine formula—or formulas, actually, because there are two. They were born from a ferocious mid-20th century rivalry between scientists Jonas Salk and Albert Sabin. Salk’s formula, the first to be approved, is injected; it uses an inactivated version of the virus, and protects against developing disease, but does not stop viral transmission. Sabin’s formula, which came a few years later, used an artificially-weakened live virus. It does block transmission, and—because it is a liquid that gets squirted into a child’s mouth—it is cheaper to make and easier to distribute, since it doesn’t require trained healthcare workers or careful disposal of needles. Those qualities made the Sabin oral version, known as OPV, the bulwark of polio control, and eventually the main weapon in the global eradication campaign.

The oral vaccine had a unique benefit. Wild-type polio is actually a gut virus: It locks onto receptors in the intestinal lining and replicates there before migrating to the nerve cells that control muscles. But because it’s in the gut, it also passes out of the body in feces and then spreads to other people in contaminated water. The Sabin vaccine takes advantage of that process: The vaccine virus replicates in a child, gets pooped out, and spreads its protection to unvaccinated neighbors.

Yet that benefit concealed a tragic flaw. Once out of every several million doses, the weakened virus reverted to the neurovirulence of the wild type, destroying those motor neurons and causing polio paralysis. That mutation would also make a child who harbored the reverted virus a potential source of infection, rather than protection. That risk is what caused rich nations to abandon the oral version: In 1996, when wild polio was no longer occurring in the US, the oral vaccine caused about 10 cases of polio paralysis in children. The US switched to the injectable formula, known as IPV, in 2000, and the UK followed in 2004.

Polio vaccination requires several doses to create full protection, and once that occurs, children are protected against both wild-type and vaccine-derived versions of the virus. So the international vaccination campaign continued to rely on OPV, arguing that the risk would diminish as more children received protection. That was a reasonable gamble when the effort was new and health authorities thought it would take 10 to 12 years to achieve eradication. But thanks to funding shortfalls, political and religious unrest, and the Covid pandemic—which imposed a slowdown not just on eradication activities but on all childhood vaccines—it’s now been 34 years, and the job is not done. Meanwhile, last year in 20 countries there were a total of 688 cases of paralysis of what’s called “circulating vaccine-derived poliovirus,” and only six cases of wild-type polio, in three nations.

Author(s): MARYN MCKENNA

Publication Date: 24 Aug 2022

Publication Site: Wired

What We’ve Learned — and Failed to Learn — from a Million COVID Deaths

Link: https://www.governing.com/now/what-weve-learned-and-failed-to-learn-from-a-million-covid-deaths

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The pandemic is not done. The number of new infections — surely an undercount due to unreported home tests — again tops 75,000 per day. The number of hospitalizations has climbed 20 percent over the past two weeks. The Biden administration has warned there could be 100 million more Americans infected by early next year. Yet Congress seems unwilling to provide more money for basic responses such as tests and vaccines, even as it becomes increasingly clear that even mild cases can lead to dangerous long-term damage.

Yet there are positive developments to consider as well. Vaccinations and certainly boosters are not where they should be, but three out of four Americans have received at least a single dose and two-thirds are fully vaccinated. The Commonwealth Fund has estimated that, absent vaccines, an additional 2.3 million Americans would have died, and 17 million more would have been hospitalized. Public health measures such as masking have largely fallen out of favor, but they helped prevent a death toll that could have been even more terrible.

“A million is way too many people, but as a result of the work that has been done, through public health and vaccination, it’s a number that’s a lot lower than it might have been,” says David Fleming, a distinguished visiting fellow at the Trust for America’s Health. “If we did not do those things, we would not be looking at the 1 million death threshold, we’d be looking at the 3 million death threshold.”

Author(s): Alan Greenblatt

Publication Date: 12 May 2022

Publication Site: Governing

If you’re vaxxed, you’re more likely to be killed by lightning than die of COVID: study

Link:https://nypost.com/2022/02/08/lightnings-more-likely-good-odds-for-vaxxed/

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Those odds can be gauged from a study by researchers at the National Institutes of Health, published by the Centers for Disease Control and Prevention. They tracked more than 1 million vaccinated adults in America over most of last year, including the period when the Delta variant was surging, and classified victims of COVID according to risk factors such as being over 65, being immunosuppressed or suffering from diabetes or chronic diseases of the heart, kidney, lungs, liver or brain.

The researchers report that none of the healthy people under 65 had a severe case of COVID that required treatment in an intensive-care unit.

 Not a single one of these nearly 700,000 people died, and the risk was minuscule for most older people, too. Among vaccinated people over 65 without an underlying medical condition, only one person died.

In all, there were 36 deaths, mostly among a small minority of older people with a multitude of comorbidities: the 3% of the sample that had at least four risk factors.

Author(s): John Tierney

Publication Date: 8 Feb 2022

Publication Site: NY Post

Study suggests Pfizer COVID-19 vaccine may only partially protect against Omicron

Link:https://www.reuters.com/business/healthcare-pharmaceuticals/pfizer-covid-19-vaccine-partially-protective-against-omicron-bloomberg-news-2021-12-07/?fbclid=IwAR0rKPM8dNsMnI_iQ0Hbph-KLY0HiI-PzeLmdYGWWoeFdYKsU07SuDjnuNg

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The Omicron variant of the coronavirus can partially evade the protection from two doses of Pfizer Inc (PFE.N) and partner BioNTech’s COVID-19 vaccine, the research head of a laboratory at the Africa Health Research Institute in South Africa said on Tuesday.

Still, the study showed that blood from people who had received two doses of the vaccine and had a prior infection were mostly able to neutralize the variant, suggesting that booster doses of the vaccine could help to fend off infection.

Author(s): Michael Erman

Publication Date: 8 Dec 2021

Publication Site: Reuters

COVID-19 Vaccination and Non–COVID-19 Mortality Risk — Seven Integrated Health Care Organizations, United States, December 14, 2020–July 31, 2021

Link:https://www.cdc.gov/mmwr/volumes/70/wr/mm7043e2.htm?s_cid=mm7043e2_w

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What is already known about this topic?

Although deaths after COVID-19 vaccination have been reported to the Vaccine Adverse Events Reporting System, few studies have been conducted to evaluate mortality not associated with COVID-19 among vaccinated and unvaccinated groups.

What is added by this report?

During December 2020–July 2021, COVID-19 vaccine recipients had lower rates of non–COVID-19 mortality than did unvaccinated persons after adjusting for age, sex, race and ethnicity, and study site.

What are the implications for public health practice?

There is no increased risk for mortality among COVID-19 vaccine recipients. This finding reinforces the safety profile of currently approved COVID-19 vaccines in the United States. All persons aged ≥12 years should receive a COVID-19 vaccine.

Author(s): Stanley Xu, PhD1; Runxin Huang, MS1; Lina S. Sy, MPH1; Sungching C. Glenn, MS1; Denison S. Ryan, MPH1; Kerresa Morrissette, MPH1; David K. Shay, MD2; Gabriela Vazquez-Benitez, PhD3; Jason M. Glanz, PhD4; Nicola P. Klein, MD, PhD5; David McClure, PhD6; Elizabeth G. Liles, MD7; Eric S. Weintraub, MPH8; Hung-Fu Tseng, MPH, PhD1; Lei Qian, PhD1

Publication Date: 29 October 2021

Publication Site: MMWR at CDC

Wave of COVID-19 Deaths Hit RGA Hard

Link: https://www.thinkadvisor.com/2021/11/08/wave-of-covid-19-deaths-hit-rga-hard/

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After the second quarter, RGA executives told analysts they were optimistic about the effects of COVID-19 vaccination programs on mortality.

Instead, “the third quarter saw increases in both COVID-19 and non-COVID-19 general population mortality,” Porter said.

In the United States and India, the typical age of people dying of COVID-19 is falling, Porter added.

That hurts life insurers because people under 65 are more likely than older people to have life insurance.

Author(s): Allison Bell

Publication Date: 8 Nov 2021

Publication Site: Think Advisor

Who Had Covid-19 Vaccine Breakthrough Cases?

Link:https://www.nytimes.com/interactive/2021/10/28/us/covid-breakthrough-cases.html

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Compared with the unvaccinated, fully vaccinated people overall had a much lower chance of testing positive for the virus or dying from it, even through the summer’s Delta surge and the relaxation of pandemic restrictions in many parts of the country. But the data indicates that immunity against infection may be slowly waning for vaccinated people, even as the vaccines continue to be strongly protective against severe illness and death.

“The No. 1 take-home message is that these vaccines are still working,” said Dr. David Dowdy, an epidemiologist at the Johns Hopkins Bloomberg School of Public Health. “If you saw these data for any disease other than Covid, what everyone’s eyes would be drawn to is the difference between the unvaccinated and fully vaccinated lines.”

The data shows notable differences in breakthrough death rates by age and slight differences in both case and death rates by vaccine brand, trends that experts say are important to consider as tens of millions of Americans weigh whether to get a booster shot.

Author(s): Aliza Aufrichtig, Amy Schoenfeld Walker

Publication Date: 28 Oct 2021

Publication Site: NYT

How Jefferson and Franklin Helped End Smallpox in America

Link:https://www.governing.com/context/how-jefferson-and-franklin-helped-end-smallpox-in-america.html

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In the new world, inoculation had a very rough reception. When John Dalgleish and Archibald Campbell began inoculating individuals in Norfolk, Virginia, an angry mob burned down Campbell’s house. Similar incidents occurred in Salem and Marblehead, Mass. In Charleston, S.C., an inoculation control law of 1738 imposed a fine of £500 on anyone providing or receiving inoculation within two miles of the city. A similar law was passed in New York City in 1747. 

The measures in New England were so draconian that Benjamin Waterhouse noted the paradox: “New England, the most democratical region on the face of the earth voluntarily submitted to more restrictions and abridgements of liberty, to secure themselves against that terrific scourge, than any absolute monarch could have enforced.” (This, strangely prescient, anticipates the current debate about liberty versus public health). It was in the middle colonies — Maryland, Pennsylvania, New Jersey — that inoculation was most tolerated in the second half of the 18th century. That’s why Jefferson made the long journey to Philadelphia to be inoculated in 1766. 

Jefferson first became aware of the discovery of a true smallpox vaccine from the newspapers he read in Philadelphia and the new capitol in Washington, D.C. Then, on Dec. 1, 1800, just after Jefferson’s election to the presidency, Benjamin Waterhouse sent him his pamphlet on the vaccine with a lovely cover letter saying that he regarded Jefferson as “one of our most distinguished patriots and philosophers.” Jefferson responded immediately, thanking Waterhouse for the publication and declaring, with his usual grace, that “every friend of humanity must look with pleasure on this discovery, by which one evil the [more] is withdrawn from the condition of man: and contemplating the possibility that future improvements & discoveries, may still more & more lessen the catalogue of evils. in this line of proceeding you deserve well of your [country?] and I pray you to accept my portion of the tribute due you.” 

Author(s): Clay Jenkinson, Editor-at-Large

Publication Date: 29 April 2020

Publication Site: Governing

COVID-19 Vaccination and Non–COVID-19 Mortality Risk — Seven Integrated Health Care Organizations, United States, December 14, 2020–July 31, 2021

Link:https://www.cdc.gov/mmwr/volumes/70/wr/mm7043e2.htm

Graphic:

Excerpt:

What is already known about this topic?

Although deaths after COVID-19 vaccination have been reported to the Vaccine Adverse Events Reporting System, few studies have been conducted to evaluate mortality not associated with COVID-19 among vaccinated and unvaccinated groups.

What is added by this report?

During December 2020–July 2021, COVID-19 vaccine recipients had lower rates of non–COVID-19 mortality than did unvaccinated persons after adjusting for age, sex, race and ethnicity, and study site.

What are the implications for public health practice?

There is no increased risk for mortality among COVID-19 vaccine recipients. This finding reinforces the safety profile of currently approved COVID-19 vaccines in the United States. All persons aged ≥12 years should receive a COVID-19 vaccine.

Author(s): Stanley Xu, PhD1; Runxin Huang, MS1; Lina S. Sy, MPH1; Sungching C. Glenn, MS1; Denison S. Ryan, MPH1; Kerresa Morrissette, MPH1; David K. Shay, MD2; Gabriela Vazquez-Benitez, PhD3; Jason M. Glanz, PhD4; Nicola P. Klein, MD, PhD5; David McClure, PhD6; Elizabeth G. Liles, MD7; Eric S. Weintraub, MPH8; Hung-Fu Tseng, MPH, PhD1; Lei Qian, PhD1

Publication Date: 22 Oct 2021

Publication Site: CDC