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July 16, 2022

2nd Booster for People Less than 50

The Omicron BA.5 variant is now spreading fast and is over 60% of infections this last week.  Breakthrough infections have increased, and now hospitalizations and deaths are increasing.  The BA.5 variant is much more transmissible, in part because there is some immune escape from the antibodies.  It does not seem to be  more severe and vaccination does reduce hospitalizations and deaths.  The FDA/CDC are now in discussions whether a second booster will be offered to people <50 if they are more than 4 months after their 1st booster. Dr. Walenski (CDC), Dr. Jha (White House Pandemic Coordinator,) and Dr. Fauci (NIAID/NIH) are reported to be in favor of reducing the age to get a second booster. The CDC and FDA will make the decision.  I will try to follow the announcements and post the information re: approval as soon as it is available.

Booster shots are strongly recommended, antibodies do increase after both the 1st booster (3rd shot of mRNA vaccine) and data shows that they also are increased after the 2nd booster (4th shot).  A new CDC study found that 2nd boosters can restore vaccine protection against hospitalization and death that might have waned over time. Some younger immunodeficient people can also get the boosters.  The FDA and CDC expect that the new  bivalent booster, containing the original Wuhan virus strains combined with the Omicron variants BA.4 and BA.5, will be available in October.  It is recommended however that you don't wait for the Fall booster, but instead get the current booster for which you are eligible - if you are 5 months after your primary series of 2 shots, and 4 months after your 1st booster.  See Below

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My current plan is to follow new information about SARS-CoV-2 and Covid-19 and to post it to my Blog and Facebook page when there is significant new information about the pandemic, (vaccines, drugs, and variants). For now  I will add a collage and info only on Saturdays for the time being.  

 

July 9, 2022

Breakthrough Omicron Infections

The Omicron subvariants BA.5 and BA.4 are now the dominant circulating viruses in the US. "Eric Topol, Professor of Molecular Medicine at Scripps Research, says that BA.5 is the worst version of the virus that we've seen."  Reinfections which were rare before Omicron (1% in UK April 2021), seem to be increasing.  The UK is reporting 11-27% reinfections now, but it is unclear whether the US will follow this surge.  Epidemiologist Katelyn Jetelina says the rate of first infection in NY is now 28/100K, with a current reinfection rate of 5/100k.  Unvaccinated people, those who had a mild first case, or those with waning immunity are at greatest risk.  Reinfections with Omicron can occur as soon as the virus clears (i.e. 20 up to 90 days).  Fortunately, as we follow these variants, it seems as if protection against severe disease is still present if vaccines are up to date or with prior Covid-19 infections.  
 
These new subvariants of Omicron have increased transmissibility and can avoid immunity from vaccines and prior infections.  Both of the variants have mutations in their spike proteins that are different enough from earlier versions of the virus.  It is unclear whether the US will have a big surge, but mRNA for these 2 variants will probably be part of the bivalent Covid Fall vaccines that are manufactured by Pfizer and Moderna.  The CDC says there is no evidence so far that these virus subvariants cause more severe disease, although if there is a surge, hospitalizations will rise just due to the increased number of cases in the country.

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Friends:  If you are eligible for a 2nd booster, please get it now.  The infection rate of the variants is increasing and these boosters reduce deaths.  See the last blog post for real data. On Friday NYC residents were told to wear high-quality masks indoors and crowded outdoor venues because of the spread of omicron subvariants.

July 6, 2022

Covid-19 Death Rates by Vaccination/Booster Status - Early Analysis

The FDA VRBPAC Advisory Committee met June 28th to discuss plans for generating a Fall 2022 booster dose for SARS-CoV-2.  My comments re: proposed plans were in my blog post from last Saturday <http://www.paperandthreads.com/2022/07/illio2.php>. I was impressed with new unpublished information that was presented to the Advisory committee about the safety and efficacy of 1st and 2nd Booster doses of the current vaccine.   

The second Covid-19 booster dose is recommended for people ages 50+ if it has been more than 4 months since their last vaccine dose.  

EARLY ANALYSIS among people ages 50 years and older diagnosed with Covid-19 in April 2022:

1.  Unvaccinated people had 42 times the risk of dying from Covid-19, compared to those with 2 booster doses.  

2.  People vaccinated with one booster dose had 4 times the risk of dying from Covid-19, compared to those with 2 booster doses - providing early evidence of the benefits of a 2nd booster dose.        

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July 2, 2022

Bivalent Booster Dose for Fall 2022?

The FDA VRBPAC Advisory Committee met on Tuesday for the 2nd time in order to discuss Covid-19 booster shots for Fall.  The influenza vaccine given each Fall is selected late Spring and prepared for administration in October-November.  The influenza virus doesn't mutate as quickly as the coronavirus, and for many years a WHO committee has selected the circulating variants to make a combined flu vaccine for the Fall.  They have lots of experience planning which influenza variants should be used for the vaccine.  

The original SARS-CoV-2 mRNA vaccines (prototype) still have remarkable ability to prevent hospitalization and death, but the coronavirus virus is mutating faster than influenza viruses. Omicron has mutated frequently since its appearance in Dec. 2022, and the current subvariants BA.4 and BA.5 are now the dominant strains in the US.  There is a slight decrease of the prototype vaccine against these variants in lab tests.  After a full day of reviewing the recent efficacy and safety of vaccines made against the variants by Moderna and Pfizer the committee was asked whether the fall booster shot should contain the omicron variants to broaden the efficacy of the vaccine.  See Below 

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The committee voted 19 yes and 2 no, and soon will decide whether it should be a bivalent vaccine combining the original coronavirus mRNA (Wuhan strain) and omicron subvariant mRNA.  Both Moderna and Pfizer have made and tested some bivalent vaccines against the coronavirus SARS-CoV-2 virus and they do have broader efficacy.  Both Moderna and Pfizer said they could manufacture enough of the proposed vaccine by early to mid-October.  For now, vaccinated people should get the 2nd booster.