CORONAVIRUS INFO PROVIDED BY DR. JIM HARRIS –11/06/2021

Pediatric COVID-19 Vaccines What Parents, Practitioners, and Policy Makers Need to Know. (Click)

(J. Harris: Very readable and reassuring for parents and grandparents.)

NEW FROM HOPKINS TODAY:

Why Is Delta So Infectious? New Lab Tool Spotlights Little Noticed Mutation That Speeds Viral Spread (Science) As the world has learned to its cost, the Delta variant of the pandemic coronavirus is more than twice as infectious as previous strains. Just what drives Delta’s ability to spread so rapidly hasn’t been clear, however. Now, a new lab strategy that makes it possible to quickly and safely study the effects of mutations in SARS-CoV-2 variants has delivered one answer: a little-noticed mutation in Delta that allows the virus to stuff more of its genetic code into host cells, thus boosting the chances that each infected cell will spread the virus to another cell. That discovery, published today in Science, is “a big deal,” says Michael Summers, a structural biologist at the University of Maryland, Baltimore County—not just because it helps explain Delta’s ravages. The new system, developed by Nobel Prize winner Jennifer Doudna of the University of California (UC), Berkeley, and her colleagues, is a powerful tool for understanding current SARS-CoV-2 variants and exploring how future variants might affect the pandemic, he says. “The system she has developed allows you to look at any mutation and its influence on key parts of viral replication. … That can now be studied in a much easier way by a lot more scientists.”

JAMA DAY:

Association Between mRNA Vaccination and COVID-19 Hospitalization and Disease Severity

Unvaccinated patients accounted for 93.9% (261/278) of cases with disease progression to death or invasive mechanical ventilation.

Unvaccinated patients accounted for 91.0% (91/100) of deaths among patients with COVID-19 in this study. Death occurred in 9 of 142 (6.3%) vaccine breakthrough cases and 91 of 1055 (8.6%) unvaccinated patients with COVID-19. Progression to death after COVID-19 hospitalization was associated with a lower likelihood of vaccination (aOR, 0.41; 95% CI, 0.19-0.88).

(J. Harris: This JAMA article if readable and the vaccine hesitant folks should read it. It is a life or death matter if you get carless and catch Covid.)

EDITORIAL EXPLAINING THE ABOVE ARTICLE AND SOME CONCERNS

”…The current surge in infections with the SARS-CoV-2 Delta variant has made it clear to health care workers and the public alike that fully vaccinated people remain at risk for SARS-CoV-2 infections…Vaccines not only decrease transmission rates, but also decrease disease severity among individuals who do acquire infection. Vaccinated people with breakthrough infections, including infection with the Delta variant, are less likely to develop symptoms, less likely to develop severe symptoms, more likely to recover from their illness quickly, and much less likely to require hospitalization compared with unvaccinated people.8,12 As of August 28, 2021, the age-adjusted rate of hospitalization among US adults aged 18 years or older was 83.6 per 100 000 for unvaccinated persons compared with 4.5 per 100 000 for fully vaccinated persons.13…On balance, the study by Tenforde and colleagues offers equal measures of reassurance and concern. The reassurance is that mRNA vaccines are highly effective against hospitalizations, that this benefit is preserved against the Delta variant, and that when breakthrough infections lead to hospitalization, the clinical course is milder and less likely to require intubation or culminate in death. The concerns are that mRNA vaccines are much less effective in preventing hospitalizations for immunocompromised individuals compared with immunocompetent individuals and that protection against hospitalizations for all people may wane over time, particularly for the mRNA BNT162b2 vaccine. Fortunately, emerging data suggest boosters may mitigate these risks.

Antibody Titers Before and After a Third Dose of the SARS-CoV-2 BNT162b2 Vaccine in Adults Aged ≥60 Years (GOOD NEW!)

This study found that a third BNT162b2[PFIZER] dose in adults aged 60 years and older was associated with significantly increased IgG titers after 10 to 19 days, with no major adverse events……A third dose of the SARS-CoV-2 mRNA-1273 vaccine (Moderna) induced seropositivity in 49% of kidney transplant recipients [GROSSLY IMMUNOCOMPRAMISED] who did not respond after 2 vaccine doses,³ although this observation cannot be generalized to older adults. In a study from Israel among 1 137 804 adults aged 60 years and older who had received 2 BNT162b2 doses 5 or more months earlier, a third dose was associated with lower rates of confirmed SARS-CoV-2 infections and severe illness.⁴ This study adds serologic data to the clinical data on response to a third dose in adults aged 60 years or older.

(J. Harris: This great Moderna response might make “mix and match” worth considering for Pfizers vaccinated folks and definitely for those who too J &J vaccines. I’m watching this issue.)