1. Wastewater-based Detection of an Influenza Outbreak (MedRxiv) Traditional influenza surveillance informs control strategies but can lag behind outbreak onset and undercount cases, while wastewater surveillance is effective for monitoring near real-time dynamics of outbreaks but has not been attempted for influenza. We quantified Influenza A virus RNA in wastewater during an active outbreak. RNA concentrations were strongly associated with reported clinical cases and reflected the outbreak pattern and magnitude, suggesting this approach could aid in early detection.  

2. The C.D.C. Isn’t Publishing Large Portions of the Covid Data It Collects (New York Times) For more than a year, the Centers for Disease Control and Prevention has collected data on hospitalizations for Covid-19 in the United States and broken it down by age, race and vaccination status. But it has not made most of the information public. Two full years into the pandemic, the agency leading the country’s response to the public health emergency has published only a tiny fraction of the data it has collected, several people familiar with the data said…..MORE (HOPKINS): US CDC DATA According to reporting by The New York Times, the US CDC is sharing only a small portion of the data it collects on COVID-19, 2 full years into the pandemic. The data could help state and local officials better understand how and when to use specific mitigation measures, what populations are most at risk, who needs booster doses, and where outbreaks might occur or new variants emerge. CDC representatives gave various reasons why the agency has been slow to release some information, including outdated systems incapable of handling large amounts of data, fear that the information might be misinterpreted, and concerns over some data representing only a sampling of the US population. A string of necessary bureaucratic approvals also adds to the delays. Several epidemiologists and scientists said gaps in data have the potential to erode trust in public health and science and countered that the release of detailed data analyses and effective communication of that information can help bolster public trust and provide a better understanding of the pandemic.


FOURTH VACCINE DOSE Questions about the necessity of a second SARS-CoV-2 vaccine booster, or fourth dose, arose shortly after announcements regarding the importance of an initial booster. Several new studies attempting to shine a light on the durability of vaccine-mediated immunity provide evidence that a 3-dose regimen of mRNA-based vaccines—possibly only 2 doses—may be able to protect most people against severe COVID-19 disease for months or even years. Evidence for possibly lengthy protection from vaccination includes an increase in neutralizing antibody diversity, T cells that can recognize the Omicron variant, and germinal center activation for up to 15 weeks post-vaccination. Leading immunologists have stated that fourth or fifth doses of the vaccine might lead to diminishing returns for the majority of the population when compared to 3 doses. However, a fourth vaccine dose may still be necessary for certain populations, including older and immunocompromised individuals. 

Several nations have begun offering fourth vaccine doses to specific populations or openly discussing that possibility. Many health officials in the US have agreed that it is too early to officially recommend a fourth vaccine dose, but the US FDA is continually examining emerging data to determine if and when another booster may be necessary. If a fourth dose does appear to be warranted, for all age groups or only older adults, experts say it likely would be recommended in the fall to coincide with annual flu shots and the rise of respiratory virus transmission. Additional considerations include whether the vaccine should be reformulated for novel variants. Other nations are moving forward with plans to provide fourth doses to certain populations, including the UK, Italy, South Korea, Sweden, and Israel. While fourth doses of SARS-CoV-2 vaccine may be necessary for certain populations, it is critical to ensure that populations in low- and middle-income countries (LMICs) are not left behind. Vaccine equity must be addressed now so the world can be prepared for future pathogens with pandemic potential. 


A new Covid vaccine shows 100 percent efficacy against severe disease and hospitalizations, its makers say.

”…The new vaccine had an efficacy of 75 percent against moderate-to-severe disease. It showed 58 percent efficacy against symptomatic disease in its Phase 3 clinical trial. Although that number is lower than was observed for the mRNA vaccines made by Pfizer-BioNTech and Moderna in their initial trials, it is “in line with expected vaccine effectiveness in today’s environment dominated by variants of concern,”….Used as a booster dose after one of the other available coronavirus vaccines, the Sanofi-GSK shot increased antibody levels by 18- to 30-fold. The companies intend to submit the vaccine for authorization to regulatory authorities in the United States and Europe, they said on Wednesday…In laboratory studies, two doses of the Sanofi-GSK vaccine stimulated the production of more neutralizing antibodies than an approved mRNA vaccine, according to the companies. The data have not yet been published. The vaccine was safe and well-tolerated by adults of all ages, the companies said...The best target for Covid vaccines is a protein called spike that covers the surface of the virus like a crown. While the mRNA vaccines contain the genetic instructions for making the protein, the Sanofi-GSK vaccine uses a slightly modified version of the [SPIKE] protein itself to stimulate an immune response..This is a commonly used approach for vaccines, and so may convince some people who have been hesitant to adopt the newer mRNA technology. Protein-based vaccines are also relatively inexpensive to manufacture and may not require the ultracold storage needed for the mRNA vaccines. Those features make them more likely candidates for rollout in African nations where vaccine coverage is still very low.

…The pharmaceutical company Novavax last month applied to the Food and Drug Administration for authorization of a similar protein-based vaccine.

(J. Harris: New Covid Vaccines are being tried all over the world. The US got a head start and also is helping to finance other vaccine programs throughout the world. These new protein vaccines might make a good “chaser” vaccine to kick up antibody production in older previously vaccinated individuals.)

Population Immunity and Covid-19 Severity with Omicron Variant in South Africa

”…the results of our survey showed widespread underlying SARS-CoV-2 seropositivity across the province (73.1%), including a prevalence at the subdistrict level of up to 85.8%, before the onset of the omicron-dominant wave. This high seroprevalence was primarily induced by previous SARS-CoV-2 infection, as evidenced by the 68.4% seroprevalence among participants who had not received a Covid-19 vaccine. The methods used for selecting the random sample of households in the survey, with a distribution proportionate to subdistrict population sizes, ensured that the sample was representative of the general population of Gauteng…We think that the decoupling of the incidence of Covid-19 cases from the incidences of hospitalization and death during the omicron-dominant wave in South Africa heralds a turning point in the Covid-19 pandemic, if the primary goal is protection against severe disease and death rather than prevention of infection. The 70% vaccine effectiveness against severe disease with BNT162b2 [PFIZER] in South Africa31 might well be due to the hybrid cell-mediated immunity induced by vaccination and natural infection. Whether the same protection against severe Covid-19 due to the omicron variant will be seen in countries in which immunity is mainly from vaccination remains to be determined…”

(J. Harris: My interpretation of this NEJM article is that in S. Africa, which was given mRNA vaccine late, the combination of prior infection and good vaccines conferred considerable protection against sever Covid infections (mostly Delta) and “perhaps” made Omicron less lethal. So, folks with prior Covid infections PLUS continued vaccinations should be well protected against sever Covid.)

Do masks really harm kids? Here’s what the science says.

(J. Harris: Good read for parents and grandparents.)




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