Out in the Countryside – 7 July 2022 – East Anglia, United Kingdom

Editor note:

More from Tom  

By Tom Allin

A Note from Tom – July 17, 2022

Yesterday the high was 71.  Today the high is predicted to be 88.  Monday 96.  And Tuesday 103.  But Wednesday its back to 73.  Keep in mind our apartment has no air conditioning.  

Nothing like being in the UK when it is having one of its hottest hot spells.  My favorite headline: Climate models predicted current heat — in 2050.  The climate deniers continue to be correct — the models are not perfect; the models keep predicting cooler weather than is occurring!

Stay cool, safe, healthy and avoid the Covid.

Out of the city and into the countryside.  Life is better: no jet lag, Nancy’s bag finally arrived, and we are walking paths not cobblestone streets and sidewalks.

U-turn and continue walking the broad pathway with very little to look at.

The plan for today is to stop at three Royal Society for the Protection of Birds nature reserves.  The Royal Society for the Protection of Birds (RSPB) was begun in 1889 and is the largest nature conservation charity in the United Kingdom.  There are more than 150 reserves spread across the UK.  For more on the RSPB go to: https://www.rspb.org.uk

Use the links below to read Tom’s complete story




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 HELLO:  Take your time. 

You don’t have to read it all at once. Frequently, I find a need to include additional material for my physician readers. This is one of those editions. 



”…The dominance of the COVID-19 omicron variant continues to persist throughout the U.S., with subvariant BA.5 now accounting for 53.6 percent of the nation’s cases, but one expert says it could be hard to predict what will happen next….Right now, it’s all about which virus can outcompete the next one in terms of transmission. And in some cases, [the] ability to cause disease transmission is really a prime driver,…And that can be tied to its ability to evade immune protection to the host.”…’This is a stay-tuned moment’: Dr. Michael Osterholm on omicron uptick…”

2. Is it time to update the definition of ‘fully vaccinated’?

”…Based on the CDC’s definition, individuals are considered fully vaccinated against COVID-19 if they’ve received their primary series, which entails two doses of Pfizer or Moderna’s vaccine or one dose of Johnson & Johnson’s. …The CDC says people who receive recommended booster doses are “up to date” on their vaccines and best-protected, but While research shows BA.5 can evade immunity from vaccination and past infection, vaccines are still effective at protecting against severe disease, Anthony Fauci, MD, director of the National Institute of Allergy and Infectious Diseases, said during a July 12 White House briefing.

, I’d like being  “fully vaccinated” as well as “up to date” on boosters with two of them — for a total of 4 jabs.  Now, I’m anxious to hear about the new, slightly altered designed vaccines to cover more variants. I’m also intherested in “mix and match” vaccinations with some of the more old fachion vaccines that seem to work. Obviously, I believe in the vaccines usefulness.)

3. COVID-19 admissions to rise through July + 2 more forecasts

4. Don’t wait for an omicron-tailored booster, experts warn


1. Reactogenicity of Simultaneous COVID-19 mRNA Booster and Influenza Vaccination in the US

Key Points:

Question  Are systemic reactions more common after simultaneous administration of COVID-19 mRNA booster and seasonal influenza vaccines than after COVID-19 mRNA booster alone?

Findings  In this cohort study of self-reported data from 981 099 persons aged 12 years or older, simultaneous administration of a COVID-19 mRNA booster dose and an influenza vaccine was associated with 8% to 11% increases, respectively, in systemic reaction compared with COVID-19 mRNA booster alone. These differences were statistically significant.

Meaning  Findings from this study suggest that simultaneous administration of COVID-19 mRNA booster and influenza vaccines may be associated with increased likelihood of systemic reactions.

(J. Harris: Reactions were mild. See the following Opinion piece. I plan to take the flu shot with my next Covid booster.)

2. Reactogenicity and Concomitant Administration of the COVID-19 Booster and Influenza


”…Although emphasis on the benefits of vaccination and minimization of their adverse events might seem a reasonable approach to limiting nocebo effects, negative information about the COVID-19 vaccine is common, and from an ethics standpoint, individuals have the right to complete information so they can decide whether they want to receive the vaccine. Some argue that the best approach to gaining the public’s trust is to offer both the positive and negative scientific evidence, with refutational 2-sided risk and benefit messages.6 Thus, while messaging could include the fact that serious reactions are rare even when the vaccines are given concomitantly, in light of these data, clinicians can confidently inform patients that concurrent administration of the COVID-19 booster and seasonal influenza vaccine is both safe and associated with only a slight increase in adverse events compared with the COVID-19 booster alone……

Substantial efforts have been undertaken to increase rates of COVID-19 vaccination and boosting; however, less effort has focused on influenza vaccination. Nationally, during the 2020 to 2021 season, influenza vaccination coverage was only 50.2%.7 Significant disparities have also been noted by race and ethnicity. Influenza results in significant morbidity annually which could be averted by increased vaccination coverage. Despite the limitations detailed above… the data reported by Hause et al3 suggest that the development of public health campaigns to increase dual vaccination should be undertaken. Although logistical challenges may serve as barriers to the implementation of dual vaccination, organizing for provision of both influenza vaccination and COVID vaccination within clinical settings and at community-based nonclinical venues would be advantageous and may increase the likelihood of uptake. Given the small increase in rate of adverse events reported by Hause et al,3 health care systems should be encouraged to develop routine and streamlined processes for coadministration of these vaccinations.

2. Incidence and Relative Risk of COVID-19 in Adolescents and Youth Compared With Older Adults in 19 US States, Fall 2020

”…These results suggest that, contrary to reports from Europe and Asia, infection rates and relative risk among US adolescents and youth exceeded that in older adults from the start of the COVID-19 pandemic through fall 2020, before vaccines were available.”

3. Effectiveness of Casirivimab-Imdevimab and Sotrovimab During a SARS-CoV-2 Delta Variant Surge

”Findings of this study suggest that casirivimab-imdevimab [Regen-Cov] and sotrovimab[ Xevudy] were both associated with reduced risk of hospitalization or death and had similar effectiveness, although they did not meet the prespecified criteria for statistical inferiority or equivalence.

(J. Harris: These are injectable Monoclonal Antibodies)

4. Association Between COVID-19 Booster Vaccination and Omicron Infection in a Highly Vaccinated Cohort of Players and Staff in the National Basketball Association

Individuals who were fully boosted experienced 608 confirmed SARS-CoV-2 infections and were significantly less likely to be infected than fully vaccinated individuals who were booster eligible and had not received a booster, who had experienced 127 confirmed infections  The secondary analyses evaluating symptomatic infection showed a similar association… No hospitalizations or deaths occurred. Omicron was the dominant variant, representing 93% of 339 sequenced cases.

Discussion | This study found that in a young, healthy, highly vaccinated cohort frequently monitored for SARS-CoV-2, booster vaccination was associated with a significant reduction in incident infections during the Omicron wave.


1. One Coronavirus Infection Wards Off Another — but Only If It’s a Similar Variant (Nature) Natural immunity induced by infection with SARS-CoV-2 provides a strong shield against reinfection by a pre-Omicron variant for 16 months or longer, according to a study1. This protection against catching the virus dwindles over time, but immunity triggered by previous infection also thwarts the development of severe COVID-19 symptoms — and this safeguard shows no signs of waning. The study… which analyses cases in the entire population of Qatar, suggests that although the world will continue to be hit by waves of SARS-CoV-2 infection, future surges will not leave hospitals overcrowded with people with COVID-19. The research was posted on the medRxiv preprint server on 7 July.

2. COVID-19 Pandemic Fuels Largest Continued Backslide in Vaccinations in Three Decades (WHO) The largest sustained decline in childhood vaccinations in approximately 30 years has been recorded in official data published today by WHO and UNICEF. The percentage of children who received three doses of the vaccine against diphtheria, tetanus and pertussis (DTP3) – a marker for immunization coverage within and across countries – fell 5 percentage points between 2019 and 2021 to 81 percent. As a result, 25 million children missed out on one or more doses of DTP through routine immunization services in 2021 alone. This is 2 million more than those who missed out in 2020 and 6 million more than in 2019, highlighting the growing number of children at risk from devastating but preventable diseases.

(J. Harris: Routine childhood and adult vaccinations and boosters must still be performed!)


The Durability of Natural Infection and Vaccine-induced Immunity Against Future Infection by SARS-CoV-2 (Proceedings of the National Academies) 

”…We estimated typical trajectories of waning and corresponding infection probabilities, providing the distribution of times to breakthrough infection for each vaccine under endemic conditions. Peak antibody levels elicited by messenger RNA (mRNA) vaccines mRNA-1273 [MODERNA] and BNT1262b2 [PFIZER] exceeded that of natural infection and are expected to typically yield more durable protection against breakthrough infections (median 29.6 mo; 5 to 95% quantiles 10.9 mo to 7.9 y) than natural infection (median 21.5 mo; 5 to 95% quantiles 3.5 mo to 7.1 y). Relative to mRNA-1273 and BNT1262b2, viral vector vaccines ChAdOx1[Oxford-AstraZeneca] and Ad26.COV2.S [Johnson & Johnson/Janssen] exhibit similar peak anti-S IgG antibody responses to that from natural infection and are projected to yield lower, shorter-term protection against breakthrough infection (median 22.4 mo and 5 to 95% quantiles 4.3 mo to 7.2 y; and median 20.5 mo and 5 to 95% quantiles 2.6 mo to 7.0 y; respectively)….’By quantifying the peak antibody levels for each vaccine relative to peak antibody levels following natural infection, we found that mean antibody response to the mRNA vaccines mRNA-1273 and BNT162b2 exceeded the mean antibody response to natural infection. In contrast, the mean antibody response to viral vector vaccines ChAdOx1 and Ad26.COV2.S was lower than the mean antibody response to these mRNA vaccines and similar to that of natural infection (Table 1)…These first estimates of the durability of immunity following vaccination provide essential knowledge to policy decision-making that can curb transmission long term, mitigating morbidity and mortality consequent to SARS-CoV-2 infection. Our quantitative estimates will be improved as data on long-term immunological responses to SARS-CoV-2 infection and vaccination are generated, providing increasingly precise knowledge that can refine our estimates not only for currently available vaccines, but for vaccines of the future as well….”

4. Investigating Trends in those who Experience Menstrual Bleeding Changes after SARS-CoV-2 Vaccination (Science Advances) Early in 2021, many people began sharing that they experienced unexpected menstrual bleeding after SARS-CoV-2 inoculation. We investigated this emerging phenomenon of changed menstrual bleeding patterns among a convenience sample of currently and formerly menstruating people using a web-based survey. In this sample, 42% of people with regular menstrual cycles bled more heavily than usual, while 44% reported no change after being vaccinated. Among respondents who typically do not menstruate, 71% of people on long-acting reversible contraceptives, 39% of people on gender-affirming hormones, and 66% of postmenopausal people reported breakthrough bleeding. We found that increased/breakthrough bleeding was significantly associated with age, systemic vaccine side effects (fever and/or fatigue), history of pregnancy or birth, and ethnicity. Generally, changes to menstrual bleeding are not uncommon or dangerous, yet attention to these experiences is necessary to build trust in medicine.



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