Vaccining the U.S. with Covid-19: Preventing COVID-19 spread across the world through the end of 2021

An analysis published this week found that if more people in the United States get their booster by the end of the year, about 90,000 Covid-19 deaths could be prevented this fall and winter.

For parents who haven’t yet gotten their children vaccinated, it’s not too late — especially as “we are entering a phase when COVID-19 cases are increasing,” Marks said.

With the winter holidays upon us and people gathering with loved ones, Sandra Lindsay says to think about Grandma. Lindsay was the first person in the U.S. to receive a COVID-19 vaccine in December 2020 as a critical care nurse, and now she’s vice president of public health advocacy at Northwell Health in New York. She says that everyone has a responsibility to their friends and family. Stay home if you are sick. Grandma — take her to get vaccinated as a Christmas gift.”

People head indoors in the winter for holiday celebrations, which causes Respiratory Viruses to spread quickly. Rising Covid-19 cases in the UK and Europe may be a signal of what’s to come in the United States. The Omicron BA.5 subvariant dominates global markets, but othervariants are also starting to spread.

According to a study released Friday, Covid 19 vaccinations lowered hospitalizations and deaths from the coronaviruses last year.

The study analyzed and extrapolated data from 26.8 million older Americans and others enrolled in a Medicare fee-for-service health plan through the end of 2021. Last year, it had data from the Delta and Omicron surge.

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“This report that they have issued, I believe, doubles down on the work that we’re doing on vaccination, why it’s so important to continue this effort and to get the right information out to Americans who can benefit and ultimately stay alive, stay healthy, stay out of the hospital and help us defeat Covid once and for all,” HHS Secretary Xavier Becerra said Friday.

If a child has already gotten two original doses of the vaccine, they can receive a booster if it’s been at least two months since their last shot.

Protein-based vaccines like the Novavax shot teach the immune system to recognize little modified pieces of the virus that the vaccine is targeting. That means pieces of the coronaviruses spikeprotein. The vaccine was created out of a genetic sequence of the original strain of the coronavirus.

“It’s just really critical that [people] — especially those at high risk — understand the value of getting vaccinated and making sure they stay up to date on their boosters,” Hannan says.

Moderna and Pfizer have updated their vaccines to fit the BA.4 and BA.5 omicron strains that are now dominant. Now BA.5 descendants are responsible for most COVID-19 cases.

The data came from two small studies that measured immune responses around three to five weeks after the booster dose, and both found that the booster shots worked against the BA.4 and BA.5 Omicron subvariants. The studies were released as preprints and have not been peer-reviewed or published.

Although the bivalent vaccines have been helpful, new data suggests that just like the boosters that came before them, their protection may be starting to drop off.

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The side effects in the trials were mild and lasted about two days. The most common side effects reported with the Novavax booster were pain or tenderness at the injection site, fatigue, muscle pain and headache.

People who received the bivalent booster had 57% less risk of hospitalization than unvaccinated people and 45% less risk of hospitalization than people who had received two to four doses of the original vaccine and received their last shot 11 or more months earlier. The risk of hospitalization after a bivalent booster is 42% less than if people received two to four doses of the original vaccine.

The Omicron subvariants have been gaining against the US Covid-19 infections. The US Centers for Disease Control and Prevention shows that BA.5 accounts for nearly 50% of new infections in this country.

The FDA proposes to update COVID-19 Vaccines once a year, in stark contrast to the agency’s approach of updating Influenza vaccines. At a meeting of the FDA’s vaccine advisory panel on 26 January, some researchers argued that the plan would help to simplify the country’s complex COVID-19 immunization schedule and might boost uptake as a result.

Pfizer and BioNTech are still conducting larger clinical trials of the updated boosters, and said they are continuing to test the vaccine against the other variants of the virus.

The Food and Drug Administration’s decision aims to better protect the littlest kids amid an uptick in COVID-19 cases around the country — at a time when children’s hospitals already are packed with tots suffering from other respiratory illnesses including the flu.

The FDA now has authorized use of the tweaked shots starting at age 6 months — but just who is eligible depends on how many vaccinations they’ve already had, and which kind. Only about 5% of youngsters under age 5 have gotten the full primary series since vaccinations for the littlest kids began in June.

The FDA expects data from Pfizer and its partner BioNTech sometime next month to determine whether those tots will need an omicron-targeted booster “and we will act on that as soon as we can,” he said.

A group of experts that advises the US FDA on its vaccine decisions recommended in January that the agency phase out the monovalent vaccines, which protect only against the ancestral strain, and give bivalent doses for first shots to Americans who haven’t had their first Covid-19 vaccines, a group that would primarily include babies and toddlers.

According to the Kaiser Family Foundation, the fight with HIV is going to be an uphill battle. “I do think it’s a tough sell just because of where we are on this point in the pandemic.”

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Uptake of bivalent boosters has been low in the United States: about 15% of eligible people have received a two-strain jab. Some experts say that is because many people receive a mixture of vaccines which has led to confusion over which vaccine is better for them and when.

“That is very concerning,” says Claire Hannan, who helps immunization officials from all 50 states run vaccination programs as the executive director of the Association of Immunization Managers.

The approach to public health is changing. The CDC is looking to put a lot of single-dose vial in long-term care facilities that have the right storage equipment. It would make sense to get a single dose of vaccine out of the pharmacy- grade fridge at the nursing home so that staff could administer it to someone who was ready for a booster.

“We desperately need to simplify the vaccination schedule,” says Megan Ranney, a physician and public-health specialist at Brown University in Providence, Rhode Island. “If we’re going to sustain our ability to vaccinate the country, we have to move toward a more standardized schedule, from a behavioural-science point of view.” The proposal to adopt a single vaccine composition for the whole series would alleviate some of that confusion, and it might boost vaccine uptake because jabs could be offered alongside annual influenza vaccines, she adds. The changes make a lot of sense.

It’s slow going with community health workers that work in Maryland who are out talking to people about vaccinations. “I don’t think that we or anybody else doing this work has found any particular message or fact or phrase that is kind of really changing hearts and minds,” Baur says.

She says providers are still the top source for vaccine recommendations. It will lead to a conversation, and the likelihood of someone being more cautious about vaccines if they’re recommended by providers.

There are a lot of ways to combat vaccine hesitancy, including focusing on misinformation or politicization or trust in public health. “I decided to take an angle that’s a little bit different, which is to look at how to improve the vaccination experience,” says Moore of Immunize.org.

She points out that a quarter of adults are afraid of needles. “How many of those people who are refusing to come in for vaccination are saying, I don’t want it, I don’t have time or I don’t think it works? For how many of them is that really just an excuse?”

She says the Autism Society for America has been pioneering strategies to help families and kids with autism get vaccinated, since it can be especially stressful and upsetting for people with autism. They have low cost ideas, like using headphones or a plastic shot blocker, that you can use to make a basketball shot less painful.

I tried a variation of this when I took my seven-year-old daughter, Noa, to get her booster. (Fear of needles among kids is even higher than among adults — more like 2 in 3.) I cut out the over-the-counter lidocaine patch to fit her bicep after buying it at the drugstore. I used it on the upper arm of her before we left. Then I drew an outline on her skin around the patch, so the immunizer could give her the shot in that area. Noa said the shot didn’t hurt — she was thrilled and proud that she hadn’t cried. And she asked if we could use it for every shot from now on.

Peter Marks, the Head of the FDA’s Center for Biologics Evaluation and Research said that administering the jab before the winter surge could prevent a rush of hospitalizations. In winter, clinics are swamped with people infected with influenza and respiratory syncytial virus (RSV), which led to some US hospitals nearing capacity this season.

It will be hard to coordinate the compositions of COvid-19 jabs around the world because the world doesn’t seem to sweep as uniformly as seditious strains. Bruce Gellin, a global-health specialist at the Rockefeller Foundation, asked at the meeting if the annual-update proposal would require that other countries follow the FDA’s decisions. The vice-president for global supply chain at Pfizer was asked if it was a possibility.

Standardizing vaccine composition for the primary and booster series would probably mean that the bivalent vaccine would become the main formulation for people who haven’t yet had a primary series.

The original strains of the coronaviruses are not currently circulating so it is not known how helpful those antibodies are. The strain that was the dominant in the summer and fall was called BA.5. The biggest boost was seen for the antibodies that are designed to defend against the newer Omicron subvariants, such as BQ.1 and XBB, which were not circulating when the experiments were conducted.

“There’s a clear step down” in protection as the variants continue to progress, said Dr. Dan Barouch, a professor of medicine at Harvard Medical School who led one of the studies.

In most cases, the boosters appear to be safe. Last month, the F.D.A. and C.D.C. issued a joint statement that said there was preliminary evidence the bivalent booster may raise the risk of stroke in adults over the age of 65. However, updated data revealed that it was because the comparison group had fewer strokes than normal, not because the recently boosted group had more.

Some people who are younger than 50 don’t have an increased risk of severe disease, but there is a debate about whether another shot is worth it. The booster is still effective, but not as much as it could be.

The US is weighing whether to give people at risk of severe Covid-19 the chance to get another booster, according to a source who asked not to be named because they were not authorized to share details of ongoing discussions.

While most Americans have gladly put pandemic precautions – including vaccines – in the rear view, some who are trying to protect themselves or their loved ones from severe illness have been anxiously wondering how soon they can get another shot.

Even if he had been able to get a second bivalent booster, he still might have gotten sick, despite the lack of sterilizing immunity required to block infections completely, and he wondered if he might have gotten sick.

A study shows the effectiveness of the Covid-19 vaccine, which has shown that its protection against infections fades after a few months. The B-cells and T-cells are part of the immune system that is able to retain a memory of past invaders.

The added protection from bivalent vaccinations for the measures falls to a little over 30% by four months, according to data presented in the February meeting of the CDC.

If they are older, live in residential care or are over the age of 12 with a condition that impairs their immune function, they might be offered an additional bivalent shot.

Vaccine manufacturers could also ask the FDA to tweak its emergency use authorizations to include so-called permissive language that would allow for a second bivalent dose.

If the FDA grants that application, it will give the CDC flexibility to change its recommendations for the use of the boosters, offering doctors permission to give another dose to vulnerable patients.

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“This is absolutely currently the most frequently asked question I get,” said Dr. William Schaffner, an infectious disease expert at Vanderbilt University. “It’s on the mind of that segment of the population that’s thinking about this very, very carefully.”

“One of the disappointments about the mRNA vaccines is that they’re not holding up as well as we’d like for reasons that I think we don’t entirely understand,” said Dr. Peter Hotez, dean of the National School of Tropical Medicine at the Baylor College of Medicine in Houston.

If we do not use them soon, they will have to be thrown out. So better to give them to people who are all in and willing to take it than just the tossing, right?” Hotez said. I believe the FDA and CDC will say something soon. I think there is enough available in the public domain that we will hear from them very soon on this.

“In that situation, I just don’t know if additional boosters are going to make a difference, because we know for a lot of those people, their immune responses are not going to be great,” she said.

On the other hand, she says, Covid-19 still hasn’t settled into any predictable pattern that would help health officials know whether they’re giving another round of shots at the best time.

If this were a seasonal virus it would only show up once a year but we don’t have a pattern of circulation for it. So it is a little risky to go through the next few months waiting for a fall booster,” Maldonado said.