Category: COVID-19 vaccines

Thoughts on Upcoming CDC ACIP Meeting

Sena and I are talking about the upcoming CDC meeting on February 28th-29th next week. The agenda looks like they’ll be talking about an “additional dose” of the Covid-19 vaccine.

Given the extent of vaccine fatigue going on, I tried to find a layperson-friendly article on the web about vaccine immunity with details about how long it lasts.

There’s review article from 2022 that helps a little bit. The author says that boosting every few months may not be practical as a long-term strategy. It leads to vaccine fatigue in the population. We all know how low the Covid-19 vaccine uptake has been. The author says that boosters should be offered annually or even less often. There is more to immunity than neutralizing antibodies.

The suggestion of some experts is to offer Covid-19 boosters to whoever wants it. I feel like I’m getting mixed and circular messages when I read that my immunity is “waning,” and I need another one. We’ve gotten every Covid-19 shot since the vaccine campaign began. Experts even differ on whether to call Covid-19 a “seasonal” respiratory virus. That would suggest you could get one shot annually during the respiratory virus season-like the flu shot. Obviously, it’s not that simple if the CDC recommends another Covid-19 vaccine this spring.

And the CDC respiratory virus channel snapshot from February 16, 2024 is a little concerning. A couple of days ago there was a news report that schools in Forest City, Iowa would have to move to remote learning because of outbreaks of influenza, strep throat, and even stomach flu. According to the CDC, respiratory virus activity levels are high all over Iowa, which surprised me this late in the season.

CDC ACIP Meeting February 28-29, 2024 to Discuss Covid-19 and Other Vaccines

There are news stories about a pending CDC-ACIP meeting (February 28-29, 2024) which might include information about a CDC recommendation to possibly add a 3rd additional Covid-19 vaccine booster this spring.

The Covid-19 vaccine portion of the meeting is scheduled for February 28, 2024 at 8:30 AM EST. There will be a vote at 1:55 PM EST that day.

Interestingly, also on the agenda is a discussion about the RSV vaccine on February 29, 2024 at 8:30 AM EST. We wonder whether the committee will talk about the current requirement for a shared clinical-decision making discussion with a physician for getting the RSV vaccine.

New Large Covid-19 Vaccine Study Shows Association with Rare Side Effects Which Other Smaller Studies Have Found

I’ve seen a couple of news stories about the CDC supported large study across many countries which essentially shows that Covid-19 vaccines can be associated with rare side effects. The stories might tend to raise anxiety about the vaccines’ overall safety, which has been repeatedly proven in other studies.

The study is published in the journal Vaccine and the conclusions are consistent with smaller studies showing the Covid-19 vaccines safety although they do have rare side effects.

One of the news stories contacted an expert, Dr. Marc Siegel, clinical professor of medicine at NYU Langone Medical Center, who confirmed that.

Unfortunately, there are over 1200 comments (and counting) containing alarmist and misleading information about the vaccines.

CDC May Change the 5 Day Covid-19 Isolation Guidelines

I see many news headlines reporting that the CDC may be planning to drop the 5 day Covid-19 isolation guidelines. For now I’m taking that as a rumor until the CDC website says something official about it.

Word on the street is that we may know more in April.

CDC Healthcare Provider Toolkit

The CDC has a healhcare provider toolkit available to prepare their patients for the 2023 for the fall and winter virus season. It’s up to date and comprehensive.

CDC Issues Health Alert Network Announcement Recommending Vaccinations for Seasonal Respiratory Illnesses

The CDC recently issued a Health Alert Network (HAN) announcement urging physicians to recommend that patients get their influenza, Covid-19, and RSV vaccines.

CDC Weekly Update on Viral Respiratory Illness

As of December 8, 2023, the CDC reports:

  • “National test positivity, emergency department visits, and hospitalizations for influenza continue to increase. Influenza A(H1N1) is the predominant influenza virus circulating although influenza A(H3N2) and influenza B viruses are also being reported.
  • RSV-associated hospitalization rates remain elevated among young children and are increasing among older adults; of note, only 15.9% of adults 60+ report having received an RSV vaccine.
  • National vaccination coverage for COVID-19, influenza, and RSV vaccines increased slightly for children and adults compared to the previous week and remains low for both groups.”

However, the overall respiratory illness rates have gone from “moderate” to “low” in Iowa.

What’s Up with Intranasal Covid-19 Vaccines?

I saw the JAMA article on intranasal vaccines research for Covid-19. It starts off pretty supportive of the principle. However, at the bottom of the article, the outlook looks pretty stable for injectable vaccines for at least a good long while.

It’s an interesting read. Skip to the Many Questions section:

How these experimental mucosal vaccines stack up against mRNA vaccines, considered the standard of care, remains to be seen, Beigel noted. The NIAID intends to conduct phase 2 trials that would compare mucosal and mRNA vaccines head-to-head, “so you’d know for certain what you’re trading off,” he said.

Ideally, a mucosal vaccine would generate as good a systemic immune response as an mRNA vaccine as well as a robust mucosal immune response. But an excellent mucosal immune response might make up for a bit of a decline in the systemic immune response, Beigel explained. Perhaps a vaccine inhaled through the mouth and into the lungs could provide the best of both worlds—strong mucosal and systemic immunity—but there are no data yet to support that theory, he said.

“Everyone knows we need a better vaccine and would really like it if we could get something that interrupts transmission and stops even mild disease,” Beigel said. “Whether that’s attainable or not, we don’t know.”

I’m not knocking the concept by suggesting you read the Conflict of Interest Disclosures.

Reference:

Rubin R. Up the Nose and Down the Windpipe May Be the Path to New and Improved COVID-19 Vaccines. JAMA. Published online December 06, 2023. doi:10.1001/jama.2023.0644

Moderate Respiratory Illness Activity in Iowa

The CDC tracks respiratory illness and there is moderate activity in Iowa according the data tracker.

The weekly snapshot as of December 1, 2023 shows highlights including:

  • “COVID-19 test positivity (percentage of tests conducted that were positive), emergency department visits, and hospitalizations have increased nationally. A group of Omicron variants (XBB and its sublineages) are the predominant lineages detected in the U.S., with HV.1 being most common. The prevalence of another lineage, BA.2.86, is projected to account for 5-15% of currently circulating variants. CDC continues to monitor HV.1, BA.2.86, and all other lineages.
  • National test positivity, emergency department visits, and hospitalizations for influenza continue to increase.
  • RSV emergency department visits and hospitalizations continue to increase across the country. RSV-associated hospitalization rates remain elevated among young children and are increasing among older adults; of note, only 14.8% of adults 60+ report having received an RSV vaccine.
  • National vaccination coverage for COVID-19, influenza, and RSV vaccines increased less than one percentage point for children and adults, where indicated, compared to the previous week and remains low for both groups.
  • CDC has been monitoring increases in respiratory illness reported recently among children, including potential elevated rates of pediatric pneumonia in parts of the United States. These reported increases do not appear to be due to a new virus or other pathogen but to several viral or bacterial causes that we expect to see during the respiratory illness season. CDC will continue to work closely with our state and local public health partners to maintain strong situational awareness and will provide updates, as needed.”

CDC Update on Covid-19 Variant BA.2.86

I saw a news item headline which mentioned Covid-19 Variant. BA.2.86. The CDC website tracking respiratory variants has a definitive update as of November 27, 2023:

“What to know about BA.2.86

  • The virus that causes COVID-19 is constantly changing over time. Sometimes these changes allow new variants to spread more quickly or effectively. If that occurs, the new variant may become more common relative to other variants that are circulating.
  • Since CDC’s first post on BA.2.86 in August 2023, the proportion of infections caused by BA.2.86 has slowly increased. In the CDC Nowcast posted Nov. 27, 2023, BA.2.86 is projected to account for 5-15% of currently circulating variants.
  • CDC projects BA.2.86 and its offshoots like JN.1 will continue to increase as a proportion of SARS-CoV-2 genomic sequences.
  • At this time, BA.2.86 does not appear to be driving increases in infections or hospitalizations in the United States.
  • CDC contributed to and agrees with the World Health Organization’s recent risk assessment about BA.2.86 suggesting that the public health risk posed by this variant is low compared with other circulating variants, based on available limited evidence.
  • Updated COVID-19 vaccines are expected to increase protection against BA.2.86, as they do for other variants.
  • As mentioned in previous updates, COVID-19 tests and treatments are expected to be effective against this variant, including its offshoot JN.1.
  • It is not possible at this time to know whether BA.2.86 infection produces different symptoms from other variants. In general, symptoms of COVID-19 tend to be similar across variants. The types of symptoms and how severe they are usually depend more on a person’s immunity than which variant causes the infection.
  • Regardless of what variants happen, CDC will continue to track them, working closely with partners around the world to understand how they are spreading and how they respond to vaccines and treatments.”