Category: Covid-19

CDC Update Today on Covid-19 Variant BA.2.86

Today’s update by the CDC on the Covid-19 variant BA.2.86 is at this link.

Highlights:

  • “The variant has been identified in at least four states in the United States in samples from either people or wastewater.
  • This variant is currently being studied in the laboratory to help understand how the immune system may interact with this virus.
  • The current increases in cases and hospitalizations in the United States are likely being driven by infections with XBB lineage viruses, not the new BA.2.86 variant.”

“CDC’s current assessment is that the updated COVID-19 vaccine, which will be available in mid-September, will likely be effective at reducing severe disease and hospitalization. Immune responses generated from prior infection also help protect against severe outcomes of COVID-19. There is currently no evidence that this variant is causing more severe illness. That assessment may change as additional scientific data are developed. CDC remains committed to releasing updates on trends and observations of this variant.”

“Immune Impacts:  Approximately 97% of the U.S. population has antibodies to SARS-CoV-2 from vaccination, previous infection, or both (hybrid immunity). Immune responses to vaccines and infections are complex and involve both humoral (antibodies) and cellular immunity. It is likely that the humoral and cellular immune responses will continue to provide protection against severe disease from this variant. Laboratories are currently working on measuring antibody neutralization of BA.2.86 as well as other immune responses. This is an area of ongoing scientific investigation.

Therapeutics: The assessment as to the impact of BA.2.86 on currently approved or authorized therapeutics is unchanged. Examination of the mutation profile of BA.2.86 suggests that currently available treatments like nirmatrelvir-ritonavir (Paxlovid), remdesivir (Veklury), and molnupiravir (Lagevrio) will be effective against this variant. This assessment is from the SARS-CoV-2 Interagency Group (SIG), which comprises experts from multiple United States government agencies. Monitoring is ongoing, and CDC will update this document as additional data on the impact of this variant on therapeutics become available.”

CDC ACIP to Discuss Covid-19 Vaccines on September 12, 2023

The CDC Advisory Committee on Immunization Practices (ACIP) has a scheduled meeting on September 12, 2023 to discuss Covid-19 vaccines. The information about it is a bit difficult to find. It’s announced as a notice on the Federal Register. On the agenda:

Matters To Be Considered: The agenda will include discussion of COVID–19 vaccines. Recommendation votes for COVID–19 vaccines are scheduled. Agenda items are subject to change as priorities dictate. For more information on the meeting agenda, visit https://www.cdc.gov/vaccines/acip/meetings/index.html.

Clicking the link as of August 28, 2023 did not reveal a meeting agenda, but I expect this to be updated in the near future.

Official CDC Update on New Covid-19 Variant BA.2.86

I’ve been looking for official CDC news about the new Covid-19 variant, BA.2.86 and it looks like it was just posted on their website yesterday.

Highlights:

“Last week, a new variant of SARS-CoV-2 called BA.2.86 was detected in samples from people in Denmark and Israel. At least two cases have been identified in the United States. This variant is notable because it has multiple genetic differences from previous versions of SARS-CoV-2.”

“Based on what CDC knows now, existing tests used to detect and medications used to treat COVID-19 appear to be effective with this variant. BA.2.86 may be more capable of causing infection in people who have previously had COVID-19 or who have received COVID-19 vaccines. Scientists are evaluating the effectiveness of the forthcoming, updated COVID-19 vaccine. CDC’s current assessment is that this updated vaccine will be effective at reducing severe disease and hospitalization. At this point, there is no evidence that this variant is causing more severe illness. That assessment may change as additional scientific data are developed. CDC will share more as we know more.”

Moderna Files for FDA Authorization of Updated Covid-19 Vaccine

The Moderna corporation announced in June 2023 that it filed for FDA authorization of its monovalent XBB. 1.5 vaccine.

Pfizer also announced the same message in August. It’s on page 4 of the Pfizer Earnings Call.

New Dominant Covid-19 Variant EG.5

There is a new dominant Covid-19 variant called EG.5. It’s also called Eris. It’s descended from the XBB strains. It’s in the Omicron family and there is no indication it causes more severe disease and would be susceptible to current vaccines.

What’s Up with Seasonal Vaccines This Fall?

I just read an interesting article in JAMA on this fall’s Covid-19 vaccine. Most of it is from the FDA meeting in June (Rubin R. This Fall’s COVID-19 Vaccines Will Target Omicron XBB Subvariants, but Who Needs Them Remains to Be Seen. JAMA. Published online July 05, 2023. doi:10.1001/jama.2023.10053).

One expert was quoted, indicating that there will be “…an elaborate discussion” at the CDC ACIP meeting about who should get the new monovalent XBB.1.5 vaccine. I don’t see that the meeting is scheduled yet.

There are some other interesting quotes to pass along:

“Back in March and the first half of April, XBB.1.5 represented more than 80% of circulating SARS-CoV-2 in the US, according to CDC estimates. Its dominance began to slip in late April, and as of late June, XBB.1.5 represented little more than a quarter of circulating SARS-CoV-2 variants. By then, though, XBB.1.5 and 9 other XBB subvariants together accounted for a total of 96% of circulating SARS-CoV-2 in the US. Fortunately, members of the XBB family of subvariants are antigenically similar to each other, so a vaccine against XBB.1.5 should protect against the rest of them as well, the WHO committee noted.”

“By the third quarter of 2022, an estimated 96.4% of approximately 143 000 blood donors in a nationwide, longitudinal cohort had SARS-CoV-2 antibodies from previous infection or vaccination or both, according to an analysis published in June in Morbidity and Mortality Weekly Report.

Or, as Sawyer told JAMA, “[t]he whole US has had this virus in one form or another.”

Because of the high prevalence of SARS-CoV-2 antibodies in the population, Paul Offit, MD, in an interview predicted “a focused recommendation by the CDC” regarding who should receive the XBB.1.5 vaccine.”

“Offit said he expects that the CDC will recommend the new monovalent XBB.1.5 vaccine for groups at the greatest risk for severe disease, reflected in continuing hospitalizations for COVID-19. Those groups likely would include people who are 75 years or older, people with severely compromised immune systems, and pregnant people, Offit said.”

“At least for people 60 years or older, the fall vaccine situation will be more complicated than it was a year earlier, Schaffner noted. That’s because at its regular monthly meeting in June, ACIP voted to recommend that this age group have the option of being vaccinated against respiratory syncytial virus (RSV) after consulting with their physician or pharmacist.”

That would mean that there would be 3 vaccines coming in the fall: RSV, Covid-19, and influenza. Sena and I have been doubtful about why a conversation with a physician would be necessary for the RSV vaccine. We don’t know whether that means you couldn’t get it without a physician’s order. There are also questions about coadministration of the RSV and Covid-19 vaccines.

Because the time is coming soon for seasonal vaccines, we’re hoping the questions will be answered soon.

Selected Highlights of CDC ACIP Meeting on Covid-19 Vaccines

Today I’m highlighting a few items of interest to older adults from the summary slide set on Covid-19 vaccines presented on June 23, 2023 at the CDC ACIP meeting last week. Information for other age groups are included in the slide set.

Covid-19 continues to be a major health threat for the population, especially older adults and the immunocompromised. Vaccines are still the most effective intervention. However, the bivalent vaccine uptake was very low; most people didn’t get it.

A new Covid-19 monovalent vaccine with an XBB.1.5 composition, is expected to be available this fall.

In the fall, the vaccine manufacturers will switch to the commercial marketplace. In order to continue making Covid-19 vaccines available to the uninsured, there is a Bridge Access Program for Covid-19 Vaccines and Treatments” which is described at the HHS website.

Covid-19 Variants in the News

Sena alerted me to a CBS news item with the headline “CDC tracking new Covid variant EU.1.1.” The story seemed a bit misleading because the FDA just announced approval of vaccines for XBB.1.5. beginning in the fall.

I checked the CDC Data Tracker for variants and noticed XBB.1.5 is still the most common Covid-19 subvariant in the U.S.

While the EU.1.1 is on the list of subvariants tracked, it’s pretty far down the line and is much less common than the news headline seems to suggest. And it’s not clear the new vaccine for XBB.1.5 wouldn’t protect against EU.1.1 as well.

CDC ACIP Meeting Today on Vaccines

The ACIP meeting on several vaccines begins today and runs through Friday, 8:00 a.m-5:30 p.m. on the 21st-22nd and 8:00 a.m.-12:40 p.m. on the 23rd, ET.

The committee will discuss vaccines for Respiratory Syncytial Virus in adults, Polio, and Influenza vaccines on the 21st. There will be a vote for each.

They will discuss vaccines for Pneumococcal, Dengue, Chikungunya, Respiratory Syncytial Virus (pediatric and maternal) on the 22nd. They will vote on the pneumococcal vaccine.

They will discuss Mpox, Meningococcal, and Covid-19 vaccines on the 23rd.