RESEARCH UPDATES

20. NACI Considering Changes to AstraZeneca Age Recommendations (Apr.16/21)

The National Advisory Committee on Immunization (NACI) is considering whether to change its recommendation that the Oxford-AstraZeneca COVID-19 vaccine not be offered to anyone under the age of 55. Health Canada announced earlier this week the vaccine will remain authorized for all adults in Canada after the country reported its first case of blood clots linked to the shot. The agency says the new and extremely rare blood clotting syndrome may be linked to the vaccine, but they concluded the benefits of the shot still far outweigh any risks.

Dr. Susy Hota with the University Health Network says offering the shot to more people makes sense. “As long as people are aware of what the possibility is and they consent to it, I think it’s an important strategy you need to consider,” Hota said. Dr. Daniel Gregson with the University of Calgary says people do riskier things than get the shot on a daily basis without a second thought. “Surely based on risks, most people are much better off with a vaccine than not a vaccine,” he said.

In late March, NACI recommended a pause on AstraZeneca COVID-19 vaccinations for people under 55 due to safety reasons. Health officials continue to urge Canadians to take whichever vaccine is offered to them. More than 700,000 doses of the vaccine have been administered in Canada and about two million doses have been shipped.

The rollout of the Oxford-AstraZeneca vaccine in Canada has been shrouded with confusion, due to safety concerns and changing guidance over who can receive the shot. Health Canada asked AstraZeneca for a full risk assessment of its vaccine after reports of similar clots in Europe, but the agency says the side effect is extremely rare and the vaccine’s benefits still outweigh its risks.

https://www.680news.com/2021/04/16/naci-considering-changes-to-astrazeneca-age-recommendations/amp/ 

21. Canada Purchases 8M More Pfizer Doses as Moderna Vaccine Shipment Cut Nearly in Half (Apr.16/21)

Canada has purchased an additional eight million doses of the Pfizer-BioNTech COVID-19 vaccine that will be delivered in May, June and July, Prime Minister Justin Trudeau said Friday. The country will receive four million doses in May, two million in June, and another two million in July. The first shipment of Johnson and Johnson one-shot COVID-19 vaccine will be coming on April 27. The 300,000 doses will be distributed the first week of May. The news came shortly after it was announced that a shipment of Moderna vaccines expected next week has been cut nearly in half from 1.2 million to 650,000 doses. “The supplier has also indicated that 1 to 2 million doses of the 12.3 million doses scheduled for delivery in the second quarter may be delayed until the third quarter,” Minister of Procurement Anita Anand added in a statement Friday. Moderna blames slower than anticipated production capacity for the shortfall. 

https://toronto.citynews.ca/2021/04/16/canadas-moderna-vaccine-shipment-next-week-cut-nearly-in-half/amp/ 

Source de l'image : https://www.cidrap.umn.edu/news-perspective/2020/12/fda-documents-show-pfizer-covid-vaccine-protects-after-1-dose 

22. Results of the Safety and Immune-Efficacy of 1 Versus 2 Doses of COVID-19 Vaccine for Cancer Patients (Mar.17/21)

This study presents data on the safety and immune efficacy of the BNT162b2 (Pfizer-BioNTech) vaccine in 54 healthy controls and 151 mostly elderly patients with solid and haematological malignancies, respectively, and compares results for patients who were boosted with BNT162b2 at 3 weeks versus those who were not.

Findings show that the vaccine was largely well tolerated. However, in contrast to its very high performance in healthy controls (>90% efficacious), immune efficacy of a single inoculum in solid cancer patients was strikingly low (below 40%) and very low in haematological cancer patients (below 15%). Of note, efficacy in solid cancer patients was greatly and rapidly increased by boosting at 21-days (95% within 2 weeks of boost). Too few haematological cancer patients were boosted for clear conclusions to be drawn.

Researchers concluded that delayed boosting potentially leaves most solid and haematological cancer patients wholly or partially unprotected, with implications for their own health. Prompt boosting of solid cancer patients quickly overcomes the poor efficacy of the primary inoculum in solid cancer patients.

https://www.medrxiv.org/content/10.1101/2021.03.17.21253131v1 

23. So far, 5,800 fully vaccinated people have caught Covid anyway in US (Apr.15/21)

About 5,800 people who have been vaccinated against coronavirus have become infected anyway, the US Centers for Disease Control and Prevention tells CNN. According to the CDC, some became seriously ill, and 74 people died. Additionally, 396 (7%) of those who got infected after they were vaccinated required hospitalization. 

“To date, no unexpected patterns have been identified in case demographics or vaccine characteristics,” the CDC told CNN via email. Although rare, breakthrough cases are expected. The vaccines are not 100% effective in preventing infections and as tens of millions of people are vaccinated, more and more such cases will be reported.

Pfizer/BioNTech’s vaccine was 95% effective in preventing symptomatic disease in clinical trials, and earlier this month the companies said real-life data in the US shows the vaccine is more than 91% effective against disease with any symptoms for six months. Moderna’s vaccine was 94% effective in preventing symptomatic illness in trials, and 90% effective in real life use. Johnson & Johnson’s vaccine was 66% overall globally in trials, and 72% effective at preventing disease in the US.

Vaccine breakthrough infections make up a small percentage of people who are fully vaccinated. The likelihood of these “very rare” infections depends on how much virus is circulating within a community, Dr. Kawsar Talaat, an infectious disease physician and assistant professor at Johns Hopkins Bloomberg School of Public Health, told CNN. CDC recommends that all eligible people get a COVID-19 vaccine as soon as one is available to them.

https://www.cnn.com/2021/04/14/health/breakthrough-infections-covid-vaccines-cdc/index.html 

Source de l'image : https://medical.mit.edu/covid-19-updates/2021/01/got-vaccine-can-i-toss-my-mask 

24. CDC Study Finds Pfizer, Moderna Vaccines are 90% Effective After Two Doses in Real-World Conditions (Mar.29/21)

At full vaccination, the Pfizer and Moderna vaccines were 90% effective at preventing infections, including asymptomatic infections. At least 14 days after first dose but before second dose, they were 80% protective, according to the agency’s Morbidity and Mortality Weekly Report published Monday. 

The study assessed how the vaccines protected nearly 4,000 health care workers and first responders. Most of the volunteers of the study (>62%) had received both doses of either a Pfizer or Moderna Covid-19 vaccine. More than 12% had received just a single dose. Among the 2,961 people vaccinated with one or more doses and the 989 unvaccinated participants, a total of 205 had a positive PCR test for Covid-19. 161 infections were identified when participants were unvaccinated, whereas 8 were identified among those partially immunized and 3 were identified among those fully immunized (more than 14 days after their second dose). More than 87% of Covid-19 cases had symptoms. Nearly 23% of the cases sought help from a doctor. There were two hospitalizations, but no deaths.

“This study is tremendously encouraging,” CDC Director Dr. Rochelle Walensky said Monday at the White House Covid-19 briefing. “These findings also underscore the importance of getting both of the recommended doses of the vaccine in order to get the greatest level of protection against Covid-19, especially as our concerns about variants escalate.”

https://www.cnn.com/2021/03/29/health/pfizer-and-moderna-covid-19-vaccines-work-wellness/index.html 

25. AstraZeneca Safe for Canadians as Young as 30, Vaccine Panel Says (Apr.23/21)

A national advisory panel has recommended Canadians 30 and older can get the Oxford-AstraZeneca vaccine if they don’t want to wait for an alternative, but some provinces say they don’t have enough supply to expand eligibility for the shot. While the committee originally recommended a pause on using AstraZeneca shots for people younger than 55, Health Canada released a safety assessment last week that showed the benefits of the shot outweigh the risks, which the committee said it also evaluated. The committee said the blood clots are rare, and people have an individual choice if they would rather wait to take the Pfizer-BioNTech or Moderna vaccines. The Pfizer-BioNTech and Moderna vaccines use messenger RNA, or mRNA, to trigger an immune response, unlike AstraZeneca, which is a viral-vector vaccine that delivers a safe virus to teach the body to protect against COVID-19.

Although provinces initially suspended giving AstraZeneca shots to younger people based on the committee’s previous advice, Ontario, Manitoba, Saskatchewan, Alberta and British Columbia have since started administering it to people over 40, given the current spread of the virus. Ontario reported its first case on Friday of a rare blood clot in a man in his 60s who received the vaccine, bringing the number of reported cases in Canada to four out of more than 1.1 million doses given, according to the province’s top doctor. Manitoba will also take time to review NACI’s advice, which it said was not a “blanket recommendation” of using this vaccine for all people aged 30 and older, a spokeswoman said in a statement. “Eligibility for AstraZenca will remain at 40 and over until further notice,” the statement said.

Procurement Minister Anita Anand said last week that Canada still expects to receive 4.1 million doses of AstraZeneca from all sources by the end of June. She also said the country can expect to receive around one million doses of Pfizer-BioNTech early next week and 650,000 doses of Moderna by mid-week.

https://nationalpost.com/news/canada/canadian-press-newsalert-naci-recommends-astrazeneca-vaccine-for-people-30-and-older 

Source de l'image : https://www.dw.com/en/astrazeneca-germany-other-european-countries-to-resume-use-of-vaccine/a-56922088 

26. The Latest on COVID-19 (Apr.15/21)

Pfizer CEO says we may need annual vaccinations for COVID-19

The chief executive officer of Pfizer said Thursday that people may need to get a third COVID-19 vaccination within 12 months of being full vaccinated. Albert Bourla added that annual inoculations may be needed to prevent future spread of the disease. Researchers still haven’t determined how long protection against the disease lasts after someone is vaccinated.

Blood clots rare in Moderna, Pfizer vaccines

A new study reports that the number of blood clot cases is about the same for the Moderna, Pfizer-BioNTech, and AstraZeneca vaccines. The researchers said about 4 in 1 million people who get the Moderna or Pfizer-BioNTech vaccine will develop blood clots. The rate is about 5 in 1 million for the AstraZeneca shot. They note that about 39 in 1 million people who develop COVID-19 get blood clots.

India reports 1-day record in COVID-19 cases

India reported a record 200,000 new cases of COVID-19 today, becoming the second country after the United States to reach this single-day toll, reported The Washington Post. These new cases have pushed India’s total cases to more than 14 million and turned the nation into the pandemic’s global epicenter with little indication the outbreak will slow. To contain the COVID-19 surge, Maharashtra Chief Minister Uddhav Thackeray announced curfew-like restrictions on the movement of people in the state from April 14 to May 1, reported The Indian Express.

https://www.healthline.com/health-news/covid-19-updates?utm_source=Sailthru%20Email&utm_medium=Email&utm_campaign=daily&utm_content=2021-04-16&apid=35071678&rvid=f0f57ada60cbcff8355009cb5e3a7d953ab89292aca3a379e264fc111d37cf3b#4/15/21-12:30-p.m.-PDT-Pfizer-CEO-says-we-may-need-annual-vaccinations-for-COVID-19 

27. COVID-19 Vaccines Are Still Effective Amid Rising Number of Variants (Apr.23/21)

Recent research from Pfizer looked at 44,000 people around the world — including people in South Africa who were predominantly exposed to the B.1.351 variant — and found that the vaccine remained 100% effective against severe disease and death. Real-world data also shows that the Pfizer vaccine held up against the B.1.1.7 variant, which was first detected in United Kingdom. Even in an area where B.1.1.7 was the dominant strain, the shot was 97% effective against symptomatic COVID-19, hospitalizations, and death. Evidence shows that the same is true with the Moderna, AstraZeneca, and Johnson & Johnson vaccines.

Johnson & Johnson vaccine clinical trials were conducted in South Africa and Brazil — both of which were being pummelled by the B.1.351 variant and P.1 variant, respectively, when the trials were conducted. Though the Johnson & Johnson vaccine was less effective overall against mild and moderate disease in South Africa and Brazil, the one-dose shot still provided strong protection against hospitalization and death.

How the immune system fights variants 

The immune system is complex, and antibodies alone won’t determine how protected you are against a pathogen, explains Dr. Joseph Craft, a professor of immunobiology and medicine at Yale School of Medicine. The cell-mediated immune response, which includes B-cells that produce antibodies along with T-cells, also mount a robust response against pathogens, often lasting for years. Our antibodies help prevent an infection from occurring by neutralizing a virus, but the T-cells can recognize parts of the virus on infected cells and clear out the infection before it becomes serious. Research shows that T-cells can identify 52 parts of the coronavirus, so even if there are mutations, the T-cell will still recognize and attack the variants.

How long will T-cell protection last?

According to Craft, once our bodies have been exposed to a virus, we’re typically protected against that virus for a long time. A recent study found people had “strong T-cell responses to variants (including B.1.1.7, B.1.351, P.1, and CAL.20C) equal to the T-cell responses you get from the ancestral strain,” explained Dr. Monica Gandhi, an infectious disease specialist with the University of California, San Francisco. Another study found that T-cell immunity might be our greatest weapon at avoiding severe disease since they’re skilled at rapidly clearing viruses. Scientists will need to continue studying T-cell immunity over time to understand just how protective and durable our cell-mediated response is.

https://www.healthline.com/health-news/covid-19-vaccines-are-still-effective-amid-rising-number-of-variants#How-long-will-T-cell-protection-last? 

Source de l'image : https://www.wwltv.com/article/news/health/supporting-your-immune-system-against-covid-19/289-dc6de4cb-fda6-42fc-b7fd-133e2422f3e0 

28. Cancer Patient Advocacy Groups Urge the Prime Minister and Premiers to Help Our Cancer Patients Complete the Vaccine Series within the Clinical Trial Recommended Timeline!  (Apr.28/21)

Cancer Patient Advocacy Groups, including CCRAN, took out a full-page ad in the Globe & Mail, urging the Prime Minister and provincial Premiers to ensure that cancer patients complete their covid vaccine series within the recommended clinical trial data timelines.  Evidence to support the recommended timeline appear below.