“All we have to decide what to do with the time that is given us” J R Tolkien
By the numbers: 57.2 % are fully vaccinated; 66.2% partially vaccinated. To date 46,175,122 have tested positive, and 753,749 people have died. This is an increase of 400,974 and 9,364 respectively in over last week.
Food And Drug Administration Finally Approve COVID-19 Booster Shot For Johnson & Johnson And Moderna Vaccines: The Food and Drug Administration (FDA) approved COVID-19 boosters for the Johnson & Johnson and Moderna vaccines recipients. The regulatory agency also added that the extra dose did not have to be the brand they initially received. Dr. Peter Marks, director of the FDA’s Center for Biologics Evaluation and Research, said, “We are also taking action today to include the use of mix and match boosters to address this public health need. We will work to accrue additional data as quickly as possible to further assess the benefits and risks of the use of booster doses in additional populations and plan to update the healthcare community and public with our determination in the coming weeks.”
Moderna Booster More About Delta Than the Shot: The recommendation from a Food and Drug Administration advisory committee for some people to get a booster shot of the Moderna COVID-19 vaccination says more about the dangers of the delta variant of the coronavirus than it does about the quality of the vaccine, Dr. Ashish Jha, the dean of the Brown University School of Public Health, said Friday on Newsmax.
"It is so contagious that it is causing breakthrough infections even in people (that) are vaccinated now," says Jha "I'm one of the 69 million who got the Moderna. It still protects against hospitalizations and deaths."
FDA advisers said Thursday that some Americans who got the Moderna vaccine should get a half-dose booster shot to protect them further. The panel voted unanimously to recommend a booster shot for senior citizens, and other adults with health problems or who have jobs or living situations putting them at increased risk for illness.
Jha says that annual shots against COVID-19 will likely happen, and he hopes most Americans agree to get the immunizations.
"[This] virus is not going away," said Jha. "It's going to become endemic in our lives. We're going to have to deal with it. It won't dominate our lives the way it has in the last year-and-a-half. It will fade much more into the background the way most people don't go around thinking about the flu all the time."
But still, one of the ways to deal with COVID-19 moving forward will be to get an annual shot, said Jha, adding that he'll probably get his annual vaccine as well.
Meanwhile, the best way to protect against COVID-19 is to get vaccinated, and "if you don't want to get a booster, you don't have to. The two shots will protect you from hospitalizations and deaths and that's probably the thing that matters most," said Jha.
Pfizer and BioNTech Announce Phase 3 Trial Data Showing High Efficacy of a Booster Dose of Their COVID-19 Vaccine: October 21, 2021 — Pfizer Inc. and BioNTech SE announced topline results from a Phase 3 randomized, controlled trial evaluating the efficacy and safety of a 30-µg booster dose of the Pfizer-BioNTech COVID-19 Vaccine in more than 10,000 individuals 16 years of age and older. In the trial, a booster dose administered to individuals who previously received the Pfizer-BioNTech primary two-dose series restored vaccine protection against COVID-19 to the high levels achieved after the second dose, showing a relative vaccine efficacy of 95.6% when compared to those who did not receive a booster. These are the first efficacy results from any randomized, controlled COVID-19 vaccine booster trial.
Natural immunity is good. Getting vaccinated after being sick with COVID-19 is better: Contracting COVID-19 provides immune "memory" that helps protect against a future infection. But it's still unclear how sick a person has to get with COVID-19 to develop enough immune memory to be protective and for how long. That's why the Centers for Disease Control and Prevention recommends even people who have had COVID-19 get vaccinated against it. A growing body of research suggests infection plus vaccination provides the strongest protection against a wide range of variants, possibly for a long time.
Breakthrough COVID Infections Are Less Transmissible. Here's Why: Evidence suggests that COVID-19 vaccines render the virus less transmissible and infectious by enveloping the pathogen with antibodies. Dr. Ross Kedl, a professor of immunology and biology at the University of Colorado Anschutz School of Medicine, says that the virus that vaccinated people shed is not as virulent as the virus that unvaccinated people transmit. Kedl explains that the antibodies produced by vaccinated people coat the virus and make it less infectious. He points out that in cases “where you have these big breakthrough infections, there’s always unvaccinated people in the room.”
A recent study from Israel bears out Kedl’s theory. Researchers reported that in the case of breakthrough infections among healthcare workers “all 37 case patients for whom data were available regarding the source of infection, the suspected source was an unvaccinated person.”
Michal Caspi Tal, a visiting scientist at Massachusetts Institute of Technology, and her colleagues found that in addition to circulating antibodies through the body, the vaccines deposited them in mucous membranes in the nose and mouth, which are primary entry points for COVID-19.
COVID -19 breakthrough deaths more common among older Americans data shows: Despite getting vaccinated against COVID-19, Colin Powell remained vulnerable to the virus because of his advanced age and history of cancer, highlighting the continued risk to many Americans until more of the population is immunized. General Powell was 84 years old, had multiple myeloma, a blood cancer that impairs the body’s ability to fight infections and Parkinson’s. So, age and being immunocompromised due to his health conditions putting him at risk for breakthrough infections despite him receiving two doses of the vaccine. It is unknown whether he received a Booster dose.
“The more people that are vaccinated, the less we have viral spreading in the community, the less chances of people like him (Powell) getting infected to begin with,” said Dr. Mangala Narasimhan, chief of critical care at Northwell Health in New York. Data from the Centers for Disease Control and Prevention shows that adults over the age of 65 make up the bulk of breakthrough Covid deaths.
Moreover, people with weakened immune systems because of illnesses like cancer -- or cancer treatments -- don’t always get the same level of protection from vaccinations as healthier people. Several studies have found as few as 45% of people with multiple myeloma may develop protective levels of coronavirus-fighting antibodies after getting the vaccine.
Age also is a risk, especially months after someone is first vaccinated. The Centers for Disease Control and Prevention has tracked dips in protection, especially among older Americans who were among the first people vaccinated last winter. The reduced protection is the result of either waning immunity or the extra-contagious delta variant. Hence the need for Booster Shots amongst the elderly.
COVID-19 was the No. 1 killer of Americans age 35 to 54 last month, and No. 2 overall: COVID-19 was the No. 1 leading cause of death in the U.S. in January, at the peak of last winter's brutal coronavirus surge, but then vaccines became widely available and it dropped to No. 7 by July, the Kaiser Family Foundation says in a new analysis of COVID-19 fatalities. Then the Delta variant hit and found ample unvaccinated Americans to kick COVID-19 back up to the No. 2 killer in August and September, the leading cause of death for Americans age 35 to 54, and even the sixth or seventh leading cause of death for children.
Once a mother is infected or vaccinated, her breast milk contains high levels of Covid antibodies: Although babies and young children are at lower risk of getting very sick with Covid-19 compared to older adults, a small proportion of babies will require hospital care.
There are now several studies looking at breast milk antibody responses in women who have had Covid-19, while research is increasingly exploring breast milk antibody responses in mothers following vaccination with an mRNA vaccine.
After Covid-19 infection, antibodies have been found to persist in breast milk for at least six months, with emerging data suggesting they are still abundant ten months later. Antibodies are found in breast milk even after mild SARS-CoV-2 infections, and in women who have no symptoms at all.
Meanwhile, the breast milk of women who are vaccinated while lactating (who have not had Covid-19) has been found to contain significant levels of SARS-CoV-2 antibodies after vaccination. Determining how long SARS-CoV-2 antibodies in breast milk last after vaccination will take time, but reports suggest they persist for at least six weeks.
Male and female fetuses respond differently to COVID-19: Male placentas showed increased immune activation compared with female placentas, according to a new study published in Science Translational Medicine. The significantly higher levels of certain genes and proteins associated with increased immune activation may help protect male fetuses from becoming infected with SARS-CoV-2 in utero, but the resulting inflammation could pose risks to the fetus and child, notes Andrea Edlow, senior author of the study and maternal-fetal medicine specialist at Harvard-affiliated Massachusetts General Hospital (MGH).
Moreover, pregnant women with COVID-19 transferred significantly less immunity to the virus to male fetuses than to female fetuses, which could affect an infant's risk for becoming infected with SARS-CoV-2. "The sex of the fetus influenced both the mom's ability to generate antibodies to COVID-19 and to transfer them to her baby," says Edlow.
The CDC issued their recommendation that pregnant people receive the covid-19 vaccine in April of this year, and the leading organization of obstetrician-gynecologists has also recommended the vaccine since July.
CDC Updates COVID Guidelines Before Holidays: The guidance this year is not holiday-specific like it was last year. The guidance published Friday comes after some confusion earlier in the month when the CDC published an update to its holiday pages on its website. The CDC said at the time that it was just a technical update to the page.
After a recent downturn in Covid-19 hospitalizations in the past month, some public health experts have warned that the US could see another spike in cases this winter, particularly around the holidays.
"I think we're making some important progress in terms of increasing vaccinations, but the fact of the matter is there are still dangerous gaps in immunity throughout the country, and as long as that's the case, there are still pathways for the virus to spread," said Jennifer Nuzzo, a senior scholar at the Johns Hopkins Center for Health Security.
"I'd like to think that the worst is behind us, just given how much we've already endured in terms of high numbers of cases but also increasing progress in increasing vaccination. So, I don't think that a rise in cases in the winter will be as bad as last year's winter surge, but there's nothing built into the decline that means that the momentum will be sustained. What we will see is really up to us."
The new guidance for fully vaccinated people, those with two doses of the Pfizer or Moderna vaccines, or one dose of the Johnson & Johnson shot, say that those folks can now "participate in many of the activities that they did before the pandemic."
They can also resume domestic travel without testing, before or after, their trip, and no longer quarantine after traveling to a location.
That can also apply to international travel, unless the destination country requires testing or quarantines, according to the CDC.
To avoid getting a "breakthrough case," especially from the delta variant, fully vaccinated people should wear a mask inside where there is a high rate of transmission, or if someone in their household is at an increased risk for disease or immunocompromised, the CDC guidance said.
Until next time, Stay Safe, Stay Well, Practice Mitigation Factors and consider getting vaccinated if you have not already done so. Speak with your physician regarding any concerns about your health and the vaccine in order to make the best medically informed decision for you.
James A Vito, D.M.D.