“You’re on the verge of overcoming what you’ve been struggling with. Soon your heart and mind will be at peace. Keep the faith and have patience. Everything will work out for the better.” Kathy Vanek
PERIODONTAL DISEASE AND RISK OF COVID -19 COMPLICATIONS: Blood markers indicating inflammation in the body were significantly higher in COVID-19 patients who had gum disease compared to those who did not, suggesting that inflammation may explain the raised complication rates, according to research published today in the Journal of Clinical Periodontology, The study of more than 500 patients with COVID-19 found that those with gum disease were 3.5 times more likely to be admitted to intensive care, 4.5 times more likely to need a ventilator, and almost nine times more likely to die compared to those without gum disease.
VACCINE UPDATES: Astra Zeneca: Developed in the United Kingdom, the COVID-19 vaccine from AstraZeneca and the University of Oxford has shown 74.6% effectiveness against the new, more contagious UK-based variant, B117, of SARS-CoV-2. The research results were published online in The Lancet, but the paper is still undergoing peer review. While public health officials around the globe are concerned about vaccines’ abilities to fight off the new variants emerging in places like the UK and South Africa, the AstraZeneca vaccine prevented severe illness or death in all clinical trial participants. This vaccine is not yet available in the United States as the Food and Drug Administration is awaiting results of a US-based, 30,000-subject clinical trial. The data from this study are expected in March.
Johnson & Johnson (J&J) has applied for an Emergency Use Authorization (EUA) from the United States Food and Drug Administration (FDA) for its one-shot COVID-19 vaccine, which has shown 66% efficacy in preventing moderate to severe COVID-19 illness. The J&J vaccine may be a game changer in the arduous fight against the novel coronavirus due to the need for only one immunization and the fact that it can be stored at 34° to 46° F. The only COVID-19 vaccines currently available in the US require two shots and sub-zero storage. However, both the Pfizer and Moderna vaccines have higher rates of efficacy (95%) than the J&J immunization. The FDA, along with contracted outside experts, will meet on February 26 to make a decision on the EUA application.
Mutations and the Vaccines: The South African variant has 27 mutations, nine of which occur in the spike protein. Where most of the vaccines are focused, is on the spike. That's where the monoclonal antibody therapeutics are focused, as well. There is a mutation at position 484 that is absolutely key for this loss of antibody protection. You would introduce an RNA that now has that same mutation at position 484 into the vaccine to create a vaccine that is really tailored to take that particular type of virus out. And that mutation is shared between the South African and the Brazilian variants. But the mRNA vaccine platform (Moderna and Pfizer) is quite amenable to this type of updating. That's a real advantage, much more so than the adenoviral vectors (Johnson and Johnson and Astra Zeneca) the virus-delivered vaccines. It's a more complicated process there. These variants, the Brazilian and the South African variants, are only compromising the neutralizing antibody response against the coronavirus. The T-cell immune response presumably is fully intact and remains unevaluated. So, it's quite possible that these vaccines will stand up better than we expect or predict.
Fauci reasoning for a second dose and staying on schedule: After the second dose or "boost," which is given 21 (Pfizer) or 28 (Moderna) days later depending on the vaccine, the neutralizing antibody response was "10-fold higher. So, it went, for example, from one to 100 to well over one to 1,000 in the titer," Fauci said.
"The reason that's important, not only because of the height of the response and the potency of the response, but as you get to that level of antibody you get a greater breadth of response and by breadth of response, we mean it covers not only the wild-type and currently circulating virus, but also the variants that we see circulating, particularly the 1.1.7 and the 3.5.1," he said, referring to the two variants first reported in Great Britain (B.1.1.7) and South Africa (B.3.5.1), respectively.
"So, it's not just a matter of potency; it's a matter of the breadth of what you can cover," Fauci stressed.
Additionally, there's a "theoretical" concern that could potentially become a problem if the U.S. were to shift to a single-dose focused strategy, he said. That is, "if you get a suboptimum response, the way viruses respond to pressure, you could actually be inadvertently causing more mutations."
For these reasons, Fauci said, the "optimum approach" the response team will continue to recommend is to get as many people as possible their first dose of vaccine while also ensuring that people get their second vaccine dose on time. Fauci also confirmed that "it's true" that modeling has shown that the B.1.1.7 variant is likely to become the dominant strain in the U.S. by the end of March.
However, he reminded the public that the Pfizer and Moderna vaccines are "quite effective" against this variant. To that end, he stressed the importance of continuing adherence to public health measures -- social distancing, masking, hand washing -- and focusing on "get[ting] as many people vaccinated as quickly as we possibly can. That's the best defense against the evolution of variants."
How long are you covered after 2nd Dose? Those who have received two doses of either the Pfizer or Moderna COVID-19 vaccine no longer need to quarantine if they come in contact with someone infected with SARS-CoV-2, according to the United States Centers for Disease Control and Prevention (CDC). The second dose of the vaccine must have been administered 2 weeks before the exposure.
However—as it remains uncertain how long immunity is conferred by the vaccines—individuals who were fully inoculated for more than 3 months should still quarantine in light of a COVID-19 exposure. The CDC also asserts that mask wearing, social distancing, and handwashing remain important as the novel coronavirus can live within vaccinated individuals who may then in advertently pass it on.
Until studies shows otherwise, there’s a chance that people who are vaccinated can still become infected with COVID-19 without experiencing symptoms and shed the virus. Even after you receive your two doses, the available vaccines are not 100% effective at preventing COVID-19 infection. So, if the novel coronavirus makes its way into your body after you get the vaccine, your immune system will have a good chance of fighting it off—but it also might allow small amounts of the virus to replicate, says Dr. Adalja, senior scholar at the Johns Hopkins Center for Health Security.
Why Do you Feel the Second COVID Vaccine injection More than the First?: "The first time the immune system comes into contact with something, it's getting primed," said Purvi Parikh, MD, an immunologist at NYU Langone Health in New York City. "That goes for everything, from vaccines to allergies. It's rare on the first time to have a strong reaction. After that, the immune system recognizes it, you have a much stronger reaction." Symptoms to expect following the second dose: Fever, headache, fatigue, myalgia, arthralgia, and chills were far more common after the second dose compared with the first dose and with all placebo doses.
Importance of Masks: "Double masking" with a cloth mask over a medical mask could substantially reduce exposure to aerosols even from unmasked sources, a CDC lab study suggested. Double masking decreases exposure to aerosols from 42% with a single medical mask to 83% - 93% wearing a cloth mask over a medical mask. Therefore, improving the fit as well as adding fabric layers block aerosol particles which is critical to stopping the spread. Washington Post, New York Times and the Associated Press
CDC Director Rochelle Walensky, MD, emphasized the study results at a White House COVID-19 briefing Wednesday morning. "The bottom line is this: masks work, and they work best when they have a good fit and are worn correctly," she said. "Masks should be used in combination with other prevention measures to offer you and your community the most protection from COVID-19. Stay at least 6 feet apart from people you don't live with, avoid crowds and travel, and wash your hands often."