COVID Stunning Effectiveness of the Covid Vaccines

[Astronuc]

Good essay on vaccination for SARS-Cov-2:

Role in the transmission chain: Vaccinated vs. unvaccinated​

https://yourlocalepidemiologist.substack.com/p/role-in-the-transmission-chain-vaccinated

 

[atyy]

https://www.nature.com/articles/s41586-021-03744-4
Antibody epitopes in vaccine-induced immune thrombotic thrombocytopaenia
Angela Huynh, John G. Kelton, Donald M. Arnold, Mercy Daka & Ishac Nazy
Nature 596: 565–569 (2021)
"Vaccine-induced immune thrombotic thrombocytopaenia (VITT) is a rare adverse effect of COVID-19 adenoviral vector vaccines. VITT resembles heparin-induced thrombocytopaenia (HIT) in that it is associated with platelet-activating antibodies against platelet factor 4 (PF4); ... Our data indicate that VITT antibodies can mimic the effect of heparin by binding to a similar site on PF4; this allows PF4 tetramers to cluster and form immune complexes, which in turn causes Fcγ receptor IIa (FcγRIIa; also known as CD32a)-dependent platelet activation. These results provide an explanation for VITT-antibody-induced platelet activation that could contribute to thrombosis."

 

[merlinbennie]

The Delta variation was also shown to be less susceptible to “sera from naturally immunised individuals,” implying that persons who have already been infected with the virus may not be protected against reinfection with the Delta form.

 

[nsaspook]

https://www.medrxiv.org/content/10.1101/2021.08.24.21262415v1

Comparing SARS-CoV-2 natural immunity to vaccine-induced immunity: reinfections versus breakthrough infections​

Every adult that hasn't been infected greatly benefits from vaccination but it seems natural immunity will be an important fact in ending the pandemic.

 

[Astronuc]

natural immunity

Can it be achieved with exposure to a killed virus as opposed to a live virus? Is natural immunity achieved through exposure to the 28 proteins of the virus as opposed to the one or two proteins in a vaccine?

 

[nsaspook]

Can it be achieved with exposure to a killed virus as opposed to a live virus? Is natural immunity achieved through exposure to the 28 proteins of the virus as opposed to the one or two proteins in a vaccine?

This is what the study compared and the time period.

We conducted a retrospective observational study comparing three groups:
(1)SARS-CoV-2-naive individuals who received a two-dose regimen of the BioNTech/Pfizer mRNA BNT162b2 vaccine,
(2)previously infected individuals who have not been vaccinated, and
(3)previously infected and single dose vaccinated individuals.
...
The follow-up period of June 1 to August 14, 2021, when the Delta variant was dominant in Israel.

I would guess a similar study with CoronaVac would answer the question.
https://covid19.trackvaccines.org/vaccines/7/

​

 

[bhobba]

Interesting latest paper comparing vaccine effectiveness against Delta:
https://www.ndm.ox.ac.uk/files/coro...ction-survey/finalfinalcombinedve20210816.pdf

Some highlights are:
1. The length of time between the first and second shot is not a factor anymore
2. While Pfizer starts at about 88% efficacy against symptomatic infection and AZ is 67%, Pfizer effectiveness declined at 22% per month, while AZ only at 7% per month. This likely accounts for the low efficacy of 39% in Isreal because they vaccinated their population early.
3. Pfizer provides better protection after one dose than AZ.

This could change how we vaccinate. 4 weeks instead of 12 weeks for AZ second dose, for example, and perhaps earlier boosters at 6 months (better vaccine options may come along during that time). However, priority is likely to be given to getting as many as possible with a second dose rather than starting a third dose rollout because of the much better protection with the second dose.

Thanks
Bill

 

[atyy]

Can it be achieved with exposure to a killed virus as opposed to a live virus? Is natural immunity achieved through exposure to the 28 proteins of the virus as opposed to the one or two proteins in a vaccine?

I agree natural immunity will be important in ending the pandemic, but not because we deliberately infect people. In populations in which the a first infection or vaccination is highly effective against severe disease (eg. for healthy people below the age of 40, where some estimates indicate 96% or more protection by vaccination against severe disease), we should not worry too much about them getting naturally reinfected, and in that sense using natural immunity as a booster. Here I'm also assuming a population like the UK where combined vaccination and infection indicate ~97% seropositivity in ages 40-49 and ~99 seropositivity among those 60 and older.

I don't think Delta alone implies that additional doses or boosters for populations in which the first two doses don't provide enough protection requires vaccines with a greater variety of antigens. The spike-based mRNA vaccines work well against severe disease by Delta (UK: 91-98% against hospitalization; Israel: 94% for age 40-59, 86% for age 60+), so we can expect that boosters will increase protection against severe disease caused by Delta. We can see how the Israel 3rd dose turns out, and also studies on 3rd doses in immunocompromised patients.

However, I agree that there may be an advantage to inactivated virus vaccines, or vaccines that have more antigens than just the RBD of the spike protein. Here are some similar guesses:

https://www.virology.ws/2021/03/25/t-cells-will-save-us-from-covid-19/
"It is possible that SARS-CoV-2 will continue to produce altered spike proteins that will completely evade antibody neutralization. In this case T cells might not be enough to prevent severe disease – they could be overwhelmed by so many infected cells. Our rush to make vaccines – understandable given the urgency – have led us to such a situation. Most of the vaccines were based only on the spike protein. If we change the spike protein to accommodate variants, we might get in a never-ending cycle of changing COVID-19 vaccines on a regular basis. A better approach would be to produce second-generation COVID vaccines that include other viral proteins besides spike protein. Inactivated and attenuated vaccines fall into this category; another solution would be to modify authorized mRNA vaccines to encode additional viral proteins."

https://www.sciencemag.org/news/202...-coronaviruses-could-prevent-another-pandemic
"... Some groups have turned their sights far from the RBD, in molecular terms. Spike has both a head, which includes the RBD, and a stem—known as S2—that varies little between coronaviruses. “The S2 subunit is by far the most conserved portion of Coronavirus spike,” says Jason McLellan, a structural biologist at the University of Texas, Austin, who co-authored the failed grant proposal with Ward.
...
... Finally, there’s an old-school approach to a pancoronavirus vaccine, one that should call into battle both B and T cells. NIAID’s veteran flu researchers Matthew Memoli and Jeffery Taubenberger want to combine inactivated versions of representative coronaviruses from the four known lineages in the beta genus. Vaccines based on the entire virus help the immune system take “multiple shots at the target,” Memoli explains, rather than focusing all the responses on spike or bits of it."

 

[bhobba]

Can it be achieved with exposure to a killed virus as opposed to a live virus?

Of course. That's the old fashioned way of making a vaccine. Sinovac Vaccine is made that way. The trouble is it is not as effective as modern methods. And this proved the case with Sinovac. It works, but Phizer, for example, is more effective. Interestingly by giving a third dose 6 months later, those vaccinated can still achieve good immunity:
https://www.globaltimes.cn/page/202107/1229716.shtml

Thanks
Bill

 

[cmb]

I am unclear on the nature of the discussion above about relying on natural immunity.

Surely, at some point, we have to end up relying on natural immunity it is a matter of when, not if?

As the vaccine is not of unlimited time benefit, boosters are required, this seems to be accepted. Then the only alternative to relying on natural immunity eventually is for never ending and legally imposed boosters for the rest of human existence?

Or ... we do rely on natural immunity eventually. I accept the question of 'when' need neither be 'now' nor even some pre-determined time period (though in general that is how it works for targetted 'flu vaccines).

But I think it would be prudent to ask what the conditions should be before we may forego vaccines and relying on natural immunity becomes the appropriate way forward?

So, how do we know when the right time is to forego vaccines?

 

[atyy]

So, how do we know when the right time is to forego vaccines?

In the long run you can have both natural immunity and vaccines (like the flu vaccine, well worth taking even if it doesn't prevent infection, but not part of travel requirements etc). I think the question is more what to do in the short run. At what stage do we stop caring about reducing transmission by mandatory quarantine, masks etc? Also, vaccinating the whole world is important, and boosters that don't provide much benefit should be avoided as they contribute to vaccine shortages.

 

[cmb]

In the long run you can have both natural immunity and vaccines (like the flu vaccine, well worth taking even if it doesn't prevent infection, but not part of travel requirements etc). I think the question is more what to do in the short run. At what stage do we stop caring about reducing transmission by mandatory quarantine, masks etc? Also, vaccinating the whole world is important, and boosters that don't provide much benefit should be avoided as they contribute to vaccine shortages.

Yes, that is my question.

It seems in the UK it is now sufficiently widespread that it has become 'another endemic disease' and more people are dying here from general pneumonia than identified as specifically from Covid. Is that the point to back of vaccinations, when the death rate is not a cause of death any more significant than others?

I think the approach of course is not 'no more vaccines' that is mad, but the vulnerable carry on getting boosters. I have taken 'flu jabs for the last few years as my company has paid for them and it seemed to make some sense for us older types, I've no problem with that in principle.

 

[atyy]

Yes, that is my question.

It seems in the UK it is now sufficiently widespread that it has become 'another endemic disease' and more people are dying here from general pneumonia than identified as specifically from Covid. Is that the point to back of vaccinations, when the death rate is not a cause of death any more significant than others?

I think the approach of course is not 'no more vaccines' that is mad, but the vulnerable carry on getting boosters. I have taken 'flu jabs for the last few years as my company has paid for them and it seemed to make some sense for us older types, I've no problem with that in principle.

Also of course, the UK has a terrific vaccination rate. The sensible discussions I've seen on this are from the UK (just gathering the links I've seen in other posts/threads).
https://www.bbc.com/news/health-58270098
Natural infection and / or vaccination?
https://www.bbc.com/news/health-58322882
""So I think the whole thing needs to be much more carefully managed than just giving it to everybody which would be a huge waste and ethically dubious given the resources we have. I think we need a more targeted approach than last time.""
"Prof Adam Finn, a government vaccine adviser, said other studies had shown that the vaccines maintained good protection against serious illness and hospitalisation.
But he said: "We do need to watch out very carefully to see if this waning against milder disease begins to translate into occurrence of more severe cases because then boosters will be needed.""

 

[pinball1970]

I posted a news item in relation to surplus vaccines a few weeks ago w.r.t UK and Gordon Brown
The West in general now has or will have a huge surplus as yet nothing has moved according to the below.https://www.theguardian.com/world/2...ges-emergency-covid-vaccine-airlift-to-africaAs well as saving lives the article mentions the reduced risk of new variants arising with such a large population as a potential reservoir for mutation.

 

[bhobba]

As well as saving lives the article mentions the reduced risk of new variants arising with such a large population as a potential reservoir for mutation.

Yes, it is like the Aboriginal issue in Australia. A big issue. Just as a personal opinion, I believe the industrialized countries can handle this and give a third dose as well. But we must not 'slack' off. We have come so far; we can't falter now.

Thanks
Bill

 

[PeroK]

But we must not 'slack' off. We have come so far; we can't falter now.

We've been faltering since July! Our whole anti COVID effort just seemed to fade away to a few half-hearted guidelines.

A few months ago I was speaking to my mother, who had heard someone praising Boris Johnson's leadership skills. Her comment was "the leadership skills of the Pied Piper of Hamlyn"!

 

[pinball1970]

We've been faltering since July! Our whole anti COVID effort just seemed to fade away to a few half-hearted guidelines.

A few months ago I was speaking to my mother, who had heard someone praising Boris Johnson's leadership skills. Her comment was "the leadership skills of the Pied Piper of Hamlyn"!

We are in better shape Pero.
40,000 cases per day is a lot. The school roll out has not been tough enough agreed. We simply cannot allow those kids to have any more time off. @PeroK

 

[cmb]

Yes, it is like the Aboriginal issue in Australia. A big issue. Just as a personal opinion, I believe the industrialized countries can handle this and give a third dose as well. But we must not 'slack' off. We have come so far; we can't falter now.

Thanks
Bill

"we can't falter now"

Could I ask what that means, in practice? Do we have to keep taking these vaccinations forever now, and if not then we will have faltered?

Vaccinations do not last indefinitely, and they are also not going to eradicate this now. Are we now intellectually committing ourselves to being co-dependent on these vaccinations for the rest of humanity's history? Is there an end point which we'll not regard as 'faltering'?

 

[bhobba]

Could I ask what that means, in practice?

We do not know if we will need to keep taking vaccinations forever and what future research will bring. We already take yearly doses of the flu vaccine, so to keep vaccinating is nothing new. Even the triple-antigen needs a regular booster, but many forget. What I do know is Covid research is ongoing, and vaccinations have made a big difference. Here in Aus, we now have 99% vaccination in one state/territory, with 90%+ in another. Other states look like they will have 90%+ by years end. Already it has controlled the breakout in Sydney. Restrictions are gradually being lifted, with cases still falling. Then there are third doses which Isreal shows could have a significant impact when generally adopted. This shows what can be done when we, as human beings, mobilise our resources. I believe not only can we tackle Covid in our countries, but worldwide as well. We need the will.

Thanks
Bill

 

[cmb]

We do not know if we will need to keep taking vaccinations forever and what future research will bring. We already take yearly doses of the flu vaccine, so to keep vaccinating is nothing new. Even the triple-antigen needs a regular booster, but many forget. What I do know is Covid research is ongoing, and vaccinations have made a big difference. Here in Aus, we now have 99% vaccination in one state/territory, with 90%+ in another. Other states look like they will have 90%+ by years end. Already it has controlled the breakout in Sydney. Restrictions are gradually being lifted, with cases still falling. Then there are third doses which Isreal shows could have a significant impact when generally adopted. This shows what can be done when we, as human beings, mobilise our resources. I believe not only can we tackle Covid in our countries, but worldwide as well. We need the will.

Thanks
Bill

I know a doctor who was vaccinated early on as part of the move to protect front line health professionals, but the efficacy only lasted a few months and, having taken it early, has now caught it and suffered some serious complications.

I have had a first shot now and due another ... but ...

To have to keep boosting a vaccination every few months, for everyone on the planet, does not strike me as the hallmarks of a stunning success.

 

[bhobba]

To have to keep boosting a vaccination every few months, for everyone on the planet, does not strike me as the hallmarks of a stunning success.

This requires a new thread I will create.

Thanks
Bill

 

[Astronuc]

To have to keep boosting a vaccination every few months, for everyone on the planet, does not strike me as the hallmarks of a stunning success.

Who has determined that the SARS-Cov-2 vaccine has to be boosted every few months? As far as I know, only one booster is recommended and that applies to elderly (65+) and those who are immunocompromised. Otherwise, only two shots of Pfizer or Moderna, or one of others is currently recommended. Boosters are optional otherwise. It is too early to determine if annual immunizations (like that of influenza) are necessary. It is recommended to get the influenza vaccine annually, but many don't.

It will most likely come up that Colin Powell died from complications of Covid-19. He was apparently vaccinated, but he was being treated for "a blood cancer known as multiple myeloma — precisely the kind of “immunocompromised” condition that experts have said from the start could lead to lower vaccine efficacy. In fact, the vaccines seemed to work especially poorly in patients afflicted with that type of cancer, even after a booster shot. (Powell also suffered from Parkinson’s disease, a neurodegenerative condition.)"
https://www.yahoo.com/news/colin-po...ficacy-of-coronavirus-vaccines-173102331.html

 

[cmb]

Who has determined that the SARS-Cov-2 vaccine has to be boosted every few months?

Experts don’t know yet how long COVID-19 vaccines will be effective. Studies of two of the most prominent COVID-19 vaccines suggest they remain effective for at least six months. The CEO of one vaccine maker said immunity may start to fade within a year.

 

[OCR]

I will create.

And thus, a new thread came to be . . . .

j/k . . . .

.

 

[pinball1970]

Experts don’t know yet how long COVID-19 vaccines will be effective. Studies of two of the most prominent COVID-19 vaccines suggest they remain effective for at least six months. The CEO of one vaccine maker said immunity may start to fade within a year.

In terms of success the UK we are out of lockdown and have been since June.

Rough numbers

40,000 cases = 1500 deaths Jan

40,000 = 150 deaths Oct

(NYT agreed with this - 11 times more likely to die unvaccinated) too much other stuff to post that link though...

The NHS although busy (it was busy before) is no longer overwhelmed

IF we get Covid to seasonal flu levels and process ie one jab per year that will a success?What has not been a success is the policy on children.

Probably because of things like this?

https://www.bbc.co.uk/news/health-58438669

followed by this (notice they use the same image)

https://www.bbc.co.uk/news/health-58547659

1 in 10 jabbed in England so far- England using schools to vaccinate where Scotland is using drop in centers/pharmacies (todays METRO UK)

I cannot remember if that is instead of as well as.

Boosters not exactly flying off the shelf either.

Getting jabbed earlier than other countries does have a down side. (Ferguson is back in the good books following the initial independent assessment of the Covid crisis) I won't say any more than that.

https://metro.co.uk/2021/10/19/terr...are-going-as-uk-records-49000-cases-15446407/

 

[cmb]

...

The NHS although busy (it was busy before) is no longer overwhelmed

That is a very political, and non-scientific, turn of phrase because there is no data to suggest the NHS was ever 'overwhelmed' any more than it normally is/was, in fact quieter than usual.

If you have your own 'theory' about this, then it's not the place.

Millions were spent to set up over-flow hospitals that never saw patients.

 

[pinball1970]

That is a very political, and non-scientific, turn of phrase because there is no data to suggest the NHS was ever 'overwhelmed' any more than it normally is/was, in fact quieter than usual.

If you have your own 'theory' about this, then it's not the place.

Millions were spent to set up over-flow hospitals that never saw patients.

We are at a quarter of the numbers pre double vaccine in Jan
“Millions were spent to set up over-flow hospitals that never saw patients.”

That is nothing to do with how effective the vaccine roll out has been

 

[Astronuc]

NY Times attempts to report numbers/data for state trends (US), but the origin of the numbers is not clear.
https://www.nytimes.com/interactive/2021/us/covid-cases.html

NY Times, Sources: State and local health agencies (cases, deaths); U.S. Department of Health and Human Services (hospitalizations); Centers for Disease Control and state governments (vaccinations); Census Bureau (population and demographic data). The daily average is calculated with data that was reported in the last seven days. Vaccination data is not available for some states. All-time charts show data from Jan. 21, 2020 to present.

In a Table of State Trends, Washington state is assigned a fully-vaccinated rate of 62% (all ages, including children under 12, for whom vaccination is not approved) and 73% of the population ages 12 and older are fully vaccinated. An estimate of 78.1% of 12 and older have at least one dose of vaccine.

Washington State Dept of Health declares 72% fully-vaccinated.
https://www.doh.wa.gov/Emergencies/COVID19/DataDashboard
As of October 18, 78.1% of Washingtonians 12 and older have received at least one dose of COVID-19 vaccine and 72% of people 12 and older are fully vaccinated.

https://www.nytimes.com/interactive/2020/us/covid-19-vaccine-doses.html (Updated)

 

[Astronuc]

As of data received through October 24, 2021, the New York State Department of Health is aware of:

• 120,653 laboratory-confirmed breakthrough cases of COVID-19 among fully-vaccinated people in New York State, which corresponds to 1.0% of the population of fully-vaccinated people 12-years or older.
• 8,114 hospitalizations with COVID-19 among fully-vaccinated people in New York State, which corresponds to 0.07% of the population of fully-vaccinated people 12-years or older.

These results indicate that laboratory-confirmed SARS-CoV-2 infections and hospitalizations with COVID-19 have been uncommon events among the population of people who are fully-vaccinated (≥14 days after completing their vaccine series).

To understand the above statistics, it is important to consider that they reflect not only the effectiveness of vaccines, but also changes over time in the intensity of the epidemic, circulating variant strains (such as Delta), and protective behaviors (e,g, masking and social distancing) against COVID-19, as well as the growing number of people fully-vaccinated in New York State.

https://coronavirus.health.ny.gov/covid-19-breakthrough-data

https://coronavirus.health.ny.gov/daily-hospitalization-summary

For NY City - https://www1.nyc.gov/site/doh/covid/covid-19-data-totals.page

Confirmed Cases People with a positive molecular test	914,510
Probable Cases People with a positive antigen test, or symptoms and confirmed exposure, or probable death	204,726
Total Cases	1,119,236
Hospitalizations People hospitalized within 14 days of diagnosis	124,327
Confirmed Deaths Deaths with positive molecular test	29,398
Probable Deaths Cause of death listed as COVID-19 or similar, but no positive molecular test	5,159
Total Deaths	34,557

NY State reports 2,533,557 positive tests (out of 75,746,454 total tests), and 45,541 confirmed deaths (those reported from a hospital or care facility) with slightly more than 12372 deaths at home or other non-care agency, as of October 29, 2021. Delta variant now accounts for essentially 100% of cases in NY State.

NY City accounts for ~44.2% of NY State's positive cases and approximately 64.6% of confirmed deaths (or ~59.7% of confirmed and probably deaths). NY State has changed how they present their CovidTracker as of today.

Meanwhile, the number of deaths in Texas attributed to Covid-19 is approaching the number in California.

 

[nsaspook]

A Interesting article with important questions.

https://www.theatlantic.com/health/archive/2021/11/what-americas-covid-goal-now/620572/

We know how this ends: The Coronavirus becomes endemic, and we live with it forever. But what we don’t know—and what the U.S. seems to have no coherent plan for—is how we are supposed to get there. We’ve avoided the hard questions whose answers will determine what life looks like in the next weeks, months, and years: How do we manage the transition to endemicity? When are restrictions lifted? And what long-term measures do we keep, if any, when we reach endemicity?

The answers were simpler when we thought we could vaccinate our way to herd immunity. But vaccinations in the U.S. have plateaued. The Delta variant and waning immunity against transmission mean herd immunity may well be impossible even if every single American gets a shot. So when COVID-related restrictions came back with the Delta wave, we no longer had an obvious off-ramp to return to normal—are we still trying to get a certain percentage of people vaccinated? Or are we waiting until all kids are eligible? Or for hospitalizations to fall and stay steady? The path ahead is not just unclear; it’s nonexistent. We are meandering around the woods because we don’t know where to go.

 

[Astronuc]

Looking at the NY Times numbers, I looked at the top 10 states in the US for mortality due to Covid-19.

Nov 02                            fully (18+ yrs)
State        pos cases   deaths   vaccinated      state pop. 2020
Calif        4,933,895   72,289   61%             39.54 M
Texas        4,233,730   71,587   53%             29.18 M
Florida      3,650,637   59,670   60%             21.57 M
New York     2,563,625   56,044   67%             20.21 M

Pennsylvania 1,564,939   31,454   61%             13,01 M
Illinois     1,706,985   28,695   60%             12,81 M
Georgia      1,600,593   28,142   48%             10,71 M
New Jersey   1,199,738   27,980   66%              9.29 M
Ohio         1,547,788   24,527   52%             11.80 M
Michigan     1,283,087   23,706   54%             10.08 M

Texas has been gaining on California, although California has seen a recent surge in positive cases.
About a week ago, Texas was more than 1000 fatalities behind California. A lower vaccinate rate may be a factor, as well as a policy of no mask mandate. Florida and Texas used to be behind NY.

The gap between the next group is substantial and may reflect the much lower total populations.

As of this morning.

Nov 05                            fully (18+ yrs)
State        pos cases   deaths   vaccinated
Calif        4,951,476   72,559   62%
Texas        4,246,805   71,987   54%
Florida      3,656,010   59,670   60%
New York     2,575,181   56,144   67%

Pennsylvania 1,580,346   31,783   61%
Illinois     1,715,452   28,803   61%
Georgia      1,604,539   28,345   48%
New Jersey   1,203,755   28,011   67%
Ohio         1,560,695   24,763   52%
Michigan     1,295,049   23,855   54%

https://www.nytimes.com/interactive/2020/us/covid-19-vaccine-doses.html

 

[russ_watters]

A Interesting article with important questions.

https://www.theatlantic.com/health/archive/2021/11/what-americas-covid-goal-now/620572/

Well if you don't set goals, then you'll never fail to achieve them. The near-term (6-12mo?) path remains as it has been for the past several months; keep vaccinating and ease restrictions as we get tired of them as infection rates allow.

The lack of interest in a near-term strategy probably tells us the longer term strategies as well. I foresee it being incorporated into the seasonal flu mitigation strategy, with optional annual booster shots and an acceptable annual death toll on a similar level of the flu. In the US, the flu usually kills 20-50,000 people a year. So I think we might stomach up to 100,000 additional COVID deaths a year without bothering with a stronger effort. If the 2022-2023 season is worse than that (or the summer 2022 trend doesn't look good), maybe we'll try something else.

What's more interesting/worrisome to me is the countries that have had low case rates to date (China and the island countries). They are at much higher risk than the US because they set a goal - an aggressive goal - and will likely need to abandon it because I don't think it would be possible to live with draconian mitigation measures forever. China of course can just force everyone to get vaccinated and digitally contact trace, but even at that, they are going to have to live with several orders of magnitude more deaths. If we believe them (not sure if I do), they've only had 5,000 deaths from COVID, achieved with draconian lockdowns. Unless they want to continue that forever, they'll have to accept maybe 500,000 deaths a year (something of a wild guess). That will be a tough pill to swallow.

We're watching Australia's vaccination rate in another thread and will have to see where they land. But they've already seen more cases in the past few months than the rest of the pandemic combined. They've had 1,450 deaths so far. What if they need to live with 10,000 per year moving forward? How will they stomach it if the new normal for them is worse than the pandemic?

 

[nsaspook]

Well if you don't set goals, then you'll never fail to achieve them. The near-term (6-12mo?) path remains as it has been for the past several months; keep vaccinating and ease restrictions as we get tired of them as infection rates allow.

The lack of interest in a near-term strategy probably tells us the longer term strategies as well. I foresee it being incorporated into the seasonal flu mitigation strategy, with optional annual booster shots and an acceptable annual death toll on a similar level of the flu. In the US, the flu usually kills 20-50,000 people a year. So I think we might stomach up to 100,000 additional COVID deaths a year without bothering with a stronger effort. If the 2022-2023 season is worse than that (or the summer 2022 trend doesn't look good), maybe we'll try something else.

What's more interesting/worrisome to me is the countries that have had low case rates to date (China and the island countries). They are at much higher risk than the US because they set a goal - an aggressive goal - and will likely need to abandon it because I don't think it would be possible to live with draconian mitigation measures forever. China of course can just force everyone to get vaccinated and digitally contact trace, but even at that, they are going to have to live with several orders of magnitude more deaths. If we believe them (not sure if I do), they've only had 5,000 deaths from COVID, achieved with draconian lockdowns. Unless they want to continue that forever, they'll have to accept maybe 500,000 deaths a year (something of a wild guess). That will be a tough pill to swallow.

We're watching Australia's vaccination rate in another thread and will have to see where they land. But they've already seen more cases in the past few months than the rest of the pandemic combined. They've had 1,450 deaths so far. What if they need to live with 10,000 per year moving forward? How will they stomach it if the new normal for them is worse than the pandemic?

We're in a sort of equilibrium right now in cases with evidence of seasonal causes. We seem to be seeing the effects of Vaccination and Ventilation. In the south people go indoors because of the heat, in the north people go indoors because of the cold.

https://www.cnbc.com/2021/11/10/aft...d-off-at-a-high-level-the-ers-are-packed.html

Cases have fallen most sharply in the South, where the delta wave hit earliest and hardest over the summer, with average daily infections in the region down by about 84% from peak levels and continuing to fall. The decline has been so steep that Florida, where hospitals were overrun as it fought one of the worst Covid outbreaks in the nation this summer, is now the state with the fewest number of average daily new cases on a population-adjusted basis.
..
“I think we are really starting to see some seasonality – maybe not winter-spring like we see with the flu, but more when people are more indoors versus outdoors,” she said. “In Florida, we were more indoors in the hot time of the summer, and now we have the opportunity to be more outdoors.”

Things are trending in the opposite direction outside of the U.S. South. Cases are up 25% in the Midwest, 18% in the Northeast and 4% in the West over the past two weeks. Hospitalizations, which lag reported infections, are down 9% in the Northeast over that same period but largely flat in the Midwest and West.

https://www.nytimes.com/interactive/2021/us/covid-cases.html

 

[Astronuc]

Today New York State reports total cumulative tests for COVID-19 as 77,844,664 tests as of yesterday. The total number is ~4x the total population of the state, and not everyone has been tested.

New York reports cumulative positive tests of 2,591,345. The number of COVID-19 fatalities in hospitals and care facilities is 45,960, while the number of COVID-19 fatalities reported and compiled by the CDC is 58,479, which includes those who died at home or other places away from medical care.

 

[Astronuc]

Family members battle SARS-Cov-2 a second time!
https://www.npr.org/sections/health...reinfection-kids-grandparents-immunity-waning

On a Friday afternoon in early October this year, 8-year-old Maricia Redondo came home from her third grade class in the San Francisco Bay Area with puffy eyes, a runny nose and a cough.

"On Saturday morning we both got tested," says Vanessa Quintero, Maricia's 31-year-old mother. "Our results came back Monday that we were both positive."

She was freaking out for two reasons. First, her large, extended family had already fought a harrowing battle against COVID-19 last year — in the fall of 2020. The virus had traveled fast and furious through their working class neighborhood back then, in the East Bay city of San Pablo. Four generations of Vanessa's family live next door to each other in three different houses there, all connected by a backyard.

Research suggests immunity against a natural infection lasts about a year. And here it was almost exactly the same time of year and the family was fighting COVID-19 again.

"Reinfection is a thing," says Dr. Peter Chin-Hong, a specialist in infections diseases and professor of medicine at the University of California, San Francisco. "It probably manifests itself more when the variant in town looks different enough from the previous variants. Or enough time has elapsed since you first got it, [and] immunity has waned." He says a second infection is still not common, but doctors are starting to see more cases.

In the case of this family, fewer family members were sick the second time — they credit vaccination.

Naturally enhanced neutralizing breadth against SARS-CoV-2 one year after infection​

https://pubmed.ncbi.nlm.nih.gov/34126625/

Abstract: More than one year after its inception, the Coronavirus disease 2019 (COVID-19) pandemic caused by severe acute respiratory syndrome Coronavirus 2 (SARS-CoV-2) remains difficult to control despite the availability of several working vaccines. Progress in controlling the pandemic is slowed by the emergence of variants that appear to be more transmissible and more resistant to antibodies^1,2. Here we report on a cohort of 63 individuals who have recovered from COVID-19 assessed at 1.3, 6.2 and 12 months after SARS-CoV-2 infection, 41% of whom also received mRNA vaccines^3,4. In the absence of vaccination, antibody reactivity to the receptor binding domain (RBD) of SARS-CoV-2, neutralizing activity and the number of RBD-specific memory B cells remain relatively stable between 6 and 12 months after infection. Vaccination increases all components of the humoral response and, as expected, results in serum neutralizing activities against variants of concern similar to or greater than the neutralizing activity against the original Wuhan Hu-1 strain achieved by vaccination of naive individuals^2,5-8. The mechanism underlying these broad-based responses involves ongoing antibody somatic mutation, memory B cell clonal turnover and development of monoclonal antibodies that are exceptionally resistant to SARS-CoV-2 RBD mutations, including those found in the variants of concern^4,9. In addition, B cell clones expressing broad and potent antibodies are selectively retained in the repertoire over time and expand markedly after vaccination. The data suggest that immunity in convalescent individuals will be very long lasting and that convalescent individuals who receive available mRNA vaccines will produce antibodies and memory B cells that should be protective against circulating SARS-CoV-2 variants.

 

[StevieTNZ]

https://news.harvard.edu/gazette/story/2021/12/moderna-vaccine-slightly-more-effective-than-pfizer/

Compared with the Pfizer COVID-19 vaccine, the Moderna COVID-19 vaccine has a slightly lower risk of COVID-19 outcomes, including documented SARS-CoV-2 infection, symptomatic COVID-19, and COVID-19-related hospitalization, intensive care unit admission, and death, over a 24-week period, according to a team of researchers. This pattern was consistent for periods when Alpha or Delta were the predominant variant.The study was published online Wednesday in the New England Journal of Medicine.

 

[Astronuc]

As of this morning (Nov 5).

A month later

Dec 05                            fully (18+ yrs)
State        pos cases   deaths   vaccinated
Calif        5,111,469   75,008   64%
Texas        4,343,389   74,512   55%
Florida      3,699,624   61,701   62%
New York     2,775,977   57,273   69%

Pennsylvania 1,779,151   33,902   59%
Georgia      1,634,659   29,537   50%
Illinois     1,840,377   29,521   62%
New Jersey   1,272,728   28,457   68%
Ohio         1,731,003   26,851   53%
Michigan     1,514,467   26,077   55%

Georgia has pulled ahead of Illinois with fatalities (although they are very close; a month ago, Georgia had about 460 fewer fatalities than Illinois), but Illinois has more cases

The majority of new hospitalizations for Covid-19 in New York are unvaccinated.
https://coronavirus.health.ny.gov/covid-19-breakthrough-data

 

[StevieTNZ]

https://www.stuff.co.nz/national/he...ng-children-after-twodose-regimen-falls-short

Parents will have to wait for a Coronavirus vaccine for their young children after Pfizer and BioNTech announced that they are modifying their clinical trial to include a third shot at least two months after the initial two-dose regimen for children under age 5.

The companies reported that two doses of the paediatric vaccine failed in 2-, 3- and 4-year-olds to trigger an immune response comparable to what was generated in teens and older adults. The vaccine did generate an adequate immune response in children 6 months to 2 years old.

If three doses are successful at triggering a protective immune response, the companies expect to submit the data to regulators in the first half of next year.

 

[Astronuc]

Dr. Peter Hotez and Dr. Maria Elena Bottazzi of Texas Children's Hospital and Baylor College of Medicine have developed a COVID-19 vaccine that could prove beneficial to countries with fewer resources.

The vaccine is called CORBEVAX. It uses old but proven vaccine technology and can be manufactured far more easily than most, if not all, of the COVID-19 vaccines in use today.
. . .
The story of CORBEVAX begins some two decades ago. Peter Hotez and Maria Elena Bottazzi were medical researchers at George Washington University in Washington, D.C., where they worked on vaccines and treatments for what are called neglected tropical diseases, such as schistosomiasis and hookworm.

When a strain of Coronavirus known as SARS broke out in 2003, they decided to tackle that disease. After moving to Houston to affiliate with Baylor College of Medicine and the Texas Children's Center for Vaccine Development, they created a vaccine candidate using protein subunit technology. This involves using proteins from a virus or bacterium that can induce an immune response but not cause disease.

"It's the same technology as the hepatitis B vaccine that's been around for decades," Hotez says.
. . .
When a new strain of Coronavirus triggered the COVID-19 pandemic, Hotez and Bottazzi figured they could dust off their old technology and modify it for use against COVID-19. After all, the virus causing COVID-19 and the virus causing SARS are quite similar.

 

[Astronuc]

Slightly more than a month later

Jan 07                            fully (18+ yrs)
State        pos cases   deaths   vaccinated
California   6,037,652   77,248     67%
Texas        4,996,914   76,770     57%
Florida      4,633,077   62,688     64%
New York     4,057,084   59,913     72%

Pennsylvania 2,240,549   37,642     64%
Illinois     2,386,672   31,660     65%
Georgia      1,925,143   30,478     51%
Ohio         2,170,139   30,072     56%
Michigan     1,850,791   29,920     57%
New Jersey   1,815,163   29,444     71%

The numbers of cases and deaths contain confirmed and probable according to the respective states. One should visit the state websites/dashboards for the data.

 

[Ygggdrasil]

A study by the CDC of 12-18 year olds shows that the Pfizer vaccine is 90% effective at preventing multisystem inflammatory syndrome in children.

What is already known about this topic?

The Pfizer-BioNTech vaccine, currently authorized for persons aged ≥5 years, provides a high level of protection against severe COVID-19 in persons aged 12–18 years. Vaccine effectiveness against multisystem inflammatory syndrome in children (MIS-C), which can occur 2–6 weeks after SARS-CoV-2 infection, has remained uncharacterized.

What is added by this report?

Estimated effectiveness of 2 doses of Pfizer-BioNTech vaccine against MIS-C was 91% (95% CI = 78%–97%). Among critically ill MIS-C case-patients requiring life support, all were unvaccinated.

What are the implications for public health practice?

Receipt of 2 doses of Pfizer-BioNTech vaccine is highly effective in preventing MIS-C in persons aged 12–18 years. These findings further reinforce the COVID-19 vaccination recommendation for eligible children.

Effectiveness of BNT162b2 (Pfizer-BioNTech) mRNA Vaccination Against Multisystem Inflammatory Syndrome in Children Among Persons Aged 12–18 Years — United States, July–December 2021
https://www.cdc.gov/mmwr/volumes/71/wr/mm7102e1.htm

Popular press summary: https://www.reuters.com/business/he...st-rare-covid-19-complication-cdc-2022-01-07/

Two doses of the Pfizer Inc (PFE.N) and BioNTech (22UAy.DE) COVID-19 vaccine are highly protective against a rare but often serious condition in children that causes organ inflammation weeks after COVID-19 infections, a U.S. Centers for Disease Control and Prevention report said on Friday.

The vaccine was estimated to be 91% effective in preventing Multisystem Inflammatory Syndrome in Children (MIS-C) in 12- to 18-year-olds, the study said. MIS-C causes inflammation in children in organs including the heart, lungs, kidneys and brain two to six weeks after a mild or asymptomatic infection.

 

[Ygggdrasil]

Dr. Peter Hotez and Dr. Maria Elena Bottazzi of Texas Children's Hospital and Baylor College of Medicine have developed a COVID-19 vaccine that could prove beneficial to countries with fewer resources.

Protein subunit vaccines have been shown to have similar efficacy before (e.g. Novavax released data from a phase 3 trial of its protein subunit vaccine back in January 2021 which showed 90% efficacy against symptomatic infection; it also recently received emergency use authorization in India). However, despite being among the vaccine candidates selected for funding by the Coalition for Epidemic Preparedness Innovations (CEPI) and Project Warp Speed, it has fairly consistently failed to meet expectations in delivering its vaccine, in part due to many manufacturing issues. Whether these manufacturing issues are limited to Novavax or applies to other protein subunit vaccines (like the CORBEVAX vaccine) is not clear. However, these issues may stem from Novavax's lack of experience with production and manufacturing, an issue that would also likely apply to the CORBEVAX vaccine as well. Thus, having a working vaccine is not sufficient for making an impact on global vaccination; it is also important to have the experience to scale up production as well.

Here's a nice piece in the BMJ discussing some of the issues with the Novavax vaccine: https://www.bmj.com/content/375/bmj.n2965

Hopefully, Novavax and CORBEVAX are able to scale up production of their vaccines and deliver them around the globe as they would be sorely needed to ensure everyone in the world is able to get vaccinated, which may help slow the emergence of new variants.

 

[fresh_42]

I found an interesting analysis of virtual vaccine side-effects:

Question What was the frequency of adverse events (AEs) in the placebo groups of COVID-19 vaccine trials?

Findings In this systematic review and meta-analysis of 12 articles including AE reports for 45 380 trial participants, systemic AEs were experienced by 35% of placebo recipients after the first dose and 32% after the second. Significantly more AEs were reported in the vaccine groups, but AEs in placebo arms (“nocebo responses”) accounted for 76% of systemic AEs after the first COVID-19 vaccine dose and 52% after the second dose.

https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2788172

 

[Astronuc]

COVID-19 Incidence and Death Rates Among Unvaccinated and Fully Vaccinated Adults with and Without Booster Doses During Periods of Delta and Omicron Variant Emergence — 25 U.S. Jurisdictions, April 4–December 25, 2021​

https://www.cdc.gov/mmwr/volumes/71/wr/mm7104e2.htm?s_cid=mm7104e2_w

In 25 U.S. jurisdictions, decreases in case incidence rate ratios for unvaccinated versus fully vaccinated persons with and without booster vaccine doses were observed when the Omicron variant emerged in December 2021. Protection against infection and death during the Delta-predominant period against infection during Omicron emergence were higher among booster vaccine dose recipients, and especially among persons aged 50–64 and ≥65 years.

During the first two weeks of January 22 (1 Jan - 14 Jan), New York state reported the following mortality. Cumulative means from March 2020-present, Fraction = (1-14 Jan)/(Cumulative). Note the larger fractions for the 0-9 and 10-19 groups, which are mostly likely unvaccinated and may have underlying comorbities. Nevertheless, SARS-Cov-2 can result in mortality of children, adolescents, youth and young adults. The numbers represent those fatalities in health care or elder care facilities (i.e., confirmed). Not included in the cumulative are approximately 12,600 who died outside of medical facilities (so may or may not be confirmed, or are probable). There are no statistics/data (demographic, co-morbidity) on these cases. Also not included are 9 deaths for whom the age is unknown/not reported.

          Cumulative  1-14Jan,2022  Fraction of
Age Group   Deaths      Deaths      Cumulative
90 and Over  7,915         351       0.0443
80 to 89    13,480         541       0.0401
70 to 79    13,024         475       0.0365
60 to 69     9,207         336       0.0365
50 to 59     4,401         196       0.0445
40 to 49     1,575          72       0.0457
30 to 39       659          34       0.0516
20 to 29       203          12       0.0591
10 to 19        26           4       0.1538
0 to 9          23           5       0.2174
             50513        2026

Currently, New York State reports 51532 cumulative deaths (so more than 1100 deaths in past week) and a total reported to the CDC of 64120.

 

[bhobba]

Here in Queensland, with 90% double vaccinated, of the 50 in ICU, 40% were unvaccinated. Vaccination looks like it does provide significant protection. The number of deaths we are seeing is about the same, so far, as a bad flu season. Considering the large difference in R0, this is very positive. Fingers crossed, these early signs are maintained as the predicted peak is now occurring or nearing where I live.

Thanks
Bill

 

[atyy]

Here in Queensland, with 90% double vaccinated, of the 50 in ICU, 40% were unvaccinated. Vaccination looks like it does provide significant protection. The number of deaths we are seeing is about the same, so far, as a bad flu season. Considering the large difference in R0, this is very positive. Fingers crossed, these early signs are maintained as the predicted peak is now occurring or nearing where I live.

Thanks
Bill

Hmmm, like a very bad flu season ... is it still looking like triple vax is good enough, even among the elderly? It's sad to see so many deaths in Australia even with 99% of the elderly double vaccinated - triple vax was necessary and good enough (except for the immunocompromised) for Delta. Is triple vax still good enough for Omicron?

 

[bhobba]

Is triple vax still good enough for Omicron?

We will know when the peak is over.

Thanks
Bill

 

[fresh_42]

Is triple vax still good enough for Omicron?

I think the current opinion is that triple J&J does not work very well, but 2 Pfizer and 1 Moderna (or the other way around) work best.

I have read today that the reason why Omicron is less severe than Delta is, that Omicron can't stop the cells from interferon production.

 

[Ygggdrasil]

Is triple vax still good enough for Omicron?

Laboratory tests of serum from people with different vaccination statuses suggests that the booster shot does induce the development of antibodies against Omicron:

In this issue of Cell, three studies confirm that SARS-CoV-2 Omicron strongly evades a key immune defense—neutralizing antibodies. However, while one- or two-dose vaccine regimens fail to induce anti-Omicron neutralizing antibodies, a homologous third-dose booster rescues neutralization function in a way that highlights the adaptability of immune memory, where recalled immunity extends antibody reach across SARS-CoV-2 variants.

https://www.cell.com/cell/fulltext/S0092-8674(22)00006-X?rss=yes

Here are the three studies that the article references:
SARS-CoV-2 Omicron-B.1.1.529 leads to widespread escape from neutralizing antibody responses
https://www.cell.com/cell/fulltext/S0092-8674(21)01578-6

mRNA-based COVID-19 vaccine boosters induce neutralizing immunity against SARS-CoV-2 Omicron variant
https://www.cell.com/cell/fulltext/S0092-8674(21)01496-3

The Omicron variant is highly resistant against antibody-mediated neutralization: Implications for control of the COVID-19 pandemic
https://www.cell.com/cell/fulltext/S0092-8674(21)01495-1

This data from laboratory tests is backed up from observational data collected by the CDC showing that individuals who received boosters were less likely to be infected:

https://www.cdc.gov/mmwr/volumes/71/wr/mm7104e2.htm

The original vaccine series (without booster) still seems effective at preventing deaths from Omicron, which is consistent with data showing that vaccination can induce T-cells that target all major variants of the virus, and that memory T-cell responses were much more durable than neutralizing antibody and memory B-cell responses:

SARS-CoV-2 vaccination induces immunological T cell memory able to cross-recognize variants from Alpha to Omicron
https://www.cell.com/cell/fulltext/S0092-8674(22)00073-3

Abstract:

We address whether T cell responses induced by different vaccine platforms (mRNA-1273, BNT162b2, Ad26.COV2.S, NVX-CoV2373) cross-recognize early SARS-CoV-2 variants. T cell responses to early variants were preserved across vaccine platforms. By contrast, significant overall decreases were observed for memory B cells and neutralizing antibodies. In subjects ∼6 months post-vaccination, 90% (CD4+) and 87% (CD8+) of memory T cell responses were preserved against variants on average by AIM assay, and 84% (CD4+) and 85% (CD8+) preserved against Omicron. Omicron RBD memory B cell recognition was substantially reduced to 42% compared to other variants. T cell epitope repertoire analysis revealed a median of 11 and 10 spike epitopes recognized by CD4+ and CD8+ T cells, with average preservation > 80% for Omicron. Functional preservation of the majority of T cell responses may play an important role as second-level defenses against diverse variants.

 

[Ygggdrasil]

I think the current opinion is that triple J&J does not work very well, but 2 Pfizer and 1 Moderna (or the other way around) work best.

I have read today that the reason why Omicron is less severe than Delta is, that Omicron can't stop the cells from interferon production.

Do you have sources for these two statements? I would be interested in seeing the data.