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COVID-19 UPDATE / Immunity and Vaccine Development

Dr Doug Quarry from International SOS shares the very latest insights on the development of COVID immunity and vaccine development

DR DOUG QUARRY


In this edition:

  1. Israel: Hospitalisations reduced by vaccination
  2. Israel: Cases in 60+ group down nearly 50% since start of vaccination program
  3. US to accelerate vaccination program
  4. Differing efficacy of vaccines according to outcome
  5. B.1.1.7 appears not to cause more severe illness in children
  6. Spain’s recovering COVID-19 patients must wait six months for vaccine
  7. Israel Plans “Green Pass” to Leisure for COVID-Immune on 23 February
  8. Use AstraZeneca’s vaccine even in countries with South African variant: WHO Panel
  9. Fauci: Vaccines for kids as young as first graders could be authorised by September
  10. CDC: Fully vaccinated people don’t need to quarantine if exposed to COVID
  11. Denmark says it has U.K. coronavirus variant under control, for now
  12. Experts say it will be six years before the world is vaccinated against COVID-19
  13. Israeli study suggests that Pfizer/BioNTech vaccine reduces viral load
  14. Wealthy German high-tech hub doubles as anti-vaxxer base

1. Israel: Hospitalisations reduced by vaccination

This graph tweeted by Eran Segal** shows that the drop in cases & hospitalizations of 60+ age group in cities with early vaccination is stronger than in late-vaccinated cities.

Note that the effect is independent of the thirdrd lockdown which began country-wide on 8 January.

International SOS Comment:

Israel continues to lead the world in terms of percentage of population vaccinated.

The effect of the Israeli vaccination program is expected to be able to be extrapolated to other communities as their vaccination rate increases.


2. Israel: Cases in 60+ group down nearly 50% since start of vaccination program

OurWorldinData now has several detailed graphs looking at the extent and impact of the Israeli vaccination program.

Read the instructions for this graph carefully.

Tweet from Eric Topol***

If we look to Israel, with nearly all B.1.1.7 strain, and ask if an mRNA vaccine is working, the answer is “really well.”


3. US to accelerate vaccination program

Tweet from Andy Slavitt****

“Good news. President Biden just announced the US has accelerated timeframe to have enough vaccines to supply 300 million Americans by the end of July.

“This is an acceleration over what I announced just 2 weeks ago.”


4. Differing efficacy of vaccines according to outcome

Last week we provided a “back of the napkin” sketch from Prof Natalie Dean***** of how different vaccines can have a range of efficacies.

The efficacies measured can be the effect on:

  • Severe symptoms
  • Moderate symptoms
  • Mild symptoms
  • Asymptomatic

The Economist has this week formalized these diagrams showing two main vaccine types:

1.     Vaccine that prevents disease but not infection

2.     Vaccine that prevents disease and infection

International SOS Comment:

This is sound structure with which to consider the different types of vaccines AND especially their effect on variant strains of SARS-CoV-2.


5. B.1.1.7 appears not to cause more severe illness in children

There have been recent concerns and media reports that B.1.1.7 has more effects in children and young adults than the ancestral strain.  This notion has been challenged by a recent Lancet article  which includes this statement in the summary:

“Importantly, we have found no evidence of more severe disease having occurred in children and young people during the second wave, suggesting that infection with the B.1.1.7 variant does not result in an appreciably different clinical course to the original strain.


6. Spain’s recovering COVID-19 patients must wait six months for vaccine

Reuters reports that:” Spain’s Health Ministry said on Wednesday that people under the age of 55 without major health complications, who have previously contracted coronavirus, will have to wait six months from their diagnosis before receiving a vaccine.

“The provisional measure, which appears to be unique in Europe, will apply to the vaccines developed by Pfizer and BioNTech, Moderna, and Oxford University and AstraZeneca currently being distributed in Spain.

“Justifying the decision to prioritise those without a history of COVID-19, the ministry said reinfection within six months was ‘exceptional’.

“A major British study published last week found 99% of participants who previously tested positive retained antibodies for three months, while 88% still had them after six months.”


7. Israel Plans “Green Pass” to Leisure for COVID-Immune on 23 February

“Israel plans to open up some hotels, gyms and other leisure facilities in two weeks to those documented as being immune to COVID-19…” reports Reuters.

“Israel has said it would issue an official app allowing users to link up to their Health Ministry files and show if they have been vaccinated against or recovered from COVID-19, with presumed immunity, in order to gain entry to leisure facilities.

“Those who have not been vaccinated and have not had COVID-19 would be able to get a COVID-19 test and, if the result is negative, display it on the app for up to 72 hours of similar access.”


8. Use AstraZeneca’s vaccine even in countries with South African variant: WHO Panel

The World Health Organisation “Strategic Advisory Group of Experts on Immunization (SAGE)” at its extraordinary meeting on 8 February 2021, said that the AstraZeneca COVID-19 vaccine is safe and effective and should be deployed widely, including in countries where the South African variant of the coronavirus may reduce its efficacy.

The vaccine should be given in two doses with an interval of eight to 12 weeks and should also be used in people aged 65 and older.

Even in countries such as South Africa, where questions have been raised about the AstraZeneca vaccine’s efficacy against a newly-emerged variant of the SARS-CoV-2 coronavirus, “there is no reason not to recommend its use,” SAGE’s chair, Alejandro Cravioto, said.

“We have made a recommendation that even if there is a reduction in the possibility of this vaccine having a full impact in its protection capacity, especially against severe disease, there is no reason not to recommend its use even in countries that have circulation of the variant,” he said.


9. Fauci: Vaccines for kids as young as first graders could be authorised by September

“’Children as young as first graders may be able to get the coronavirus vaccine by the time school starts in September, presuming trials are successful in those age groups, Dr. Anthony Fauci, Director of the National Institute of Allergy and Infectious Diseases’, said in an interview with ProPublica.”


10. CDC: Fully vaccinated people don’t need to quarantine if exposed to COVID

People who have been fully vaccinated against COVID-19 do not need to quarantine if they are exposed to the coronavirus, the Centers for Disease Control and Prevention (CDC) said Wednesday in updated guidance on its website.

In the updated guidance, the CDC said such quarantining is not necessary for fully vaccinated people within three months of having received their last doses if they did not develop any symptoms. “Fully vaccinated” means that at least two weeks have passed since a person has received the second dose of a two-dose vaccine or one dose of a single-dose vaccine.

Other recommendations remain in place for fully vaccinated people; they include wearing masks, social distancing and avoiding crowds and poorly ventilated spaces.


11. Denmark says it has U.K. coronavirus variant under control, for now

The Washington Post reports: “After more than six weeks of a rigid national lockdown, Denmark says it has curbed the spread of the coronavirus variant first identified in Britain.

“Danish health authorities – who are trying to sequence all positive coronavirus tests, giving them a detailed view most countries do not have – worried earlier that established methods of control might not work against the more contagious variant.

“But new data suggests that at least at the beginning of the month, infection levels in Denmark were constant – not shrinking but not growing exponentially, as they had been in earlier weeks.

“That’s hopeful news with implications far beyond Denmark, as the variant has been quickly spreading around the world. The Centers for Disease Control and Prevention estimates it will be dominant in the United States by next month.”


12. Experts say it will be six years before the world is vaccinated against COVID-19

briefing at the Australian National Press Club, reported by the Sydney Morning Herald, has been told

“…it will take six years to vaccinate enough of the world’s population to reduce the threat of COVID-19, but public health experts say vaccines are no silver bullet and hygiene measures and masks will be part of life for years to come.

“Infectious diseases expert, Associate Professor Sanjaya Senanayake, said the SARS-CoV-2 virus could eventually become another seasonal cold or flu-like virus, but there were some major obstacles to that, including the global vaccine rollout.

“’Only about 70 nations have started to vaccinate their populations, and at the current rate of vaccination, it is estimated we won’t reach global coverage of 75 per cent with vaccines for about six years – not one or two years, but six years,’ he said.

“’In addition, Oxfam has said that by the end of this year, there will be 70 poorer nations where only one in 10 people have been vaccinated.’”


13. Israeli study suggests that Pfizer/BioNTech vaccine reduces viral load

The study uses quite complex sampling and mathematical logic but it is well explained by the Guardian here.


14. Wealthy German high-tech hub doubles as anti-vaxxer base

Reuters reports that: “Christoph Hueck illustrates the challenge Germany faces in rolling out a mass vaccination campaign to tackle the coronavirus pandemic. A scientist living in a wealthy, high-tech region, he does not plan to have any of the shots on offer.

“’I will not get vaccinated,’ Hueck, a molecular geneticist who authored a string of immunology papers before changing careers, told Reuters with a smile.

“Now 59, he trains teachers for the Waldorf kindergartens inspired by esoteric thinker Rudolf Steiner, which began in Stuttgart. He has also addressed several anti-lockdown and anti-vaccination protests, although he does not reject vaccines altogether.

“’I am convinced that should I get infected anywhere, I will weather the illness,’ he said of COVID-19. ‘I am not vaccinated against other diseases either, except when I travel to the tropics where it’s mandatory.’

“Almost a third of Germans (31%) said in a December poll that they would not take a coronavirus vaccine, a number that rises to almost half in neighbouring France.”


**Eran Segal: Scientist at the Weizmann Institute. Microbiome, Genetics, Nutrition, Machine learning

***Eric Topol: Professor of Molecular Medicine at The Scripps Research Institute. Editor-in-chief of Medscape and theheart.org

**** Andy Slavitt: White House Senior Advisor, COVID Response

****Natalie Dean: Assistant Professor of Biostatistics at the University of Florida specialising in emerging infectious diseases and vaccine study design.


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