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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.     Study suggests AstraZeneca vaccine does not protect against mild/moderate COVID-19

2.     Update on the three major variants by Eric Topol

3.     Rise in paediatric proportion of Israeli COVID-19 cases over 2020

4.     Reinfection warning from the WHO

5.     Singapore Airlines becomes second airline to have fully vaccinated crew

6.     WHO gives emergency vaccine approval to AstraZeneca/Oxford vaccine

7.     AstraZeneca/Oxford vaccine to begin trials in children

8.     France recommends single vaccine dose for people who have already had COVID-19

9.     Australian churches on collision course with the government over AstraZeneca vaccine

10.  Israeli study finds 94% drop in symptomatic COVID-19 cases with Pfizer vaccine

11.  Pakistan lab expects Sputnik V doses for commercial sale in a week

12.  Two Swedish regions pause AstraZeneca vaccinations after mild side-effects

13.  The five key mitigation strategies from the CDC’s new guidance to reopen schools


1.     Study suggests AstraZeneca vaccine does not protect against mild/moderate COVID

The results of a non-peer-reviewed double-blind randomized multi-centre trial conducted in South Africa between June and November 2020 has been published on Medrix.

Approximately 2,000 non-HIV-infected participants were given vaccine (two doses 21-35 days apart) or placebo.

Results

1.     Twenty-five serum samples were tested by neutralisation assays against the D614G strain and the B.1.351 variant. The variant showed increased resistance to vaccinee sera.

2.     In the primary endpoint analysis, 23/717 (3.2%) placebo and 19/750 (2.5%) vaccine recipients developed mild-moderate COVID-19. Of the cases, 39/42 (92.9%) were the B.1.351 variant.

Conclusions: A two-dose regimen of ChAdOx1-nCoV19 did not show protection against mild-moderate COVID-19 due to B.1.351 variant, however, efficacy against severe COVID-19 is undetermined.


2.     Update on the three major variants by Eric Topol**

Eric Topol has updated his table summarizing the major three variants. 

·       “B.1.1.7 spreading further globally and in US would likely overrun the others due to increased transmissibility”

·       “Efficacy of mRNA vaccine in Israel suggests B.1.1.7 immune escape not very worrisome”

Data from https://cdc.gov/coronavirus/2019-ncov/transmission/variant-cases.htm

and https://cov-lineages.org/global_report.html


3.     Rise in pediatric proportion of Israeli COVID-19 cases over 2020

Eric Feigl-Ding*** has tweeted about the fall/winter trend in Israel toward relatively more cases in children. This data continues into January. Many reports of relative pediatric surge in Israel continuing in January 2021. He comments that: “We need to watch this.”


4.     Reinfection warning from the WHO

“We are now getting reports of people getting reinfected with a new variant of the virus … suggesting people who’ve had prior infection could get infected again,” says Chief Scientist Dr. Soumya Swaminathan.

“The good news, however, is that the vaccines developed to guard against the virus appear to reduce the severity of illness in those who do develop COVID-19, even if it doesn’t completely protect them from infection,” Dr. Soumya Swaminathan went on to say.


5.     Singapore Airlines becomes second airline to have fully vaccinated crew

The Straits Times reported that Singapore Airlines announced on 11 January that it will become the second airline in the world to only operate flights with fully vaccinated cabin crew and pilots. Etihad Airways made a similar announcement a day earlier.


6.     WHO gives emergency vaccine approval to AstraZeneca/Oxford vaccine

The World Health Organization (WHO) has listed AstraZeneca/Oxford COVID-19 vaccine for emergency use and said the two doses should be given about eight to 12 weeks apart. The COVAX vaccine-sharing initiative relies heavily on this vaccine, which the WHO panel said can be used even in countries with the South African variant of the coronavirus.

A WHO emergency use listing (EUL) helps less-resourced nations approve medicines more quickly, without using their own regulatory resources. The WHO authorized Pfizer/BioNTech’s vaccine late last year; but AstraZeneca vaccine is less expensive and easier to store.


7.     AstraZeneca/Oxford vaccine to begin trials in children

The Guardian reports that Oxford/AstraZeneca will begin clinical trials in children aged between six and 17 years of age. About 300 participants will undergo the trials. Pfizer is already conducting trials among children between 12 and 15 years and Moderna’s trials are underway for 12 to 17-year-olds.


8.     France recommends single vaccine dose for people who have already had COVID-19

The French Health Authority said that people who have had confirmed COVID-19 infections should only get one dose of the vaccine. Ideally, this single dose would be given six months following their natural infection, though it is permissible to vaccinate them as soon as three months after. This single dose would count as a “booster” to their natural immunity, which the statement said is known to last at least three months.


9.     Australian churches collide with the Government over AstraZeneca vaccine

The Sydney Morning Herald reports that major churches in Australia are at odds with authorities over the AstraZeneca vaccine, with religious leaders telling parishioners they are entitled to request a different vaccine but the Federal Government saying most people will not have a choice.

Religious concerns about the AstraZeneca vaccine arise from its use of decades-old aborted foetal cells in the development process, which is a common scientific practice that some Christians find objectionable.The disagreement could frustrate or delay attempts to innoculate the country against further COVID-19 outbreaks and lockdowns as authorities prepare to start the vaccine rollout later this month.


10.  Israeli study finds 94% drop in symptomatic COVID-19 cases with Pfizer vaccine

Reuters reports that: “Israel’s largest healthcare provider reported on 14 February a 94% drop in symptomatic COVID-19 infections among 600,000 people who received two doses of the Pfizer vaccine in the country’s biggest study to date.

“Health Maintenance Organization (HMO) Clalit, which covers more than half of all Israelis, said the same group was also 92% less likely to develop severe illness from the virus. The comparison was against a group of the same size, with matching medical histories, who had not received the vaccine.

“It shows unequivocally that Pfizer’s coronavirus vaccine is extremely effective in the real world a week after the second dose, just as it was found to be in the clinical study,” said Ran Balicer, Clalit’s chief innovation officer.

“Israel has been conducting a rapid vaccine rollout and its database offers insights into vaccine effectiveness and at what point countries might attain herd immunity.”


11.  Pakistan lab expects Sputnik V doses for commercial sale in a week

Reuters reports that: “A Pakistani lab will soon receive Russia’s Sputnik V COVID-19 vaccine for commercial sale, a company official said on Sunday, making Pakistan one of the first countries to market shots privately as it scrambles to secure supplies.

“Despite concerns over fairness and higher prices, Islamabad agreed this week to allow the commercial import and sale of vaccines without price caps, in contrast to most countries, which are importing and administering vaccines through government channels. We are told the first shipment is expected within the next week,” Chughtai Lab director Omar Chughtai told Reuters, adding it would be receiving several thousand doses.

“Sputnik V is one of four vaccines approved for emergency use in Pakistan, in addition to those by China’s Sinopharm and CanSinoBio, and the AstraZeneca/Oxford University shot.Chughtai Lab aims to import the others as well, but Sputnik V was the first to become available, Chughtai said.”


12.  Two Swedish regions pause AstraZeneca vaccinations after mild side-effects

Sweden’s English language online news source “The Local” reported that: “On 12 February, the region of Sormland, south of Stockholm, stopped giving the Astra Zeneca jab, after 100 of a total 400 hospital employees reported high temperatures and other side effects.

“Gävleborg, north of Stockholm has also stopped giving the vaccine, and Jönkoping has expressed concern over the surprisingly large number of side-effects. We’re stopping partly to investigate [the situation] but also so that we don’t suffer staff shortages,” Magnus Johansson, the health chief in Sormland region, told Sweden’s state broadcaster SVT.

“Fredrik Gustavsson, a press spokesperson for the region, said that although the side effects were not serious, more staff than expected had called in sick after receiving the vaccine on Thursday. Tina Mansson Söderlund, vaccine coordinator in the Gävleborg Region, told SVT that the side-effects were the expected ones: ‘It’s the usual ones: chills, body aches and fever,’ she said.

“’The problem is that we have vaccinated so many people in the same workplace. That is why we’re pausing. It’s nothing to do with the vaccine. We are just a little worried about staffing over the weekend.’”


13.  The five key mitigation strategies from the CDC’s new guidance to reopen schools

Full CDC details here

**Eric Topol: Professor of Molecular Medicine at The Scripps Research Institute, and a senior consultant at the Division of Cardiovascular Diseases at Scripps Clinic in La Jolla, California. Editor-in-chief of Medscape and theheart.org.

*** Eric Feigl-Ding:  Senior Fellow at the Federation of American Scientists in Washington DC. He was formerly a faculty member and researcher at Harvard Medical School and Harvard T.H. Chan School of Public.


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