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Mix-and-match COVID vaccines: the case is growing, but questions remain

01 Jul 2021

A slew of studies suggests that mixing vaccines provokes potent immune responses, but scientists still want answers on real-world efficacy and rare side effects.

NIH Director's Blog: How Immunity Generated from COVID-19 Vaccines Differs from an Infection

22 Jun 2021

A key issue as we move closer to ending the pandemic is determining more precisely how long people exposed to SARS-CoV-2, the COVID-19 virus, will make neutralizing antibodies against this dangerous coronavirus. Finding the answer is also potentially complicated with new SARS-CoV-2 “variants of concern” appearing around the world that could find ways to evade acquired immunity, increasing the chances of new outbreaks.

Antibody-laden nasal spray could provide COVID protection — and treatment

04 Jun 2021

A nasal spritz of a designer antibody offers strong protection against variants of the coronavirus SARS-CoV-2 — at least in mice1. Since the early days of the pandemic, scientists have been developing antibodies as treatments for COVID-19. Today, several such antibodies are in late-stage clinical trials, and a handful have been approved for emergency use by regulatory agencies in the United States and elsewhere. Among doctors, however, antibody treatments have not been very popular, says Zhiqiang An, an antibody engineer at the University of Texas Health Science Center at Houston. That’s partly because those available are delivered through intravenous infusions rather than directly to the respiratory tract, where the virus is mainly found — so it takes high doses for them to be effective. Another challenge is the emergence of SARS-CoV-2 variants that seem to be resistant to some existing antibodies. An and his colleagues set out to engineer an antibody that could be delivered directly into the nose. They scanned a library of antibodies from healthy humans and zeroed in on those that were able to recognize a component of SARS-CoV-2 that the virus uses to latch on to and enter cells2. Among the promising candidates were IgG antibodies, which are relatively slow to appear after an infection but are precisely tailored to the invading pathogen. The team stitched IgG fragments targeting SARS-CoV-2 to a different type of molecule: IgM antibodies, which act as speedy first-responders to a broad range of infection. The engineered IgMs had a much stronger ‘neutralizing’ effect against more than 20 variants of SARS-CoV-2 than did the IgGs alone. When squirted into the noses of mice either six hours before or six hours after infection, the engineered IgMs sharply reduced the amount of virus in the rodents’ lungs two days after infection, the team reports in Nature1. This work is a “big feat of engineering”, says Guy Gorochov, an immunologist at Sorbonne University in Paris. But he adds that there are open questions, such as how long these antibodies will linger in humans. An envisions these antibodies as a kind of chemical mask that could be used by anyone who has been exposed to SARS-CoV-2, and as an extra line of defence for people who might not be fully protected by vaccines. Because IgM molecules are relatively stable, it might be feasible to formulate them into a nasal spray to be bought at a pharmacy and kept for emergency use, An adds. IGM Biosciences, a biotechnology company in Mountain View, California, that collaborated in An’s study, will test this antibody in clinical trials.

Moderna applies for full F.D.A. approval for its Covid vaccine.

02 Jun 2021

Moderna on Tuesday became the latest pharmaceutical company to apply to the U.S. Food and Drug Administration for full approval for its Covid-19 vaccine for use in people 18 and older. F.D.A. approval would allow the company to market the shot directly to consumers, and could also help raise public confidence in the vaccine.

Seven European countries begin issuing a digital Covid certificate for travel.

02 Jun 2021

A digital Covid certificate system intended to ease travel within the European Union became operational in seven countries on Tuesday — ahead of schedule — offering a preview of what could become a standard for post-pandemic global mobility.


The epidemiological impact of the NHS COVID-19 App

12 May 2021

The COVID-19 pandemic has seen digital contact tracing emerge around the world to help prevent spread of the disease. A mobile phone app records proximity events between app users, and when a user tests positive for COVID-19, their recent contacts can be notified instantly. Theoretical evidence has supported this new public health intervention1-6, but its epidemiological impact has remained uncertain7. Here we investigated the impact of the NHS COVID-19 app for England and Wales, from its launch on 24 September 2020 through to the end of December 2020. It was used regularly by approximately 16.5 million users (28% of the total population), and sent approximately 1.7 million exposure notifications: 4.4 per index case consenting to contact tracing. We estimated that the fraction of app-notified individuals subsequently showing symptoms and testing positive (the secondary attack rate, SAR) was 6.0%, comparable to the SAR for manually traced close contacts. We estimated the number of cases averted by the app using two complementary approaches. Modelling based on the notifications and SAR gave 284,000 (108,000-450,000), and statistical comparison of matched neighbouring local authorities gave 594,000 (317,000-914,000). Roughly one case was averted for each case consenting to notification of their contacts. We estimated that for every percentage point increase in app users, the number of cases can be reduced by 0.8% (modelling) or 2.3% (statistical analysis). These findings provide evidence for continued development and deployment of such apps in populations that are awaiting full protection from vaccines.

Preliminary Findings of mRNA Covid-19 Vaccine Safety in Pregnant Persons

22 Apr 2021

BACKGROUND Many pregnant persons in the United States are receiving messenger RNA (mRNA) coronavirus disease 2019 (Covid-19) vaccines, but data are limited on their safety in pregnancy. CONCLUSIONS Preliminary findings did not show obvious safety signals among pregnant persons who received mRNA Covid-19 vaccines. However, more longitudinal follow-up, including follow-up of large numbers of women vaccinated earlier in pregnancy, is necessary to inform maternal, pregnancy, and infant outcomes.

Association of Race/Ethnicity With Likeliness of COVID-19 Vaccine Uptake Among Health Workers and the General Population in the San Francisco Bay Area

30 Mar 2021

Surveys have demonstrated racial differences in the public’s willingness to receive a COVID-19 vaccine1,2 but have not directly compared vaccine intentions among health workers and the general public.3 We investigated COVID-19 vaccine intentions among racially and ethnically diverse samples of health workers and the general population.

SARS-CoV-2 infection of the oral cavity and saliva

25 Mar 2021

Despite signs of infection—including taste loss, dry mouth and mucosal lesions such as ulcerations, enanthema and macules—the involvement of the oral cavity in coronavirus disease 2019 (COVID-19) is poorly understood. To address this, we generated and analyzed two single-cell RNA sequencing datasets of the human minor salivary glands and gingiva (9 samples, 13,824 cells), identifying 50 cell clusters. Using integrated cell normalization and annotation, we classified 34 unique cell subpopulations between glands and gingiva. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) viral entry factors such as ACE2 and TMPRSS members were broadly enriched in epithelial cells of the glands and oral mucosae. Using orthogonal RNA and protein expression assessments, we confirmed SARS-CoV-2 infection in the glands and mucosae. Saliva from SARS-CoV-2-infected individuals harbored epithelial cells exhibiting ACE2 and TMPRSS expression and sustained SARS-CoV-2 infection. Acellular and cellular salivary fractions from asymptomatic individuals were found to transmit SARS-CoV-2 ex vivo. Matched nasopharyngeal and saliva samples displayed distinct viral shedding dynamics, and salivary viral burden correlated with COVID-19 symptoms, including taste loss. Upon recovery, this asymptomatic cohort exhibited sustained salivary IgG antibodies against SARS-CoV-2. Collectively, these data show that the oral cavity is an important site for SARS-CoV-2 infection and implicate saliva as a potential route of SARS-CoV-2 transmission.

Assessment of protection against reinfection with SARS-CoV-2 among 4 million PCR-tested individuals in Denmark in 2020: a population-level observational study

17 Mar 2021

The vast majority of people who recover from Covid-19 remain protective immunity from the virus for at least six months, researchers reported on Wednesday in a large study from Denmark. The study revealed protective immunity to be approximately 80–83% in people younger than 65 years. We found no difference in immunity over the study period. Among those aged 65 years and older, immunity was estimated to be approximately 47%.

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