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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.

Association of COVID-19 Vaccination With Symptomatic SARS-CoV-2 Infection by Time Since Vaccination and Delta Variant Predominance

14 Feb 2022

Key Points Question How does the association between prior COVID-19 vaccination and symptomatic SARS-CoV-2 infection change with time since vaccination and the SARS-CoV-2 Delta variant? Findings In this test-negative, case-control study that included 1 634 271 tests from symptomatic adults, the odds ratio for prior mRNA vaccination and SARS-CoV-2 test positivity was lower before than during Delta variant predominance. The attenuation in effect size related to time since vaccination was greater than the attenuation related to the Delta variant. Meaning The findings are consistent with a steady decline in estimated mRNA vaccine effectiveness over time, separate from variant-specific differences in protection.

Long-term cardiovascular outcomes of COVID-19

09 Feb 2022

The cardiovascular complications of acute coronavirus disease 2019 (COVID-19) are well described, but the post-acute cardiovascular manifestations of COVID-19 have not yet been comprehensively characterized. Here we used national healthcare databases from the US Department of Veterans Affairs to build a cohort of 153,760 individuals with COVID-19, as well as two sets of control cohorts with 5,637,647 (contemporary controls) and 5,859,411 (historical controls) individuals, to estimate risks and 1-year burdens of a set of pre-specified incident cardiovascular outcomes. We show that, beyond the first 30 d after infection, individuals with COVID-19 are at increased risk of incident cardiovascular disease spanning several categories, including cerebrovascular disorders, dysrhythmias, ischemic and non-ischemic heart disease, pericarditis, myocarditis, heart failure and thromboembolic disease. These risks and burdens were evident even among individuals who were not hospitalized during the acute phase of the infection and increased in a graded fashion according to the care setting during the acute phase (non-hospitalized, hospitalized and admitted to intensive care). Our results provide evidence that the risk and 1-year burden of cardiovascular disease in survivors of acute COVID-19 are substantial. Care pathways of those surviving the acute episode of COVID-19 should include attention to cardiovascular health and disease.

Durability of Anti-Spike Antibodies in Infants After Maternal COVID-19 Vaccination or Natural Infection

07 Feb 2022

COVID-19 vaccination in pregnancy generates functional anti-spike (anti-S) IgG antibodies in maternal circulation that are detectable in umbilical cord blood at birth and can protect the newborn and infant from COVID-19.1-4 Anti-S IgG titers in the umbilical cord are correlated with maternal titers and are highest after late second and early third trimester vaccination.2-4 We characterized the persistence of vaccine-induced maternal anti-S IgG in infant blood and compared persistence of infant anti-S IgG after maternal vaccination vs natural infection.

Association of Major Depressive Symptoms With Endorsement of COVID-19 Vaccine Misinformation Among US Adults

21 Jan 2022

Key Points Question Are major depressive symptoms associated with increased risk of believing common misinformation about COVID-19 vaccines among US adults? Findings In this survey study including 15 464 US adults, people with moderate or greater major depressive symptoms on an initial survey were more likely to endorse at least 1 of 4 false statements about COVID-19 vaccines on a subsequent survey, and those who endorsed these statements were half as likely to be vaccinated. Meaning These findings suggest another potential benefit of public health efforts to address depressive symptoms, namely reducing susceptibility to misinformation.

Characteristics and Outcomes of Hospitalized Patients in South Africa During the COVID-19 Omicron Wave Compared With Previous Waves

30 Dec 2021

On November 24, 2021, a SARS-CoV-2 variant of concern, Omicron (B.1.1.529), was identified in South Africa as responsible for a fourth wave of COVID-19.1,2 The high number of spike mutations has raised concerns about its ability to evade vaccine and spread.3,4 We assessed hospitalized patients with a positive SARS-CoV-2 test result during the fourth wave compared with previous waves.