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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.




Articles


Variants of SARS-CoV-2


13 Aug 2021

When a virus develops a new mutation, it is called a variant of the original virus. As viruses spread, they constantly change through mutations to their genetic code. Most mutations in the SARS-CoV-2 genome do not affect the functioning of the virus. However, mutations in the spike protein of SARS-CoV-2, which binds to receptors on cells lining the inside of the human nose, may make the virus easier to spread or affect how well vaccines protect people. Other mutations may lead to SARS-CoV-2 being less responsive to treatments for COVID-19.




Randomized Trial of a Third Dose of mRNA-1273 Vaccine in Transplant Recipients


11 Aug 2021

In organ-transplant recipients, the standard two-dose vaccination strategy for coronavirus disease 2019 (Covid-19) has suboptimal immunogenicity.1 Both patients and health care providers have questioned whether a third-dose booster in transplant recipients would be safe and enhance immune response.2 We performed a double-blind, randomized, controlled trial of a third dose of mRNA-1273 vaccine (Moderna) as compared with placebo (the protocol is available with the full text of this letter at NEJM.org; ClinicalTrials.gov number, NCT04885907. opens in new tab).




Long-term Symptoms After SARS-CoV-2 Infection in Children and Adolescents


15 Jul 2021

Children can experience SARS-CoV-2 postviral syndromes, but it is unclear to what extent these individuals are affected by long COVID. Evidence is predominantly limited to select populations without control groups,1-4 which does not allow estimating the overall prevalence and burden in a general pediatric population. We compared symptoms compatible with long COVID in children and adolescents (hereafter “children”) reported within 6 months after SARS-CoV-2 serologic testing.




Study Suggests Lasting Immunity After COVID-19, With a Big Boost From Vaccination


14 Jul 2021

After an infection with SARS-CoV-2, most people—even those with mild infections—appear to have some protection against the virus for at least a year, a recent follow-up study of recovered patients published in Nature suggests. What’s more, this and other research demonstrates that vaccinating these individuals substantially enhances their immune response and confers strong resistance against variants of concern, including the B.1.617.2 (delta) variant.




Return to Play After COVID-19 Infection in Children


28 Jun 2021

As the pandemic continues, children may experience long-term effects from COVID-19 infections. Because children may become “long haulers” or develop multisystem inflammatory syndrome in children (MIS-C), close monitoring after a COVID-19 diagnosis is important. In addition, children who are athletes require a separate return-to-play evaluation before they return to competitive sports or physical activities.




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