Category: COVID

Categories : COVID HIVTags :

Novavax COVID Vaccine only 49.4% Effective in SA

On By ModernMedia

On Thursday, Novavax announced that its vaccine was 89% effective, according to its UK trials which had 15 000 participants. However, its SA trials showed a much lower effectiveness of 49.4%, believed to be caused by the SA COVID variant B.1.351 (aka 501.V2). 

The company conveyed the information in a press release, with a detailed journal publication still to come. The SA trial had 4400 participants, and the observed protection varied depending on HIV status. In people who were HIV negative, the vaccine conferred 60% protection. If the vaccination trial included a representative proportion of HIV positive adult South Africans, it may mean that its effectiveness for this vulnerable segment is very low.

“The higher efficacy of the vaccine in the UK than in South Africa is because the variants circulating in SA are less sensitive to vaccine induced immune responses,” said Professor Shabir Madhi, Executive Director of the Vaccines and Infectious Diseases Analytics Research Unit (VIDA) at Wits, and principal investigator in the Novavax COVID vaccine trial in SA.

“Nevertheless, the 60% reduced risk against Covid-19 illness in vaccinated individuals in South Africans underscores the value of this vaccine to prevent illness from the highly worrisome variant currently circulating in South Africa, and which is spreading globally. This is the only Covid-19 vaccine for which we now have objective evidence that it protects against the variant dominating in South Africa.”

Novavax is pressing ahead with a trial involving 30 000 participants in the United States and Mexico, and has shared data with the UK’s pharmaceutical regulator. It is not clear whether the data from the US and Mexico trial will be required before the vaccine receives approval there. Meanwhile on Friday, the Johnson & Johnson vaccine developed by its subsidiary Janssen has been shown to be 66% effective. It is a single dose vaccine with minimal refrigeration requirements, making it very important for the logistical challenge of vaccinations in developing countries. Since Aspen would be producing some of the doses locally, the SA government had been in talks with Johnson & Johnson to secure some of those vaccines for SA use. However, there are signs that it too is less effective against the B.1.351 variant.

Source: Business Insider

Categories : COVID PoliticsTags :

EU Demands AstraZeneca Vaccine Produced by UK Plants

On By ModernMedia

In another twist to the EU’s seemingly never-ending vaccine procurement problems, the EU health minister has demanded that vaccine production from AstraZeneca’s UK operations be sent to EU countries to make up for the company’s shortfall at its two European plants. 

EU health commissioner Stella Kyriakides dismissed AstraZeneca’s argument that it the UK take precedence.

“We reject the logic of first come, first served,” the commissioner declared. “That may work at the neighbourhood butcher’s [shop] but not in contracts and not in our advanced purchase agreements. There’s no priority clause in the purchase agreements.”

The Anglo-Swedish company had triggered fury in Brussels when it was revealed that it would only be able to deliver 25% of the agreed vaccine doses when they received approval as expected this Friday. However, AstraZeneca assured the UK government that it would meet its commitment of supplying 2 million doses a week. UK government sources insisted that only once AstraZeneca had fulfilled its order to provide the UK with 100 million doses would its vaccine production be allowed to be released to serve other countries.

The EU meanwhile is flagging far behind, with only 2% of its adult population vaccinated compared to 10% of the UK’s. Kyriakides pointed out that in its contract with AstraZeneca, four European plants were listed as suppliers and two of those were located in the UK, and she expected them to work for EU citizens.

An AstraZeneca spokesperson said: “Each supply chain was developed with input and investment from specific countries or international organisations based on the supply agreements, including our agreement with the European commission.

“As each supply chain has been set up to meet the needs of a specific agreement, the vaccine produced from any supply chain is dedicated to the relevant countries or regions and makes use of local manufacturing wherever possible.”

Kyriakides said the argument was unacceptable, emphasising that the company had a moral duty to treat the EU similarly to the UK, adding that there was no “priority clause” that would justify UK residents benefiting first from doses made there.

Germany meanwhile has said that it is facing 10 weeks of vaccine shortage.
However, there is encouraging news as Israel reported a 92% effectiveness with the Pfizer/BioNTech vaccine outside trials. Only 31 of 163 000 Israelis caught COVID within ten days of the innoculation reaching its full strength. None were hospitalised.

Source: The Guardian

Categories : COVIDTags :

Six Key Takeaways of SA’s Vaccination Programme

On By ModernMedia

From a webinar held by the Department of Health late Wednesday night, there are six key points that were learned about the government’s vaccination programme.

1: To receive a vaccine, people will need an internet connection, cellphone and an ID. The internet connection is needed for self-enrolment on the Electronic Vaccine Data System (EVDS), and the cellphone is needed to receive an SMS detailing the time and place for vaccination. An ID book is required for identification. After the second vaccination (if a two-dose vaccine), an “electronic vaccination certificate” can be accessed from the EVDS. No mention was made of alternatives for those without ID books or internet access to the EVDS.

2: Private doctors and nurses will be paid R50 to R60 per shot administered. However, the government would prefer to use public healthcare facilities wherever possible.

3: Medical aids will pay double or triple for the vaccine doses. As reported in early January, medical aid schemes will pay for some of the costs of achieving herd immunity. The single exit price (SEP) of vaccines will be higher. Whether medical aids cover the number of additional doses for uninsured people at 1:1 or 2:1 is yet to be determined.

4: Mines have significant vaccination capacity – assuming they have enough doses on hand. The head of health for the Minerals Council, Thuthula Balfour, explained: “We’ve actually worked out that the industry can administer about 60 000 to 80 000 vaccines a day, so within two months we could vaccinate between 2.5 million to 3 million people.” This would equate to some five extra people per mineworker.

5: Rural clinics without generators will not receive vaccines. The distribution will use a hub-and-spoke model with hubs that are able to guarantee security and available electricity receiving vaccine stocks.

6: The auditor-general is already involved, to forestall corruption. Health Minister Zweli Mkhize said that “all the approaches that we’re taking to make sure that at the end of it they can give us a sense of checks and balances they are going to suggest as we deal with the risks associated with this process.”

Source: Business Insider

Categories : COVIDTags :

Sceptical South Africans Want More Vaccine Info

On By ModernMedia

Professor Carin Runciman, Director of the Centre for Social Change at UJ, has said that most people who are sceptical about COVID vaccines simply want more information. 

An online survey of 10 000 South African adults conducted with the Human Sciences Research Council showed that 67% were likely to take the vaccine if it were offered to them. Runciman said that many of the participants had indicated that they wanted more information before they could decide to take it.

Government and scientists came for criticism recently for giving mixed messages about vaccines, which are a few days away from their first rollout in South Africa. With the first million doses arriving in SA from the end of January, an ambitious target of 31 000 vaccinations a day has been announced, though with few firm details. The majority (70%) of the vaccines are to be AstraZeneca, although given their delays in supplying the EU and the bloc’s subsequent restrictions on vaccine exports, that may impact on SA’s vaccination programme.

Opinions also differed according to age and race. In a very strange result, those with higher levels of education were less likely to want to take a vaccine than those with a lower level. Age and race also played a factor, although no explanation was offered for the discrepancy. “Black African adults were more likely to want to take the vaccine – 69% for black African adults, 55% for white adults – those who [are] older are more likely to want to take the vaccine compared to those that are younger. Those that have a less than matric education are much more likely to want to take the vaccine than those with a tertiary education.”

Source: Eyewitness News

Categories : COVIDTags :

EU to Restrict AstraZeneca Exports to Tackle Vaccine Shortage

On By ModernMedia

In response to AstraZeneca’s COVID vaccine production and delays, the European Union has warned that it will tighten exports of the company’s vaccine to countries outside its borders.

EU Health Commissioner Stella Kyriakides warned it would “take any action required to protect its citizens”, adding that she had requested detailed delivery schedules and a meeting next week with the company. She added that “in the future, all companies producing vaccines against Covid-19 in the EU will have to provide early notification whenever they want to export vaccines to third countries”.

The vaccine, developed by Oxford University and the British-Swedish company AstraZeneca, is still yet to be approved in the EU but should receive it by the end of January, with distribution set to start on the 15th of February. The EU has been suffering from a number of vaccination programme setbacks, including a previous announcement last week from Pfizer that its own deliveries were being delayed in order to upgrade manufacturing capabilities at a plant in Belgium, provoking ire amongst EU politicians. Italy’s PM has resigned over handling of the pandemic.

The EU had signed a deal in August to secure 300 million doses from AstraZeneca, with an option for another 100 million. Last week, AstraZeneca had announced a slowdown in delivery due to “reduced yields at a manufacturing site within our European supply chain”. The problem is thought to be from a manufacturing plant also in Belgium, which is run by an AstraZeneca partner firm. The exact size of the shortfall is not known but some believe it to be a drop of 31 million doses, or 60% of those meant to be delivered by the end of the quarter.

Where this leaves low and middle-income countries counting on the Oxford/AstraZeneca vaccines is unclear, but it certainly will add to mounting tension between countries seeking vaccines for their populations amidst the spread of more contagious COVID variants. President Cyril Ramaphosa warned in an address to the World Economic Forum that vaccine nationalism was a growing concern and threat to global recovery. The African Union’s vaccine task team has thus far managed to secure only 270 million doses.

Source: BBC News

Categories : COVID Immune SystemTags :

NSAIDs Suppress Antibodies in COVID Infections

On By ModernMedia

A new study has found that non-steroidal anti-inflammatory drugs (NSAIDs) suppress antibody counts as well as inflammatory levels in mice infected with the SARS-CoV-2 virus.

NSAIDs inhibit the enzymes cyclooxygenase-1 (COX-1) and cyclooxygenase-2 (COX-2), which are needed for prostaglandin generation – lipid molecules involved in homeostasis and inflammation. The study used ibuprofen and meloxicam in mice infected with SARS-CoV-2. The researchers aimed to observe: viral infection through modified expression of angiotensin-converting enzyme 2 (ACE2), the cell entry receptor for SARS-CoV-2, effects on viral replication and modulated response of the immune system. However, they did not observe altered viral infection or replication.

“NSAIDs are arguably the most commonly used anti-inflammatory medications,” said principal investigator Craig B Wilen, Assistant Professor of Laboratory Medicine and Immunology, Yale University School of Medicine.

As well as taking NSAIDs for chronic conditions, eg arthritis, people take them “for shorter periods of time during infections, and [during] acute inflammation as experienced with COVID-19, and for side effects from vaccination, such as soreness, fever, and malaise,” Dr Wilen explained.

“Our work suggests that the NSAID meloxicam dampens the immune response to SARS-CoV-2 infection. Taking NSAIDs during COVID-19 could be harmful or beneficial, depending on the timing of administration,” said Dr Wilen. Dexamethasone, a potent anti-inflammatory but not an NSAID, is detrimental when administered at early stages of COVID but beneficial at later stages. NSAIDs may similarly be detrimental at the early stage because they counteract beneficial inflammation.

An antibody reduction by NSAIDs might not be harmful, but it could also reduce the immune system’s ability to mount a defence early on, or even reduce the length or magnitude of immunity or vaccination protection, Dr Wilen said. Antipyretics such as paracetamol have also been observed to blunt immune system response to vaccination.  

According to Dr Wilen, the original motivation from the study “was a twitter thread, suggesting NSAIDs should not be used during COVID-19. This seemed suspicious to us, so we wanted to investigate.”

Dr Wilen and his team believed there would be no effect of NSAIDs on viral infection, which turned out to be correct. However, they also thought there would be no effect on antibody response.

“In fact, we initially didn’t even carefully look at the antibody response, because we didn’t expect it to be altered by NSAIDs. This turned out to be wrong,” commented Dr Wilen.

Source: Medical Xpress

Journal information: Jennifer S. Chen et al. Non-steroidal anti-inflammatory drugs dampen the cytokine and antibody response to SARS-CoV-2 infection, Journal of Virology (2021). DOI: 10.1128/JVI.00014-21

Categories : COVID Immune SystemTags :

New “Double Antibodies” can Treat COVID Variants

On By ModernMedia

A new generation of “double antibodies” has been developed which can protect against all SARS-CoV-2 variants, as well as inhibiting mutations against the antibodies.

These “bispecific”  antibodies were created by the Institute for Research in Biomedicine (IRB; Bellinzona, Switzerland), which is affiliated to the Università della Svizzera italiana (USI).

While traditional antibody-based immunisation is able to offer protection against SARS-CoV-2, there is still a need to protect against variants which may achieve “vaccine escape”, as well as inhibiting mutations which give rise to resistance, as with antibiotic resistance in bacteria.

The researchers overcame these difficulties by splicing together a pair of antibodies to make a “bispecific” antibody that simultaneously targets two viral sites. The bispecific antibody treatment has proved effective in mouse models, which maintained body weight when infected with SARS-CoV-2, compared to infected controls, which lost 20-30% body weight before humane euthanisation. The paper is available on the bioRxiv preprint server.

Study author Luca Varani of USI explained: “We exploited our knowledge of the molecular structure and biochemical traits of the virus to fuse together two human antibodies, obtaining a single bispecific molecule simultaneously attacking the virus in two independent sites critical for infectivity. Supercomputing simulations allowed us to refine and validate the bispecific antibody design, which was later produced and tested in the laboratory. Although the virus can mutate and escape from the attack of a single first-generation antibody, we have shown that it cannot do so against the double action of the bispecific.

“A single injection of the bispecific antibody provides instantaneous protection against the disease in pre-clinical trials. The antibody effectively reduces viral burden in the lungs and mitigates inflammation typical of COVID-19”, said Daniel Ruzek from the Czech Academy of Sciences who led the antibody pre-clinical testing.

The effectiveness of the bispecific antibodies holds promise for human clinical trials, with the prospect of being both an effective prevention and treatment of COVID.

Source: News-Medical.Net

Journal information: Gasparo, R D., et al. (2020) Bispecific antibody prevents SARS-CoV-2 escape and protects mice from disease. bioRxiv.doi.org/10.1101/2021.01.22.427567.

Categories : COVID T-cellsTags :

Severe COVID May Lead to Stronger Immunity

On By ModernMedia

Researchers from La Jolla Institute for Immunology (LJI), The University of Liverpool and the University of Southampton have discovered that the degree of COVID severity appears to be linked to how long-lasting and strong the subsequent immunity is. 

“The data from this study suggest people with severe COVID-19 cases may have stronger long-term immunity,” said study co-leader LJI Professor Pandurangan Vijayanand, MD, PhD.

The research examines T-cells from COVID infections in unprecedently high detail.

“This study highlights the enormous variability in how human beings react to a viral challenge,” added co-leader Christian Ottensmeier, MD, PhD, FRCP, a professor at the University of Liverpool and adjunct professor at LJI.

Vijayanand and Ottensmeier have been studying how antibodies and the different subsets of T-cells control COVID disease severity. In this study, they examined CD8+ T-cells, which are the T-cells responsible for destroying virus-infected cells, and “memory” CD8+ T-cells are also important for guarding the body against reinfections of the same virus. These memory T-cells are poised to rapidly proliferate and engage their cell-destroying functions on subsequent antigen encounters. They can reside in peripheral organs and their memory can also be shaped by infection history.

Utilising a new technique called single-cell transcriptomics analysis, they were able to study expressions of individual genes of 80 000 CD8+ T-cells drawn from 39 COVID patients and from 10 non-exposed donors, whose blood samples had been taken before the pandemic. Of the COVID patients, 17 cases were mild and non-hospitalised, 13 were hospitalised and 9 had required ICU care.

Surprisingly, the researchers found that the strongest CD8+ T-cell responses were from those with the more severe form of the disease, and not the milder cases.”There is an inverse link between how poorly T cells work and how bad the infection is,” observed Ottensmeier. “I think that was quite unexpected.” A stronger response would be expected from CD8+ T-cells in mild cases due to having the resources of a better functioning immune system. However, the mild group of CD8+ T-cells showed signs of “exhaustion”, which happens when the immune system overloads the T-cells, causing them to lose effectiveness.

The researchers believe that it will be beneficial to study whether this phenomenon may hinder the ability to build long-term immunity.

“People who have severe disease are likely to end up with a good number of memory cells,” said Vijayanand. “People with milder disease have memory cells, but they seem exhausted and dysfunctional—so they might not be effective for long enough.

“What the researchers would like to look at next is to look at T-cells from lung tissue as opposed to blood samples, because that is where the infection hits hardest.

“This study is very much a first step in understanding the spectrum of immune responses against infectious agents,” said Ottensmeier. The researchers will also look at T-cells in cancer patients who are also infected with COVID.

Source: Medical Xpress

Journal information: Anthony Kusnadi et al, Severely ill COVID-19 patients display impaired exhaustion features in SARS-CoV-2-reactive CD8+ T cells, Science Immunology  21 Jan 2021: Vol. 6, Issue 55, eabe4782 DOI: 10.1126/sciimmunol.abe4782

Categories : COVIDTags :

Biden’s Promise to “Manage the Hell” out of COVID

On By ModernMedia

Almost immediately upon assuming office, the newly sworn-in President Joe Biden started to deliver on his promise to tackle the COVID pandemic raging in the United States.

On Wednesday, shortly after being sworn in, he wrote to both the United Nations Secretary General and the WHO Director General to notify them of the United States’ return to the WHO – a move no doubt welcomed around the world. He also began to sign a raft of orders related to the COVID pandemic.

Following up on his promise to “manage the hell” out of the COVID pandemic, President Biden signed a directive which “seeks to support the international health and humanitarian response to the COVID-19 pandemic and its secondary impacts, global health security and diplomacy, and better biopreparedness and resilience for emerging and future biological threats.”

His actions and executive orders include:– Increased equipment procurement. Using the Defense Production Act (DPA) to accelerate manufacturing and meet shortfalls in COVID-related equipment and supplies.
– Increased COVID testing. Another order establishes a testing board to help expand the supply of tests and testing equipment, as well as supporting the public healthcare force.
– Increasing studies on COVID-19 treatments. More studies requested on COVID, as well as on COVID in diverse populations. Also requests more healthcare workers.
– Speeding up vaccinations. Federal Emergency Management Agency (FEMA) is directed to begin deploying vaccination centres, aiming toward a goal of 100 in the next month.
– Reopening schools and businesses. The Departments of Education and Health and Human Services (HHS) are directed to provide guidance on safe reopening and operating for education institutions and child care providers.
– Improving protections for workers. Clear guidance for employers to keep employees safe from COVID exposure.
– Increasing travel safety. Masks are to be worn in federal buildings, and mask requirements are extended to interstate travel, including on planes, trains, and buses. People flying into the US from another country will need to test negative for COVID prior to departure and quarantine upon arrival.

President Biden’s plan and the full texts of the executive orders were detailed in a 200 page document which was made available on Thursday.

At a White House signing ceremony, he affirmed his commitment to “following the science” on COVID, saying: “We will make sure that scientists and public health experts will speak directly to you — not the president, but real, genuine experts and scientists.” He added that they will work free of political interference.

He also warned Americans of a “dark winter” ahead, and the nation was in a national emergency and that “we should treat it like one.”

Source: MedPage Today

Categories : COVID Expert OpinionTags :

UCT Expert Talks COVID and Warns of Third Wave

On By ModernMedia

If South Africa does not pursue a rapid vaccination programme to achieve herd immunity, it may face a third wave as a consequence, warned a leading local expert.

Professor Marc Mendelson of UCT’s Division of Infectious Diseases and HIV Medicine at Groote Schuur Hospital made these statements while speaking during a virtual Summer School lecture on Saturday, titled “COVID-19 Insights and Lessons”.

“Without rapid vaccination of at least two thirds of the population, we [South Africa] are not going to get to population immunity, and without that, we will see another wave,” Mendelson warned.

However, he emphasised that much had been accomplished in the battle against COVID. “It is associated with a scientific endeavour that we have never seen before. We’re definitely better off a year down the line, but there are a huge number of things that we need to answer. As a country we still face deep problems with severe issues around vaccine strategy, and we haven’t even talked about vaccine denial,” he said.

Criticism has been directed at the South African government because of its failure to start a vaccination programme, despite its huge case load and status as Africa’s most wealthy nation. A leaked phone call from a Pfizer executive has only added to this, as it was revealed that for months SA health officials had not been responding to requests for vaccine discussions.

Regarding COVID transmission, he said that the virus resided in the upper respiratory tract as well as the lungs, and that it could be expelled in aerosol droplets. The clinical and epidemiological evidence suggested that larger, heavier droplets carried the virus.

“The household infection rates were high. A very large number of cases, the vast majority [in fact], were within families in close proximity [to one another]. This, epidemiologically, suggests that large droplets play a role in transmission.

“If you want to reduce transmission from large droplets, then you need to increase the distance you are from someone. Also, because droplets drop onto surfaces … you will need to clean surfaces and wash your hands well. This is the science behind the use of masks, handwashing, social distancing and ventilation.”

However, he added that a number of studies had found the virus in remote corners of hospitals at a distance from patients, suggesting that it had been carried there by smaller, aerosolised particles.

“If you want to reduce aerosols, one way of doing that is to improve ventilation. The more the air is changed, the [quicker] it will dilute small droplets,” he said.

Source: University of Cape Town