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COVID Vaccinations for Those Who Have Recovered?

On By ModernMedia

As mass COVID vaccination programmes get underway around the world, an Op-Ed in MedPage Today debates whether people who have recovered from COVID should receive a vaccination.

Even given that there are over 200 vaccines in development, with a typical 7% success rate for vaccines, the 80-95% efficacy reported for the various vaccines being administered and the numbers of successful vaccines is a great outcome. Despite this, considering the great difficulty in producing enough vaccines for the world, should perhaps people who recovered from COVID not receive the vaccine, as they now are protected by a level of immunity?

The perspectives of immunology and bioethics indicate why such a person should also be vaccinated. There would be no difference in vaccinating a person who has had COVID to a person who has recovered then been re-exposed or re-infected. In both cases, a rapid immune response will be mounted in either individual, and either will be asymptomatic or present with mild, manageable symptoms. A re-exposure to the SARS-CoV-2 virus or receiving a vaccine might strengthen such a person’s immunity to future COVID infections.The immune system maintains an immunological library in our lymphatic system which stores memory lymphocytes (B cells) that respond to any past infection encountered by an individual. On a second or third exposure to a particular pathogen, these B cells are mobilised and rapidly prevent re-infection. Vaccines are designed to mimic a viral exposure without eliciting a dangerous viral infection. B cells don’t cause illness, only prompting the immune system, mitigating the infection.
Furthermore, vaccinations confer additional protections beyond just that of the disease which they are meant to protect against. There are abundant data that shows that vaccinations against measles, influenza, or TB generate lymphocytes that even help protect vaccinated individuals against COVID. In one theory on why young children do not present with severe COVID, standard childhood vaccinations are believed to  boost their overall level of immunity.

With so many factors complicating vaccine administration, it is best not to add yet another wrinkle, and there is also no information to suggest that vaccinating someone who has recovered from a virus will cause harmful effects. On the contrary, re-exposure to a virus or a subsequent vaccination against that virus could generate superior lymphocytes to combat further infection.

Source:MedPage Today

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New Year Sees SA Hospitals Battling for Resources Amid COVID Surge

On By ModernMedia

As the new year begins, South African hospitals are struggling as unprecedented numbers of COVID cases in the second wave are pushing resources to the limit. Hospitals are having to cope with the situation even as their own workers are off sick or self-isolating.

Last week, at least one province was reported to have reached out to the army to request additional personnel to help cope with the additional burden. Wester Cape premier Alan Winde said the province was recruiting an additional 1 300 health care workers (HCWs)In a weekly media briefing, KwaZulu-Natal premier Sihle Zikalala stated on Sunday that a total of 8 723 public sector HCWs had been infected with COVID since the start of the pandemic.

“Of the total infected, 98 have sadly succumbed to the disease. The majority of the infected health-care workers are nurses,” he said. HCWs are also struggling with burnout and illness.  Experts had long been predicting the impact the second wave would have on South Africa’s already weakened health infrastructure. As of Sunday, 3rd January, there were a total of 167 492 active cases in the country.  

Dr Kams Govender, who works west of Durban, said: “What we are experiencing now is just the tremor, the tsunami is yet to come in mid January. It’s hit us hard and it’s going to hit us even harder then. We are physically and emotionally exhausted, and worse, losing our health-care colleagues every single day. But still we push on and show up and pray for better days where there is more light than darkness.”

The hospital at Prince Mshiyeni Memorial Hospital (PMMH) in Umlazi, KZN, was reported to be full and bodies had to be taken to funeral homes within 48 hours.

One nurse at PMMH said, “The hospital is full, the Covid wards are full, the normal wards are full. There are no beds for our outpatients, they lie in the passage on stretchers waiting for beds. The Covid patients will be placed with one another in a consultation room. We try to separate them but it’s not a proper place for patients to be in because there are no beds, just the stretchers. We are running out of oxygen points because there are so many patients that need oxygen. We tend to prioritise who needs it more, but right now everyone needs it.”
Source: Sowetan Live

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WHO Team Barred from Entry into China

On By ModernMedia

According to the World Health Organization, its team sent to China to investigate the origins of COVID were denied entry.

Conveying his disappointment at the team being barred from entry into China due to visas not being issued, WHO Director-General Tedros Adhanom Ghebreyesus said, “today, we learned that Chinese officials have not yet finalized the necessary permissions for the team’s arrival in China.”

Addressing the media in Geneva, he continued, “I’m very disappointed with this news, given that two members had already begun their journeys and others were not able to travel at the last minute, but had been in contact with senior Chinese officials.”

“But I have been in contact with senior Chinese officials. And I have once again made it clear that the mission is a priority for WHO and the international team.” He added, “We are eager to get the mission underway as soon as possible.” 

The experts were to investigate the origins of the SARS-CoV-2 virus in Wuhan.  The team of 10 will be led by Peter Ben Embarek, WHO’s expert on zoonoses – diseases that cross over the species barrier into humans from animals.

Dr Michael Ryan, the emergencies chief at WHO, said the understanding was that the team would begin the deployment from Tuesday, and that two of its members had begun travelling to China, with one member already turned back due to visa issues while the other was still in transit.

“We did not want to put people in the air unnecessarily if there wasn’t a guarantee of their arrival in China being successful,” said Ryan. “Dr Tedros has taken immediate action and has spoken with senior Chinese officials and has fully impressed upon them the absolute critical nature of this.”
“We hope that this is just a logistical and bureaucratic issue that can be resolved very quickly,” he continued.

According to the The Financial Times, Hua Chunying, the Chinese foreign ministry spokesperson, on Wednesday said, “Tracing the source [of the virus] is a complicated issue. To ensure that the international team’s work progresses smoothly, they must go through the necessary procedures.”

Source: The Independent

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A New Initiative to Boost Advanced Therapy Medicinal Products Development

On By ModernMedia

The University of Sheffield in concert with pharmaceutical giant Pfizer, has announced the creation of a new consortium to help accelerate the development of Advanced Therapy Medicinal Products (AMTPs), enabling radical new treatments such as gene therapy to reach patients sooner.

The Accelerating Research and Innovation for Advanced Therapies (ARDAT) consortium will bring together 34 academic, nonprofit and private organisations from across Europe and the United States. They will bring their expertise to bear on a €25.5 million project to accelerate ATMP development.

Rapid growth is expected in the AMTP field, with the submission of some 10-20 new drug applications annually to the FDA by 2025.
“While still an emerging field, ATMP research has largely been fragmented and siloed within organisations with little opportunity to share best practices and information,” said Dr Greg LaRosa, Head of Scientific Research, Rare Disease Research Unit at Pfizer.

“As gene and cell therapies research grows and more potential ATMPs move into later-stage clinical trials, it is in the interest of the industry and of patients to further our collective understanding of their mechanisms by sharing data and regulatory expertise.”

Source: University of Sheffield

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COVID Risks Resurgence of a Tropical Disease

On By ModernMedia

In an article on The Conversation, Raphael Taiwo Aruleba, a PhD in the Department of Molecular and Cell Biology, University of Cape Town, writes that COVID is causing a dangerous setback for the battle against preventable diseases, potentially leading to the resurgence of a particular tropical disease.

One of these is the tropical disease leishmaniasis, which is caused by a parasite transmitted by sandflies in environments with open sewage. It can cause disability, social stigma and death.

Aruleba believes that COVID has reversed the progress against  leishmaniasis by ten years. Prevention is focused on controlling the insect disease vector with surveillance, insecticides and nets. However, COVID has made it difficult for researchers to assess areas and for routine spraying to be done, and resources have been diverted to fight COVID. Only 0.6% of the WHO’s research budget is for leishmaniasis.

The Leishmania parasite and SARS-CoV-2 are also potentially co-infectious, exacerbating one another. Aruleba concludes that other diseases should not be neglected in the fight against COVID.

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SA Currently Without Access to Pfizer/BioNTech’s “90% Effective” Vaccine

On By ModernMedia

Despite taking part in a recent successful vaccine trial, South Africa does not have guaranteed access to it. South Africa missed out on the first deadline to take part in the WHO-backed COVAX scheme, but is currently understood to be negotiating with COVAX and manufacturers.

Early results from the Pfizer/BioNTech two-dose vaccine’s trial showed a 90% reduction in symptomatic COVID cases over placebo, and caused a media sensation. 800 South African participants are to take part in the trial.

“This is a massive development. It’s very exciting, and the interim results are very promising. It leaves me with lots of hope as this could pave the way for a vaccine to be developed before the end of the year,” said Dr Essak Mitha, the head of the South African arm of the clinical trial who is a clinical trial specialist and owner of Newtown Clinical Research in Johannesburg.

The news was met with some caution; the decision to announce the news via a company press release instead of a peer reviewed article was controversial.

The BioNTech vaccine is based around messenger RNA (mRNA). The mRNA in the vaccine carries viral proteins, and once introduced into the body’s cells, instructs them to make copies of viral proteins. One such protein coded for is the infamous “spike” protein that SARS-CoV-2 uses to latch onto cells, and which contributes to its high infectivity. 

Source: AllAfrica

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Exenatide and Dapagliflozin Outlast Metformin for Diabetes Treatment

On By ModernMedia

An AstraZeneca-funded trial called DURATION-8 has shown a viable alternative for metformin with a combination of two medications, exenatide and dapagliflozin.

The standard treatment for type 2 diabetes is metformin, but for many patients it loses its effectiveness over time. To get around this, a combination of exenatide (a glucagon-like peptide-1 receptor agonist) and dapagliflozin (sodium-glucose cotransporter-2 inhibitor) was trialled.

Originally a 28 week trial, DURATION-8 was extended to 52 weeks on the strength of its initial results.

“Many therapies in diabetes management are short-lived, which is why it is useful to test for long-term effect,” says first author Dr Serge Jabbour, director of the division of endocrinology and the Diabetes Center at Thomas Jefferson University.

The trial, with 695 participants, compared the two medications, either individually with a placebo or in combination. The combination group saw the greatest drop in glycated hemoglobin (HbA1c) levels. This was accompanied by drops in systolic blood pressure and body weight.

The authors note the need for a follow-on study to determine if there were protective effects against cardiovascular and renal events with the combination.

Source: Medical News Today

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Discovery of New Genetic Targets for Endometriosis Treatment

On By ModernMedia

Endometriosis can be a debilitatingly painful disease which can lead to infertility, and has few treatment options for more severe forms – but new treatment options are unfolding as genetic targets for drugs are discovered.

Jake Reske, a graduate student in the MSU Genetics and Genome Sciences Program, explains: “There haven’t been many successful nonhormonal therapies for this form of endometriosis that have made it to the bedside yet.”

Some severe forms of endometriosis involve a gene called ARID1A. A mutation in this gene triggers “super-enhancer” DNA which in turn allows cells to run rampant and set up outside the uterus, causing great pelvic pain.

The researchers aim to implement a novel treatment, “epigenetic therapy”, to prevent the cells from running rampant. 

“It can seriously impact women’s quality of life and their ability to have a family and work,” said study supervisor Ronald Chandler, an assistant professor of obstetrics, gynaecology and reproductive biology. “It’s not easy to treat, and it can become resistant to hormone therapy. The most clinically impactful thing we found is that targeting super-enhancers might be a new treatment for this deeply invasive form of the disease.”

The compound they used targeted protein called P300, which suppressed the super-enhancers and relieving the effects of the  ARID1A mutation. This could also possibly be applied to other forms of endometriosis. The researchers plan to look for more compounds that can also target the P300 protein.  

Source: News-Medical.Net

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Aspen Shifts to SA Production of COVID Vaccines

On By ModernMedia

Aspen Pharmacare has secured a deal to manufacture the Johnson & Johnson COVID vaccine, in an effort to adapt to the pharmaceutical market. 

Elective surgeries being deferred due to the pandemic has reduced demand for certain medications, and the company withheld dividends for the second year running in September. However, the company does produce some medications which are currently in demand due to COVID.

Dexamethasone, one of the medications Aspen has the rights to produce, is a key treatment for COVID patients, which according to a study done in June, reduces mortality by 30%. Colchicine is another medication used to treat COVID, normally used for gout.

Tavros Nicolaou, a senior Aspen executive, said in an interview: “In February, we looked at how we best respond to this looming disaster facing us and we split it into three buckets — what we can do at a therapeutic level, what can we do at a vaccine level and what can we do to generally help society.” This positioned them “globally as a company that had a multifaceted response to this pandemic.”

The pharmaceuticals company has invested R3 billion in a Port Elizabeth plant to manufacture the Johnson & Johnson COVID vaccine at a rate of 300 million per year, which will help supply the rest of Africa. The need for local COVID vaccines may come sooner rather than later.

Despite peaking in July, the country’s COVID pandemic is not yet over with at least two provinces seeing increases in cases again, while on the horizon a second surge is expected in January.

Source: Moneyweb

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HIV Prophylactic Injection 9 Times More Effective than Oral Administration

On By ModernMedia

According to The Citizen, researchers have reported that pre-exposure prophylaxis (PrEP) in the form of an injection once every eight weeks was 9 times more effective than a daily oral pill in preventing HIV contraction. The daily pill is currently the standard PrEP available to the public.

Dr Sinead Delany-Moretlwe, director of research at the Wits Reproductive Health and HIV Institute (Wits RHI), said, “We know that adherence to a daily pill continues to be challenging, and an effective injectable product such as a long-acting CAB [cabotegravir injection] is a very important additional HIV prevention option for them. We are grateful to the women who volunteered for this study and the research staff, as this study would not have been possible without their commitment to HIV prevention.”

The HIV Prevention Trials Network (HPTN) took place over several years, measuring the effectiveness of PrEP in preventing the contraction of HIV.  3223 cisgendered women with an average age of 26 were enrolled in the study in South Africa, Botswana, Eswatini, Kenya, Malawi, Uganda and Zimbabwe. The trial found that of 38 women who contracted HIV, four were receiving the injection while the remainder were using the oral pill.

Executive director of Wits RHI, Professor Helen Rees, said, “These results are a milestone for prevention of HIV among women at risk worldwide and especially for women in sub-Saharan Africa. If we are to turn the tide on the HIV epidemic, we will need prevention options that work for women in sub-Saharan Africa. These findings provide great hope and motivation for additional studies to show safety and acceptability in adolescents, pregnant and breastfeeding women.”

The game-changing medication will not be available to the public until further testing is completed.