News Scan for Jun 24, 2022

Fourth Pfizer dose effective against severe COVID-19 in nursing homes

A study yesterday in JAMA Internal Medicine shows that a fourth Pfizer COVID-19 vaccine dose provided 64% to 67% protection against hospitalization and 72% protection against death in nursing home residents, but only 34% protection against infection during an Omicron-dominated period.

The Israeli study was based on 24,088 recipients of a fourth dose of vaccine and 19,687 who had received a third dose only (4 months previously or earlier). All study participants were residents in long-term care facilities (LTCFs) and were aged 60 years or older. The study took place from Jan 10 to Mar 31, 2022, when Omicron was the predominant circulating strain.

During the study follow-up period of more than 1 week post vaccination, SARS-CoV-2 infection was detected among 4,058 fourth-dose recipients compared to 4,370 third-dose recipients (cumulative incidence, 17.6% vs 24.9%), the authors wrote.

The adjusted protections were 34% (95% confidence interval [CI], 30% to 37%), 64% (95% CI, 56% to 71%), and 67% (95% CI, 57% to 75%) against COVID-19 infection, hospitalization for mild-to-moderate illness, and hospitalization for severe illness, respectively, and 72% (95% CI, 57% to 83%) against related deaths.

“The results of this cohort study suggest a strong association of receipt of a fourth BNT162b2 dose with increased protection compared with 3 doses administered 4 months previously or earlier among LTCF residents against COVID-19 hospitalizations and deaths during the Omicron surge in Israel,” the authors concluded. “The fourth dose was also associated with a moderate degree of protection against overall SARS-CoV-2 infection.”
Jun 23 JAMA Intern Med study

CDC recommends Moderna COVID vaccine for children 6 to 17

The Centers for Disease Control and Prevention’s (CDC’s) Advisory Committee on Immunization Practices (ACIP) yesterday voted unanimously to recommend Moderna’s COVID-19 vaccine for children ages 6 to 17, and the CDC today followed suit.

The Food and Drug Administration authorized the vaccine for that age-group last week. The ACIP vote was 15-0, according to CNN. The vaccine is already recommended for adults.

In a statement, the CDC said, “This recommendation reinforces the use of Moderna’s COVID-19 vaccine as an important tool in the pandemic and provides another vaccine option for children and adolescents. The ACIP recommendation comes after a thorough review of the scientific evidence demonstrating safety and efficacy.”

CDC Director Rochelle P. Walensky, MD, MPH, added, “It is critical that we protect our children and teens from the complications of severe COVID-19 disease.… Vaccinating this age group can provide greater confidence to families that their children and adolescents participating in childcare, school, and other activities will have less risk for serious COVID-19 illness.”

In related news, the Biden administration yesterday rolled out free at-home COVID-19 tests designed for those who are visually impaired, CNN reports

The United States reported 121,315 new COVID-19 cases yesterday and 507 deaths, according to the Johns Hopkins COVID-19 tracker. The 7-day average of new daily cases is 96,428, with 301 daily deaths, according to the Washington Post tracker. And the Department of Health and Human Services Protect Public Data Hub shows 31,976 inpatient beds in use for COVID-19. 

The CDC COVID Data Tracker shows that 66.9% of Americans are fully vaccinated against COVID-19, 78.1% have received at least one dose of vaccine, 47.3% of those eligible have received their first booster dose, and 26.1% of those eligible have received their second booster dose.
Jun 23 CNN story
Jun 24 CDC statement

Pakistan reports wild-type polio cases; vaccine-derived polio elsewhere

The Global Polio Eradication Initiative (GPEI), in its weekly update, reports 2 new wild poliovirus type 1 (WPV1) cases in Pakistan, along with 15 new circulating vaccine-derived poliovirus type 2 (cVDPV2) cases in the Democratic Republic of the Congo (DRC) and 5 cVDPV2 cases in Yemen.

In addition, the World Health Organization (WHO) yesterday reported more details on a WPV1 case in Mozambique that is genetically linked to a strain detected in Pakistan and similar to a case of WPV1 reported in Malawi in February.

The WPV1 cases in Pakistan were both in Khyber Pakhtunkhwa province and bring the number of 2022 cases to 10. The country confirmed 1 WPV1 case in all of 2021. It also has had 8 cVDPV2 cases in 2022.

Of the 15 cVDPV2 cases in the DRC, 12 are in Maniema province, 2 in Sud-Kivu, and 1 in Tanganyika. The number of 2022 cases now stands at 63. The country saw 28 cases in 2021. “The outbreak is affecting primarily the east of the country, and the risk of further expansion of the outbreak is compounded by a significant number of zero-dose children in the area,” the GPEI said.

Yemen reported 2 cVDPV2 cases in Saadah governorate and 1 each in Dhamar and Hajjah governorates and in Sanaa City. The country has now reported 45 cVDPV2 cases in 2022. The affected areas are also undervaccinated, the GPEI said.

The case in Mozambique involves a 12-year-old girl who had onset of paralysis on Mar 25. The WHO first noted the case, the country’s first in 30 years, on May 18. The girl is from Changara district in Tete province, which borders Zimbabwe and Malawi. Her samples were confirmed to be WPV1 by the National Institute for Communicable Diseases in South Africa on May 14. The child had previously received three doses of bivalent (two-strain) oral poliovirus vaccine but not the newer inactivated poliovirus vaccine.

The WHO said, “The risk of international spread, particularly across the South East region of Africa, remains high, due to persisting sub-optimal immunity and surveillance gaps, and large-scale population movements.”
Jun 23 GPEI update
Jun 23 WHO notice
Feb 18 CIDRAP News scan on Malawi case