Could mixing Covid vaccines boost immune response?

‘Vaccine developers often combine two vaccines to combat the same pathogen, and researchers are keen to deploy the strategy — known as a heterologous prime-boost — against the coronavirus. A heterologous prime-boost combination was approved last year by European regulators to protect against Ebola, and experimental HIV vaccines often rely on the strategy, says Dan Barouch, director of the Center for Virology and Vaccine Research at Beth Israel Deaconess Medical Center in Boston, Massachusetts. But it has yet to be tested for vaccines against COVID-19, which are typically given as a repeat injection of the same vaccine.

‘The ability to mix and match vaccines could make vaccination programmes more flexible: it would speed up the process and reduce the impact of any supply-chain disruptions. “It really makes the implementation much more simple,” said Mary Ramsay, head of immunization at Public Health England, at a press briefing on 3 February.’

Read here (Nature, Feb 4, 2021)

Political warfare, inequity, and insufficient data in coverage of the vaccine rollout

‘Ellen Ruppel Shell, a professor of science journalism at Boston University, told me yesterday that vaccine framing can be “schizophrenic—alarmism followed by sometimes misleading reassurance.” This is true, for example, of many stories warning about vaccines’ possible reduced efficacy against new variants of the virus, whose scary headlines often belie more nuanced expert assessments and key questions that have yet to be answered...

‘It’s hard to generalize, obviously, but it’s increasingly clear that much vaccine coverage is stuck in conventional journalistic rhythms that don’t serve the story well. Given that the pandemic is a “once-in-a-hundred-years event, it’s time for journalists to step back and think about what our priorities need to be,” Shell told me. “We don’t just take notes and put them out there. Almost every piece should have some analysis in it.” In the course of this reflection, we need to reckon, too, with the idea that vaccines may not be a magic bullet. Elena Conis, a science historian and journalism professor at Berkeley, told me yesterday that her biggest concern with vaccine framing is that “we have rushed to cover, talk, and think about vaccination all while failing to have much harder conversations about other things we can do to keep this epidemic in check.”

Read here (Columbia Journalism Review, Feb 3, 2021)

Pregnant women get conflicting advice on Covid-19 vaccines

‘Pregnant women looking for guidance on Covid-19 vaccines are facing the kind of confusion that has dogged the pandemic from the start: The world’s leading public health organizations — the U.S. Centers for Disease Control and Prevention, and the World Health Organization — are offering contradictory advice. Neither organization explicitly forbids or encourages immunizing pregnant women. But weighing the same limited studies, they provide different recommendations.’

Read here (New York Times, Feb 2, 2021)

CommuniVax: A coalition to strengthen the community’s involvement in an equitable vaccination rollout

‘CommuniVax is a national alliance of social scientists, public health experts, and community advocates who seek lasting solutions to a serious problem: in the United States, historically underserved Black, Indigenous, and Latino populations have endured negative health and economic impacts from the COVID-19 pandemic at tragic and disproportionate rates. While these communities could benefit greatly from safe and effective COVID-19 vaccines, longstanding biases and barriers hinder their access to and acceptance of vaccination.

‘The coalition is strengthening national and local COVID-19 vaccination efforts in the United States by putting communities of color at the center of those endeavors. The coalition is listening to Black, Indigenous, and Latino/Latinx individuals on how best to promote awareness of, access to, and acceptability of COVID-19 vaccines in their respective communities; and developing longstanding, local governance systems that enable underserved groups to exercise collective agency over their own health and wellness, during this pandemic and going forward. Funding for CommuniVax is provided by the Chan Zuckerberg Initiative.

‘CommuniVax relies on efforts from 3 groups: local teams, a central working group, and national stakeholders.

• Local Teams are composed of resident researchers, grassroots leaders, and public health implementers. They will engage local communities of color to identify improvements needed to vaccine delivery and communication strategies in their communities.
• The Central Working Group includes experts in public health, public policy, medical science, anthropology, and public involvement. With input from diverse stakeholders, the working group will coordinate the local research processes and ensure the implementation of findings nationwide
• National Stakeholders represent groups with political, technical, cultural, and social justice perspectives on vaccine delivery and uptake. These associations will amplify information generated from local teams within their networks and provide feedback to the central working group.

Read here (John Hopkins Center for Health Security, Feb 2021)

How influencers, celebrities, and FOMO [fear of missing out] can win over vaccine skeptics

‘Drawing from product innovation theory, Rohit Deshpandé and colleagues offer three recommendations to speed adoption of COVID-19 vaccines...

‘Governments are prioritizing certain groups to receive the vaccine, with medical professionals and certain government personnel at the top, followed by first responders and vulnerable populations, and then the general population. The diffusion of innovations model indicates that each of these groups will have five customer segments based on their willingness to get vaccinated earlier or later. For example, some medical professionals will be eager to get vaccinated early (the innovators, early adopters, and majority) while others will wait (the late majority and laggards).

‘So, how do we maximize the number of individuals in any prioritized group who are willing, if not eager, to get vaccinated as soon as possible?

‘The answer requires keen understanding of each segment, for example, of both the seniors in the early majority and the seniors that are laggards less keen on taking the vaccine. The diffusion of innovations research indicates that a combination of personal and societal factors influence the rate of adoption within and between segments factors, with the ultimate driver being word of mouth.

‘For the COVID-19 vaccine, the personal factors include people’s perceived efficacy and need for the vaccine, past immunization experiences, and opinions about vaccines more generally, along with those of their families.

‘Societal drivers include the advice of experts, media, and other influencers within their demographic, socioeconomic, and innovation adoption segment. Influencers will need to mitigate concerns about the “newness” of the vaccine, such as the probability of side effects and solutions when they occur. They will also need to reinforce the positive consequences of taking the vaccine, such as the ability to visit family, go to work, and have more entertainment options.’

Read here (Harvard Business School, Jan 29, 2021)

Why it takes 2 shots to make mRNA vaccines do their antibody-creating best – and what the data shows on delaying the booster dose

‘With current vaccine shortages, and problems with setting up the infrastructure to vaccinate millions of people, many physicians are concerned that the second dose of vaccine won’t be delivered in the prescribed three-to-four-week window.

‘That booster shot is necessary for the T-cells to stimulate the memory B-cells to produce massive quantities of antibodies. If the booster isn’t given within the appropriate window, lower quantities of antibodies will be produced that may not provide as powerful protection from the virus.’

Read here (The Conversation, Jan 29, 2021)

Pregnant women can pass antibodies to their foetus: Some implications for vaccinations

‘A study published in JAMA: Pediatrics provides evidence that pregnant women may be able to pass IgG antibodies against SARS-CoV-2 to their fetus. The study involved 1,417 women who recently gave birth. Among 83 mothers with detectable SARS-CoV-2 antibodies, 72 (86.7%) transferred IgG antibodies to their fetus—as detected in the newborns’ cord blood. IgM antibodies were not detected in any cord blood specimens, and antibodies were not detected in any infants born to mothers without detectable antibodies. The concentration of antibodies in the cord blood was significantly correlated with the concentration in the mother, but the antibodies were successfully transferred by mothers who exhibited symptomatic disease and asymptomatic infection. The study did not explicitly evaluate the ability to transfer antibodies developed as a result of vaccination; however, the researchers indicate that the results align with similar studies on transplacental transfer of vaccine-conferred antibodies for other diseases. Further research is necessary to determine the recommended timing for vaccination of pregnant women in order to achieve sufficient transplacental transfer of SARS-CoV-2 antibodies to the fetus.’ [John Hopkins Newsletter]

Assessment of maternal and neonatal cord blood SARS-CoV-2 antibodies and placental transfer ratios

‘Our findings demonstrate the potential for maternally derived antibodies to provide neonatal protection from SARS-CoV-2 infection and will help inform both neonatal management guidance and design of vaccine trials during pregnancy. Further studies are needed to determine if SARS-CoV-2 antibodies are protective against newborn infection; if so, at what concentration; and whether the transplacental kinetics of vaccine-elicited antibodies are similar to naturally acquired antibodies.’

Read here (Jama Pediatrics, Jan 29, 2021)

More than 85 poor countries will not have widespread access to coronavirus vaccines before 2023

• The rollout of vaccines against the coronavirus (Covid-19) has started in developed countries, but mass immunisation will take time. 
• Production represents the main hurdle, as many developed countries have pre-ordered more doses than they need. 
• The costs associated with mass immunisation programmes will be significant, especially for less-developed countries that have limited fiscal resources. 
• Vaccine diplomacy will play a role in determining which countries get access to a vaccine in the coming months. 
• Russia and China will use the rollout of their own coronavirus shots to advance their interests. 
• With priority groups vaccinated in rich economies by end-March, The EIU expects global economic prospects to brighten from mid-2021. 
• For most middle-income countries, including China and India, the vaccination timeline will stretch to late 2022. 
• In poorer economies, widespread vaccination coverage will not be achieved before 2023, if at all.

Read here (The Economist, Jan 27, 2021)

Is govt doing enough about Covid-19? – P Gunasegaram

‘The warning to manufacturers by the International Trade and Industry Ministry (Miti) reported over the weekend raises very serious questions on the handling of the Covid-19 pandemic. According to reports, Miti is involved in 99 of the more than 300 Covid-19 clusters in the country. This makes the manufacturing sector the main source of Covid-19 infections. Also, Miti indicated that there would be a shutdown/strict lockdown if Covid-19 numbers did not improve...

‘First, if indeed manufacturing is the main source of infections – it is no secret that cramped living quarters are the main source of Covid-19 – why is there no public information on this? Why is the matter only between manufacturers and the government?...

‘There are other questions, too. With the rising cases and contact tracing, it should have been obvious that the hospital system would reach full capacity and be strained. Why was there not enough serious effort put in to ease the strain on hospitals? When did we know that hospitals were going to be strained? Why wait so long before we announce it and formulate measures to take care of that? Why did contact tracing break down? What do we do now? What is the alternative?...

‘And then, there is the matter of the vaccine. Why was Khairy Jamaluddin, minister of science, technology and innovation, appointed to lead our search and procurement of suitable vaccines? It should have been led by health authorities. Let’s get this right, because the success of Covid-19 containment finally depends on it. Why the seeming delay in getting our vaccine rolled out? Why is our vaccine not yet ready? Singapore has got theirs, even Ecuador and Indonesia have theirs.

‘But where is ours? Why is it later than others? Are we prepared to roll out the vaccines in time, or will it take till next year, when enough of us are inoculated? And, have all the concerns about vaccination been sufficiently addressed?’

Read here (The Vibes, Jan 26, 2021)

Indonesia's Covid vaccination campaign prioritises workers

‘Indonesia has decided to prioritise vaccination for people aged 18-59, arguing the workforce needs to be protected first to boost the economy... The first two phases of Indonesia's vaccination campaign started on January 13 and are expected to run concurrently until April, according to the Health Ministry. The first shots will go to health workers and support staff. This will be followed by members of the public workforce, including public servants at ports and stations, electric companies, banks, water companies and any officials providing community services.’

Read here (DW, Jan 22, 2021)

Covid-19 vaccine — Frequently asked questions

Paul Sax, M.D., a Professor of Medicine at Harvard Medical School and an infectious disease specialist, provides concise and engaging answers to clinicians’ questions about Covid-19 vaccination and to the questions and concerns patients will raise.

Read here (New England Journal of Medicine, as at Jan 18, 2021)

World questions whether China’s Covid jab is safe

‘Although Turkish researchers found that the Sinovac vaccine was 91.25 percent effective in preventing the onset of the coronavirus, trials in the United Arab Emirates found it to be somewhat lesser, at 86 percent effective, while Indonesian trials found the drug was only 61 percent effective. The Turkish trials were conducted on only 29 subjects. Even worse news emerged from Brazil, where the Chinese vaccine was found to be effective in only 50.4 percent of cases in clinical trials numbering13,000 participants. Too many across Asia and elsewhere believe there wasn’t sufficient scientific rigor, the trials were too short and too rushed, and that, in the words of one observer who declined to be named, “poor Asians and others are being given a shoddy vaccine because Beijing wants to score political points with its crappy jab.”

‘Whether that is true or not, those countries going ahead with the Chinese vaccine, however, seem to be proceeding on the basis that, while it may only be 50 percent effective, it’s better than zero percent without a vaccine. Pfizer and Moderna vaccines have been found to be more than 90 percent effective, but it’s a question of availability and price. Although legions of common citizens from the Philippines to Indonesia to Turkey to Brazil are shying away from China’s vaccine, governments are sticking with it. Singapore has announced it will continue with the Chinese products, as will Thailand although authorities have also bought 26 million doses of the UK-based AstraZenica vaccine – which won’t arrive until June. It will still need to be approved by the Thai FDA.’

Read here (Asia Sentinel, Jan 17, 2021)

Correcting misleading information by Western media on Chinese vaccines responsible measure in global pandemic fight

‘Fair reporting of allergic events and side effects from both Chinese vaccines and Pfizer’s vaccines is of great significance. The biased reports by Western media outlets have made the Chinese vaccine like a boat sailing against the current in the international public opinion arena. It is not only unfair, but also harmful to the global fight against the pandemic. The Global Times has the obligation to correct the environment of public opinion created by misinformation from Western media and do our part to promote the fairness of public perceptions regarding different vaccines.’

Read here (Global Times, Jan 16, 2021)

EU looks at vaccine certificates to help summer tourism

‘The European Union is looking at a common vaccine certificate to help get travelers to their vacation destinations and prevent tourism from suffering another disastrous year due to the coronavirus pandemic.

‘European Commission President Ursula von der Leyen said the certificates for individuals who have been vaccinated could be combined with COVID-19 tests for those awaiting shots to allow as many people as possible to travel during the summer, which is vital for warm weather Mediterranean destinations like Greece, Italy and Spain.’

Read here (AP, Jan 15, 2021)

Khairy: If you’re a healthy Malaysian under 60 and not a frontliner, expect to be vaccinated only by Q3 2021 or even later

‘Malaysians who are not active frontliners, below the age of 60 and in relatively good health can expect to receive their dose of Covid-19 vaccinations only by the third-quarter of this year or later, the science, technology and innovation minister revealed today. Khairy Jamaluddin, also the Special Committee on Ensuring Access to Covid-19 Vaccine Supply (JKJAV) co-chair, said this is because the first batch of vaccines to arrive will be prioritised to inoculate those within vulnerable groups. 

“Frontline workers from the healthcare and security sectors will go first. Then senior citizens and people with chronic illnesses. Only then we will move on to the general population in order to get to a meaningful herd immunity threshold.’

Read here (The Malay Mail, Jan 14, 2021)

After months of bashing Russia’s Sputnik V vaccine, Western journalists in Moscow line up to be inoculated against Covid-19

‘Since Russian President Vladimir Putin announced the registration of Sputnik V, the world's first vaccine against Covid-19, sections of the Western media have taken aim at a formula they’ve dubbed both dangerous and ineffective. However, in recent weeks, Moscow-based representatives of the very same outlets have lined up to receive the much-maligned Sputnik V. Living in Russia, it is no surprise that the correspondents have a much more realistic view of the country than their New York and London-based superiors.

‘On Friday, the New York Times’ Andrew Kramer revealed he had received his first dose of Sputnik V, praising the “bona fide accomplishment for Russian scientists continuing a long and storied practice of vaccine development,” even noting that Moscow has avoided some of the logistical problems seen in the West.’

Read here (RT, Jan 14, 2021)

Khairy explains Malaysia's vaccine procurement process, delivery schedule (full text)

‘As two of Malaysia's closest neighbours, Singapore and Indonesia, kicked off their vaccination programmes, Science, Technology and Innovation Minister Khairy Jamaluddin wrote a blog post to give an update on what Malaysia's vaccine procurement process is like — why it is not slow in getting its vaccines — and the delivery schedule that Malaysians can expect. Khairy is also the co-chair of the Special Committee on Ensuring Access To Covid-19 Vaccine Supply.’

Read here (The Edge, Jan 14, 2021)

Scientists call for pause on AstraZeneca vaccine rollout

‘The Australian and New Zealand Society for Immunology says the federal government should immediately pause the planned rollout of the AstraZeneca vaccine because it may not be effective enough to generate herd immunity.

‘Phase three clinical trials of the vaccine, which is the centrepiece of Australia's vaccination strategy, show it is only 62 per cent effective in preventing COVID-19 when given in the recommended dose. Trials suggest vaccines from Pfizer and Moderna are about 95 per cent effective.’

Read here (Sydney Morning Herald, Jan 12, 2021)

Indian nasal Covid vaccine can be potential gamechanger: Experts

 Indian nasal Covid vaccine can be potential gamechanger: Experts

‘Public health experts believe that intranasal vaccines for coronavirus, administered through nose rather than muscles, can be a potential gamechanger in Indias fight against the coronavirus pandemic. The nasal vaccine is different from two intramuscular vaccines which recently got approval, as it is non-invasive, needle-free, doesn't require trained healthcare workers, eliminates needle-associated risks, suits children and adults and has scalable manufacturing.

‘Several studies have proved that the clinical efficacy of intranasal vaccine is superior to that of injectable vaccine. In India, Hyderabad-based Bharat Biotech has sought Drugs Controller General of India's (DCGI) approval to conduct clinical trials of its nasal vaccine for coronavirus.’

Read here (Khaleej Tinmes, Jan 10, 2021)

Thailand, Indonesia and Philippines to roll out Chinese vaccines

‘Three Southeast Asian countries – Indonesia, the Philippines and Thailand – are poised to roll out COVID-19 vaccines produced by the Chinese pharmaceutical company Sinovac.’

Read here (CGTN, Jan 8, 2021)