VACCINES:
1) Here’s some positive news for people with transplanted organs who take immune-suppressing drugs: a third dose of an mRNA vaccine against COVID-19 provoked a stronger immune response, at least in the form of antibodies, in organ transplant patients than the standard two doses did, per various reports. The findings, from a small study of patients who received a third dose this spring, were published 6/15/21 in Annals of Internal Medicine. The results are “part of a broader discussion about whether and when to offer extra doses to vulnerable individuals,” writes Jennifer Couzin-Frankel at Science (6/14/21). In past studies, organ transplant patients who got a COVID-19 vaccine were far less likely to make protective antibodies against SARS-CoV-2 than the general population was. Some larger three-dose studies among people with compromised immune systems are under way, Couzin-Frankel reports. A medical oncologist at the University of Pennsylvania is not very worried about the effectiveness of COVID-19 vaccines among people with cancer, the story states. The story then describes tworecent studies of cancer patients showing that they produced antibodies against SARS-CoV-2 after receiving a COVID-19 vaccine. However, a third study found much lower antibody levels among vaccinated cancer patients than it did among their healthy family members who also were vaccinated, Couzin-Frankel reports: https://www.sciencemag.org/news/2021/06/gives-hope-third-covid-19-vaccine-dose-can-boost-protection-organ-transplant-recipients.
2) Reuters covered one of those two recent studies of cancer patients that showed that the vaccines are safe and highly effective among people in treatment for cancer (6/18/21). The 6/5/21 study, published in Cancer Cell, featured findings on “a diverse group of 200 patients undergoing anticancer therapy for a wide variety of malignancies,” the story states. One of the useful tidbits from that study: Side effects from vaccination were no worse in these patients than in the general population, an Einstein College of Medicine oncologist, the lead study author, is quoted as saying. He adds: “This study confirms that there is no need for patients to wait for vaccination until they finish their chemotherapy or immunotherapy”: https://www.medscape.com/viewarticle/953285.
3) "Everything’s obvious once it’s been pointed out,” one of my grad school profs liked to say. Case in point: “Coronavirus infections dropping where people are vaccinated, rising where they are not,” per a headline at The Washington Post (6/14/21). Sure, this is what you might expect, but the Post’s analysis of coronavirus data at the level of U.S. counties and states shows that it took a while to kick in. “As recently as 10 days ago, vaccination rates did not predict a difference in coronavirus cases [reported infections], but immunization rates have diverged, and case counts in the highly vaccinated states are dropping quickly,” write Dan Keating, Naema Ahmed, Feit Nirappil, Isaac Stanley-Becker and Lenny Bernstein. Ten U.S. states, “concentrated in the Deep South and rural West, report fewer than 35 percent of residents are fully immunized,” the story states. Rising numbers of infections in some U.S. states could turn into summer surges in cases “if the unvaccinated continue to behave as though they’re vaccinated,” an infectious-disease doctor at the University of Alabama at Birmingham is quoted as saying: https://www.washingtonpost.com/health/2021/06/14/covid-cases-vaccination-rates/.
4) Nearly all people admitted to hospitals these days for COVID-19 are also people who had not yet been vaccinated against the disease, according to various reports. Whereas some people have chosen not to get vaccinated yet, others want to get vaccinated but face barriers such as being homebound, reports Fred Mogul at Kaiser Health News (6/17/21). Many of these people are older and/or have chronic diseases, according to an NYU Langone Medical Center physician quoted in the story. “For instance, the parents of a 22-year-old man with autism wanted to get their son vaccinated, but due to very fixed routines could make him available only at limited times. Another patient, in his 90s, didn’t want to trouble anyone to come to his sixth-floor walk-up apartment,” Mogul reports. I have also read that a higher proportion of those hospitalized for COVID-19 in the U.S. nowadays are younger, due in part to high vaccination rates among older people and later authorizations of vaccines in younger people: https://khn.org/news/article/unvaccinated-homebound-and-now-hospitalized-with-covid-in-new-york-city/.
5) A 6/17/21 story by Tanya Lewis at Scientific American describes some of the inventive incentives being offered for getting vaccinated against COVID-19 — including lottery tickets, college scholarships, train tickets, firearms, cash pay-outs, cannabis joints, doughnuts, free trips, cruises, and gift certificates. “Public health experts use incentives all the time to get people to quit smoking, exercise more, and so on,” the story describes the director of the Health Decision Sciences Center at Massachusetts General Hospital’s general medicine division as saying. An unpublished study by the Mass General researcher suggests that incentives might effectively induce people to get a COVID-19 vaccine, Lewis reports. But for some people the best inducement is the opportunity to stop wearing a mask and a general return to normalcy, the story suggests: https://www.scientificamerican.com/article/from-1-million-lotteries-to-free-beer-do-covid-vaccination-incentives-work/.
6) The Unbiased SciPod posted some helpful informational graphics about Pfizer’s studies of its Covid-19 vaccine in children under 12 (6/11/21). The post states that dosages have been set based on initial smaller studies in children (one-third the adult dose for ages 5-11 and one-tenth the adult dose for ages 6 months to 5 years), and that researchers will enroll 4,500 children across 90 sites globally for the larger safety and effectiveness studies. “Children have immune system components that are more potent compared to adults. They may not need as high a dose for protection. Age criteria are related to immune system development, not physical size,” the post states. The results will likely become available this fall for review by the U.S. Food and Drug Administration, with a first batch — from studies in children ages 5 to 11 — expected in early September, the post states:
7) Novavax reports that its two-dose protein-based vaccine against Covid-19 has been 100% effective in preventing severe illness, hospitalization and death due to COVID-19, as well as 90.4% effective against COVID-19 symptoms in large-scale human studies. These studies, which involved thousands of people in the U.S. and Mexico, showed that the vaccine also was highly effective against “Alpha,” the SARS-CoV-2 variant first identified in Great Britain, reports Carl Zimmer at The New York Times (6/14/21). At Instagram, The Unbiased SciPod states: “Novavax plans to apply for authorization in UK, EU, India, South Korea, and possibly the U.S." (6/15/21):
8) In the U.S., COVID-19 vaccine distribution initially was left for states to figure out and administer, as you probably know. Fortunately, federal funds were made available in 2021 to assist, and some vaccination mega-sites have been set up to target communities heavily affected by COVID-19, people of color, and other marginalized or underserved areas. On April 20, I got to help report on the experience of patients visiting such a site, in Newark, NJ, for their second doses of the Pfizer/BioNTech vaccine. It was a wonderful experience, including the opportunity to interview people right after they were vaccinated and the opportunity to work with photographer Grant Delin, who trained with Richard Avedon. Here’s the 6/1/21 story that Grant and I collaborated on (feel free to skip scroll immediately to the photos and captions with quotes from the photographed individuals): https://www.scientificamerican.com/article/vivid-photos-capture-the-emotions-of-people-getting-their-covid-vaccinations/.
PUBLIC HEALTH:
9) Nearly one quarter of all people in the U.S. who were infected with SARS-CoV-2 last year, including 19% of those who never reported COVID-19 symptoms from their infection (were “asymptomatic”), had new medical problems within a month or more of recovering from the virus, according to a large study covered by Pam Belluck at The New York Times (6/15/21). Belluck writes: “Those affected were all ages, including children. Their most common new health problems were pain, including in nerves and muscles; breathing difficulties; high cholesterol; malaise and fatigue; and high blood pressure. Other issues included intestinal symptoms; migraines; skin problems; heart abnormalities; sleep disorders; and mental health conditions like anxiety and depression.” The study, conducted by non-profit organization FAIR Health and not formally reviewed by experts for flaws, involved evaluating electronic health-insurance records: https://www.nytimes.com/2021/06/15/health/covid-19-patients.html.
10) A 6/11/21 story by Emily Anthes at The New York Times runs down some evidence-based approaches that employers can take to reduce the risk of SARS-Cov-2 infections and other health problems as more U.S. workers return to offices nationwide. Employers should flush unused taps and other plumbing to clear any metals or Legionella bacteria colonies that accumulated, the story states. Employers also should upgrade their ventilation and filtration systems, the story states. The goal is four to six air changes per hour, the story states, which is equivalent to completely refreshing air every 10 to 15 minutes in a room. Portable air purifiers or even “desktop level HEPA filters” can help. And continue to wash your hands routinely, for at least 20 seconds each time, advises a Northwestern University environmental microbiologist who is quoted in the story. Not solutions: desk shields (plexiglass barriers are a good idea in grocery stores though), foggers, fumigators, ionizers, ozone generators and other ‘air cleaning’ devices,’ the story states. In most non-medical or non-lab settings, wiping down surfaces with bleach solutions or disinfectant solutions or wipes does little to prevent SARS-CoV-2 transmission. Besides, inhaling these substances is harmful. “The no. 1 thing is to get vaccinated,” the story quotes Joseph Allen at the Harvard School of Public Health as saying: https://www.nytimes.com/2021/06/11/health/coronavirus-reopening-office.html.
11) A graphic poster created by Katelyn Jetelina at Your Local Epidemiologist provides a summary of somewhat hard-to-find COVID-19 safety guidance for parents of unvaccinated children. The poster was made with input from several epidemiologists and public health researchers, as well as two immunologists, a neuroscientist, and an endocrinologist (6/11/21). Parents should also consider children’s and household risk factors (e.g. asthma, obesity, immune system strength) as well as the community’s current infection (case) rates and vaccination rates, Jetelina writes. The graphic ranks risks under various masking and vaccination conditions for activities such as bike riding, carpooling, flying, mass transit, dining out, summer camp activities, farmers markets, sleepovers, and sports. The highest risk activities on the chart include crowded mass transit, waiting at airports in crowded areas like baggage claim and the gate, indoor activities at camps such as crafts and lunchtime among unmasked people, sleepovers and indoor birthday parties with multiple households, movie theaters, and pre- or post-game locker room huddles for athletic events: https://yourlocalepidemiologist.substack.com/p/navigating-kid-related-activities.
12) The U.S. Centers for Disease Control’s 5/29/21 guidance on summer camps, vaccinations and mask-wearing is rounded up by Roni Caryn Rabin at The New York Times. Details reportedly include: 1) encouraging vaccination among people ages 12 and up who plan to attend camps, 2) recommending that campers and staff can go mask-free at camps with 100% vaccination, and 3) recommending that unvaccinated campers may go mask-free outdoors in most cases. Camps with unvaccinated attendees should keep up other coronavirus prevention measures such as physical distancing, grouping children in pods or cohorts that don’t mix, and avoiding poorly ventilated areas indoors, the story states (5/28/21): https://www.nytimes.com/2021/05/28/health/summer-camps-masks-covid-19.html.
13) Guidance from the U.S. Centers for Disease Control in April stated that international and domestic travel are low-risk activities for people vaccinated against COVID-19 (so, this does not pertain, unfortunately, to U.S. children under 12, for whom COVID-19 vaccines are not yet authorized here). In response to that update, Ceylan Yeginsu at The New York Times has written up answers to some of the common questions that vaccinated travelers have these days (6/15/21). A summary of the answers (again, this information is all for vaccinated people in the U.S.): 1) Yes, you must still wear a mask at the airport and on flights; 2) No, you don’t have to quarantine or test if you travel domestically, unless it is required by a state or territory; 3) No, you don’t have to take a coronavirus test before departure to international destinations — not for the U.S. at least; check for your destination though; 4) Yes, you have to test, even if vaccinated, three days before you return by air to the U.S.; 5) Check lists of countries that will accept visits from people from the U.S., including this one published 6/18/21, under certain conditions. It looks like the list includes some countries in Europe and in the Caribbean: https://www.nytimes.com/article/cdc-travel-guidelines.html.
SCIENCE:
14) Scientists at the Walter Reed Army Institute of Research in Maryland are working on a vaccine that could protect us against all coronaviruses. In this 6/9/21 podcast at Scientific American, Emily Mullins interviews Dr. Kayvon Modjarrad who is leading the effort at Walter Reed to develop a so-called universal coronavirus vaccine. The vaccine candidate that is being tested "combines nanoparticles from a blood protein called ferritin with coronavirus proteins.” (Sorry, I’m not sure what that means either.) Modjarrad says 200 different combinations of spike proteins (which are found on the surface of all coronaviruses), types of ferritin, and ways to link them eventually yielded a vaccine candidate that repeatedly provoked a strong immune response against SARS-CoV-1, SARS-CoV-2 and three of its variants in several species of animals ranging from rodents to sharks. The vaccine now is being tested in a small group of humans. “If it works and is safe, it could provide a foundation for a universal coronavirus vaccine,” Mullin says: https://www.scientificamerican.com/podcast/episode/a-universal-coronavirus-vaccine-to-prevent-the-next-pandemic1/.
15) A debate, now largely settled, among scientists about how SARS-CoV-2 spreads recently got some excellent attention from Megan Molteni at Wired. The debate has been about whether the virus spreads mainly by people touching fallen respiratory droplets on surfaces or mainly in air; and the lack of agreement hampered public health efforts to control the pandemic and to prevent deaths. The arguments against airborne SARS-CoV-2 all rested on an assumption that only particles smaller than 5 microns could hang in the air; larger ones, aka droplets, fall to surfaces. But in reality, larger particles can stay afloat and behave like aerosols, many scientists and engineers have known, including aerosols expert Linsey Marr of Virginia Tech, Molteni and others have written. Molteni’s story masterfully traces the events, conversations, and research that came to expose the “fallacy of the 5-micron boundary.” The hero of this engaging story is Katie Randall, a graduate student who specializes in detective work to figure out how bits of knowledge are passed along through published research papers over time (5/13/21): https://www.wired.com/story/the-teeny-tiny-scientific-screwup-that-helped-covid-kill/.
ENTERTAINMENT:
16)
17)
18)
19)
20)
————
TEA SUPPLY GOOD: Thanks to my patrons! However, I no longer wish to receive donations for this newsletter. Please cancel Patreon commitments.
THE PUBLISHING INDUSTRY: A lot of online media content is free during the pandemic, as a public service, but publishing, like many industries, is struggling. If you have the means, please subscribe to or purchase worthy publications.
TAG ME: Please reply to this email to send feedback and/or good SARS-CoV-2 or COVID-19 science coverage that you’ve read, written, or produced in English, Spanish, French, etc.
Love/In friendship, Robin