News Scan for Jan 27, 2022

News brief

Similar immune response after same, different COVID-19 vaccine booster

Among 457 adult participants in an ongoing phase 1/2 clinical trial who completed primary COVID-19 vaccination with the Moderna, Johnson & Johnson (J&J), or Pfizer/BioNTech vaccines, a booster dose with either the same (homologous) or a different brand (heterologous) induced an immune response and was safe.

Baylor College of Medicine researchers led the open-label trial, published yesterday in the New England Journal of Medicine (NEJM).

Adults who had completed a COVID-19 vaccine regimen of two Moderna or Pfizer doses or one J&J dose at least 12 weeks earlier received a booster dose with one of the three vaccines at 10 US sites from May 29 to Aug 13, 2021.

Among the 457 participants, 154 received a booster dose with Moderna, 150 received J&J, and 153 were given Pfizer. Participants were followed for 29 days after receipt of the booster. The researchers said they plan to monitor vaccinees for 1 year to assess long-term immune response.

Regardless of whether participants received a homologous or heterologous ("mix and match") booster, neutralizing antibody concentrations against a SARS-CoV-2 pseudovirus rose fourfold, to 73, and binding levels increased fivefold, to 55.

Homologous boosters increased neutralizing antibody levels fourfold, to 20, and heterologous boosters increased levels sixfold, to 73. Spike protein-specific T-cell responses rose in all participants except for those given a homologous J&J booster.

Concentrations of CD8+ T cells were most durable in those who received the J&J vaccine as their primary dose, and a heterologous J&J booster substantially increased spike-specific CD8+ T cells in those who completed primary vaccination with Moderna or Pfizer.

Adverse events were reported at levels similar to those observed in clinical trials of the primary vaccine series. More than half of participants said they had pain at the injection site, malaise, headache, or muscle pain, but no serious events were noted.

"These data suggest that an immune response will be generated for each of these vaccines used as a booster regardless of the primary COVID-19 vaccination regimen," the study authors wrote. "This speculation is supported by emerging data showing the effectiveness of the BNT162b2 [Pfizer] booster against symptomatic disease in the United States and against severe disease, hospitalization, or death in Israel."
Jan 26 NEJM study


Study: Pulse oximeter readings unreliable indicator of COVID-19 severity

A UK study today shows pulse oximeter readings, which measure the level of oxygen in the blood, are an unreliable tool for gauging COVID-19 severity across different ethnic groups. The study was published in the European Respiratory Journal.

The study was based on electronic data from patients admitted to Nottingham University Hospitals NHS Trust from February 2020 to September 2021 with confirmed COVID-19 infection. Pulse oximetry measurements were compared to blood gas measurements taken within a 30-minute window.

Across all ethnicity groups, there were slight differences in readings between the oximeter and blood gas measurements, but patients of mixed ethnicity saw oximetry readings 7% higher than blood gas readings, the authors said, compared with just 3.2% for White patients. For Black patients, readings were 5.4% higher, and for Asian populations the readings were 5.1% higher.

"These mean differences were particularly marked in the clinically important range when the arterial blood gas demonstrated a true oxygen saturation of 85 to 89%," the authors wrote.

The difference is attributed to pulse oximeters using light wave transmission to gather readings, which can be effected by skin pigmentation.

"This data builds on what we know, which is that patients with darker skin have less accurate oxygen measurements using the pulse oximeters," said senior study author Andrew Fogarty, MD, from Nottingham University in press release. "Any error of measurement of oxygen levels will make assessing the severity of Covid-19 infection more difficult, and may delay delivery of timely medical care."
Jan 27 Eur Respir J
Jan 27 University of Nottingham
press release


New coalition to focus on antibiotic overuse in agriculture

US PIRG (Public Interest Research Group) Education Fund today announced the launch of a new coalition dedicated to reducing antibiotic use in agriculture.

The Coalition to Preserve Antibiotics includes physicians, farmers, and animal and public health professionals. The group says in it mission statement that while overuse of antibiotics in any setting can promote the development of antibiotic-resistant bacteria, its focus is on reducing antibiotic use in agriculture because roughly two thirds of the medically important antibiotics sold in the United States are for use in food-producing animals.

Coalition members believe that antibiotics can and should be used to treat sick animals, but they say the way the conventional food system raises animals for food often relies too heavily on the routine use of antibiotics to compensate for conditions that can lead to disease, and that this overuse breeds antibiotic-resistant pathogens that can threaten both animal and human health.

"Antibiotic resistant organisms are a dire public threat in our hospitals, food supply, communities and environment," infectious disease physician and coalition member Sameer Patel, MD, MPH, said in a press release. "Healthcare workers, farmers, restaurateurs, consumers—all of us can make changes now to reduce unnecessary antibiotic use and decrease the threat of antimicrobial resistance." 

The coalition says it will work with stakeholders at all levels of government, industry, and academia to advance better antibiotic stewardship in agriculture.
Jan 27 US PIRG Education Fund press release

Flu Scan for Jan 27, 2022

News brief

H5N6 avian flu hospitalizes 2 more in China

China has reported two more human H5N6 avian influenza infections from two different provinces, part of a small but steady stream of illnesses involving the strain, according to a statement today from Hong King's Centre for Health Protection (CHP).

H5N6 infections are often severe or fatal, and both patients are hospitalized in critical condition. The first case involves a 68-year-old man from the city of Langzhong in Sichuan province, located in the southwest. His symptoms began on Jan 3, and he was hospitalized the next day. The report didn't say how the man was likely exposed to the virus.

The second case involves a 55-year-old woman from the city of Hangzhou in Zhejiang province in eastern China. She had been exposed to slaughtered poultry before her symptoms began on Jan 6. The woman was admitted to the hospital on Jan 9.

Since 2014, China has reported 65 H5N6 infections, which have mainly affected adults. The virus is known to circulate in poultry in a few Asian countries, but China and Laos are the only ones to report human cases.
Jan 27 CHP statement


Global flu shows signs of decline, but elevated in some countries

In a global flu update that covers roughly the last week of December and the first week of January, levels remained low and appeared to decline, the World Health Organization (WHO) said this week.

Flu activity in some Northern Hemisphere countries rose but appeared to decrease in Europe. In East Asia, flu in China continued to rise, with influenza B predominant in the region. In South America's tropical regions, flu activity stayed elevated, mainly due to H3N2. And in Southern Asia, predominant H3N2 activity increased in locations such as Bhutan, Iran, and Pakistan, while decreasing or remaining stable in others such as India, the Maldives, and Nepal.

Globally, of the respiratory samples that tested positive for flu at national flu labs in the 2 weeks ending Jan 9, 63.7% were influenza A. Of the subtyped influenza A samples, 95.7% were H3N2. Of characterized influenza B samples, all were from the Victoria lineage.

The WHO included the caveat that COVID-19 surveillance and measures could be impacting flu patterns. Given increased flu activity compared with the previous pandemic year, it urged countries to prepare for cocirculation of flu and COVID-19 by stepping up their surveillance of both viruses and boosting flu vaccination levels to avoid added severe disease and hospitalizations from flu.
Jan 24 WHO global flu update


New H5N1 avian flu detections at Russian zoo, Hong Kong nature preserve

In the latest highly pathogenic avian influenza developments, two jurisdictions—Russia and Hong Kong—reported H5N1 events involving birds other than poultry, according to the most recent notifications from the World Organisation for Animal Health (OIE).

Russia's outbreak struck zoo birds in Moscow, beginning on Jan 22 and killing two of five susceptible birds, which included mute swans. Another sick bird was culled to curb the spread of the virus. So far, the source of the virus isn't known.

Elsewhere, Hong Kong reported the virus in a Eurasian curlew found dead on Jan 21 at a nature park. The bird was tested as part of ongoing surveillance. The species is an abundant winter visitor. Hong Kong reported its last H5N1 detection in wild birds in mid-December 2021.
Jan 27 OIE report on H5N1 in Russian zoo birds
Jan 26 OIE report on H5N1 in Hong Kong

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