COVID-19 TIMELINE – chronological - Make Medicines Affordable.....

COVID-19 has made it clear that public health is essential to economic recovery.
The notion that we must choose between them is ridiculous – and has had deadly consequences.

The timeline plots the history of COVID-19, from the first reported case to current events,
which are kept regularly updated.

It can be viewed chronologically, as things happened, or by most recent events first.
Here you can find more a detailed introduction and a guide to abbreviations.

This timeline will be updated approximately weekly throughout 2021.
Please check back for the latest developments.

17 November 2019

The South China Morning Post reports a possible first case of illness from the novel coronavirus. Source

12 December 2019

Health officials in Wuhan, China, begin looking at people with a viral pneumonia, most of whom went to the Huanan Seafood Market, where bats, snakes and other animals are sold. Source

30 December 2019

Dr. Li Wenliang, a Wuhan ophthalmologist, posts a WeChat message to other doctors to warn them about a new virus and advises them to wear protective gear; he is reprimanded for spreading rumors. Source

31 December 2019

A cluster of pneumonia cases in Wuhan, Hubei Province, China is reported by Wuhan’s Municipal Health Commission. Source

1 January 2020

• The World Health Organization (WHO) sets up an Incident Management Support Team at country and regional levels and its headquarters.
• First onset of symptoms in a person later confirmed to have illness caused by the novel coronavirus. Source
• A seafood market in Wuhan associated with the cluster of cases is closed.

2 January 2020

41 people hospitalized in Wuhan, China with common symptoms of fever, cough and fatigue are confirmed to have the novel coronavirus. Source

4 January 2020

WHO announces the cluster of cases on social media. Source

5 January 2020

WHO publishes information on 44 pneumonia cases of an unknown cause in Wuhan China. Source

7 January 2020

Chinese researchers isolate a new coronavirus.

10 January 2020

• WHO issues online technical guidance, including on transmission of respiratory viruses such as SARS and MERS and infection control measures for healthcare workers.
• Professor Yong-Zhen Zhang, Fudan University, Shanghai, shares the first SARS-CoV-2 genome sequence which is deposited in GenBank, enabling the development of tests and vaccines. Source

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1 September 2021

• Merck and development partner Ridgeback Pharmaceuticals issue a press release to announce a phase III trial of molnupiravir, a nucleoside analog, for post-exposure Prophylaxis of COVID-19. The 1,332-person trial will compare molnupiravir versus placebo in people age 18 and over who live in the same household as a person with symptomatic COVID-19. The trial will run in Argentina, Brazil, Colombia, France, Guatemala, Hungary, Japan, Mexico, Peru, Philippines, Romania, Russia, South Africa, Spain, Turkey, Ukraine, and the US. Source

• Pfizer issues a press release to announce that the first study volunteer in a phase II/III trial has been given PF-07321332 a protease inhibitor designed to fight COVID-19. The 1,140-person randomized, double-blinded trial will compare the twice-daily oral protease inhibitor, which will be boosted with a drug called ritonavir, versus placebo in outpatients with COVID-19 who are not at risk for progression to severe illness. An ongoing trial, which is looking at the drug in outpatients with COVID-19 who are at risk for progression to severe illness, opened in July of 2021. Source

• Moderna issues a press release announcing that it has submitted data to the US FDA for a 50 µg booster dose of its coronavirus vaccine. The submission is based on data from a phase II trial in which 344 people were given a booster dose six months after initial vaccination. Source

• Japan’s Ministry of Health suspended 1.63 million doses due to contamination with stainless steel particles – which they said did not pose health risks. Moderna, Rovi (which operated the plant where the vaccine was produced) and Takeda (who distributes the vaccine) conducted a joint investigation, concluding that the contamination happened during production and that the deaths of two young men (which occurred shortly after their second dose of Moderna’s vaccine, and were from a contaminated batch) were unrelated to the vaccine. Moderna and Takeda have recalled three batches of the vaccine; 500,000 people already received shots from them. Source

31 August 2021

• China’s Livzon Pharmaceutical Group announced that the Philippines FDA approved the phase III trial of V-01, its experimental protein-based coronavirus vaccine. Source

• The EU has vaccinated 70 percent of its adult population – or 55 percent of its entire population. Vaccination rates remain uneven across the bloc; while over 80 percent of adults in Belgium, Denmark and Portugal, and more than 75 percent of adults in in the Netherlands and Spain have been fully vaccinated, rates are lower in Eastern Europe: 45 percent in Latvia, 31 percent in Romania and 20 percent in Bulgaria. Source

• A pair of senior vaccine leaders at the US FDA have resigned amidst speculation that they are frustrated about the involvement of the CDC and its advisory committee in decisions that should be up to the FDA, and the Biden Administration’s meddling on booster shots before their approval. The departure of Marion Gruber, Director of the Office of Vaccines Research & Review and Phil Krause, Deputy Director, has been described as “…A huge global loss..” by Rick Bright, Former BARDA director, adding “Dr. Gruber is much more than the Director. She is a global leader. Visionary mastermind behind global clinical regulatory science for flu, Ebola, MERS, Zika, SARS-CoV-2, many others.” Source

30 August 2021

• Researchers in South Africa report concerns about a new coronavirus variant, C.1.2, which was first identified in May 2021 and has since spread from the provinces of Mpumalanga and Gauteng to six of South Africa’s nine provinces and the Democratic Republic of Congo, Mauritius, New Zealand, Portugal, and Switzerland. Researchers noted that C.1.2 has mutations that “are associated with increased transmissibility” and an increased ability to evade antibodies. Source

• In the US, prescriptions for, and calls to poison centers about ivermectin, an antiparasitic medicine used in people and animals, have risen dramatically despite lack of evidence for its efficacy as a treatment for COVID-19 – and a plea from regulators to avoid using it. Source

• WHO and UNICEF issue a joint statement calling for schools to stay open and take preventive measures to make them safer, including offering vaccines to school staff and children ages 12 and over with pre-existing conditions that make them vulnerable to severe COVID-19, increasing ventilation, and, when possible, smaller classes and physical distancing. “The pandemic has caused the most catastrophic disruption to education in history, “said Dr Hans Henri P. Kluge, WHO Regional Director for Europe, “We encourage all countries to keep schools open and urge all schools to put in place measures to minimize the risk of COVID-19 and the spread of different variants.” Source

• New Zealand’s COVID-19 Vaccine Independent Safety Monitoring Board announced the country’s first vaccine-related death after a woman died from myocarditis (an inflammation of the heart muscle known to be a rare side effect from mRNA vaccines). Source

• The FDA is resuming use of bamlanivimab and etesevimab in 22 states and territories where the combined frequency of variants that are resistant to these monoclonal antibodies is under 5 percent. Source

• Pfizer is prioritizing marketing for its coronavirus vaccine, following full US FDA approval, posting new jobs on LinkedIn, including a senior director for its US COVID launch and a senior manager for US COVID consumer marketing. Source

• JAMA publishes research comparing humoral immune responses to mRNA coronavirus vaccines among 1,647 fully vaccinated healthcare workers in Belgium (688 received the Moderna vaccine and 959 were given the Pfizer/BioNTech vaccine). Overall, antibody titers were highest among vaccinated people with previous COVID-19. Among previously uninfected people, antibody titers were higher among Moderna recipients than those given the Pfizer/BioNTech vaccine, regardless of age (geometric mean titer of 2881 U/mL versus 1108 U/mL).

The authors suggest that the higher dose and longer dosing interval might account for the difference between the mRNA vaccines, noting that this difference might not translate into increased protection against COVID-19. Source

29 August 2021

• In Japan, where 44 percent of the population is fully vaccinated, government officials are considering whether to mix first doses of AstraZeneca with second doses of vaccines from Moderna or Pfizer/BioNtech, which would allow them to accelerate vaccination by shortening the eight-week interval between doses of AstraZeneca’s vaccine to three or four weeks. Source

• Sydney’s daily coronavirus cases reach 1,218, continuing to break records despite a two-month lockdown. Source

• China describes the US intelligence report on the origins of SARS-CoV-2 as “unscientific,” and says it could provoke more racism against Asian people. Source

• Israel expands eligibility for coronavirus booster shots to all citizens aged 12 as the Delta variant pushes the nation’s new cases up to the world’s highest rate per 100,000 people. Source

28 August 2021

• In Japan, two men died after receiving a second dose of Moderna’s coronavirus vaccine from a batch that had suspended a week earlier, after it was found to be contaminated with metal particles. Fumie Sakamoto, the infection control manager at St. Luke’s International Hospital in Tokyo, cautioned, “There may only be a temporal relationship between vaccination and death. There are so many things we still don’t know to make any conclusions on these two cases.” Source

• Lancet publishes research on COVID-19 outcomes based on data from 43,338 people in England diagnosed with COVID-19 between 29 March and 23 May 2021. The risk for hospital admission and emergency care attendance were compared according to vaccination status and by whether they were infected with the Alpha or Delta variant. Overall, the risk for hospitalization or use of emergency care were higher for Delta than Alpha: of the 8,682 people infected with the Delta variant, 5.7 percent (498) were hospitalized or sought emergency care versus 4.2 percent (1,448) of people with the Alpha variant; most people in both groups were unvaccinated. Source

• After receiving an inconclusive report on the origins of SARS-CoV-2, US President Joe Biden criticized China for its unwillingness to cooperate with US investigation. “The world deserves answers, and I will not rest until we get them,” Biden said, adding “Responsible nations do not shirk these kinds of responsibilities to the rest of the world. Source

• Despite going into a two-month lockdown, New South Wales reports a record-breaking daily total of 1,035 new COVID-19 cases. Source

• US President Joe Biden suggests that COVID-19 booster shots could be given sooner than eight months after full vaccination just nine days after announcing that people who were vaccinated eight months ago and those with immunocompromising conditions would become eligible for boosters in September, pending US FDA approval. Source

27 August 2021

• The British Medical Journal publishes a paper on the risk of blood clots with low platelets among adults in England (19 ,608 ,008 people who received the Oxford/AstraZeneca vaccine; 9 ,513 ,625 who received the Pfizer/BioNTech vaccine and 1 ,758 ,095 who tested positive for SARS-CoV-2). The risk of hospital admission or death associated with thrombocytopenia, venous thromboembolism, and arterial thromboembolism was significantly higher among people who fell ill with COVID-19 than the risk from vaccination. The authors noted an increased risk of thrombocytopenia, venous thromboembolism, and other rare arterial thrombotic events in short time intervals after the first dose of the Oxford/AstraZeneca vaccine, and of arterial thromboembolism and ischemic stroke after a first dose of the Pfizer/BioNTech. Importantly, the risks of these outcomes after vaccination were much lower than those associated with SARS-CoV-2 infection in the same population. Source

• Inovio, which has struggled to secure funding for INO-4800, its experimental DNA-based coronavirus vaccine, was granted permission to start the phase III segment of its trial in Brazil; it plans to expand the trial to other countries in Africa, Asia and Latin America. The company has already secured approval to test the vaccine in China as a booster for Sinovac’s CoronaVac. Source

• Bloomberg reports that globally, over 5.11 billion doses of coronavirus vaccines have been administered at a current rate of 38.4 million doses per day. Although enough doses have been given to cover 33.3 percent of the world’s population, distribution remains “lopsided,” with high-income regions vaccinating their populations over 20 times faster than the poorest countries. Source

• Jacinda Ardern, New Zealand’s Prime Minister, extends the country’s lockdown until 31 August to control the Delta variant. Source

• An analysis of real-world data from Israel finds that people who recovered from COVID-19 are less likely to become infected with the Delta variant than those who received both doses of the Pfizer/BioNTech vaccine. Vaccinated people were nearly six-fold more likely to contract Delta and seven-fold more likely to have symptomatic COVID-19 than people with natural immunity. Source

• Lancet publishes a study of one-year outcomes among 1,276 people hospitalized with COVID-19 who completed follow-up visits at 6 and 12 months after they were discharged. The proportion of people who had at least one symptom decreased from 68 percent (831/1227) at 6 months to 49 percent (620/1272) at 12 months, although the proportion of people with difficulty breathing increased from 26 percent (313/1185) at 6 months to 30 percent (380/1271) at 12 months and more people reported anxiety or depression at 12 months (26% [331/1271]) versus 12- 23% (274/1187) at 6 months. Women were more likely than men to experience fatigue or muscle weakness, anxiety or depression and diffusion impairment (accumulation of different cells and swelling caused by fluid in the lungs that make exercise difficult). Overall, although many COVID-19 survivors were able to return to work and resume their normal lives, they had a higher rate of pain or discomfort and mobility problems than a matched group of uninfected people. Source

• Portions of an intelligence report on the origins of SARS-CoV-2 are declassified; although inconclusive, all involved agencies agree that the virus was unlikely to have been made as a biological weapon, and that the initial outbreaks that sparked the pandemic occurred no later than November 2019. The US National Intelligence Council and four other agencies believe that the most likely origin of the virus was via “ “…natural exposure to an infected animal through an animal infected with it, or close progenitor virus,” while one agency believes that the pandemic was the result of “a laboratory-associated incident, “ involving “…animal handling, or sampling by the Wuhan Institute of Virology.” Source

26 August 2021

• The Economist Intelligence Unit releases a report, How much will vaccine inequity cost, summarizes the current state of access to coronavirus vaccines (as of late August 2021); briefly rich countries have given out vaccines at 100 times the rate of poorer countries (an estimated 60 percent of the population has had at least one dose in higher-income countries, vs. 1 percent of the population in poorer countries). The report estimates that vaccine inequity will cost the world $2.3 trillion dollars by 2025, with Asia and Africa being the hardest-hit. Source

• Japan’s Takeda Pharmaceutical Co suspends use of 1.63 million doses of Moderna’s coronavirus vaccine after discovering contamination in unused vials. Japanese health authorities noted that some of the doses might have been used, but there have been no reports of ill effects. They have asked Moderna to conduct an emergency investigation, and Rovi, the Spanish producer who manufactured the doses, is fully cooperating and is also investigating the contamination. Source

• After US President Joe Biden announced that coronavirus booster doses would become available in September (pending US FDA approval), the Wall Street Journal reports that the approval is likely to call for booster doses given six months after the previous dose, rather that the eight months specified by the Biden administration, and that boosters from J & J, Moderna and Pfizer/BioNTech are under FDA review, with approval anticipated in mid-September. Source

• A growing number of US companies are instituting vaccine mandates for their employees following full FDA approval of the Pfizer/BioNTech coronavirus vaccine. Source

• Surges of COVID-19, driven by the Delta variant, have overwhelmed Japan’s hospitals. During the period between 9-15 August, 3,361 patients were turned away by at least three hospitals. Source

• Carlito Galvez Jnr, the Philippines vaccine tsar, is forced to deny that the country’s coronavirus vaccine roll-out was delayed until next year’s presidential elections during a five-hour session where Health Secretary Francisco Duque was questioned about the government’s pandemic response. So far, only 12 percent of the country’s population has been vaccinated. Source

25 August 2021

• Officials in at least 12 Chinese cities warn unvaccinated residents that they will be held accountable if they are found to be responsible for spreading outbreaks. Overall, 55 percent of the country’s population is fully vaccinated. Source

• Coronavirus cases in New South Wales reach a daily total of 919, despite the lockdown – and Sydney’s healthcare system is becoming overwhelmed with COVID-19 patients. Source

• New Zealand’s top health official, Ashley Bloomfield, announced that that some of the 732 people who received coronavirus vaccines in Auckland last month may have been given saline solution. Source

• In Japan, where daily coronavirus cases have increased by 65 percent over the past two weeks, the state of emergency has been expanded to cover 21 of the nation’s 47 prefectures and extended until 12 September. Source

• After a failed first trial, Brii Bioscience announces positive results from an interim analysis of an 837-person trial of its antibody combination, BRII-196/BRII-198, which was developed by Beijing’s Tsinghua University and Shenzhen Third People’s Hospital. When given to outpatients with COVID-19 in Argentina, Brazil, Mexico, the Philippines, South Africa and the US, BRII-196/BRII-198 reduced the odds of hospitalization or death by 78 percent. The trial is also exploring efficacy of early (<5 days) versus later (6-10 days) treatment, although an earlier study did not show any benefit from BRII-196/BRII-198 in hospitalized patients and was stopped early. The company also reported that there were fewer adverse events among people who got BRII-196/BRII-198 than placebo recipients (3.8 percent versus 13.4 percent, respectively). Source

• J & J issues a press release to announce that support use of a booster shot for people who got its single-dose coronavirus vaccine, based on two Phase 1/2a studies that J & J performed in people who were previously vaccinated with its single-shot vaccine. Interim data from these studies demonstrate that a booster dose of the vaccine generated a rapid and robust increase in spike-binding antibodies, which was nine-fold higher than the response 28 days after the single-dose vaccine. The study was submitted for pre-print publication. J & J is working with the US FDA, the US CDC, the European Medicines Agency and other health authorities about boosting with its COVID-19 vaccine. Notably, results from J & J’s two-dose trial were not included in the press release, which only covered results from a 20-person trial – three of whom were excluded from analysis. Source

• Thailand is introducing a robotic arm developed at Chulalongkorn University. The arm, which is called the “AutoVacc”, helps draw vaccines doses more efficiently to maximize the country’s low supply – the “AutoVacc” can draw 12 doses of the vaccine from a vial in four minutes, an improvement from the 10 doses that can be drawn manually. The prototype, which can only be used with the AstraZeneca vaccine, costs $76,243. The team plans to produce similar machines that can use Pfizer-BioNTech and Moderna vaccines. Source

• New England Journal of Medicine publishes a report on safety of the Pfizer/BioNTech coronavirus vaccine, based on data from two groups of nearly 885,000 vaccinated and unvaccinated people in Israel. The vaccine was associated with an excess risk for myocarditis (an inflammation of heart tissue) -which is most likely to occur among young men – and estimated at 1 to 5 cases per 100,000 people. Notably, the risk of myocarditis was much higher among people with COVID-19, at 11 cases per 100,000 people. Source

• WHO announces that it will work to address vaccine inequity by starting a program to manufacture vaccines in Latin America and the Caribbean, where only 23 percent of residents are fully vaccinated. Currently, 30 proposals for vaccine production are under review, with a decision expected in September. Source

24 August 2021

• Coronavirus cases in the US surpass 38 million. Source

• US President Biden receives a report on the origins of the coronavirus pandemic from the Director of National Intelligence, which did not conclude whether the virus emerged from an accidental laboratory leak or in a natural leap from animals to human beings. The report, which is classified information is expected to become declassified within a week. Source

• In the US 92 million people have been vaccinated with the Pfizer/BioNTech vaccine; nearly 65 million people received the Moderna coronavirus vaccine, and nearly 14 million were vaccinated with J & J’s single-dose vaccine. Moderna applied for full FDA approval in June; J & J has yet to apply. Source

• For the first time ever, a confidential vaccine supply contract between a pharmaceutical corporation (Pfizer) and a country (Brazil) has been leaked after months of tough negotiations over pricing (100 million doses at $10 each) and arguments Pfizer’s “ …unfair and abusive clauses,” including: That Brazil renounce the sovereignty of its assets as a guarantee of payment to Pfizer; that it establish a guarantee fund in an account outside of the country; that Brazil’s jurisdiction and laws are removed, and replaced with an arbitration agreement under the laws of New York, in the United States; that there will be no penalty for delayed deliveries; and that Pfizer be indefinitely exempt from any civil liability for serious side effects arising from the use of the vaccine. Source

• Globally, over five billion doses of coronavirus vaccines have been administered: 1.96 billion in China; 589 million in India and 363 million in the US. Vaccine coverage in low- and middle-income countries remains vastly unequal. The UAE leads in per capita vaccinations (179 per 100 residents), followed by Uruguay (154 per 100 residents), Israel (149 per 100 residents), Qatar (148 per 100 residents), Singapore (147 per 100 residents), Bahrain (144 per 100 residents), Denmark (143 per 100 residents), Chile (140 per 100 residents), Canada (139 per 100 residents), Portugal and Belgium (138 per 100 residents), China (136 per 100 residents, Spain (134 per 100 residents), Ireland (133 per 100 residents) and the UK (132 per 100 residents). Source

• Nigeria approves Sinopharm’s coronavirus vaccine. It has been allocated 7.7 million doses through COVAX, but Dr Faisal Shuaib, who heads Nigeria’s national primary healthcare development agency, did not say when the vaccines would be delivered. Currently, only 1% of Nigeria’s 200 million residents have been fully vaccinated. Source

• N.K. Arora, chairman of India’s National Technical Advisory Group on Immunization, said the country would be able to resume coronavirus exports “As soon as we are through with our adult population we should have sufficient vaccine to share with the rest of the world. The way our pipeline is we should be able to reach and meet our target by the end of the year.” India should have six locally developed vaccines by the end of 2021 in addition to Serum Institute’s Covishield and Bharat Biotech’s Covaxin. Source

• The US CDC publishes research on effectiveness of coronavirus vaccines among frontline workers before and during the predominance of the Delta variant. Data from the HEROES-RECOVER Cohorts, a network of 4,217 frontline workers, showed that mRNA vaccines were 90 percent effective at preventing SARS-CoV-2 infections during the pre-Delta period (14 December 2020 to 10 April 2021). When the Delta variant became prevalent, 19 of 488 unvaccinated participants became infected, versus 24 of 2,352 fully vaccinated participants, dropping vaccine efficacy from 90 percent to 66 percent. The authors noted that vaccines might become less effective over time, as well as against Delta. Source

• The CDC reports on SARS-CoV-2 infections and hospitalization rates among 43,127 people in Los Angeles, California between 1 May and 25 July – and by their vaccination status. Notably, infection and hospitalization rates among unvaccinated persons were 4.9 and 29.2 times greater than those among fully vaccinated persons. Overall, 10,895 (25.3 percent) of SARS-CoV-2 infections occurred among fully vaccinated persons; 1,431 (3.3 percent ) among partially vaccinated persons, and 30,801 (71.4 percent ) among unvaccinated persons. Fully vaccinated people were significantly less likely to be hospitalized (3.2 percent versus 6.2 percent versus 7.6 percent), admitted to intensive care (0.5 percent versus 1 percent care versus 1.5 percent), and to require mechanical ventilation (0.2 percent versus 0.3 percent versus 0.5 percent than partially and unvaccinated people, respectively. The death rate was lower (0.2 percent among fully vaccinated persons than among partially vaccinated (0.5 percent) and unvaccinated (0.6 percent); six of the 24 fully vaccinated people who died had immunocompromising conditions. The authors noted that vaccination with other prevention strategies are essential for preventing hospitalizations and deaths from COVID-19. Source

• In the West Bank, 22 percent of residents are fully vaccinated, and 35 percent have gotten a first dose of coronavirus vaccine. Long-awaited supplies have arrived from the US via COVAX, but uptake is low. Government officials have decided to mandate vaccination for public-sector employees; those who do not get vaccinated will be put on unpaid leave. Source

• France recommends that people over age 65 and/or immunocompromised get a third coronavirus vaccine dose beginning in September (for those vaccinated at least six months before). Source

• The former President of Chad, Hissène Habré, who was serving a life sentence for crimes against humanity, including killings, torture and sex crimes, dies from COVID-19. Source

• China ships 200,000 doses of coronavirus vaccine which were requested by Viet Nam’s military on the eve of US Vice President Kamala Harris’s visit to the country. Source

• Lancet issues a pre-print publication with results from the UK OCTAVE trial, which assessed immunological effects of COVID-19 vaccination among 2,583 people with conditions that could diminish their immune responses. OCTAVE included people living with solid cancers and hematological malignancies, immune-mediated inflammatory and chronic diseases, liver disease and end-stage kidney disease requiring hemodialysis without or with immunosuppression and those who have undergone haemopoietic stem cell transplantation. Most received coronavirus vaccines from Oxford/AstraZeneca or Pfizer/BioNTech.

The pre-print covered information on humoral and T cell immune responses from 600 participants, comparing their responses at baseline, pre-second vaccine dose (boost) and/or 4 weeks post second dose and data from 231 healthy people from the PITCH (Protective Immunity from T cells in Healthcare workers) study. Overall, 100 percent of the 93 PITCH participants who were tested generated anti-Spike antibodies after vaccination, while 89% of OCTAVE’s participants seroconverted four weeks after their second vaccine dose. But some specific subgroups in OCTAVE failed to generate antibodies four weeks after vaccination, particularly people with ANCA-Associated Vasculitis (72.4 percent), dialysis recipients receiving immunosuppressants (and people with liver disease (16.7 percent among both groups). Even in those who seroconverted, 40 percent of patients across all disease cohorts generated lower levels of SARS-CoV-2 antibody reactivity compared to healthy subjects after two SARS-CoV-2 vaccines; the functional significance of these findings in providing protection from subsequent SARS-CoV-2 exposure is not currently known. Notably, Spike-specific T cell responses were similar to healthy individuals across all disease cohorts. The researchers noted that their data are a strong argument for vaccination strategies that optimize humoral immune responses against SARS-CoV-2 in people with chronic diseases and/or people on immune suppressive therapies. Source

• Nature publishes an overview of what is known about COVID-19 vaccines and blood clots. now called vaccine-induced immune thrombotic thrombocytopenia (VITT), a very rare, life-theatening condition that has occurred in about 1 of 50,000 people aged under 50 given the AstraZeneca coronavirus vaccine (and among people who have received the J & J vaccine). The mechanism linking these vaccines with VITT is still unclear, although researchers think that it is similar to HIT, a rare reaction to the anti-clotting drug heparin. In this case, the trigger seems to be the coronavirus vaccines instead of heparin. Some researchers have suggested that impurities in vaccines which are left over from the manufacturing process can trigger the reaction, while others think that the adenovirus – a vector used in both vaccines – could be the cause especially if it is injected accidently into a vein rather than muscle (which can be avoided by asking people delivering the vaccines to draw a small amount of fluid from the injection site with the syringe to check for blood before they administer the vaccine). Adenoviruses can be modified, which may reduce the risk for VITT. Also, the spike proteins may be the culprit – they also cause an inflammatory response in some people who have COVID-19, which in severely affected people can lead to clots. Researchers at Oxford/AstraZeneca and J&J are reportedly working to develop safer adenoviral vaccine vectors. The author noted that better treatment for VIIT is needed. Source

• A pre-print article describes a new SARS-CoV-2 variant, C.1.2, which was identified in South Africa during May of 2021. Since then, it has spread across South Africa and to seven other countries in Africa, Asia, Europe and Oceania. C.1.2 has more mutations, as do other variants of concern (Alpha, Beta and Gamma), including multiple substitutions and deletions within the spike protein associated with increased transmissibility and reduced neutralization sensitivity. C.1.2 is of great concern because it has additional mutations which are also likely to impact its replicative fitness. The authors note that although C.1.2.’s characteristics and epidemiology are still being characterized, it calls for attention given its “…constellations of mutations.” Source

23 August 2021

• The US FDA grants full approval for the Pfizer/BioNTech coronavirus vaccine for people ages 16 and over (it will still be available under emergency use authorization for ages 12-15). The vaccine will be marketed as Comirnaty. The agency analyzed effectiveness data from approximately 20,000 vaccine and 20,000 placebo recipients ages 16 and older who did not have evidence of the COVID-19 virus infection within a week of receiving the second dose. Based on results from the clinical trial, the vaccine was 91% effective in preventing COVID-19 disease.

The safety of Comirnaty was evaluated in approximately 22,000 people who received the vaccine and 22,000 people who received a placebo 16 years of age and older. FDA als conducted a rigorous evaluation of the post-authorization safety surveillance data pertaining to myocarditis (an inflammation of the heart muscle) and pericarditis (inflammation of the tissue around the heart) following administration of the Pfizer-BioNTech vaccine and has determined that the data demonstrate increased risks, particularly within the seven days following the second dose. The observed risk is higher among males under 40 years of age compared to females and older males. The observed risk is highest in males 12 through 17 years of age. Available data from short-term follow-up suggest that most individuals have had resolution of symptoms. However, some individuals required intensive care support. Information is not yet available about potential long-term health outcomes. Source

• In Taiwan, where only three percent of the 23.5 residents are fully vaccinated, the first locally developed and produced coronavirus vaccine is now being administered, beginning with the country’s President, Tsai Ing-wen. More than half a million people have registered to get the vaccines, despite concerns that it is being used before effectiveness and safety have been proved in phase III trials. Source

• Dr. Vivek Murthy, the US Surgeon General, issued a formal advisory warning about vaccine misinformation. Calling vaccine misinformation an “urgent threat” to public health. “The speed, scale and sophistication with which it is spreading and impacting our health is really unprecedented,” he said, adding that “…it’s happening largely, in part, aided and abetted by social media platforms. There are people who are superspreaders of misinformation and there are algorithms, still, which continue to serve up more and more misinformation to people who encounter it the first time. These are things that companies can and must change. And I think they have a moral responsibility to do so quickly and transparently.” Source

• Lebanon’s hospitals are in crisis. The Rafik Hariri University Hospital, its largest public hospital, has had to rely on generators for days, and faces shortages of fuel, medicines and blood serum – and understaffing. At least 30 percent of its doctors and more than 10 percent of its nurses have left – and many private hospitals, which offer 80 percent of Lebanon’s medical services, are shutting down because they lack resources – or are turning away patients who can’t pay. Source

• After a month of harsh measures, such as testing entire cities, quarantines, lockdowns and other restrictions to control the coronavirus, China reports zero cases. Source

• A pre-print article describes the generation and evolution of vaccine-induced immunity to SARS-CoV-2, including variants of concern, using 342 samples collected from 61 people who received mRNA vaccines at six timepoints (pre-vaccination baseline to six months post-vaccination), including people who had also recovered from SARS-CoV-2. They found that mRNA vaccines induced durable immune memory which continues to evolve over time by examining binding and neutralizing antibodies, memory B cells, and memory CD4+ and CD8+ T cells. Specifically, SARS-CoV-2-specific memory B cell responses were robustly induced following mRNA vaccination and continue to increase in frequency for at least six months, even while circulating antibody levels declined in the same person. Also, mRNA vaccination generated highly mutated memory B cells capable of cross-binding to variants including Alpha, Beta and Delta, which could also rapidly generate new antibody responses. The researchers noted that potential discrepancies in vaccine efficacy at preventing infection versus severe disease, hospitalization and death may be due to declining antibody titers over time, which are likely to reduce the potential for sterilizing or near sterilizing immunity. Also, the durability of cellular immunity may contribute to rapid responses that prevent severe disease. They observed that boosting pre-existing immunity with mRNA vaccination mainly resulted in a transient benefit to antibody titers with little-to-no long-term impact on cellular immune memory. Source