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

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