People wear face masks during the outbreak of coronavirus disease (COVID-19) in Singapore, April 3, 2020. REUTERS/Edgar Su
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May 23 (Reuters) - The following is a summary of some recent studies on COVID-19. They include research that warrants further study to corroborate the findings and that has yet to be certified by peer review.
Omicron breakthrough infections may spare young hearts
The Omicron variant of the coronavirus does not have a negative affect on cardiovascular health in young adults who have been vaccinated, a small study suggests.
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Earlier variants have had a detrimental affect on patients' hearts and blood vessels, and researchers expected to see similar patterns when they compared 23 young adults with Omicron breakthrough infections diagnosed within the past six weeks to 13 vaccinated young adults who never had COVID-19. The average age of study participants was early- to mid-20s. As reported on Friday in the American Journal of Physiology - Heart and Circulatory Physiology, markers of cardiovascular health included blood vessel function and responsiveness to stimuli, stiffness of artery walls, heart rate variability, and the heart's responses to changes in blood pressure. "Contrary to our hypothesis," the researchers said, there were no differences in any of these parameters between healthy, vaccinated young adults who contracted COVID-19 during the Omicron wave and those who never had COVID.
The finding that "not all variants may be detrimental to cardiovascular health in young, otherwise healthy adults... is all very promising," they said. "However, there is some recent evidence that cardiovascular health may still be impacted in the long term... Therefore, follow-up studies will be needed to determine long-term cardiovascular health outcomes."
Delaying mammography after COVID vaccination unnecessary
Women should not delay routine mammograms after receiving a COVID-19 mRNA vaccine, experts now say.
In some women, the vaccines cause swollen lymph nodes around the armpits, which could be misread as a possible sign of breast cancer on a mammogram. Early after the vaccines became available, the Society for Breast Imaging advised women to wait four-to-six weeks after the second shot before having a screening mammogram because it was thought the abnormalities would resolve by then. New research shows that so-called axillary lymphadenopathy after vaccination can last longer than initially reported. In 111 women with this side effect after receiving an mRNA COVID vaccine, the swelling took an average of 12-13 weeks after the second shot to resolve completely, researchers reported in the American Journal of Roentgenology. Women should not delay their mammograms for extended periods, the Society for Breast Imaging now says.
In an updated guideline directed at asymptomatic, average risk women with no history of breast cancer or lymph node cancer, the group now advises that if screening mammograms show the kind of lymph node abnormalities associated with the vaccines, the exams should be repeated six months later.
mRNA vaccine response stronger after fourth dose vs third
A fourth dose of a COVID-19 mRNA vaccine can boost antibodies and other immune responses to levels higher than those seen after the third dose, according to UK trial data.
Researchers recruited 166 adults who had received a booster dose of the Pfizer (PFE.N)/BioNTech (22UAy.DE) mRNA vaccine after two doses of either AstraZeneca's (AZN.L) viral vector vaccine or initial inoculation with Pfizer/BioNTech's shots. They were randomly assigned to receive either another Pfizer/BionTech shot or Moderna's (MRNA.O) mRNA booster as a fourth dose. Half of the participants were older than 70, and the average interval since the third shot was seven months. Two weeks after the fourth dose, levels of antibodies targeting the spike on the coronavirus were up to twice as high as antibody levels seen four weeks after the third dose for both vaccines, regardless of initial vaccine schedule, the researchers reported in The Lancet Infectious Diseases. Responses of immune cells called T cells were significantly increased 14 days after the fourth dose compared with 28 days after the third dose, but only in participants who received three Pfizer shots followed by a Moderna booster.
Researchers cautioned that all of the increases "will probably wane rapidly, as has been observed after third doses." Participants with high levels of immune responses before the fourth dose had limited boosting from that shot, they said, which suggests there may be a "ceiling" to the booster effect and that people with high antibody levels "are unlikely to gain much boosting from additional doses."
Click for a Reuters graphic on vaccines in development.
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Reporting by Nancy Lapid; Editing by Bill Berkrot
Our Standards: The Thomson Reuters Trust Principles.
The Korean Central News Agency (KCNA) said that between Friday and Saturday there had been 186,090 new cases, 299,180 recoveries and one death.
If true, that figure would be a marked drop -- the country has been reporting more than 200,000 of what it terms "fever cases" every day for the past week in an outbreak that has infected more than 2.5 million people and killed 67, according to official figures.
However, given the lack of independent reporting inside North Korea, it is difficult to verify the figures and there has long been widespread skepticism over the country's Covid reporting.
Before the current outbreak was announced earlier this month, North Korea claimed to be Covid-free. The country of 25 million reported what it said were its first cases earlier this month, referring to the outbreak as "explosive," raising fears about the ability of the country's dilapidated health care infrastructure to cope.
North Korea is not known to have imported any coronavirus vaccines and has previously snubbed offers such as one from China last year to provide nearly three million doses of its Sinovac shots.
On Monday, three North Korean cargo planes flew to China and back, according to a South Korean government official with knowledge of the matter. It is not known what the planes were carrying, but the rare trip came after China pledged to help North Korea with its Covid outbreak.
United States President Joe Biden, who is currently visiting South Korea as part of his first trip to Asia, said on Saturday the US had also offered to provide vaccines to North Korea but that Pyongyang has not responded.
A senior US administration official said on Sunday that Covid restrictions may be playing a role in Pyongyang's lack of response to offers of talks, Reuters reported.
"The fact that Kim Jong Un has decided to come out and publicly announce this health crisis is quite telling," Lina Yoon, a senior Korea researcher at Human Rights Watch told CNN. "(It) may have a political element, obviously."
North Korea's state media claims its outbreak peaked at over 390,000 new cases on Monday. After showing "rapid growth in the beginning" the outbreak is now in decline, it claims, "after being stably controlled and managed."
Among the actions KCNA credited were "intensive disinfection efforts" by nearly 200,000 medical and anti-epidemic workers at around 100,000 spots nationwide, including waste and sewage treatment plants.
It also said military medics had been deployed to 670 pharmacies in Pyongyang to supply medicine around the clock and "around 20 mobile temporary medicine service centers" had been created to distribute medicine "faster and more accurately."
North Korea's present problems are not limited to the outbreak. There have also been suggestions it is facing widespread food shortages, caused in part by strict border lockdowns that were meant to keep the virus out.
Editors Note: Adar Poonawalla is chief executive officer of vaccine manufacturer the Serum Institute of India. He is founder of Clean City Pune, an environmental institute aimed at making cities more liveable. The views expressed in this commentary are his own. Read more opinion on CNN.
CNN
Whether it was conducting groundbreaking research, completing clinical studies, manufacturing Covid-19 vaccines or distributing and administering billions of doses, scientists, public health officials, doctors and countless others have taken on the Herculean task of protecting people around the world from the novel coronavirus with vaccines, diagnostics and therapeutics.
While we the worlds largest manufacturer of vaccines by volume recognize the innovation and effort the global community undertook in the past two years, we also acknowledge that there is more to do. As world leaders come together at the World Economic Forum this week, I hope that they collectively work toward a healthy and safe future for the generations to come.
Developing vaccines or treatments that can actually prevent transmission of disease, not just hospitalizations and deaths, would help control the virus. And there needs to be multilateral cooperation from countries to provide equitable access to vaccines and therapeutics to all.
So, what are the lessons we learned? And how can we avoid a fragmented immunization effort in the event of another pandemic?
In 2021, around 11 billion doses of Covid-19 vaccines were produced, according to the World Economic Forum, however, the access to these vaccines was not equitable.
To ensure a fair global health system, there is no other option but to adopt a Global Pandemic Treaty aimed at building a common regulatory framework which would enable knowledge-sharing, provide resources and logistical support and maintain a transparent approval system of vaccine certificates.
Given the disruption and devastating loss of life weve seen in the past two years of Covid-19, it is of utmost importance that there are systems in place to prevent the next pandemic.
I am certainly not nave enough to think a global treaty would solve all our problems. Countries will still need to continue investing in their own health care systems and pharmaceutical manufacturing and create agile systems of detection for emerging diseases.
But beyond that, we still need political will and multilateral cooperation between countries to bring about a coordinated global response to any pathogen.
There would have to be at least four major cornerstones in such a treaty:
1.) A free flow of raw materials and vaccines to be exported and shared by major producing countries of essential drugs and medicines. Each country should agree to export at least 25% of what it can produce for itself, for example. Hopefully, more and more nations will build their own capabilities in the years to come.
2.) Sharing of intellectual property (IP) of breakthrough technologies, on a commercial basis that rewards the innovator to scale up the manufacturing in different parts of the world during a global pandemic. This could apply to diagnostics, treatments and vaccines. For instance, the partnerships between vaccine makers and manufacturers significantly cut down the time it took to get doses distributed and administered around the world, likely saving countless lives.
3.) Global agreement of regulatory standards: Clinical trials and manufacturing standards should be agreed to in advance, with oversight headed by a multilateral organization such as the World Health Organization. This will enable more manufacturers to be able to come forward and produce treatments and vaccines that adhere to good manufacturing practices and standards at a faster pace. This could also help fight misinformation about different treatments and vaccines, which fueled vaccine hesitancy and preferences for different vaccines over others.
4.) Universal travel vaccine certificates on a digital platform that is at the ready. This could eliminate any questions about authenticity and acceptance, especially for travelers in the event of future lockdowns.
These are just some elements that could help governments and international health regulatory bodies respond more quickly and effectively to future pandemics. A treaty like this could also provide a fair and predefined framework that would dial up the political will and help leaders deal with periods of crisis in their own countries.
LANSING, Mich. - Following the U.S. Food and Drug Administration authorization and the Centers for Disease Control and Prevention recommendation, the Michigan Department of Health and Human Services (MDHHS) announces Michiganders ages 5 through 11 are eligible for a booster vaccine five months after receiving their primary series. Pfizer is the only COVID-19 vaccine currently authorized for those under age 18. COVID-19 booster doses may be given at the same time as other vaccines, including the flu vaccine.
"We are excited for continuing developments in our fight against COVID-19,said Dr. Natasha Bagdasarian, MDHHS chief medical executive. "We have safe and effective tools to prevent severe outcomes and this booster is another way to combat this virus and keep our children and vulnerable populations protected. Children ages 5 through 11 may now receive a booster dose five months after their primary series.It is important that all Michiganders ages 5 and up get vaccinated if they arent already,and we urge everyone to stay up-to-date on vaccines.
Symptoms may vary when children are infected with COVID-19, and unvaccinated children can still infect those around them even if they are not showing symptoms. Getting children vaccinated and boosted helps keep communities safe.
The CDC is also strengthening its recommendation that those 12 and older who are immunocompromised, and those 50 years and older should receive a second booster dose at least four months after their first booster dose.
When getting a booster dose, youre encouraged to bring your COVID-19 vaccine card or immunization record to show the vaccine provider. Downloadable immunization records are accessible for adults 18 and older free of charge at theMichigan Immunization Portal. Visit Michigan.gov/MiImmsportaland upload a valid government-issued photo ID, such as a driver's license, state ID or passport. If you do not have records in the portal or are seeking records for a child under 18 years of age, contact a health care provider or local health department.
To date over 6.7 million Michiganders ages 5 and up have gotten at least their first dose of safe and effective COVID-19 vaccines. Eligible Michiganders are encouraged to stay up-to-date on vaccinations, which includes booster doses that provide extra protection, and residents of long-term care facilities where outbreaks can spread quickly and extra protection is strongly recommended.
MDHHS also encourages Michigan residents to pay attention to local guidance as some communities may be at a higher risk of COVID-19 transmission.
To schedule a primary or booster dose of the COVID vaccine, visit vaccines.gov.
To learn more about the COVID-19 vaccine, visitMichigan.gov/COVIDvaccine.
For more information about COVID-19 in Michigan, visitMichigan.gov/coronavirus.
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COVID-19 Vaccination Schedule --non-immunocompromised.
COVID-19 Vaccination Schedule moderately to severely immunocompromised.
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A large UK study in BMJ suggests that COVID-19 vaccination after infection lowers the odds of persistent symptoms, with a 12.8% initial decline after the first dose and an 8.8% drop after the secondalthough the long-term effects are unclear.
Published this week, the observational study included 28,356 participants aged 18 to 69 years in the Office for National Statistics COVID-19 Infection Survey who had received one or more doses of the AstraZeneca/Oxford adenovirus vector or the Pfizer/BioNTech or Moderna mRNA vaccines after COVID-19 infection.
The team, led by researchers from the Office for National Statistics, monitored participants from Feb 3 to Sep 5, 2021, to identify those with COVID-19 infections and symptoms lasting at least 12 weeks. The study period spanned the emergence and dominance of the SARS-CoV-2 Delta variant but preceded the emergence of Omicron.
Participants answered survey questions and underwent COVID-19 polymerase chain reaction (PCR) testing once weekly for 1 month and then monthly for a year or longer, and those in households in which a household contact had tested positive for COVID-19 were asked to provide monthly blood samples for SARS-CoV-2 antibody testing.
Average participant age was 46 years, 55.6% were women, and 88.7% were White. Follow-up was a median of 141 days after the first COVID-19 vaccine dose for all participants and 67 days after the second dose for the 83.8% who received both doses.
Among the 28,356 participants, 23.7% reported long COVID symptoms of any severity once or more during follow-up. One vaccine dose was tied to an initial 12.8% reduction in the likelihood of long COVID, followed by increases and decreases (0.3% weekly; 95% confidence interval [CI], -0.6% to 1.2%).
A second vaccine dose was linked to an initial 8.8% (95% CI, -14.1% to -3.1%) reduction in the risk of lingering symptoms, declining 0.8% per week (95% CI, -1.2% to -0.4%) thereafter. The results didn't differ by sociodemographic factors, health status, hospital admission for the initial infection, vaccine type, or time from diagnosis to vaccination.
Of all participants, 16.7% reported that long COVID symptoms limited their ability to participate in activities at least once during follow-up. A first vaccine dose was tied to an initial 12.3% (95% CI, 19.5% to 4.5%) reduction in the chances of activity-limiting long COVID effects (0.9% per week; 95% CI, 0.2% to 1.9%) until receipt of a second dose. A second dose was linked to an initial 9.1% decline (95% CI, 15.6% to 2.1%) in the likelihood of activity-limiting long COVID, followed by a 0.5% reduction per week (95% CI, 1.0% to 0.05%) until the last follow-up.
The risk of long COVID after a first dose of COVID-19 vaccine fell over time from infection, at 24.8%, 16.5%, and 4.8% for participants who received their first dose 9, 12, and 15 months after diagnosis.
The likelihood of experiencing most symptoms, as well as more than three or five symptoms at once, declined after each vaccination, with the largest reductions in loss of smell (12.5%), loss of taste (9.2%), and poor sleep (8.8%). After the second dose, the largest declines occurred in fatigue (9.7%), headache (9.0%), and poor sleep (9.0%).
The probability of experiencing most individual symptoms and more than three or five symptoms at once fell after the first dose. Trends were mostly positive between the first and second doses, but most returned to a declining or flat trend after the second.
"People with long COVID who experience dysregulation of the immune system may benefit from autoimmune processes being 'reset' by vaccination (although whether this is long lasting remains to be established), while any residual viral reservoir may also be destroyed by the antibody response," the authors wrote.
While the observational nature of the study precludes establishment of causality, "vaccination may contribute to a reduction in the population health burden of long COVID," they concluded.
In a related editorial, Manoj Sivan, MD, of the University of Leeds in England; Trisha Greenhalgh, MD, of the University of Oxford; Ruairidh Milne, MBBS, of the University of Southampton; and Brendan Delaney, BMBCh, of Imperial College London, said the results show that vaccination is likely to avert long COVID in only a low percentage of patients.
"A clear explanation for how vaccines might reduce the multisystem manifestations of long COVID is still lacking," they wrote. "Particularly for people already well past the stage of systemic inflammatory responses, and those with end organ damage from COVID-19, such as lung fibrosis."
While the benefits of vaccination outweigh the potential risks and is particularly important for long-COVID patients, Sivan and colleagues said that much remains unknown about the effects of recurrent infection or booster doses and the long-term prognosis.
CanSino (Convidecia ) COVID-19 vaccine: Interim recommendations and more information Pan American Health Organization
In a recent study published in the American Academy of Pediatrics journal, researchers investigated the safety of coronavirus disease 2019 (COVID-19) vaccines in children in the US.
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccines have played a critical role in curbing the COVID-19 pandemic. However, there is limited data available regarding the safety of the BNT162b2 COVID-19 vaccination in younger children.
In the present study, researchers assessed post-authorization safety surveillance data related to the BNT162b2 messenger ribonucleic acid (mRNA) COVID-19 vaccine administered to children aged between five and 11 years.
The v-safe database established by the Centers for Disease Control and Prevention (CDC) monitored the effects on health post-COVID-19 vaccination. Health-based surveys were sent to guardians or parents through text messages from day 0 to day 7 after the receipt of the vaccine. The surveys were also answered six weeks and three, six, and 12 months after the vaccination. Health questionnaires in the first week included questions related to the injection site and the presence of any systemic reactions. VAERS was set by the CDC and the Food and Drug Administration (FDA) and accepted reports of vaccinated-related adverse effects.
The team collected information from v-safe and VAERS from 3 November 2021 to 27 February 2022 and from the vaccine safety datalink (VSD) from 31 October 2021 to 26 February 2022. The data included information related to children aged between five and 11 years who were vaccinated with the BNT162b2 COVID-19 vaccine.
The study described responses and health effects reported in the health surveys recorded in v-safe and serious and non-serious reports in VAERS. The number of myocarditis cases was evaluated for VAERS and classified according to gender and the number of vaccine doses received. The outcome rates of the VSD data recorded one to 21 days post-vaccination were compared to those recorded after 22 to 42 days after vaccination.
In the v-safe dataset, a total of 48,795 children aged between five to 11 years received the BNT162b2 vaccine who had a median age of eight years including 49.7% of females. Almost 96% of the v-safe participants had received one vaccine dose while 99.3% had received two doses. The study results showed that injection site reactions were reported by 54.9% of the participants after the first vaccine dose and 56.8% after the second dose. On the other hand, systemic reactions were reported by 35.3% of the single-dosed and 41.0% of the double-dosed participants. The team noted that symptoms including injection site pain, fever, myalgia, and fatigue were most commonly reported and were mild to moderate in severity.
The team also observed that 7.6% of the parents reported the inability of their child in performing normal daily tasks the day after the second vaccination, 9.0% reported the inability of the child to attend school, while 0.3% reported that their child required medical care. After the first and second dose administration, a visit to the outpatient clinic was required by 0.7% and 0.6% while hospitalization was required by 0.02% and 0.02% of the vaccinees, respectively.
In the VAERS dataset, a total of 7,578 adverse effect reports were recorded for children aged between five to 11 years who received the BNT162b2 vaccine. The median age of the participants was eight years including 47.0% of females. Almost 97.7% of the participants had received only the COVID-19 vaccine while 2.0% also received the seasonal influenza vaccine. The study results showed that 97.4% of the VAERs reports recorded non-serious events with 5.0% reporting syncope, 5.2% experiencing dizziness, 7.3% fever, 7.3% vomiting, 6.3% headache, 4.5% nausea, 4.2% urticaria, and 4.2% rash. Notably, serious adverse effects were reported by 13.4% with multisystem inflammatory syndrome in children (MIS-C), 10.8% with seizure, 9.7% with myocarditis, 6.7% with appendicitis, and 4.1% with an allergic reaction.
Furthermore, the team identified 45 reports of myocarditis with the onset of symptoms incident zero to 21 days post-vaccination. The reporting rate for vaccine-associated myocarditis was higher in males than in females and was significantly higher after the second dose as compared to the first vaccine dose. The team noted that the reporting rate of myocarditis in males detected zero to seven days after the second dose was 2.2 per one million vaccine doses administered.
Overall, the study findings showed that most of the adverse events reported after the vaccination of the BNT162b2 COVID-19 vaccine in children aged between five to 11 years were mild and showed no safety signals.
May 20, 2022
The California Department of Public Health (CDPH) is hosting a COVID-19 Vaccine Administration Billing and Reimbursement webinar on Wednesday May 25, 2022, from 11 a.m. -12 p.m. Attendees will hear information and updates from Robert Schechter, M.D., MPH, Chief of the CDPH Immunizations Branch , and Hisham Rana, M.D., and Cindy Garrett from the California Department of Health Care Services.
Click here to register.
