On February 16, Scott Nguyen went hunting. And what he found is a bit surprising: a coronavirus variant that looks like a Frankenstein virus. It has the head of the omicron variant stuck onto the body of the delta variant.
Officially, Scott Nguyen is a bioinformatician at the Public Health Laboratory in Washington, D.C. He tracks emerging coronavirus variants around the city.
But on the side, Nguyen and a handful of scientists around the world have an intriguing hobby: "We're variant hunters," he says. "I think that's a pretty cool way to describe it."
Nguyen and other variant hunters search through millions of SARS-CoV-2 genome sequences in a massive database, called GISAID, looking to uncover strains that could shift the course of the pandemic or simply give scientists a better understanding for how the virus evolves.
For instance, back in November one variant hunter found "a very weird set of ...mutations coming from a variant in South Africa," Nguyen says. "That became omicron."
Then early one morning in February, Nguyen detected not simply another variant but a whole new class of variants: variants that mix together parts of delta and omicron. And not just any parts, randomly put together. In some instances, the virus seems to be optimizing the combinations picking the best traits from each for infectiousness and immune evasion.
Specifically, Nguyen found a variant that's mostly delta but contains the spike protein of omicron the tiny studs on the surface of the virus that initiate infection. "So a good chunk of the virus' spike protein is omicron but the body of the virus is still delta," Nguyen says. "So yes, that's the best way to describe it."
So far, this variant, called XD, is rare. So, scientists have detected it in only France, Denmark, Belgium, the Netherlands and Germany. But there are likely many of these deltracrons out there. Scientists in San Mateo, California, have already found a handful of them in the U.S. At least one has emerged in the U.K. and Brazil.
Health officials, including those at the World Health Organization, are watching these hybrid variants closely. Because they demonstrate how the virus can take its most successful parts and combine them quickly into a supervirus. This process is called recombination, and it's how dangerous strains of flu are made.
"So very often recombination is the way in which we get pandemics of influenza. ," Dr. Mike Ryan with the World Health Organization said on Friday. "So we have to be very cautious ... we have to watch these recombinant events very, very closely."
For instance, omicron's spike protein is especially apt at hiding the virus from our immune system, especially our antibodies. And so the XD variant is essentially the delta variant wearing omicron's invisibility cloak.
"From the variant's perspective, it has the best of worlds," Nguyen says. ""It's surprising that the virus can really do this, and do it very well, as well.
So how does the virus do this? How does it create these Frankenstein hybrids?
For starters, a person has to catch both omicron and delta at the same time, says Shishi Luo, a bioinformatician at the genomics company Helix. "So a person has to be exposed to both variants in a short enough time frame so that they have both of them in this system."
Luo and her colleagues recently analyzed samples from nearly 30,000 Americans infected with SARS-CoV-2 during the rise of omicron in this country, from November until February. They found 20 people co-infected with both delta and omicron. In other words, they were infected twice.
"Omicron happened around Christmas and New Year, when there were many social gatherings," Luo explains. "So you can imagine, you go to one social gathering and got exposed to delta, and then you go to a different social gathering, and you catch omicron."
If both variants manage to infect the same cell, at the same time, then the virus can end up doing recombination, Luo says. In essence, during replication, one variant steals a chunk of genes from another variant. So the delta variant, in way, plagiarized part of omicron's genetic code.
"If you're writing a document, you can have typos where you change a single letter," Luo says. "But you can also copy and paste and move big chunks of text. That's recombination, where one variant, in this case delta, takes a big chunk of text from omicron."
Grabbing chunks of code instead of just single letters makes the virus more malleable or flexible, Luo says, so it can quickly evolve new variants, including ones that can evade our immune protection. "It just shows how SARS-CoV-2 has many tools in its kit for changing itself."
Scientists are just starting to understand how important recombination is for SARS-CoV-2 evolution. "It's been known that coronaviruses, in general, have a lot of recombination. For SARS-CoV-2, this is the first time we've seen so much evidence that it's happening," she adds.
In fact, recombination may be the reason SARS-CoV-2 exists in the first place. Last month, scientists at the University of Glasgow published a study in which they speculate about the origins of SARS-CoV-2. Their analysis suggests an animal in the Wuhan seafood market could have been co-infected with two coronaviruses at the same time and that these two viruses recombined, just like omicron and delta are doing right now, to generate the initial version.
"You know, early on in the pandemic, we were all expecting SARS-CoV-2 to not mutate too much," Scott Nguyen says. "But this virus has surprised us at every corner. So I think these recombinant variants provide some interesting clues to how this virus is going to evolve next" and just how quickly the next variant of concern may appear.
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A quiet change to how the US Centers for Disease Control and Prevention (CDC) publicly reports Covid death details underscores the need for the agency to communicate clearly and transparently about rapidly evolving science, experts say.
The past two years have created numerous communication challenges for the agency, which works with massive amounts of data from scores of different sources, including states and territories.
Mistakes are inevitable because humans are fallible, but there should always be an effort promptly to explain what happened and whats being done to prevent it from happening again, said Tom Frieden, a former CDC director and the president and CEO of Results Save Lives.
You have to over-communicate, basically, he said. Any time there is something that needs to be corrected, be upfront about it: heres what happened, heres what we know, heres what we dont know.
Last week, after reporting from the Guardian on mortality rates among children, the CDC corrected a coding logic error that had inadvertently added more than 72,000 Covid deaths of all ages to the data tracker, one of the most publicly accessible sources for Covid data.
The agency briefly noted the change in a footnote, although the note did not explain how the error occurred or how long it was in effect.
A total of 72,277 deaths in all age groups reported across 26 states were removed from the tracker because CDCs algorithm was accidentally counting deaths that were not Covid-19-related, Jasmine Reed, a spokesperson for the agency, told the Guardian.
The problem stemmed from two questions the CDC asks of states and jurisdictions when they report fatalities, according to a source familiar with the issue.
One data field asks if a person died from illness/complications of illness, and the field next to this asks for the date of death. When the answer is yes, then the date of death should be provided.
But a problem apparently arose if a respondent included the date of death in this field even when the answer was no or unknown. The CDCs system assumed that if a date was provided, then the no or unknown answer was an error, and the system switched the answer to yes.
This resulted in an overcount of deaths due to Covid in the demographic breakdown, and the error, once discovered, was corrected last week. The CDC did not answer a question on how long the coding error was in effect.
Working with near real-time data in an emergency is critical to guide decision-making, but may also mean we often have incomplete information when data are first reported, said Reed.
The death counts in the data tracker are real-time and subject to change, Reed noted, while numbers from the National Center for Health Statistics, a center within the CDC, are the most complete source of death data, despite lags in reporting, because the process includes a review of death certificates.
Reporting on causes of death is difficult even in non-pandemic times, experts said.
Its really hard to get accurate numbers, said Glen Nowak, a former director of media relations at the CDC and co-director of the Center for Health & Risk Communication at the University of Georgias Grady College. Its not just with Covid it happens with pretty much any infectious disease or even foodborne illnesses and waterborne illnesses, where theres a large outbreak.
There are a few reasons for that. Healthcare providers usually report the initial data, but treating patients is a more pressing priority. Death certificates take time to complete, and the cause of death may be subject to political pressure or difficulty determining the underlying reason or reasons. States and other jurisdictions may have lags in sending the data to the CDC; currently, one-third of deaths are reported after 10 days. Then the CDC processes the data, which can also be an involved process.
Most CDC data comes from state and local governments, and the quality can vary widely because there has been a decades-long under-investment in public health at the national, state, city and local levels, Frieden said.
The public health and healthcare system we have in this country makes it extraordinarily difficult to collect data well.
The CDC estimates that more than 968,000 Americans have died of Covid, and this change does not seem to have affected that estimate. The tracker shows demographic data on about 785,000 deaths, which means there may be more than 180,000 deaths not yet tallied in these breakdowns.
The recent change to demographic data shows the difficulty of offering up-to-date assessments while data reporting and analysis have lagged in the face of a massive outbreak. Data on the same topic across the CDC can also vary depending on the source and how numbers were calculated.
The level of precision that you see in these numbers makes you think that they must be really super accurate, Nowak said. Instead, they are informed estimates that help contextualize the scope of Covid compared with other illnesses.
I dont think public health and others do a good-enough job of reminding people that these numbers have significant margins of errors, Nowak said. The caveats need to be clear that these are our best estimates based on the data that has been reported to CDC.
As the scientific evidence accumulates, adjustments and changes are inevitable and frequent. But significant changes in calculations and records need to be explained clearly, particularly in an emergency where the public is frequently attuned to data and to unexplained changes like this.
The best practice, really, is to have virtually daily briefings, so that youre updating daily about what youre seeing and youre answering questions daily, Frieden said. Thats how the agency addressed past outbreaks of Ebola, Zika and H1N1, also known as swine flu.
These briefings should be held by the scientists with expertise in many areas, not just the director of the CDC, he said. The current CDC administration has gradually been getting back in the habit of doing that, and I hope that trend will continue.
The CDC is a government agency that provides data to inform national policy, and public health policies often have some political component, Frieden said. It can never be apolitical. But you should never have any concerns about the accuracy of the data.
The United States may be vulnerable to an unseen surge of COVID-19 cases right now, according to multiple health experts.
Why it matters: The United States has reached a lull period in the coronavirus outbreak. All of that could be upended without much foresight because of how Americans are currently handling the pandemic.
Driving the news: Experts are worried theres not enough public data on COVID-19 cases and there are fewer COVID-19 testing sites, forcing the U.S. to fly blind in the face of a resurgence.
What theyre saying: Comprehensive case data is critical to an effective response. As we have seen throughout the pandemic, lack of data leads to poor decision making and ultimately costs lives, Dr. John Brownstein, an epidemiologist at Boston Childrens Hospital, told ABC News.
Yes, but: PerBloomberg, data from wastewater testing sites across the country could warn us of a potential rise in COVID-19 infections because traces of COVID-19 end up in peoples waste.
What to watch: Coronavirus cases are expected to rise in the coming weeks because of the BA.2 subvariant, which has been spreading throughout Europe.
What theyre saying:I would expect that we might see an uptick in cases here in the United States because, only a week or so ago, the CDC came out with their modification of the metrics for what would be recommended for masking indoors, and much of the country right now is in that zone, where masking indoors is not required,Dr. Anthony Fauci, the nations top infectious disease expert, toldKGTVlast week.
The bottom line: System-wide modernization and change to benefit all of public health requires CDC to have the authority to coordinate and guide how data are reported and shared for evidence based decision-making, an unnamed CDC representative told ABC News. The nation can no longer continue with the current, fractured approach of collecting public health data to be better prepared for future pandemics.
CNN
In 2010, doctors told Ben Sobieck, now 37, that his kidneys were inexplicably failing. Shortly after, he had a kidney transplant and started on the lifelong medications that weaken his immune system to keep his body from rejecting the donor organ. They never figured out what caused Sobiecks kidney failure. But a decade later, he confronted another threat to his health: the Covid-19 pandemic.
I am on immunosuppressants that make me more vulnerable for serious Covid complications, said Sobieck, 37, who lives in Minnesota. If youre immunocompromised, you may not have a very good response to the [Covid-19] vaccine.
Seeking evidence that his immune system was working the way it should, Sobieck made an unusual request: He asked his nephrologist to do a blood test that gives a rough measure of antibodies, a type of protein the body creates in response to an infection or vaccine. Antibody titers reveal the concentration of a specific antibody found in someones blood.
Millions of Americans not just those with weakened immune systems are wondering about their protection after a winter of booster shots and Omicron infections. As mask mandates are lifted and restrictions removed in a step toward normalcy, a test to measure immunity would be a powerful tool to measure individual risk.
The biggest reason I wanted to get my antibody titer checked is because I dont know how to assess risk, Sobieck said. Anyone who is immunocompromised, from the beginning of this pandemic right through today, has very few tools to assess risk: if theyre going to leave the house, when theyre going to leave the house, how to interact with other people, which situations are OK.
Sobieck had his antibody levels checked after his second, third and fourth doses of the Moderna Covid-19 vaccine. Each result showed that he had more than the maximum number of antibodies the test could detect, indicating a robust immune response.
Although there is no specific guidance on how to interpret these results to figure out the level of protection against infection or disease, Sobieck felt reassured that his immune system was doing its job.
More than 50% of transplant patients dont have enough immune response to be protected, even if they get not two but three doses of the vaccine that we use in the general population, said Dr. Dorry Segev, professor of surgery at New York University Langone Health. For them, [an antibody titer] is a particularly poignant indicator of whether they have any protection at all.
Segev, a transplant surgeon, advocates using tests that measure antibodies as a way to check immune protection in people who are immunocompromised.
Sobieck says the test results allowed him to make decisions for himself and his family.
Knowing that I had the antibody response that I had meant that my son could go to in-person school. Thats huge, he said.
About 95% of Americans 16 and older have antibodies against Covid-19 as of December, the most recent date that data is available, according to US Centers for Disease Control and Prevention estimates that use information from blood donors.
But its one thing to measure antibody levels. Its another to measure how much they protect you against Covid-19.
The US Federal Drug Administration recommends against checking antibody levels at all because theres no agreed-upon way to calculate how any given antibody level protects you from infection or severe disease. It may also give a false sense of security, the agency says.
There arent good correlates of protection something that says that this is the measurement that one needs to know how well they are protected, Emory University virologist Mehul Suthar said.
Scientists are trying to fill the knowledge gap. Studies measure average antibody levels across a population to check vaccine efficacy, often using antibody levels months after vaccination to determine the need for a booster. One study in people who got the Moderna vaccine found that higher antibody levels after vaccination were associated with lower risk of Covid-19 infection.
But not all antibodies are created the same. Of all the antibodies that the body may make after infection or vaccination, only a fraction are considered neutralizing antibodies, meaning they can actively prevent infection.
Tests to measure antibodies can be either quantitative or qualitative. Quantitative tests provide a specific number, up to a certain point, of antibodies in the blood. Qualitative tests will indicate only whether certain antibodies were detected. Results of qualitative tests are either positive, negative or indeterminate for neutralizing antibodies.
When it comes to measuring neutralizing antibodies specifically, there is only one type of test that has been given emergency FDA authorization to detect them, and it is qualitative.
Several studies have demonstrated that neutralizing antibodies are a strong correlate for protection against symptomatic infection with Covid-19 and its variants, with boosters enhancing neutralization.
Peter Gilbert, professor of vaccine and infectious diseases at the Fred Hutchinson Cancer Research Center and lead author of the Moderna study, says these correlates are useful to apply to large groups. For example, scientists can use data from larger studies about the correlation between antibody levels and vaccine efficacy in adults to make a prediction about vaccine efficacy in children.
However, reaching conclusions based on one persons antibody levels is far more limited. Gilbert compares individual antibody titers with a dipstick for oil in a car.
Is the oil in a particular car low? Therefore, you need to go out and get some new oil, or in this case, get another shot of the vaccine, he said. For that purpose, the markers arent as good.
This is largely due to how antibody levels vary from person to person. That correlate of protection also changes over time and with different coronavirus variants, which makes it hard to define a cutoff for antibody levels above which scientists can confidently say that someone is protected against Covid-19.
Theres a key difference in how antibody levels compare in people who have been vaccinated against Covid-19 versus those who have been infected with the coronavirus.
Whereas a vaccine response, you may have all individuals that got the vaccine have high antibodies and sort of wane over time. With infection, its remarkably heterogeneous. Youll have lots of individuals that have very low and individuals that have very high antibody responses, Suthar said.
According to Marion Pepper, an associate professor of immunology at the University of Washington, location matters, especially for the immune system.
There are different immunological environments that make up your body. When you see an immune response in your arm, its going to be a different cast of characters than if you see an immune response in your lungs, Pepper said.
The immune system is like lots of different neighborhoods, and each one has a different flavor, depending on how an individual gets exposed to the coronavirus, whether its through a vaccine injected into the upper arm or through an infection to the respiratory system.
The CDC cites one study, which is in preprint and has not been peer-reviewed, that found antibody titers waned more quickly in vaccinated people than in people who had been infected. This may help explain the growing evidence of stronger and more durable vaccine efficacy in people who have immunity through both illness and vaccination, called hybrid immunity.
Although they may not provide the best way to tell how protected someone is, antibodies are useful to understanding how we compare people with natural immunity with those with vaccine-acquired immunity.
We know that people who have this hybrid immunity are better protected. So it also really begs the question, which of these parameters is associated with that protection? said Pepper, who leads a lab that is studying hybrid immunity.
Observing levels of immune cells and antibodies as they change over time in different groups of people can help scientists learn how to create vaccines and time vaccinations to replicate the strength of hybrid immunity without the actual infections.
Antibody levels are only one part of the immunity story. There are also T cells, a type of white blood cell that helps fight infection by killing cells that have been infected with a virus or by helping another type of white blood cell, the B cell, create antibodies.
So why do we focus so much on antibodies? One aspect is that antibodies are probably one of the easiest to measure in the laboratory, Suthar said.
I think when you go to the T-cell-based assays, theyre much more challenging, he explained. Each individual has different what are called H.L.A. types that make it a bit more challenging to understand how well ones T-cell responses are against this virus.
Unlike antibodies, which are responsible for preventing an infection, T cells are responsible for destroying cells that are already infected. T cells may play a big role in vaccine efficacy against serious disease from more transmissible coronavirus variants, such as Omicron.
One study showed that while the highly mutated Omicron could evade previously neutralizing antibodies, T cells preserved a strong response.
A memory B cell is a B cell that can get reactivated to make antibodies. It generally doesnt do that unless a T cell tells it to go, so studying the T cells is going to be really important for understanding this immune protection, Pepper said.
However, she said that the complexity of measuring T cells means there isnt going to be a rapid test to measure them any time soon.
The Omicron surge has demonstrated that infection rates can still be high even after a vaccine or a prior infection. With the possibility of more variants forming, Covid-19 has become a moving target requiring a constantly evolving understanding of these correlates of protection.
The biggest question I have and I think everyone else has is: What level of antibody equals protection from serious complications from Covid? Sobieck said.
Sealed off area following the coronavirus disease (COVID-19) outbreak in Shanghai The Denver Gazette
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A recent study posted to the Research Square* preprint server and under consideration at BMC Infectious Diseases assessed the impact of coronavirus disease 2019 (COVID-19) vaccines on unvaccinated populations and analyzed the various vaccination policies in Israel.
Various surveys have reported a stark decrease in new severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections in Israel after 48% of its population was immunized against COVID-19. Understanding the parameters and variables that affected this decline in positive cases is important to formulate more effective COVID-19 policies.
The present observational study used daily demographics of SARS-CoV-2 cases and the economic data from 250 Israeli cities to investigate the impact of vaccination on unvaccinated populations. The researchers also studied the shift from the transition phase to the community-immunity phase observed in this country.
The team collected demographic data, including individual identification numbers, age, geographic area, date of polymerase chain reaction (PCR) test for COVID-19-diagnosis and test result, time of hospitalization, the worst hospital event, and COVID-19 outcome. Also, they obtained vaccination-related data like the number of vaccinations administered per day for different age groups and geographical areas. Additionally, data like the median age of a city population and the number of people belonging to each age group were collected.
The study defined two groups of populations, including the total population in a city and the populations susceptible to COVID-19 infections like the unvaccinated individuals and recovered COVID-19 patients. Furthermore, two important factors were also defined, namely the hospitalization impact factor and the positive impact factor.
An extended framework of the susceptible-exposed-infectious-removed (SEIR+) model was used to simulate COVID-19 transmission in Israel and the impact of vaccination policies on this spread. In this model, each person is represented by one out of the following range of states: susceptible (S), exposed (E), infected but pre-symptomatic (Ipre), infected and asymptomatic (Iasym), infected and symptomatic (Isym), recovered (R), hospitalized (H), fatal (F), quarantined and susceptible (Qs), quarantined and exposed (QE), quarantined and pre-symptomatic (Qpre), quarantined and asymptomatic (Qasym), quarantined and symptomatic (Qsym), and quarantined and recovered (QR). The transitions between each state were assessed from the known probabilities of COVID-19 in Israel.
The study also simulated vaccination policies having different vaccination rates. For each vaccination rate, four vaccination policies were simulated prioritizing the vaccination of:
1) younger populations,
2) older individuals,
3) people aged over 60 years, and
4) individuals aged between 16 and 35 years and then the rest of the populations; the last policy equally distributed vaccinations among all age groups.
The study results showed that from March 2020 and January 2021, a significant number of COVID-19-positive cases were observed in three SARS-CoV-2 infection waves. Also, an increase in cases was found in each subsequent wave. It was noted that when the vaccinations were first administered to the at-risk populations, there was a significant increase in the number of cases in the unvaccinated individuals, indicating the beginning of the transition phase. However, when 48% of the total population was vaccinated or COVID-19-recovered, a remarkable reduction in the number of cases was found across all the ages, suggesting the onset of the community-immunity phase.
The positive impact factor of the young population in comparison to the entire population (impactptot) and the susceptible population (impactpsus) was evaluated. The impactptot of 0.6 observed before the onset of vaccinations indicated that the positive ratio of the younger population was 60% as compared to the entire population. The impactptot reached 1.3 after the vaccinations started, which suggested that a higher number of unvaccinated individuals were infected.
The study noted that cities with populations of a lesser median age exhibited a reduction in new SARS-CoV-2 infections even when a lower percentage of total individuals were vaccinated as compared to the other cities. Furthermore, the entire country of Israel, having a median age of 30.5 years, had a similar decrease in new positive cases when 50% of the countrys population was vaccinated.
The simulation of four vaccination policies showed that the prioritization of vaccine administration and vaccination rate of a region play a significant role in the number of COVID-19 cases and related hospitalizations. The present model showed that simultaneously vaccinating individuals of all age groups is the most efficient vaccination policy against COVID-19.
The study findings showed that the age structure of a country plays a vital role in its COVID-19 vaccination policies. The study also highlighted the need to implement measures towards establishing community immunity across all populations. The researchers believed that this study can serve as a foundation for other countries for the development of effective COVID-19 policies.
Research Square publishes preliminary scientific reports that are not peer-reviewed and, therefore, should not be regarded as conclusive, guide clinical practice/health-related behavior, or treated as established information.
Prostock-Studio / iStock.com
As much as we might like to think that public health and the economy are not dependent on one another, the reality is they are inexorably linked. A strong economy allows us to have state-of-the-art research facilities and medical treatments, but at the same time, we cant have a healthy economy without a healthy population.
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When people are sick, they dont go out and spend money, and economic activity slows. This is exactly what we saw when industries related to travel and entertainment slowed to a crawl due to the pandemic.
Fortunately, vaccines started to become available in less than a year a time that felt long but was actually lightning-quick compared to past vaccines. Its no surprise then that the companies that led the way in developing vaccines were rewarded handsomely with big increases in their stock prices. Some even saw two-year increases that were well into the triple-digit range.
Lets take a look at some of the biggest names in vaccine development and how their stocks fared since the beginning of the pandemic, and since the beginning of the COVID vaccine rollout.
BioNTech was the trailblazer for COVID vaccines released in the United States. BioNTech partnered with Pfizer in producing what is often referred to as the Pfizer vaccine, which was the first COVID vaccine available in the U.S. The two-dose vaccine is 95% efficacious, making it a key tool in preventing serious illness due to COVID-19.
Given BioNTechs key role in fighting the pandemic and the fact the company wasnt really known beforehand it comes as no surprise that its stock (NASDAQ: BNTX) has more than quadrupled since March 2020. At the time, its shares sold for $30.93, but have since increased by 338% to more than $135 per share. However, its shares have declined significantly as of late, down more than 45% in the past six months.
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Pfizer is a large pharmaceutical company many people know for drugs such as Viagra. However, the company was instrumental in helping BioNTech develop the first FDA-approved COVID vaccine in the U.S.
Pfizer stock (NYSE: PFE) has increased as a result, though not as dramatically as some of the other names mentioned here. Its stock increased 62% from March 2020 to March 2022 and 44.83% since March 2021. Its stock slipped slightly in the past month, though it only declined by 1%.
Along with Pfizer/BioNTech, Moderna is the other developer of a two-dose mRNA vaccine approved for use in the United States. Modernas vaccine is slightly less effective than the Pfizer/BioNTech vaccine, but at 94.1% efficacy, the Moderna vaccine still provides outstanding protection.
Recently, both Pfizer and Moderna have asked the FDA to approve second boosters. Pfizer and BioNTech asked for approval for adults 65 and over, while Moderna seeks approval for all adults.
Moderna stock (NASDAQ: MRNA) has done extremely well since the start of the pandemic with a nearly 550% rise in its stock since March 2020. It went from just over $21 per share in March 2020 to more than $321 per share in October 2021. However, the stock has done poorly more recently shares are up 0.88% overall for the year, but down 57% in the past six months. In the latter period, its stock price has dropped by more than $183, closing at $138.20 on March 11, 2022.
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Johnson & Johnson is a large pharmaceutical that produces much more than just vaccines. Many people know the Johnson & Johnson brand, but the company also owns brands such as Band-Aid, Neutrogena and Tylenol. J&J developed a one-dose COVID vaccine that was initially thought to be an important part of fighting the pandemic because recipients wouldnt have to return for a second dose.
But the vaccine was shown to be just 66.3% effective in clinical trials compared to more than 90% for Pfizer and Moderna. This may help explain why Johnson & Johnson (NYSE: JNJ) has fared the worst in the past two years of any stock mentioned here, up just 27.85%. Its one-year change is just 7.58%. On the plus side, it has continued a slow and steady rise in the past six months.
AstraZeneca has a two-dose vaccine that was approved for emergency use in the U.K. at the start of 2021. In November 2021, AstraZeneca announced that two billion doses of the vaccine had been administered. AstraZenecas stock (NASDAQ: AZN) hasnt fared as well as other vaccines on this list, with a 42.62% increase from March 2020 to March 2022.
The vaccine is 76% efficacious according to the World Health Organization, which is good, but not as good as other vaccines in the U.S. Plus, the vaccine was temporarily suspended in several countries due to concerns over rare blood clots.
Despite all this, shares of AZN have fared better in the past year with a 24.54% increase from March 2021 to March 2022.
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Novavax is an American biotech company that is developing a COVID vaccine. This vaccine is notable because, unlike the BioNTech and Moderna vaccines, the Novavax vaccine is a protein vaccine. While this vaccine will be a protein subunit vaccine, protein recombinant vaccines have been around since the 1970s, which could be a positive for those who are hesitant toward mRNA vaccines.
Despite this development, Novavax stock (NASDAQ: NVAX) has been even more of a roller coaster than Moderna. Its shares are up nearly 767.90% since the start of the pandemic, but down 64% the past year. That said, Novavax stock sold for just $8.41 at the start of the pandemic, and in March 2022 it sold for nearly $73.
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Methodology: For this piece, GOBankingRates used Yahoo Finance data in order to discover how the COVID-19 vaccine as affected certain vaccine/medical company stocks. First, GOBankingRates found the following for each company looked at: (1) March 13, 2020 stock closing price; (2) March 12, 2021 stock closing price; (3) October 13, 2021 stock closing price; (4) February 11, 2022 stock closing price; and (5) March 11, 2022 stock closing price. With these figures collected GOBankingRates next found the following for each stock: (6) two year (Mar. 2020 to Mar. 2022) change in stock price; (7) one year (Mar. 2021 to Mar. 2022) change in stock price; (8) six month (Oct. 2021 to Mar. 2022) change in stock price; and (9) one month (Feb. 2022 to Mar. 2022) change in stock price. All data was collected and is up to date as of March 14, 2022.
Bob Haegele is a personal finance writer who specializes in topics such as investing, banking, credit cards, and real estate. His work has been featured on The Ladders, The Good Men Project, and Small Biz Daily. He also co-runs Modest Money and is a dog sitter and walker.
John Tesser, MD: I want to dive into the waters of COVID-19 figuratively, clearly not absolutely. Lets start discussing COVID-19 vaccinations in patients with rheumatic and musculoskeletal diseases. Lets first touch on the importance of it and get into if its recommended. What are the potential problems? What are the difficulties and challenges we have in recommending them to our patients? Jen, how do you feel about the value of vaccination? Whats your understanding of how our field, through guidelines that have been coming down the pike, is advising us to recommend [the vaccine] to our patients?
Jennifer Simpson, DNP: Vaccinations are very important for our patient population. Their immune systems arent functioning the way they should be, so theyre at high risk for contracting these infections and having worse complications from them than someone without this type of disease. Vaccinations are definitely very important and should be reiterated and encouraged to our patients, and they should talk with their primary care providers about this as well. Its important to note to our patients that they may get a vaccine and it may not be as effective for them as the next person, which is why getting their [COVID] boosters and being on top of the timing with that are so important.
Generally speaking, were still understanding, and getting more information about how we need to make recommendations to our patients as far as how to take medicine, hold their medication, and how thats going to affect the vaccine efficacy. On our team weve been having patients hold their medications for a week after receiving their vaccine. What Ill often tell a patient whos on a once-a-week type of schedule, say with etanercept or with their methotrexate, is to get their flu shot and the COVID-19 vaccine on that date theyre due for their injection or pills. That way, theyre getting a week before or week after with their coverage, and hopefully that will be enough for them to mount some type of immune response.
That being said, in the general population, people think if they dont feel well after getting a vaccine, it caused them to be sick. [We need to] manage expectations with our patients, explaining to them you kind of want to feel unwell after getting a vaccine. Its telling your body youre mounting a response to what youve received. Youre building those antibodies, and thats what your immune system is doing when youre not feeling great after getting a vaccine. Thats what you want. Its working. A lot of people in the general population think thats a bad thing and that theyre getting sick and youre not, but its working.
I definitely think we need to encourage our patients and not make them feel unwelcome because you have certain patients for whom COVID-19 has been very polarizing, unfortunately, from a political standpoint. [We need to] take note of that for patients and not trying to make them feel uncomfortable in any sense. I always tell my patient, Its just my job to give you the expert opinion on whats going on and give you our viewpoint, but at the end of the day, its your decision. Its whatever you feel comfortable with because youre the one who has to live with the good, the bad, and the ugly of whatever happens. Its my job to tell you how it is, and from there you get to decide. Vaccines do go into that, especially with COVID-19, but we have to have a strong stance and really explain to patients why its so important for them to get it.
John Tesser, MD: You covered some very important points. Several of them got us through the guidelines that we have working for us. I totally agree with you. Your comments are in concert with what the ACR [American College of Rheumatology] guidance has been, and it has been changing over time. Theres a notion of things changing over time: we dont need masks, we need masks; you need to get your vaccine, maybe you dont need it, maybe it wont help you, etc. But thats how science works; everything changes. As you learn more, you change. The ACR definitely recommends to all our patients that they be vaccinated.
I agree: it needs to be a shared decision-making process. There are all kinds of reasons why people are hesitant about the vaccine, from the political, to the scared, to not wanting their disease to flare, to not believing it works, or thinking theyre going to grow 3 heads 10 years from now. But your approach is not to belittle patients, to ask them what their hesitancy is about it, and then to give them confidence. Some patients are confused because of all the misinformation and disinformation out there.
If they hear from their clinician that they recommend getting it, and now theyre hearing from their doctor, and youre a doctor too. We know that sways a lot of people in terms of their understanding. I take the stance and tell them Im a clinical immunologist. I do understand a fair amount about the immune system. We manipulate the immune system with our medicines. Vaccines are a brilliant mechanism to manipulate the system to teach it what COVID-19, the SARS-CoV-2 virus, looks like so it can recognize it. That it is a manner by which they can be protected, and that the American College of Rheumatology also advises it. You touched on holding their immunotherapies. We dont know the right answer to this. Weve been advised by the ACR with best guesses about what to do. In fact, were doing a study, called the COVER study, identifying patients who are ready to get boosters who are on these biologics and small-targeted molecules, to see if they hold their medicines and what their response will be after they get their booster shot. Were trying to figure this out. We dont know the answers. Were just flying by the seat of our pants as far as that goes.
This transcript has been edited for clarity.
