Despite some progress, the pandemic is still underway. Now, vaccine research is starting to extend its reach beyond teens and adults and on to younger children.
Although some may see children as little adults, children have different reactions to medications and vaccinations, so conducting clinical trials specific to that population is important to fully understand its benefits and potential side effects.
Currently, vaccine manufacturers Pfizer and Moderna are conducting trials in healthy children between the ages of 6 months and 11 years old. These developers have enrolled thousands of children across the United States, Poland, Finland, and Spain.
Understandably, no one wants their family member to get COVID-19. But while the vaccines seem to be the pathway out of the pandemic and to protect against the disease, many parents have questions about vaccines for their loved ones under 12.
We talked to experts about some big questions parents may have about young children and COVID-19 vaccines.
Despite decreasing cases of COVID-19, some children and many adults are still getting extremely sick, and some are even dying.
Although theres not a definitive answer yet, the CDC Advisory Committee on Immunization Practices looked at the risks and benefits of vaccinating children under 12 just recently, according to Dr. C. Buddy Creech, director of the Vanderbilt Vaccine Research Program, and professor of Pediatric Infectious Disease at Vanderbilt University Medical Center.
We certainly see disease in young children, and we have had more COVID-19-related deaths in pediatrics than we do with influenza; as a result, the risk/benefit analysis is in favor of having vaccines available for children under 12 years of age, potentially focusing first on those with underlying health issues, said Creech.
Although we currently dont know exactly when were going to see the vaccines available for those under age 12, there have been some projections for the upcoming school year.
Dr. Alok Patel, a pediatrician at Stanford Childrens Health said hes optimistic a vaccine will be given emergency use authorization for children under age 12 by this fall.
Pfizer is planning on submitting data for emergency use authorization of its COVID-19 vaccine for 5 through 11-year-old children in September or October assuming the safety and efficacy profile is like older groups, we can expect an [authorized] vaccine shortly thereafter. For younger children, my educated guess is it may be later toward the end of 2021 or early 2022, Patel said.
The timing of this vaccine for younger children is especially important as children will start to go back to school, and we now know that many people who are contracting the virus are those that are unvaccinated.
While its true that young children are less likely to become severely ill from COVID-19, theres still a chance.
Healthcare workers across the country have seen children of all ages get sick, be admitted, end up in the ICU, and some in rare circumstances die from the disease and its complications.
In some cases, children have developed multisystem inflammatory syndrome or MIS-C weeks or months after initially developing COVID-19, causing long-term health issues.
Were still learning about the spectrum of COVID in kids. The risk is also increased for any children with underlying comorbidities such as asthma, diabetes, or any type of immunosuppression, Patel told Healthline.
Many experts agree that its possible to open schools to kids for in-person learning before all school-aged children are fully vaccinated. However, its important to take precautions as much as possible to reduce transmission from one child to another.
Practices such as mask wearing, distancing, and ventilation can all assist in lowering risk.
Patel reminds everyone that herd immunity can indirectly protect young children and others who are not yet vaccinated, and parents should consider the case rate and vaccination rate in their own communities when making [a] decision for how to best protect their children against COVID-19.
Dr. Teresa Murray Amato, chair of emergency medicine at Long Island Jewish Hospital encourages parents to: Speak to their pediatricians regarding the appropriateness of their child receiving the vaccine, as vaccinating children could lead to less spread of the virus to more vulnerable populations.
Ensuring that information is from a reliable source is important in making decisions about vaccinating your child.
Having an open dialogue about the risks, benefits, and questions with a physician can assure you of the vaccines safety for your child and what it may mean for your family.
Many parents are eagerly waiting for the vaccines authorization, but some still have their concerns about the vaccines.
I think the biggest concern right now is whether the side effect profile in children will be similar to that of adults, Creech said. If so, parents will have a lot of confidence that this is a safe and effective vaccine.
Vaccine researchers are doing all they can to understand the most significant side effects associated with the vaccines continuously via previous studies with adults and with new findings in the studies that evaluate children.
We always make safety our first priority, in the spirit of first, do no harm. Parents and children can have confidence in that, said Creech.
It is our job as healthcare providers, scientists, and vaccinologists to listen carefully to concerns and try our best to provide solid, helpful information, Creech said.
He pointed out that having an open dialogue is important in the medical decision-making process. Understanding concerns, providing data, and addressing questions that are based on false information can help not only care for patients but dispel false information.
I think at this stage of the pandemic, it is clear to us in medicine that vaccinations for COVID-19 are highly safe and effective. That does not mean that rare side effects cannot happen, but it does mean that those rare side effects should be understood in context since the risk of complications after disease remains much, much higher than the 1 in a million rare events we sometimes see after vaccination, Creech explained.
The COVID-19 vaccines have a remarkable safety profile. Theres no reason to believe that young children will react any differently than older children.
In clinical trials, children aged 12 to 17 tolerated the vaccine very well, without any severe adverse side effects reported. Even still, younger children deserve their own separate trial; younger immune systems may react differently to the vaccine, said Patel.
He pointed out that the data will be thoroughly reviewed by the CDC, Advisory Committee on Immunization Practices, and FDA prior to the vaccines being administered to children under age 12.
There are some serious side effects, including myocarditis, reported in young adults and teens who have been vaccinated. But experts point out the risk from developing COVID-19 is far higher.
Parents should remember both myocarditis and pericarditis following COVID-19 vaccine administration are extremely rare events, Patel told Healthline.
The CDC reviewed the potential link between myocarditis and COVID-19 and found in 12- to 39-year-olds, heart inflammation occurred at a rate of 12.6 cases per million second doses given. The rate after the first dose was 4.4 cases per million doses administered.
Patel reminds parents of two key points regarding myocarditis or inflammation of the heart: The cases of heart inflammation tend to be mild and self-resolving, and that taking your chances with COVID is worse than with the vaccine, as the virus itself can cause heart inflammation alongside MIS-C, organ damage, and worse.
Also, given how rare the cases of myocarditis/pericarditis are and the known risks from the actual virus, its not surprising the American Heart Association, American Academy of Pediatrics, CDC, and other medical groups still recommend teens get the vaccine, Patel said.
For Immediate Release: July 13, 2021
The U.S. Food and Drug Administration today announced the following actions taken in its ongoing response effort to the COVID-19 pandemic:
The Janssen COVID-19 Vaccine Fact Sheet for Healthcare Providers Administering Vaccine (Vaccination Providers) has been revised to include a warning about GBS and the Fact Sheet for Recipients and Caregivers has been revised to include information about GBS. The warning in the Fact Sheet for Healthcare Providers Administering Vaccine notes that reports of adverse events suggest an increased risk of GBS. Additionally, the Fact Sheet for Recipients and Caregivers notes that vaccine recipients should seek medical attention right away if they develop any of the following symptoms after receiving the Janssen COVID-19 Vaccine: weakness or tingling sensations, especially in the legs or arms, thats worsening and spreading to other parts of the body; difficulty walking; difficulty with facial movements, including speaking, chewing or swallowing; double vision or inability to move eyes; or difficulty with bladder control or bowel function.
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Boilerplate
The FDA, an agency within the U.S. Department of Health and Human Services, protects the public health by assuring the safety, effectiveness, and security of human and veterinary drugs, vaccines and other biological products for human use, and medical devices. The agency also is responsible for the safety and security of our nations food supply, cosmetics, dietary supplements, products that give off electronic radiation, and for regulating tobacco products.
07/13/2021
Confirmed cases of COVID-19 have passed 187.2 million globally, according to Johns Hopkins University. The number of confirmed deaths stands at more than 4.03 million. More than 3.44 billion vaccination doses have been administered globally, according to Our World in Data.
More than 900,000 people in France rushed to set up appointments to get vaccinated on Monday night after the president warned that people would see curbs imposed on them if they did not have a health pass that covered a vaccine or negative COVID test.
Malaysia reported 11,079 new coronavirus infections on Tuesday, the most number of cases recorded in a single day since the start of the pandemic.
Myanmar's military authorities pledged on Monday to ramp up oxygen supplies to help treat COVID-19 patients. The country saw a record 80 coronavirus deaths and 5,014 new cases on Monday, state-run MRTV said.
South Korea has halted its rollout of COVID-19 vaccinations to people aged 55-59 for a week, after a spike in new cases sparked a rush for shots, booking up available supplies and crashing the official government reservation website. It came as daily infections topped 1,000 cases for the seventh day straight.
The U.S. Food and Drug Administration on Monday added a warning to the fact sheet for Johnson & Johnson's COVID-19 vaccine saying that data suggests there is an increased risk of a rare neurological disorder in the six weeks after inoculation.
Australian authorities reported a slight slowdown in new COVID-19 cases in Sydney on Tuesday, but may still extend a lockdown in the country's largest city to douse an outbreak of the highly contagious Delta variant.
Dutch Prime Minister Mark Rutte conceded on Monday that coronavirus restrictions had been lifted too soon in the Netherlands and he apologised as infections surged to their highest levels of the year.
Sweden's government said on Monday it will move ahead with a planned easing of pandemic restrictions this week but warned that new variants of the virus demanded vigilance as it urged people to adhere to social distancing recommendations.
The Delta variant is fuelling a "two-track pandemic", the World Health Organization's Director-General has warned.
Speaking at a media briefing, Dr Tedros Adhanom Ghebreyesus said: "The Delta variant is ripping around the world at a scorching pace, driving a new spike in cases and death."
Delta is now in more than 104 countries and will soon become the dominant COVID-19 strain, he said. Cases have risen worldwide for four consecutive weeks, and after 10 weeks of declines, deaths are increasing again.
He warned that it's not hitting all countries equally, depending on vaccine access.
"We're in the midst of a growing two-track pandemic where the haves and have-nots within and between countries are increasingly divergent.
"The global gap in COVID-19 vaccine supply is hugely uneven and inequitable. Some countries and regions are actually ordering millions of booster doses, before other countries have had supplies to vaccinate their health workers and most vulnerable," said Tedros.
In 2000, Gavi, the Vaccine Alliance was launched at the World Economic Forum's Annual Meeting in Davos, with an initial pledge of $750 million from the Bill and Melinda Gates Foundation.
The aim of Gavi is to make vaccines more accessible and affordable for all - wherever people live in the world.
Along with saving an estimated 10 million lives worldwide in less than 20 years,through the vaccination of nearly 700 million children, - Gavi has most recently ensured a life-saving vaccine for Ebola.
At Davos 2016, we announced Gavi's partnership with Merck to make the life-saving Ebola vaccine a reality.
The Ebola vaccine is the result of years of energy and commitment from Merck; the generosity of Canadas federal government; leadership by WHO; strong support to test the vaccine from both NGOs such as MSF and the countries affected by the West Africa outbreak; and the rapid response and dedication of the DRC Minister of Health. Without these efforts, it is unlikely this vaccine would be available for several years, if at all.
Read more about the Vaccine Alliance, and how you can contribute to the improvement of access to vaccines globally - in our Impact Story.
"In places with high vaccination coverage, Delta is spreading quickly; especially infecting unprotected and vulnerable people and steadily putting pressure back on health systems."
In countries with low vaccine coverage, the situation is particularly bad, he added: "Delta and other highly transmissible variants are driving catastrophic waves of cases, which are translating into high numbers of hospitalisations and death."
He said the current wave of infections was demonstrating vaccines are "a powerful tool" to battle the virus, but warned they have "never been the way out of this crisis on their own".
How the COVID-19 vaccine roll-out differs around the world.
Image: Our World in Data
It comes as the World Health Organization's chief scientist on Monday advised against people mixing and matching COVID-19 vaccines from different manufacturers, calling it a "dangerous trend" since there was little data available about the health impact.
"It's a little bit of a dangerous trend here. We are in a data-free, evidence-free zone as far as mix and match," Soumya Swaminathan told an online briefing.
"It will be a chaotic situation in countries if citizens start deciding when and who will be taking a second, a third and a fourth dose."
Tokyo Governor Yuriko Koike said on Tuesday that a sufficient number of hospitals combined with a speed-up in the vaccination rollout among the elderly meant the city will be able to hold a "safe and secure" Olympic Games in ten days.
But Koike, speaking to Reuters in an interview at the Tokyo government headquarters which has for the last few weeks doubled as a vaccination site, also warned that the coronavirus pandemic is far from over and the spreading Delta variant remains a risk.
"Very many people will be vaccinated in the coming ten days and during the Olympics. The biggest change as a result of that will be a substantive fall in the ratio of deaths and severe cases among the elderly," Koike said.
"Because of that, and because the medical system is ready, I think we can press ahead with a safe Olympics," said Koike, who has returned to work after a brief break due to fatigue during which she was admitted to hospital.
The Japanese capital entered its fourth state of emergency on Monday causing bars and restaurants to close early, amid a rebound in COVID-19 cases that also pushed the Games organisers last week to ban spectators from nearly all venues.
Spectators from abroad were already banned months ago, and officials are now asking residents to watch the Games on TV to keep the movement of people to a minimum.
The views expressed in this article are those of the author alone and not the World Economic Forum.
Scientists say a Belgian woman was infected with two coronavirus variants at the same time, including beta. Beta's spike protein is shown here in a scientific illustration. Juan Gaertner /Getty Images/Science Photo Library hide caption
Scientists say a Belgian woman was infected with two coronavirus variants at the same time, including beta. Beta's spike protein is shown here in a scientific illustration.
The patient came to the hospital because she was repeatedly falling down. She was breathing fine, and her blood oxygen levels were good. But tests showed that the 90-year-old Belgian woman had COVID-19 and not just one strain, but two variants of the virus. She died at the hospital in just five days after her respiratory system rapidly deteriorated.
"To our knowledge, this is one of the first reports of a double infection" with two coronavirus variants of concern, the researchers said.
The woman had both the alpha and beta variants of the coronavirus (which were detected first in the U.K. and South Africa, respectively), according to a paper that was presented over the weekend at the European Congress of Clinical Microbiology & Infectious Diseases.
"Both these variants were circulating in Belgium at the time, so it is likely that the lady was co-infected with different viruses from two different people," said Anne Vankeerberghen of the OLV Hospital in Aalst, Belgium, in a news release.
"Unfortunately, we don't know how she became infected," added Vankeerberghen, who is a molecular biologist and lead author of the report.
Before falling ill, the woman had been living alone in her home, where she received nursing care. Her previous medical history contained no red flags, according to Vankeerberghen and her co-authors.
But a screening test for SARS-CoV-2, the virus that causes COVID-19, returned a "strongly positive" result. Follow-up PCR tests for variants of concern identified the two coronavirus strains in her system. Secondary tests confirmed the unusual results.
While the case is being seen as the first confirmed instance of a double infection, Vankeerberghen and the other researchers note that similar cases have been reported. In Brazil, for instance, people were found to have two variants in their system early this year, but that study has not yet been published. And in the past, the researchers say, flu patients have been found to have contracted two distinct strains of the influenza virus.
Testing for coronavirus variants in COVID-19 patients is routine at the OLV Hospital. While the researchers call the woman's condition "exceptional," they say more widespread testing for variants of concern "would probably identify more mixed infection and could lead to a better insight for their effect on illness and treatment."
Coronavirus variants have been blamed for driving localized or regional surges of new COVID-19 cases in the U.S., even as high vaccination rates have tamped down on cases in many areas.
In April, the Biden administration announced a massive push to boost testing for variants.
"U.S. public health officials have been operating with incomplete information because of an inadequate viral genomics surveillance system," as NPR reported at the time.
Health experts say it's particularly vital to identify the strains of the virus that are responsible for thousands of U.S. "breakthrough cases," in which the virus manages to infect vaccinated people.
A single change in a key viral protein may have helped the coronavirus behind COVID-19 make the jump from animals to people, setting the virus on its way to becoming the scourge it is today.
That mutation appears to help the virus spike protein strongly latch onto the human version of a host protein called ACE2 that the virus uses to enter and infect cells, researchers report July 6 in Cell. That ability to lock onto the human cells was stronger with the mutated virus than with other coronaviruses lacking the change. Whats more, the mutated virus better replicates in laboratory-grown human lung cells than previous versions of the virus do.
Without this mutation, I dont think the pandemic would have happened like it has, says James Weger-Lucarelli, a virologist at Virginia Tech in Blacksburg. The coronaviruss global spread might have been less likely, he says.
Where exactly the coronavirus came from is still a mystery that researchers are trying to unravel (SN: 3/18/21). But figuring out how an animal virus gained the ability to infect people could help researchers develop ways to prevent it from happening again, such as with antivirals or vaccines, Weger-Lucarelli says.
The new findings hint that the mutation is important, but its potentially one of multiple changes that made the jump from animals to people possible, says Andrew Doxey, a computational biologist at the University of Waterloo in Canada who was not involved in the study. Its not necessarily the only mutation.
Virologist Ramn Lorenzo Redondo agrees. The researchers employed an approach that is not typically used for viruses, says Redondo, of Northwestern University Feinberg School of Medicine in Chicago. That means the method may have overlooked other important mutations.
In the study, Weger-Lucarelli and colleagues analyzed more than 182,000 genetic blueprints of the coronavirus, looking for signs of mutations that might have helped the virus adapt to and spread among humans. The team compared changes in the building blocks, or amino acids, of the virus spike protein with four coronaviruses from bats or pangolins that dont infect people. The scientists pinpointed one swap that replaced the amino acid threonine that is found in the animal viruses with the amino acid alanine that is found in the coronavirus that causes COVID-19.
The researchers predict that the mutation, named T372A, removes some sugars that coat the spike protein. Those sugars might be getting in the way, Weger-Lucarelli says, so removing them gives the virus better access to ACE2 to break into cells.
Experiments suggest thats true. Once a virus with an alanine gets into laboratory-grown human lung cells, it replicates more than versions with threonine, the team found. In the future, the researchers plan to explore the role other mutations might have played to help an animal virus adapt to humans.
Its unclear when the virus acquired the T372A mutation, says Arinjay Banerjee, a virologist with the Vaccine and Infectious Disease Organization at the University of Saskatchewan in Saskatoon, Canada, who was not involved in the study. A bat coronavirus with a threonine at that spot may have infected people first and then rapidly adopted an alanine, helping the virus transmit more efficiently among people. Or its possible that the alanine appeared in bats or in another animal before making the jump.
Those questions, I think, are still outstanding, Banerjee says.
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BAGHDAD The death toll at a southern Iraqi hospital treating Covid patients rose to at least 92 people on Tuesday, as witnesses described chaotic scenes of volunteers desperately trying to pry open a padlocked front door, malfunctioning fire extinguishers, and fire trucks running out of water as the ward burned.
The fast-spreading blaze tore through the new isolation ward at the Imam Hussein Teaching Hospital in the city of Nasiriya late Monday night into early Tuesday. It was the second such tragedy in the country in less than three months, after a similar fire broke out in April in a Baghdad coronavirus hospital and killed at least 82 people.
Most of the patients were breathing through ventilators and unable to move, said Dr. Aws Adel, a health official for the province of Dhi Qar which includes Nasiriya. Most of the hospital staff were able to escape.
The lack of precautions at the hospital, the speed at which the fire spread, and the feeble ability to fight it reflected a country in deep crisis after years of corruption and government mismanagement have left basic government services barely functioning.
The fire was sparked by an electrical short in a ventilator that resulted in oxygen canisters exploding, said Brig. Gen. Fouad Kareem Abdullah, a provincial police spokesman.
The Iraqi civil defense chief, Maj. Gen. Kathem Bohan, said the building that housed the three-month-old coronavirus isolation ward next to the main hospital had been constructed from flammable materials. The roof appeared to have melted along with sandwich board panels with foam cores that made up much of the construction. Other officials have said oxygen is stored haphazardly at almost all Iraqi hospitals.
Provincial health officials said that around 70 patients and at least as many of their relatives were in the ward when the fire broke out. While normal coronavirus precautions ban visitors from isolation wards, a lack of nursing and other hospital staff in Iraq mean that patients rely on family members to take care of them.
Ahmed Sachet al-Ghizzi, 21, said he was on a bridge near the hospital late Monday night when he saw smoke and flames. He rode there on his motorbike and tried to open the front door of the ward so people could escape, but found it locked.
He said he and other volunteers, many of them young men who are part of an active anti-government protest movement in Nasiriya, ran to the back door but couldnt enter because of the flames and smoke.
It was open, but it was a narrow door and people were pushing to get out, he said. Nurses rushed to try to put out the flames with portable fire extinguishers, but almost none of them were working, he added.
Mr. al-Ghizzi said he and others broke the front door down to allow more people to flee while desperate relatives who had heard about the fire tried to rush into the burning building.
People were shouting and crying: I want my dad! Im looking for my brother! Where is my mom? he said. We made a human chain to keep them out so we could try to rescue some of the wounded.
Salam al-Ghizzi, another volunteer, said that when he arrived at the hospital to try to help, he found the front door padlocked with chains. He said the ceiling began to collapse while flames engulfed the door, and no one could get in or out.
We saw the firefighting vehicles had run out of water and there was no emergency water source in the hospital, he said. We could hear people screaming, saying they needed help, that their mothers or fathers were inside. But we could not help them.
The dead were almost all patients, family members caring for them, or others who tried to rescue them, according to provincial health officials in Nasiriya. They said two health care workers were killed but other staff members managed to flee before the fire spread and the ceiling of the prefabricated building collapsed.
Dr. Adel said the dead included at least one volunteer, an engineer, who rushed into the burning building to try to help.
What happened yesterday in Nasiriya represents a deep wound in the conscience of all Iraqis, Prime Minister Mustafa al-Kadhimi told a special session of parliament on Tuesday. He ordered the detention of the provincial health director, the civil defense chief and the hospital director.
If this disaster happened in any other country, it would be reason for the resignation of the entire government, the parliamentary health and environment committee said in a statement, adding that the repeated tragedies show that Iraqi lives are not valued.
During the day on Tuesday, workers tried to retrieve the remains of victims from under the charred ruins of the three-month-old facility. At least 22 bodies were so badly burned that health officials were using DNA tests to identify them.
Iraq is in the midst of a third wave of coronavirus infections. Last week, the country reached a high of 9,000 new cases a day with more than 17,000 dead since the pandemic began, according to the health ministry. The infection and death rates are believed to be significantly undercounted because many people believe it is safer to be treated at home.
The fire in April at a coronavirus hospital in the capital, Baghdad, was believed to have been caused by a spark igniting improperly stored oxygen canisters. Some of the patients hooked up to ventilators were burned alive in their beds along with visiting relatives who would not leave them.
The hospital had no working fire alarm and no sprinkler system and Iraqs health minister at the time resigned in response.
Falih Hassan, Awadh al-Taiee and Nermeen al-Mufti contributed reporting.
Updated at 1:21 p.m. ET on July 13, 2021.
The first thing to know about the COVID-19 vaccines is that theyre doing exactly what they were designed and authorized to do. Since the shots first started their rollout late last year, rates of COVID-19 disease have taken an unprecedented plunge among the immunized. We are, as a nation, awash in a glut of spectacularly effective vaccines that can, across populations, geographies, and even SARS-CoV-2 variants, stamp out the most serious symptoms of disease.
The second thing to know about the COVID-19 vaccines is that theyre flame retardants, not impenetrable firewalls, when it comes to the coronavirus. Some vaccinated people are still getting infected, and a small subset of these individuals is still getting sickand this is completely expected.
Were really, really bad at communicating that second point, which is all about breakthroughs, a concept that has, not entirely accurately, become synonymous with vaccine failure. Its a problem that goes far beyond semantics: Bungling the messaging around our shots astounding success has made it hard to convey the truly minimal risk that the vaccinated face, and the enormous gamble taken by those who eschew the jabs.
The main problem is this. As the CDC defines it, the word breakthrough can refer to any presumed infection by SARS-CoV-2 (that is, any positive coronavirus test) if its detected more than two weeks after someone receives the final dose of a COVID-19 vaccine. But infections can come with or without symptoms, making the term imprecise. That means breakthroughs writ large arent the most relevant metric to use when were evaluating vaccines meant primarily to curb symptoms, serious illness, hospitalizations, and death. Breakthrough disease is what the average person needs to be paying attention to, Cline Gounder, an infectious-disease physician at Bellevue Hospital Center in New York, told me. Silent, asymptomatic breakthroughsthose that are effectively invisible in the absence of a virus-hunting diagnosticare simply not in the same league.
To put this in perspective, consider the original criteria laid out by the FDA about this time last year, back when the United States was still solidly in its second infectious surge. An effective inoculation, the agency said, should be able to prevent disease or decrease its severity in at least 50 percent of people who are vaccinated. Its an easy benchmark to forget. By the close of 2020, two vaccines absolutely obliterated those expectations; two months later, a third followed, and now theres buzz of a fourth.
If disease is our yardstick, then breakthrough COVID-19 casesa very small subset of all known breakthroughsmight meet our criteria for concern. These are actual illnesses, events where the shots protection has apparently crumbled; these cases are the same ones that vaccine makers searched so diligently for in clinical trials, to ensure that their products were working. By the same logic, asymptomatic coronavirus infections fall outside our shots protective purview as we defined it so many months ago. And although theyre important to track and glean data from, conflating them with the rest, experts told me, risks misrepresenting what our vaccines can do. (The CDC responded to an inquiry about its designation by saying that while a SARS-CoV-2 infection indicates any positive tests for the virus and a COVID case refers to a person with a positive test who meets other case definitions, throughout COVID the terms infection and case have often been used interchangeably.)
Read: Heres why breakthroughs happen
The term breakthrough has long been a staple of the infectious-disease community, where its used to describe the detection of vaccine-preventable pathogens in immunized individuals. This is definitely not a new idea, says Kevin Escandn, a physician and infectious-disease researcher at the University of Valle, in Colombia. But as a popular notion, it was always doomed to cause some confusion. Breakthrough is still used as an adjective of praise; the pandemic has now warped the word into a foreboding noun that tends to eclipse all clarifying qualifiers. Its confusing, its fuzzy, its already loaded, Alison Buttenheim, who studies human behavior around vaccines at the University of Pennsylvania, told me. And when news appears in a headline or push alert, or on social media, people pay attention to the word breakthrough and not much else, Ryan McNamara, a virologist at the University of North Carolina at Chapel Hill, told me. Thats unfortunate, when the simple addition of asymptomatic or symptomatic can make all the difference. As they stand, blanket breakthroughs sound far scarier than they should.
Joseph Allen, a public-health researcher at Harvard, recently pointed out on Twitter one such ambiguity, in a study documenting a very small number of breakthrough infections at a prison. All were asymptomaticthough you wouldnt know it from the papers title.
To be clear, breakthroughs of any severity are an entirely expected part of the vaccination process. No vaccines are 100 percent effective at preventing infection or disease. But our current crop of COVID-19 shots comes pretty damn close with regards to stymieing symptoms, especially the severe ones that can signal a deadly case. The Moderna and Pfizer shots have consistently demonstrated very high COVID-prevention rates, often in the 90s; Johnson & Johnsons, for the most part, isnt far behind. Symptomatic breakthroughs are the cases that wedge themselves in the gap between excellent effectiveness and perfect effectiveness; in other words, we saw them coming.
Even out in the messiness of the real world, symptomatic breakthrough cases are proving themselves quite rare. The overwhelming majority of the COVID-19 cases were seeing are among the unvaccinated. And when the virus does affect the immunized, it seems to accumulate to lower levels, and spread less enthusiastically to new hosts; its causing, on average, milder and more transient symptoms.
All of this is a reminder of how vaccines workby ratcheting up our immunity against the version of SARS-CoV-2 that the shots were formulated to mimic. If humans are wood that fuels a flame, and coronaviruses are the sparks that ignite it, vaccines are the fire suppressants that protect best against the worst of the viral burn: severe disease, hospitalization, and death. Stopping milder cases requires more immune investment, and blocking asymptomatic infectionsones that barely singe the barkis most difficult of all. Its part of why the vaccines goalposts were at first set so conservatively. This is not a magic shield that just bounces coronavirus right off you, McNamara told me.
Considering that we first took aim at stopping disease, its great news that the majority of known breakthroughs have actually been asymptomatic infections, not COVID-19 cases. The proportions of silent breakthroughs reported by various studies and federal agencies are certainly undercounts, because vaccinated people arent regularly screened for the coronavirus. (On May 1, the CDC controversially switched its reporting strategy to documenting only breakthrough cases involving some form of hospitalization or death, skewing national counts further.) Since the vaccines first deployed, the news has only improved: Researchers didnt bank on it, but in many people, the shots seem to stop the coronavirus from establishing itself at all. The vaccines are better than anything we ever dreamed of, Gounder told me, exceeding our first expectations in more ways than one.
The shots are even holding their own against SARS-CoV-2 variants. A few versions of the virus have picked up mutations that help them dodge certain anti-coronavirus antibodies. But these genetic alterations chip away only incrementally at immune protection, rather than obliterating it. Against Delta, for instance, vaccines like Pfizers are still curbing severe disease, hospitalization, and death to an extraordinary degree. And while the shots strength has slightly slackened when it comes to milder illnesses and silent infections, those are simply lower hurdles for a virus to clear. Pfizers protection is still hitting its mark where it matters the most. (One asterisk on this is long COVID, a condition whose relationship to vaccination is still being actively researched.)
None of this means, of course, that asymptomatic breakthrough infections should be ignored. To fully understand what the virus is doing and where it might be headed, experts need as comprehensive a picture as they can get of whom its afflicting, and what form those infections take, across the entire spectrum of disease. They also need to know how and when its most likely to spread. Asymptomatic infections are a part of that. Researchers around the world are still diligently sequencing any and all test-positive coronavirus samples they can, regardless of symptoms, in part to check whether any particular variants are disproportionately infiltrating the inoculated. Theyre also tabulating whos experiencing breakthroughs, and testing whether select populations might benefit from an early vaccine boost.
Read: What breakthrough infections can tell us
And when vaccines start to consistently falter against more severe tiers of diseasebecause of either a new variant, waning immune memory of the virus, or boththe diligent monitoring of breakthroughs will pick it up. Tracking milder breakthroughs is also crucial to figuring out how well the virus can be transmitted from vaccinated people, something thats much more difficult to determine than whether inoculations merely block disease. From a surveillance standpoint, casting a broad net for breakthroughsone that accounts for infections of all typesis essential, Buttenheim said. Thats how you catch everything.
The question of which breakthroughs matter ultimately depends on another: Whats the goal of vaccination? Gounder thinks that, for now, the focus should stay on using immunizations to control COVID-19, especially while so much of the world remains unvaccinated; understanding whether were accomplishing that goal, then, hinges on symptomatic breakthroughs. Eventually, well have the bandwidth to turn our attention to halting transmission and infection more comprehensively. Then, well pull asymptomatic breakthroughs back into the conversation, with more data to guide our next move.
The U.S. has seen a string of COVID-19 outbreaks tied to summer camps in recent weeks in places such as Texas, Illinois, Florida, Missouri and Kansas, in what some fear could be a preview of the upcoming school year.
In some cases the outbreaks have spread from the camp to the broader community.
The clusters have come as the number of newly confirmed cases of the coronavirus in the U.S. has reversed course, surging more than 60% over the past two weeks from an average of about 12,000 a day to around 19,500, according to data from Johns Hopkins University.
The rise in many places has been blamed on too many unvaccinated people and the highly contagious delta variant.
Gwen Ford, a 43-year-old science teacher from Adrian, Missouri, was cautiously optimistic when she eyed the dropping case numbers in the spring and signed up her 12-year-old daughter for the West Central Christian Service Camp.
But one day after the girl got home from a week of playing in the pool, worshipping with friends and bunking in a dormitory, Ford got an email about an outbreak and then learned that her daughters camp buddy was infected.
It was very nerve-wracking. It kind of seems like we finally felt comfortable and it happened, Ford said, adding that her daughter ultimately tested negative.
Ford said she definitely plans to get her daughter vaccinated but hadnt done so because there wasnt much time between the start of camp and the governments authorization of the Pfizer vaccine for 12- to 15-year-olds in May.
A note posted on the camps Facebook page showed that the camp nurse and several other staff members and volunteers were among those infected. Staff members at the camp did not return a call for comment.
JoAnn Martin, administrator of the public health agency in surrounding Pettis County, lamented the difficulty in getting people to take the virus seriously and get vaccinated.
It has been a challenge since the first case, she said. You have people who still say it is not real. You have people who say it is a cold. You have people who say what is the big deal. You have people who say it is all a government plot.
Dr. William Schaffner, a Vanderbilt University infectious disease specialist, said he isnt surprised by the outbreaks as camps reopen this year after being closed last summer. He said he had his doubts that some camps thought through all the implications of camping during COVID.
Ideally, he said, camps would require vaccinations for adults and for campers who are old enough, and would take other measures such as serving meals in shifts, putting fewer youngsters in the cabins and requiring anyone unvaccinated to wear masks indoors.
In the Houston area, health officials reported more than 130 youths and adults tested positive for the virus in cases connected to a church camp. The pastor of Clear Creek Community Church in League City said the outbreak happened in two waves, first at the camp and then when people returned home in late June.
In some cases, entire families are sick, pastor Bruce Wesley said on the churchs Facebook page.
In Illinois, health officials said 85 teens and adults at a Christian youth camp in mid-June tested positive, including an unvaccinated young adult who was hospitalized, and some people from the camp attended a nearby conference, leading to 11 additional cases.
The Illinois Department of Public Health said all the campers were eligible for the vaccine, but only a handful of campers and staff had received it. The camp didnt check peoples vaccination status or require masks indoors, according to the department.
The health department in Leon County, Florida, which includes Tallahassee, tweeted this month that an increase in cases there also was tied in part to summer camp outbreaks.
And in Kansas, about 50 people have been infected in an outbreak linked to a church summer camp held last month not far from Wichita.
Elsewhere the situation is better. The roughly 225 overnight camps and thousands of day camps run by local YMCAs are mostly open this summer, though with slightly reduced capacity, said Paul McEntire, chief operating officer for YMCA of the USA.
McEntire said he is aware of a few cases of Y camps where people tested positive for the virus, but no instances of significant spread. He said many camps are taking precautions such as serving meals in shifts or outside and trying to keep youngsters in separate groups. Most are requiring masks indoors, but he acknowledged it can be a challenge.
To be frank, there are some parents that didnt want to send their kids unless they were assured that masking was being used indoors, he said. There were others that took the exact opposite viewpoint.
Ahead of the school year, the Centers for Disease Control and Prevention updated its guidance last week to say vaccinated teachers and students dont need to wear masks inside and 3-foot distancing of desks is not necessary for the fully vaccinated.
On Monday, California announced rules for public schools that let students and teachers sit as close to each other as they want but still require them to wear masks. Other state and district officials have adopted a patchwork of coronavirus regulations for schools.
Summer camp outbreaks certainly could be a precursor to what happens when youngsters return to classrooms in the fall, said Dr. Michelle Prickett, a pulmonary and critical care specialist at Northwestern Memorial Hospital in Chicago. The outcome will depend on vaccination rates and which virus variants are prevalent, she said.
We just need to be vigilant, Prickett said.
Schaffner said he thinks schools wont face similar outbreaks because they tend to be more structured and disciplined than camps and because most got used to making adjustments over the past year and a half. But he said the best way to reduce the risk is to get most people vaccinated.
There are many parts of the country that simply have not grasped this, he said.
It could be several months before regulators make a decision on authorizing shots for children under 12. Studies on such youngsters are still going on.
Meanwhile, in Tennessee, the states top vaccination official was fired Monday after facing scrutiny from Republican state lawmakers over her departments outreach efforts to vaccinate teenagers against COVID-19. Dr. Michelle Fiscus told The Tennessean newspaper about her termination. A Health Department official said the agency would not comment.
The Department of Health instructed county-level employees recently to stop vaccination events aimed at teens and to halt any online outreach to them, The Tennessean previously reported, citing emails it obtained.
Ford, the teacher whose daughter narrowly escaped getting COVID-19 at a Missouri summer camp, is worried.
With the uptick in cases, I am concerned that we wont be able to go back to normal, and we will have to ask people to mask and stuff, she said, and I have a feeling that there is going to be a huge argument.
(Washington, DC) The Districts reported data for July 9-11, 2021 includes 71 new positive coronavirus (COVID-19) cases, bringing the Districts overall positive case total to 49,526.
The District reported that one additional resident lost her life due to COVID-19.
Tragically, 1,144 District residents have lost their lives due to COVID-19.
Visit coronavirus.dc.gov/data for interactive data dashboards or to download COVID-19 data.
Below is a summary of the Districts current ReOpening Metrics.
Below is the Districts aggregated total of positive COVID-19 cases, sorted by age and gender.
Patient Gender
Total Positive Cases
%
Female
%
Male
%
Unknown
%
All
49,526*
100
25,810
100
23,554
100
162
100
Unknown
64
<1
20
<1
39
<1
5
3
0-18
6,429
13
3,193
12
3,214
14
22
14
19-30
13,330
27
7,322
28
5,955
25
53
33
31-40
9,822
20
5,053
20
4,733
20
36
22
41-50
6,338
13
3,196
12
3,129
13
13
8
51-60
5,843
12
2,880
11
2,949
13
14
9
61-70
4,213
9
2,118
8
2,089
9
6
4
71-80
2,115
4
1,146
5
964
4
5
3
