Most COVID-19 restrictions will vanish June 15 but not everywhere in LA County LA Daily News
In many European countries and the United States, COVID-19 lockdowns began in March 2020. The Imperial College London COVID-19 Response Team and others proposed that having people stay home would help limit the spread of the virus.
Governments instituted lockdowns to try to prevent a catastrophic number of deaths and ensure that hospitals did not become overwhelmed. Nonessential businesses closed, people stayed home, and schools utilized online learning methods.
However, the lockdowns led to new problems regarding other areas of health and well-being. One such area was sleep hygiene.
According to a recent longitudinal study, which now appears in the journal Sleep, sleep quality declined during the COVID-19 lockdowns. The study examined increases in screen use during the lockdowns and how this negatively affected sleep quality.
Sleep impacts many areas of health. Getting enough quality sleep helps people feel rested, but sleep also contributes to our ability to learn and form memories, recover from injuries, and fight infections.
Not getting enough sleep or having poor sleep quality can contribute to the onset of many physical health problems, such as high blood pressure, type 2 diabetes, heart disease, stroke, kidney disease, and obesity.
People are also at increased risk of mental health conditions such as anxiety and depression when they regularly do not get enough sleep.
Karl Rollison, a professional life coach and registered hypnotherapist, told Medical News Today, When we sleep well, we feel well; we experience improved vitality, concentration, productivity, and mental resilience.
Quality slumber is the bodys opportunity to repair damaged cells and flush out harmful toxins, leaving us feeling refreshed.
When people use screens before bed, it can have a negative impact on their sleep quality. As the National Sleep Foundation notes, there are several reasons for this:
Electronic use can disrupt sleep, such as when a text alert wakes someone up in the middle of the night, and delay when people actually fall asleep, such as when they feel the need to reply to one more message or play one more game.
Rollison explained it this way: Like any process, the clearer the instruction given, the more efficiently a system will operate. Our 24-hour sleep/wake cycle is controlled by a part of our brain called the suprachiasmatic nucleus (SCN). It monitors environmental light levels and produces varying degrees of the sleep hormone melatonin accordingly.
The darker the environment, the more melatonin we produce and the better we sleep. Light emitted from electronic devices [confuses] the SCN with vague, contradictory signals, which results in sleep disruption.
Research about how the use of electronic devices impacts peoples sleep quality is ongoing. The COVID-19 lockdowns saw a new social situation with an immense increase in the use of electronic devices.
The researchers behind the new study hypothesized that this increase may be linked with a decline in sleep quality.
The study, which the researchers conducted using data from Italy, examined how increased screen exposure during the COVID-19 lockdowns affected sleep quality.
In Italy, there was a total lockdown in place from March 9 to May 4, 2020. It required most of the general population to stay home.
The COVID-19 lockdowns saw a dramatic increase in the use of the internet and electronic devices. This was related to multiple factors, such as the increased use of video calls replacing in-person meetings and an increase in the number of people working from home.
The researchers note that this increase was likely because people were trying to compensate for limited social interaction and fill up new free time.
The study involved 2,123 participants and used several surveys to evaluate sleep quality during the third and seventh weeks of lockdown.
The first round of surveys used the Pittsburgh Sleep Quality Index and the Insomnia Severity Index to evaluate the participants sleep quality and identify problems with insomnia. A person may have insomnia if they have difficulty falling or staying asleep.
The participants provided information related to their demographics, and the scientists gave them the option to fill out several questionnaires related to anxiety, depression, and perceived stress. The researchers note that these factors normally affect sleep quality, and they sought to account for them in their findings.
The second round of surveys included all previous surveys but with one additional question. The new question asked if the participants had increased, maintained, or reduced their screen time in the 2 hours before bed since the time of the initial survey.
The study found a decline in sleep quality for people who increased their screen time exposure in the 2 hours before bed. In contrast, those who reduced their screen time in the 2 hours before bed reported an improvement in sleep quality.
Contributing study author Prof. Michele Ferrara summed up the results to MNT:
Our results showed that respondents who increased screen time (35.4% of participants) reported decreased sleep quality, exacerbated insomnia symptoms, reduced sleep duration, prolonged sleep onset latency, and delayed bedtime and rising time.
Conversely, respondents reporting decreased screen exposure (only 7.1% of participants) exhibited improved sleep quality and insomnia symptoms. Finally, participants preserving screen time habits did not show variations of the sleep parameters.
However, the study did have limitations. For example, it could not prove that increased screen time before bed caused a reduction in sleep quality. Other limitations included the population sample, which had a higher prevalence of women and young people and did not include adolescents.
Also, screen time data relied on self-reporting from the participants and did not measure how large the increase or decrease was for each participant.
Similarly, the scientists could not assess the impact of different types of electronic devices and other factors, such as room lighting or the use of blue light-blocking glasses.
The authors agree that more research is necessary to look at these factors and how they affect sleep.
Nevertheless, the researchers note that the studys findings line up with previous data about the impact of electronic device use on sleep quality. Prof. Ferrara notes:
The evidence of a strong relationship between screen habits and the time course of sleep disturbances during the lockdown period suggests that [] raising public awareness about the risks of evening exposure to electronic devices could be crucial to preserve general sleep health. This applies to both the ongoing pandemic and the future, as technologies will find more and more space in our daily routine.
Drop-in shots and prize drawings hope to inspire more people to get vaccinated.
PORTLAND, Ore With a push on to hit a goal of vaccinating 70% of adults against COVID-19 by July 4 at the latest, Oregon and Washington are using a variety of incentives, and they are not alone.
At the main fire station in downtown Lake Oswego a drop-in vaccination clinic was underway Tuesday from noon until 6 p.m.
No need to register, no need to live anywhere near the city. It is open to anyone who wants the Johnson & Johnson shot.
Inside, firefighter Leah Gordon worked on her laptop as she waited to give the shot. It was very quiet.
Gordon said five people had dropped in for a shot during the first hour. But no one was there at 1 p.m.
Assistant Fire Chief David Morris said the clinic was a last-minute idea pushed on social media with the hope of serving those who make spontaneous decisions.
For some people scheduling doesnt work for them, he said. They have a lifestyle or businesses or personal lifestyle that does not allow them to schedule something. So, this gives them the opportunity - yeah, Im available and Im coming in today, Morris added.
His team will be at Lakeridge Middle school every Wednesday through June from noon until 7 p.m. with more doses for anyone who shows up.
Washington state launched its vaccine lottery to give people an extra reason to get the shot and picked its first $250,000 winner Tuesday. It will announce the winner several days later.
Kaiser Permanente is also joining the incentive game in all its territories across the country.
Wendy Watson is the chief operating officer of Kaiser Permanente Northwest.
I'm excited we're part of this last sprint to get to 70 percent, Watson said.
Kaisers deadline is July 9. You must get your shot by then to be eligible. Winners could get a variety of prizes from family trips to wellness retreats, gym memberships and more. The names will come from its pool of members who got vaccinated or nonmembers who get the shot at a Kaiser sites in several states, including everyone at the Oregon Convention Center.
Yes, you read that correctly. Everyone who got vaccinated at the Oregon Convention Center will be entered into Kaisers sweepstakes drawings.
We have vaccinated just shy of 300,000 people in Oregon Convention Center. All of those people will be automatically entered into this immunity sweepstakes, said Watson. They will join tens of thousands from other Kaiser areas who also got vaccinated against COVID.
Oregon is also offering a million-dollar statewide jackpot prize for one person who gets the vaccine and each county is offering a $10,000 prize.
The drawing is June 28 but so far the incentive has not brought a surge of new vaccinations.
All the incentives we're talking about are aimed at new people but they also include everyone who got the shot from last December on.
Have a question or comment for Pat Dooris? Email him atpdooris@kgw.com
Many more men in India have received COVID-19 vaccines than women, government data showed on Tuesday, highlighting gender disparity in the countrys immunisation drive that has also disadvantaged the rural population.
India has partly or fully vaccinated about 101 million men, nearly 17% more than women. Men account for 54% of the total number of people inoculated, according to the data.
Many federally administered regions, the capital Delhi, and big states such as Uttar Pradesh have seen some of the worst inequities. Only Kerala in the south and Chhattisgarh in central India have vaccinated more women than men.
"We are noticing that men, especially in towns and villages, prefer to take the vaccine before women as they have to travel for work, while women are relegated to domestic chores," said Prashant Pandya, medical superintendent at a big government hospital in the western state of Gujarat.
Health officials say rumours about vaccines disrupting women's menstruation cycle and reducing fertility have also contributed to the skewed data. The government has rejected the concerns.
"The government will have to ramp up awareness programmes in rural India to ensure women understand the importance of vaccines and prioritise themselves in this race to secure the two shots," said Sudha Narayanan, a former bureaucrat who worked in the health ministry in New Delhi.
Women will have to step forward to get vaccinated or the divide will rapidly widen, Narayanan added.
India, with a population of 1.3 billion, has about 6% more men than women.
A spokesperson for the federal Ministry of Health and Family Welfare did not respond to Reuters' questions about the gender disparity.
Some women in the rural parts of Gujarat and neighbouring Rajasthan state have urged the authorities to deliver vaccines at their doorstep, saying they are unable to travel to hospitals leaving their children behind.
"I don't know how to read and write...how will I register for the vaccine," said Laxmiben Suthar, a mother of four in the town of Vadnagar in Gujarat. "The government must send the medicine to us."
India's vaccination policy has evolved fast but the federal government has so far resisted calls for door-to-door immunisations given that the vaccines have only been authorised for emergency use and recipients need to be monitored for a short period for any adverse reactions.
Urban Indians are also getting COVID-19 shots much faster than the hundreds of millions of people living in the countryside, government data has shown. That is partly due to a policy that helped richer cities buy more vaccine doses than rural districts. read more
Prime Minister Narendra Modi on Monday reversed the policy and said vaccines will be offered at no charge to all adults starting June 21. The government will also facilitate more walk-in inoculations after complaints about the online registration process. read more
India has so far administered 233.7 million doses, the most in the world after China and the United States, but given the necessary two doses to only about 5% of its estimated 950 million adults.
India has the worlds second-largest number of coronavirus infections after the United States, with total cases at nearly 29 million, according to health ministry data. The country has suffered 351,309 deaths.
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Princeton University will require that all faculty, staff, researchers, appointed visiting faculty and researchers, temporary employees, and independent contractors (i.e., individuals working alongside with or providing services to students and employees) receive and provide proof of having received a COVID-19 vaccine authorized by the U.S. Food and Drug Administration (FDA) and/or World Health Organization. The requirement applies to employees and others routinely working on campus or in property occupied by the University. All employees (defined as the groups listed above) who will be on campus this fall must receive the final dose of their chosen vaccine no later than August 1, 2021.
Employees must receive a COVID-19 vaccine and provide proof of having received their final dose of the vaccine (second dose for two-dose vaccine or one dose for single dose vaccine). Employees should submit their vaccine information via the Universitys VacStatus tool.
Employees who cannot receive the vaccine because of a disability/medical contraindication or sincerely-held religious belief may request an accommodation (i.e., an exemption) to this requirement by completing and submitting the COVID-19 Vaccine Accommodation Request form found at the VacStatus link. Individuals who are granted accommodations will be required to comply with applicable workplace restrictions, including the wearingofface coveringsand social distancingindoors and participating in more frequent asymptomatic COVID-19 testing.
By July 1, 2021, all faculty, staff, researchers, appointed visiting faculty and researchers, temporary employees, and independent contractors routinely working on the Princeton campus or in property occupied by the University are required to do one of the following in VacStatus:
Employees that have not received an accommodation must provide proof of having received their final dose of the vaccine (second dose for two-dose vaccine or one dose for single dose vaccine) by August 1.
Employees who are not vaccinated and do not qualify for an accommodation must consult with their manager and Human Resources or the Office of the Dean of the Faculty to determine if a period of leave or use of accrued paid time off may be applied. Working remotely is not an approved option under this policy.
More information and answers to frequently asked questions about vaccine requirements are available on the COVID Resources website.
As previously announced, all undergraduate and graduate students are required to receive a COVID-19 vaccine for the 2021-22 academic year.
Updated guidelines for summer
The University also has amended its policies regarding social distancing, face coverings and campus gatherings to reflect updated federal and state health guidance. For the summer, all undergraduates approved to remain on campus must continue to follow the Social Contract.
Social distancing
Based on updated guidance from the Centers for Disease Control and Prevention (CDC)and New Jersey executive orders, employees who are fully vaccinated, and whose status has been verified in VacStatus, no longer need to maintain six feet of social distance on University property, indoors or outdoors. Those who are not fully vaccinated or do not have vaccination records verified in VacStatus must continue to maintain social distancing indoors.
Employees who are vaccinated no longer need to comply with the occupancy limits posted for COVID-19 mitigation. Furniture may be replaced in common spaces and, if desired, Plexiglas and other barriers may be removed.
Employees are expected to act honestly and ethically. The University will not routinely check whether individuals who are not practicing social distancing indoors are vaccinated except in response to credible complaints. However, the University retains the right to undertake periodic compliance reviews to protect the community, and any employee found to be falsely claiming to be vaccinated will be subject to discipline up to and including termination.
Face coverings
As of June 3, 2021, the University updated its face coverings policy for all students, staff, faculty and visitors. Face coverings are no longer required outdoors. However, face coverings continue to be required indoors, regardless of vaccination status. This policy will be revisited after July 1, 2021, when the University can determine the vaccination rate across campus.
Exceptions to the indoor face covering policy, such as when an employee is alone in a reserved room or a student is alone in their living space on campus, are outlined on the COVID Resources website.
Gatherings, events, and meetings
As of June 3, 2021, in-person gatherings on campus for staff, faculty and students may be approved within certain limits. Gatherings of more than 25 people indoors and 100 people outdoors may be held in-person if approved by the Gatherings Review Team. Gatherings of 25 or fewer people indoors and 100 or fewer outdoors do not need approval from the Gatherings Review Team. All University public health measures must be followed and the event should be scheduled through the EMS web appfor reservable spaces.
For information about visitors attending gatherings on campus, consult the Visitor Policy.
Testing
Beginning July 1, 2021, employees who are routinely on campus and have not been verified as fully vaccinated in VacStatus will be required to be tested two times per week during the weeks they work on campus. Those whose VacStatus records indicate that they are fully vaccinated will continue to be tested once per week. The University will continue to require weekly testing for vaccinated individuals until the data indicate that testing vaccinated individuals is no longer needed. Individuals who are not fully vaccinated (i.e., those granted an accommodation) will be tested through the Fall semester. Testing frequency for all may change if increasing risk of virus spread is identified on campus or in our community.
Daily Symptom Check
Per current New Jersey executive orders, employees must continue to use the Daily Symptom Check before coming to campus, regardless of vaccination status.
Returning to campus prior to fall semester
Individuals who have been working remotely and are fully vaccinated, as verified in VacStatus, may wish to return to their campus workplace and should work with their manager to determine if that is allowed or encouraged. As noted in the recent letter from Lianne Sullivan-Crowley and Sanjeev Kulkarni, employees are still expected to return to work on campus by August 29, 2021.
Employees who are not currently in the asymptomatic testing program will need to be enrolled and will need to be tested once per week if they are fully vaccinated and twice per week if they are not vaccinated or do not have verified vaccination records in VacStatus. Managers will need to update the employee list in their Resumption plan to enroll their employees in the asymptomatic testing program.
Outlook for the fall
Looking toward the fall, the University continues to plan for the resumption of in-person instruction and operations. Classes are expected to be taught in person and the University anticipates concluding all remote work by Sunday, August 29. All activities will continue to follow then-prevailing public health protocols, but the expectation is that all University facilities, including administrative and research spaces, will operate at full capacity.
The University also expects the following will be permitted by August 29:
A phased move-in will be held for undergraduate and graduate students arriving on campus for the fall semester, and some students may be required to quarantine or isolate upon their arrival. Quarantine and isolation procedures and accommodations also will be in place throughout the academic year.The University also will continue its asymptomatic testing program, with regular asymptomatic testing for employees who are not vaccinated and periodic asymptomatic testing for fully vaccinated faculty, staff and students for surveillance purposes.
All of the policies and guidelines above are subject to change based on public health measures and guidelines from the state of New Jersey.
The vaccines are working better than expected, and the hospital system is averaging just one new COVID patient every other day.
CLEVELAND Coronavirus cases in the United States have fallen to levels not seen since March 2020, and it's the same story in Ohio.
The state has reported an average of just 604 cases per day over the past three weeks, and testing positivity rates are down to their lowest levels of the pandemic. Here in the Cleveland area, Playhouse Square is gearing up for live theatre on Friday, and Indians game are back to 100% capacity.
"I do think it's time," University Hospitals Dr. Keith Armitage said of restrictions finally being lifted.
Armitage says the vaccines are working better than expected, and the hospital system is averaging just one new COVID patient every other day. For perspective, during the peak of the pandemic, it was up to 10 new patients every single day.
"The admissions in the last few weeks tend to be younger because people over 65 are getting the vaccine, and we aren't seeing nearly as many critical patients," Armitage explained.
The same thing is happening at the Cleveland Clinic, with fewer than 20 COVID patients in ICUs across the system.
"[It's a] Huge deal," Dr. Rahed Dweik said. "In December, the hospital numbers approached 1,000, and [in the] ICU we approached almost 200, so that's definitely a huge change in a good direction."
Monday marked the end of a 12-week-long vaccination clinic at Cleveland State University's Wolstein Center. Experts say they expect case counts to stay low through the summer and potentially rise again in the fall when the weather cools and more people start to gather indoors.
"It's clear that transmission is much more likely indoors than outdoors, and we may see more cases," Armitage said. "But I think if we get to 70% of the population vaccinated and of the unvaccinated population, maybe ... one-third or a half will have had COVID, so I think we get to this mythical herd immunity by this summer."
Health officials, including Armitage, say increased vaccinations will prevent a widespread surge and increased hospitalizations like we saw this past winter.
"It's highly unlikely we will have a surge that will challenge the health care system," Armitage declared.
However, Armitage and others warn that could change if variants get out of hand. Currently, the vaccines have been shown to work well against a majority of the variants circulating in the U.S.
In the yellow tier, gyms can be at 50% capacity indoor and outdoor. Photo via Pexels.com
San Diego County will move into Californias least restrictive yellow tier Wednesday morning, following two consecutive weeks of an adjusted new daily COVID-19 case rate of fewer than two cases per 100,000 residents, county officials announced Tuesday.
The county will move into the yellow tier just six days before the state scraps the tiered reopening blueprint on June 15, joining other urban counties such as Los Angeles, San Francisco and Orange.
In the yellow tier, outdoor music venues can increase to 67% capacity, restaurants and gyms can be at 50% capacity indoor and outdoor indoor bars can be at 25% or 100 people, whichever is fewer, and outdoor gatherings can expand to 200 people.
A full list of what limits will be lifted after the descent into the yellow tier for that one week can be found at https://covid19.ca.gov/safer- economy/.
When California fully reopens the economy on June 15, the state will move beyond the Blueprint for a Safer Economy the system of tiers the state has employed since last year. There will be no capacity restrictions or social distancing enforced, and only mega events events with crowds larger than 5,000 people indoors or 10,000 outdoors will require or recommend vaccine verification.
On Monday, the county reported 65 new COVID-19 infections, bringing the cumulative case total to 280,807, while the death toll remained unchanged at 3,764.
A total of 5,898 tests were reported to the county on Monday, with 1.1% returning positive. The 14-day rolling average percentage of positive cases is 0.8%.
As of Monday, nearly 1.68 million San Diego County residents almost 60% of residents 12 and older are fully vaccinated and more than 2.07 million residents have received one of two doses.
More than 4.21 million doses have been received by the county, with more than 3.78 million administered.
A full list of available vaccination sites can be found online.
City News Service
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A person receives a dose of the Pfizer BioNTech vaccine at a vaccination centre for those aged over 18 years old at the Belmont Health Centre in Harrow, amid the coronavirus disease (COVID-19) outbreak in London, Britain, June 6, 2021. REUTERS/Henry Nicholls
Britain on Monday reported 5,683 more cases of COVID-19 and one further death within 28 days of a positive test, according to official data.
The total number of people to have received a first vaccine dose reached 40,460,576, the figures showed.
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Whenit comes to why Victoria has had more significant coronavirus outbreaks than other parts of Australia, many theories abound.
Could it be Victoria's demographics? Are Melburnians doing the wrong thing? What about the weather?
Despite all the speculationabout what it is about Victoria that has led to its fourth lockdown since the pandemic began, experts say there is no clear answer.
Demographer Liz Allen from the Australian National University said no one state or territory was safe.
"COVID isn't picky about who the virus infects, and this should be a warning to all Australians," she said.
"No-one is safe until the majority of the nation is vaccinated. Luck plays a role, but leadership and public health measures matter too."
Let's unpack it in a bit more detail.
ABC News: Scott Jewell
Some people have wondered whether the COVID-19 outbreaks in Melbourne could be because Victoria has more young and ethnically diverse people, and more casual workers.
But according to the experts, that is wrong, wrong and wrong.
Data simply doesn't support the assertionthat Victoria is at greater risk of COVID-19 outbreaks because of its demography, especially when compared to New South Wales, Dr Allen said.
"Comparing age, population density, crowded housing, migrant composition and transportation, Victoria is no more at risk of COVID than New South Wales," she said.
Victoria's second wave disproportionately affected people in insecure, casual work who would have had no income if they self-isolated or called in sick an issue that has since been addressed with pandemic leave payments.
Some have suggested that Victoria has a higher number of casual workers than other states,thereforegiving the state a higher risk of outbreaksbut data doesn't back that up either.
Victoria does have a largenumber of casual workers, butit also has a largepopulation.
And as a proportion of the population, the amount of casual workers is not too dissimilar to other capital cities.
The simple answer is no.
Leading epidemiologist professor Catherine Bennett said people's behaviour wasnot to blame for the current lockdown.
"It's not that we're out mixing, or our level of compliance with these restrictions and things is any different," she said.
"In fact, if anything, it's better, more protective but it's not enough.
"The message is:'This could happen anywhere. And it really was a matter of time.'"
There's data that backs that up as well.
A panel of experts advising the federal government regularlycalculate each state and territory's transmission potential, or the virus's ability to spread in a population, by looking at data from cases, household surveysand Google.
One of the things they take into account is human behaviour, such as how much people are social distancing or having contact with people outside their household.
According to the federal government's latestweekly snapshot of the COVID-19 situation in Australia, the transmission potential risk in Victoria is lower than in any other state.
Even before the latest outbreak, the virus's ability to spread in Victoria was considered to be lower than in other states.
Cold weather could play some role in COVID-19 transmission, but experts say it may not have been extremely significant in Victoria.
Lower temperaturesimprovethe virus's chance of survival outside the human body, and could also encourage human behaviour that facilitates transmission, like gathering indoors and closing windows.
But experts say that alone cannot be blamed for the number of outbreaks in Victoria.
Burnet Institute's Professor Mike Toole said while all respiratory pathogens thrived in cold weather, that didn't explain the pattern of the spread ofCOVID-19.
"We had a massive outbreak in India, where it's very hot," he said.
"During the northern summer, we had those big outbreaks in the south of the US Arizona, Texas, Florida where it is hot."
He said he did not think anyone hadproven with credible data that cold weather was a factor.
"It is just bad luck," he said.
ABC News: Patrick Rocca
Humans crave certainty.
It's human nature to want to know why something is happening, particularly something difficult like being in lockdown.
We look for answersor someone to blameif something goes wrong.
Professor Bennett said knowing why something happenedgaveus a sense of security.
"I think there's a temptation to do that because it makes us think we're safe in our world," she said.
"But it could happen anywhere."
Her message is simple.
"You don't need a magic virus. You don't need a magic set of things working against you," she said.
"You don't have to be in a southern city or have a young population.
"All those things don't really matter if you've just got people who are quite infectious and mixing."
Even Victoria's infection control expert, Allen Cheng, admits it's difficult to know whether the state is more vulnerable than others.
"I think there is always an element of luck in this," he said.
Experts are hoping Victoria's run of "bad luck"will come to an end soon.
ABC News: John Graham
As the nation edges closer to President Bidens goal of a 70 percent vaccination rate, many people are beginning to wonder how long their protection will last.
For now, scientists are asking a lot of questions about Covid-19 booster shots, but they dont yet have many answers. The National Institutes of Health recently announced that it has begun a new clinical trial of people fully vaccinated with any authorized vaccine to see whether a booster of the Moderna shot will increase their antibodies and prolong protection against getting infected with the virus.
Although many scientists estimate that the Pfizer-BioNTech, Moderna and Johnson & Johnson vaccines authorized in the United States will last at least a year, no one knows for sure. Its also unclear whether emerging variants of the coronavirus will change our vaccination needs.
Were in uncharted waters here in terms of boosters, said Dr. Edward Belongia, a physician and epidemiologist at the Marshfield Clinic Research Institute in Marshfield, Wis.
Different pathogens affect our immune system in different ways. For some diseases, like the measles, getting sick once leads to lifelong protection from another infection. But for other pathogens, our immune defenses wane over time.
In some important respects, vaccines mimic natural infections without requiring that we actually get sick. Measles vaccines can produce lifelong immunity. Tetanus vaccines, on the other hand, generate defenses that fade year after year. The Centers for Disease Control and Prevention recommends getting a tetanus booster once a decade.
And sometimes the virus itself can change, creating a need for a booster to produce a new, tailored defense. Influenza viruses are so mutable that they require a new vaccine every year.
The short answer is that we cant be sure yet, since people started getting vaccinated in large numbers only a few months ago.
Even in the trials, we dont know what the immune response is a year out, said Dr. Kirsten Lyke, a vaccine expert at the University of Maryland School of Medicine and a leader of the N.I.H.s booster trial.
But early signs are encouraging. Researchers have been drawing blood from volunteers in vaccine trials and measuring their levels of antibodies and immune cells that target the coronavirus. The levels are dropping, but gradually. Its possible that with this slow rate of decline, vaccine protection will remain strong for a long time. People who were previously infected and then received the vaccine may enjoy even more durable protection.
I think theres a real possibility that the immunity could last for years against the original strain, Dr. Belongia said.
If that possibility bears out, Covid-19 boosters might not be required for years. But thats a big if.
Possibly. Scientists have already found that vaccines using different technologies can vary in their effectiveness. The strongest vaccines include Moderna and Pfizer-BioNTech, both of which are based on RNA molecules. Vaccines relying on inactivated viruses, such as those made by Sinopharm in China and Bharat Biotech in India, have proved somewhat less effective.
Its not entirely clear why thats the case, said Scott Hensley, an immunologist at the University of Pennsylvania. RNA vaccines are relatively new and so the immunity they provoke has not been thoroughly studied. In his own research on mice getting different types of flu vaccines some made with RNA and others inactivated viruses Dr. Hensley sees a similar difference. The level of antibodies produced by the two kinds of vaccines are outrageously different, he said.
Its possible that the protection from the less effective Covid-19 vaccines will fade more quickly. Sinopharms vaccine may already be showing some signs of this decline. Clinical trials indicate that it has an efficacy of 78 percent. But the United Arab Emirates and Bahrain are already offering boosters to people who received the Sinopharm vaccine to bolster their waning immunity.
Scientists are searching for biological markers that could reveal when the protection from a vaccine is no longer enough to hold back the coronavirus. Its possible that a certain level of antibodies marks a threshold: If your blood measures above that level, youre in good shape, but if youre below it, youre at greater risk of infection.
Some preliminary studies suggest that these markers known as correlates of protection exist for Covid-19 vaccines. Research is underway to find them.
June 6, 2021, 2:38 p.m. ET
That will teach us a lot, said Dr. H. Clifford Lane, the deputy director for clinical research and special projects at the National Institute of Allergy and Infectious Diseases.
We may very well need boosters to block variants, but thats not clear yet.
The emergence of variants in recent months has accelerated research on boosters. Some variants have mutations that led them to spread swiftly. Others carry mutations that might blunt the effectiveness of authorized vaccines. But at this point, scientists still have only a smattering of clues about how existing vaccines work against different variants.
Last month, for example, researchers in Qatar published a study on the Pfizer-BioNTech vaccine, which was given to over a quarter of a million of the countrys residents between December and March.
Clinical trials showed that the vaccine had an efficacy of 95 percent against the original version of the coronavirus. But a variant called Alpha, first identified in Britain, lowered the effectiveness to 89.5 percent. A variant first identified in South Africa, known as Beta, lowered the vaccines effectiveness further, to 75 percent. Against both variants, however, the vaccine was 100 percent effective at preventing severe, critical or fatal disease.
Just because a variant can dodge existing vaccines doesnt mean that it will become a widespread problem, however. Beta, for example, has remained rare in countries with strong vaccine programs, such as Israel, Britain and the United States. If Beta stays rare, it wont pose a serious threat.
But evolution still has a lot of room to play with the coronavirus. Scientists cant rule out the possibility that new variants may emerge in the months to come that spread quickly and resist vaccines.
Its clear that variants are inevitable, said Dr. Grace Lee, associate chief medical officer for practice innovation and infectious diseases physician at Stanford Childrens Health. I think the question is, how impactful are they going to be?
Its not clear yet. Some scientists suspect that a high immune response to the original version of the coronavirus will provide sufficient protection against variants as well. But its also possible that a vaccine designed to thwart one variant in particular may be more effective.
Pfizer has begun a trial to test both options. Some volunteers who have already received two doses of their vaccine will get a third dose of the same shot as a booster. As part of the same trial, researchers will give other volunteers an experimental booster designed to protect against the Beta variant.
Based on what we have learned so far, our current thinking is that until we see a reduction in SARS-CoV-2 circulation and Covid-19 disease, we think it is likely that a third dose, a boost of our vaccine, within 12 months after vaccine administration, will likely be needed to help provide protection against Covid-19, said Jerica Pitts, the director of global media relations for Pfizer.
Possibly. In fact, a lot of research on other diseases suggests that switching vaccines can strengthen boosters. This is a tried and true concept from before Covid, Dr. Lyke said.
Dr. Lyke and her colleagues are testing this mix-and-match option for boosters as part of their new trial. They are recruiting volunteers who have been fully vaccinated by any of the three vaccines authorized in the United States Johnson & Johnson, Moderna and Pfizer-BioNTech.
All of the volunteers are receiving a Moderna booster. The researchers will then observe how strong of an immune response it produces.
Its possible that other vaccines still in clinical trials may work even better as Covid boosters. Novavax and Sanofi, for example, are both running clinical trials in the United States on vaccines that consist of viral proteins. Dr. Lyke and her colleagues have designed their study so that they can add more such vaccines to the mix later on.
Behind the scenes, were working on other contracts so that we can move additional boosters into the trial, she said. Those additional boosters may also include ones tailored for variants, like the one developed by Pfizer-BioNTech.
Other mixed booster trials are also underway. In Britain, scientists are giving volunteers vaccines from AstraZeneca, CureVac, Johnson & Johnson, Moderna, Novavax, Pfizer-BioNTech and Valneva as boosters. ImmunityBio is testing its vaccine in South Africa as a booster for the Johnson & Johnson vaccine, while Sanofi is preparing to test its vaccine as a booster for those from several other companies.
The N.I.H. trial may start delivering results as soon as the next few weeks. If fading vaccines and surging variants create a burst of new infections this winter, Dr. Lyke wants to have data that she can share with policymakers.
For us, getting an answer as soon as possible was critically important, she said. We just dont have that luxury of time.
Dr. Hensley says its wise to prepare for the possibility that boosters will be needed. But he hoped that they didnt become a distraction from the pressing need to get first doses to billions of people across the world.
If more people get protected right away, then the virus will have fewer hosts to infect and less opportunity to evolve into new variants, he said.
I want to see these vaccines distributed globally, because I want to protect people across the world, Dr. Hensley added. But even if you only care about yourself, you should get behind this effort as well, because that is the only way that youre going to end the pandemic and limit the ability of variants to arise.
Noah Weiland contributed reporting.
