In a recent study published in the Annals of Internal Medicine, researchers assessed the BNT162b2 vaccines effectiveness in preventing severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections and severe disease among pediatric and adolescent individuals in the United States (US).
Study:Real-World Effectiveness of BNT162b2 Against Infection and Severe Diseases in Children and Adolescents. Image Credit:Ground Picture/Shutterstock.com
Randomized controlled trials evaluated BNT162b2 efficacy among children before SARS-CoV-2 Omicron variant emergence.
The United States Food and Drug Administration (US FDA) expanded emergency use approval to individuals aged between 12 and 15 years and five to 11 years in October 2021. By April 2023, 40% of five-to-11-year-olds and 72% of 12-to-18-year-olds in the US received 1.0 vaccine doses.
Further research is required since prior observational studies had limited follow-up periods and data on vaccine-induced protection over the long run against coronavirus disease 2010 (COVID-19) due to the Omicron variant.
The researchers of the present study evaluated BNT162b2 vaccine effectiveness against SARS-CoV-2 among pediatric and adolescent individuals during the SARS-CoV-2 Delta- and Omicron-variant predominant periods in the US.
The researchers used electronic medical record data obtained from PEDSnet, a nationwide association of pediatric healthcare systems, including the Cincinnati Medical Center, Hospital of Philadelphia, Robert Lurie & Ann Hospital in Chicago, Colorado Hospital, Nemours Health System, Nationwide Hospital, Stanford Health, and Seattle Hospital.
The study participants included 77,392 adolescent individuals (including 45,007 vaccinees) during Delta predominance, 111,539 pediatric individuals (including 50,398 vaccinees), and 56,080 adolescent individuals (including 21,180 vaccinees) during Omicron predominance. The intervention was the initial BNT162b2 vaccine dose vs. no dose of the SARS-CoV-2 vaccine.
The study outcomes included documented SARS-CoV-2 infection and severity, intensive care unit (ICU) admission, and cardiovascular complications. The team performed Poisson regression modeling to determine the relative risk values, balancing for confounders by propensity score matching.
The team conducted clinical epidemiological regression (CER) research to investigate BNT162b2s effectiveness in preventing pediatric and adolescent SARS-CoV-2 infections.
The study cohorts were as follows: the first study cohort (Delta analysis among adolescents): individuals aged between 12 and 20 years in the Delta-dominant period between July 1 and November 30, 2021; the second study cohort (Omicron analysis among children): individuals aged between five and 11 years in the Omicron-dominant period between January 1 and November 30, 2022; and the third study cohort (Omicron analysis among adolescents): individuals aged between 12 and 20 years in the Omicron-dominant period between January 1 and November 30, 2022.
The team defined SARS-CoV-2 infections by positive polymerase chain reaction (PCR), serology, antigen testing, COVID-19 diagnosis, or occurrence of post-acute COVID-19 sequelae or multisystem inflammatory syndrome (MIS) in children, irrespective of symptom presence.
They considered ICU visits a week before and 13 days after documented COVID-19 as COVID-19-related.
The clinical outcomes of cardiac complications included the incidence of pericarditis, myocarditis, or MIS to allow for a comprehensive capture of potential cardiovascular complications after infection and evaluation of BNT162b2 vaccine effectiveness concerning cardiovascular risks.
During Delta predominance, BNT162b2 effectiveness was 98% against documented COVID-19 among adolescents without significant waning following the initial dose.
Analyzing cardiovascular complications showed no significant differences between vaccinees and non-vaccinees. The vaccine was highly effective against severe infections.
The relative risk of the vaccine for cardiovascular complications was 1.2. During Omicron predominance, BNT162b2 effectiveness against SARS-CoV-2 infection in children was 74%. The team observed higher vaccine effectiveness against moderate-severe SARS-CoV-2 infection (76%) and COVID-19-related ICU admissions (85%). The relative risk of the vaccine for cardiovascular complications was 0.3.
Among adolescents, BNT162b2s effectiveness against Omicron infections was 86%, with 85% against moderate-severe Omicron infection and 92% against COVID-19-related ICU admission. BNT162b2 effectiveness against Omicron was reduced after four months of the initial dose (from 82% to 71% among children and 91% to 83% among adolescents) and subsequently stabilized.
The team observed a lowered risk for cardiovascular complications among vaccinees during Omicron predominance, with a relative risk of 0.1 for the vaccine on cardiovascular complications.
In the sensitivity analyses, the effectiveness against SARS-CoV-2 BA.1, BA.2, BA.4, and BA.5 subvariants aligned with the primary findings, whereas BNT162b2 effectiveness was lower against BQ.1, XBB, and subsequent subvariants of the virus.
The comparison results indicated that the vaccine effectiveness was consistent across different sensitivity ranges, indicating the robustness of the primary findings.
Overall, the study findings showed high effectiveness against Delta and moderate effectiveness of the BNT162b2 vaccine against Omicron, with waning effectiveness over time.
Vaccinated children and adolescents had a lower risk of cardiac complications during Omicron predominance, and there was no significant difference between vaccinated and unvaccinated individuals during Delta predominance.
The study findings underscored the role of BNT162b2 in reducing SARS-CoV-2 transmission, minimizing sick leaves, and alleviating economic burdens during the COVID-19 pandemic.
Further research is required to explore the effectiveness of COVID-19 vaccines on emerging SARS-CoV-2 subvariants and their potential waning effects.
Recent weeks have seen the first flu-related deaths of the season in Spokane and North Idaho.
There have been 201 hospitalizations related to lab-confirmed influenza in Spokane County this flu season. Of those hospitalizations, six individuals in Spokane County have died out of 24 deaths statewide.
Flu hospitalizations and deaths in Spokane County lag behind those seen in the previous season. At this time during the 2022-2023 season, 377 hospitalizations and 15 deaths in Spokane County had been recorded.
We continue to see an increase in hospitalizations from influenza in our community and we want to remind everybody that the best protection from influenza is vaccination, Spokane Regional Health District health officer Dr. Francisco Velzquez said in a statement. It is not too late to help protect yourself and others this flu season by speaking with your medical provider or pharmacist about the vaccine that is best for you.
The first two flu deaths in Spokane County were announced just before the new year. Both patients were in their 60s and had underlying health complications.
Unfortunately, this is a sad example of how serious flu can be, Velzquez said in a statement at the time. Our hearts are with the family and friends who are grieving this terrible loss.
The Panhandle Health District servicing North Idaho announced its first flu death Friday. The individual in their 20s was the ninth person in Idaho to die from the flu this season.
We want to remind residents that flu can be very serious, Jenna Dowell, Panhandles clinical services division administrator, said in a statement. We are seeing an increase in flu activity in our area and throughout the state. The best way to protect yourself, is to receive the flu vaccine.
Among the most evident symptoms of flu are fatigue, muscle aches and high fever. But other symptoms such as a sore throat, runny nose and cough can show up.
Symptoms tend to appear quickly and be the worst in the first few days until resolving within a week, but having underlying conditions can led to more serious complications.
Flu vaccines are available at many pharmacies in Spokane and provide protection within two weeks of receiving them.
If caught early enough, the flu can be treated by antiviral medication Tamiflu. The drug works by preventing the flu virus from multiplying in your body.
Over-the-counter medication can be useful to relieve pain or discomfort. The FDA recently put out a warning, however, that common decongestant ingredient phenylephrine is largely ineffective.
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Posted: January 12, 2024
People 65 years of age and older may receive another dose of updated vaccine to protect against severe illness from COVID-19, Canada's advisory body on immunizations said Friday.
The National Advisory Committee on Immunization (NACI) released guidance on offering an additional dose of COVID-19 vaccines in the spring for people at high risk of severe illness from the pandemic virus.
The "discretionary" recommendation for another dose also applies to adults living in long-term care homes and similar settings for seniors.
Dawn Bowdish, a professor at McMaster University and Canada Research Chair in Aging and Immunity, has been following long-term care residents as part of her COVID-19 studies.
"I'm really supportive of continual vaccination for the most frail, older adults," Bowdish said.
Those six months of age and older who are moderately to severely immunocompromisedby another condition or treatment, such as organ transplant recipients, may also be offered a spring dose.
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The group said its recommendations continue to aim for goals announced last February "to minimizeserious illness and death while minimizing societal disruption" from the COVID-19 pandemic and transition away from the crisis phase towards long-term management.
In general, NACI recommends an interval of sixmonths from the last COVID-19 vaccine dose.
NACI's spring recommendations come as leading public health officials elsewhere said low vaccination rates against the latest versions of the virus that causes COVID-19 and influenza are putting pressure on healthcare systems this winter.
In the United States, several European countries, and other parts of the world, there have been reports of rising hospitalizations linked to respiratory infections in recent weeks. Death rates have also ticked up among older adults in some regions, but far below the COVID pandemic peak.
Spain's government has reinstated mask-wearing requirements at healthcare facilities, as have some U.S. and Canadian hospital networks.
"Too many people are in need of serious medical care for flu, for COVID, when we can prevent it," said Maria Van Kerkhove, the World Health Organization's (WHO) interim director of epidemic and pandemic preparedness.
She cited "incredibly low"vaccination rates against flu and COVID in many countries this season, as the world tries to move past the pandemic and its restrictions.
Governments have struggled to communicate the risks still posed by COVID and the benefits of vaccination since a global public health emergency was declared over in May 2023, infectious disease experts and health officials said.
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Only 19.4 per centof U.S. adults have received this season's COVID vaccine based on the U.S. Centers for Disease Control (CDC) and Prevention's National Immunization Survey, despite a recommendation that all adults get an updated shot to protect against serious illness.
That compares roughly with 17 per cent of adults who got the bivalent booster in the 2022-2023 season, based on actual vaccine data reported to the CDC by states.
In Canada, federal figures show 15 per cent of the population aged five and up had received an updated COVID-19 vaccine by Dec. 3.
The group said national vaccination coverage last spring was about 11 per cent in people 65 and up.
Bowdish shares concerns of health officials elsewhere about low vaccine uptake.
"I worry it'll be the same 12 to 15 per cent in the spring, and the next fall."
In Europe, the new COVID shots are recommended for high-risk groups only, such as seniors and the immunocompromised. Among these groups, the WHO says there should be 100 per centcoverage.
COVID rates are also rising in the southern hemisphere during their summer, the WHO said. It is not a seasonal virus.
The vaccines are still very effective at preventing serious illness, even if they do not block infection, experts said.
Scientists have developed a vaccine that could potentially help prevent some types of pancreatic and colorectal cancers from recurring.
The shot was put to the test in a Phase I trial led by researchers at The University of Texas MD Anderson Cancer Center.
The vaccine, labeled the ELI-002 vaccine, appeared to reduce the risk of relapse in people with pancreatic and colorectal cancers whod previously had surgery and chemotherapy, according to the study, which published Tuesday in Nature Medicine.
People whove undergone surgery for pancreatic and colorectal cancer have a high risk of relapsing.
Having an effective vaccine that can attack any remaining cancer cells in the body could lower the risk of relapse and, ultimately, boost chances of survival.
These findings are very exciting because this is one of the first studies to show that a vaccine may reduce the chance of a very aggressive cancer (pancreas) from returning, said Dr. Anton Bilchik, MD, PhD, a surgical oncologist and chief of medicine and director of the Gastrointestinal and Hepatobiliary Program at Saint Johns Cancer Institute in Santa Monica, CA.
Bilchik was not involved in the study.
The trial recruited 25 individuals with pancreatic or colorectal cancer who had previously had surgery, chemotherapy, and, in some cases, another procedure like radiation therapy.
All of the patients had a tumor mKRAS mutation, which is one of the more common gene mutations linked to cancer.
The patients received a maximum of 10 doses of the vaccine, which is specifically designed to target KRAS mutations, at various doses.
The researchers investigated how peoples immune systems produced T cell responses after receiving the vaccine.
T cells are an essential component of the immune system that have a profound impact on how cells function and also build a defense against diseases like cancer from occurring or relapsing, Bilchik explained.
The team found that 84% of all patients developed a T cell response and 100% of patients who received the two highest vaccine doses developed a T cell response.
T cell responses were linked to reductions in tumor biomarkers and clearance of ctDNA, which is a type of DNA that comes from cancerous cells and tumors.
In addition, the T cell responses produced by the vaccine were associated with an 86% reduced risk of relapse or death.
The most common side effects included fatigue, injection site reaction, and muscle aches and pains.
The findings are early and preliminary but this type of vaccine could transform the future of cancer care, says Dr. Daniel Landau, an oncologist and hematologist with the Medical University of South Carolina and contributor for The Mesothelioma Center.
Landau did not work on the new study.
Having a positive finding in a vaccine that could target pancreatic cancer cells would be a huge advancement for the field of oncology in general, Landau said.
Even after pancreatic or colorectal cancer has been surgically removed and there are no traces of cancer in the body, the risk of relapse is high, explained Dr. Christopher Chen, an oncologist and hematologist with Stanford Medicine.
Microscopic cancer cells may have already escaped the cancer before the surgery that cannot be detected in imaging tests, Chen, who did not work on the new study, explained.
Relapsed cancer is often incurable.
Having an effective shot that can ignite a T cell response which plays an important role in the immune systems fight against cancer cells can help the body do the work that chemotherapy currently does, Landau said.
We have been spending decades trying to find ways to move away from traditional chemotherapies which we compare to dropping a bomb and, instead, find ways to utilize the bodys immune system to target and destroy the cancers for us, Landau said.
Scientists have been working on developing a vaccine that stimulates the immune systems T cells to destroy cancer cells, however, few have shown robust results.
The possibility that recurrence risk could be reduced further with a low-risk vaccine could be a major step forward towards increasing cure rates for this patient population, Chen said.
The shot is off the shelf, meaning it doesnt have to be tweaked for each person.
Off the shelf is beneficial because it can be produced in large quantities quickly, is less expensive and can potentially target many different types of cancer, says Bilchik.
Though these preliminary findings are promising, more data is needed to understand the shots efficacy.
Due to the successes observed in the Phase 1 trial, a Phase II trial is slated to begin later this year.
If these results can be confirmed via a larger study, this could represent a major advance for patients with resectable pancreatic and colorectal cancer, Chen said.
Scientists have developed a vaccine that may prevent some types of pancreatic and colorectal cancers from recurring. People whove undergone surgery and chemotherapy for pancreatic and colorectal cancer have a high risk of relapsing. A vaccine could teach the immune system to attack remaining cancer cells, thereby lowering the risk of relapse and boosting survival rates.
The CDC's Advisory Committee on Immunization Practices (ACIP) has updated its adult immunization schedule for 2024 to include recommendations on new vaccines for respiratory syncytial virus (RSV) and meningitis, the mpox (formerly known as monkeypox) vaccine, and the updated COVID-19 vaccines.
Key changes to this year's recommendations, published in the Annals of Internal Medicine, include the following:
The updated schedule comes on the heels of a recent CDC health advisory alert warning that many adults are not up-to-date on influenza, COVID-19, and RSV vaccination heading into the 2023-2024 winter season. As of Dec. 23, 2023 only 43.8% of adults have received an influenza vaccine. As of Dec. 2, 2023, just 17.2% of adults have received the updated COVID-19 vaccine and 15.9% have received the RSV vaccine, according to the health alert.
In an accompanying editorial, Scott Ratzan, MD, and other members of the Council for Quality Health Communication offered scathing criticism of the CDC's complex written and visual presentation of the recommendations. "We cannot stay the present course," they commented. "The Recommended Adult Immunization Schedule article and recent CDC alert on seasonal flu, COVID-19, and RSV vaccination shortfalls are the latest warning signs that the CDC needs to upgrade its health communication capability now. Our nation's health and security depend on it."
Referring to the schedule design itself, Ratzan and colleagues commented, "The color-coded grid of indications and age groups is so crammed with asterisks and fine print that CDC was apparently obliged to produce a second chart to help the reader use the first one."
They also pointed out that the updated schedule fails to address the key issue of co-administration of influenza, RSV, and COVID-19 vaccines, a topic that is confusing for clinicians and patients alike.
Inadequate implementation of the CDC's adult vaccination recommendations is not a new problem, Ratzan and colleagues wrote, adding that "the newer challenges of misinformation and loss of trust in public health exacerbate the issue, as does the seductive concept of 'medical freedom' now promoted by vaccine skeptics."
Katherine Kahn is a staff writer at MedPage Today, covering the infectious diseases beat. She has been a medical writer for over 15 years.
Disclosures
Murthy and other authors of the report have no relevant ties to industry.
Ratzan has received grants and other compensation for vaccine literacy programs from the Institute for the Advancement of Health and Wellbeing, PRIME Education, CVS Health, and others. All other authors report no ties to industry.
Primary Source
Annals of Internal Medicine
Source Reference: Murthy N, et al "Recommended adult immunization schedule, United States, 2024" Ann Intern Med 2024; DOI: 10.7326/M23-3269.
Secondary Source
Annals of Internal Medicine
Source Reference: Ratzan SC, et al "Quality health communication is critical to optimal adult immunization" Ann Intern Med 2024; DOI: 10.7326/M23-3452.
Researchers have developed an intranasal COVID-19 vaccine that enhances the immune systems response to the virus, providing longer-lasting, greater protection than vaccine injections, even against new and emerging variants. The novel vaccine candidate could mean fewer boosters in future.
While the immediate threat of the COVID-19 pandemic has dissipated somewhat, with most returning to their pre-COVID lives, the continued rise of new virus variants means that vaccination is still necessary to protect the vulnerable in the community, such as the elderly and frail and those with pre-existing medical conditions.
Although many vaccines are available now that show protection in terms of significantly reducing infections, hospitalizations, deaths and virus transmission, breakthrough infections still occur, suggesting there are limitations to the duration of protection afforded by current vaccine regimes. So, in a study led by Duke-NUS Medical School in Singapore, researchers set about developing and testing a COVID-19 vaccine thats delivered intranasally with the hope that its more effective.
Our data show that, compared to subcutaneous vaccination, the intranasal route improved the response of certain immune cells, known as T cells, which reduced disease severity, said Ashley St. John, corresponding author of the study. Not only that, but it also resulted in a greater number of T central memory cells compared to subcutaneous vaccination, which could lead to longer-lasting protection.
Given that SARS-CoV-2 infection is initiated at the mucosal surface of the nasal passages and lung airways, youd expect that a vaccine delivered into the nose right at the point where the virus enters the body would be more effective than one injected into the skin or muscle.
As expected, the researchers found that after testing their vaccine candidate on hamsters, nasal administration boosted the antibody response in the mucosa. However, compared to subcutaneous vaccination, mucosal vaccination produced distinct effects on T cells and antibody responses.
Importantly, it produced longer-lasting mucosal and systemic immune protection against SARS-CoV-2 through the preferential induction of airway-resident T cells and central memory T (TCM) cells, which play a vital role in safeguarding the body when it's re-exposed to a virus. While antigen-specific TCMs were also present in the animals that received the subcutaneously administered vaccine and could be reactivated as expected, both their numbers and the magnitude of their cytokine production responses were heightened following mucosal vaccination. Cytokines are small proteins that are crucial in controlling the growth and activity of other immune and inflammatory cells.
The researchers use of adjuvants substances that help create a stronger immune response in the vaccine influenced the T cells characteristics, as well as their activation and cytokine production, with different adjuvants producing different T cell responses.
Further, immunoglobulin G (IgG), the most common antibody in humans and one that protects against bacterial and viral infections, was found to be more effective at neutralizing viral variants, including newly emerging ones, when induced through intranasal vaccination.
The improved response by T cells and IgG following intranasal vaccination provides evidence it contributes to greater and longer-lasting protection from SARS-CoV-2, which would limit vaccine breakthrough infections, the researchers said.
While the acute phase of the pandemic may be behind us, the rise of new variants, including JN.1, which has triggered an increase in hospital admissions locally, demonstrates that we have room in our arsenal of vaccines and treatment for even better tools, said Patrick Tan, one of the studys co-authors. This study shows that mucosal vaccination holds promise for improving COVID-19 vaccine efficacy with potentially fewer boosters needed.
A patent has been filed that covers the invention of the vaccine composition formulated for intranasal delivery, paving the way for an industry partnership to potentially develop mucosal vaccines for COVID-19 and other pathogens that target mucosal surfaces.
The study was published in the journal eBioMedicine.
Source: Duke-NUS Medical School
A heat-tolerant vaccine developed by the Indian Institute of Science (IISc) researchers is said to be effective against all current strains of SARS-CoV-2 besides having the potential to be quickly adapted for future variants as well.
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According to IISc-Bengaluru, since the beginning of the COVID-19 pandemic, Prof. Raghavan Varadarajan from the institutes Molecular Biophysics Unit (MBU) and collaborators have been working on developing a heat-tolerant vaccine that can offer protection against different strains of SARS-CoV-2 both current and future variants. In a study published in npj Vaccines, they report the design of a synthetic antigen that can be manufactured as a potential COVID-19 vaccine candidate.
They showed that their vaccine is effective against all current strains of SARS-CoV-2, and can be quickly adapted for future variants as well.
According to IISc., while current vaccines are proven to be effective against most SARS-CoV-2 strains, their efficacy has declined due to rapid mutation by the virus. After analysing various proteins found in the virus, the researchers selected two parts of SARS-CoV-2s spike protein the S2 subunit and the Receptor Binding Domain (RBD) for designing their vaccine candidate. The S2 subunit is highly conserved. It mutates much less than the S1 subunit, which is the target of most current vaccines. Scientists have also known that the RBD can provoke a strong immune response in the host. Therefore, the team created a hybrid protein called RS2 by combining these two components.
The researchers used mammalian cell lines to study the expression of the hybrid protein.
The protein showed very high levels of expression, and I (initially) thought that the experiment was not working properly, said Nidhi Mittal, PhD student at MBU and first author of the study.
The team then tested the effects of the protein in both mice and hamster models. They found that the hybrid protein triggered a strong immune response and provided better protection when compared to vaccines containing the whole spike protein.
According to IISc., the RS2 antigen can also be stored at room temperature for a month without the need for cold storage, unlike many vaccines in the market which require mandatory cold storage. This would make the distribution and storage of these vaccine candidates much more economical.
Varadarajan said that his team began working on the vaccine even before the pandemic became widespread in India. At that time, the Bill and Melinda Gates Foundation provided funding and support, he said,
Since 2000, Varadarajans team has been working on designing several viral vaccines, including those against AIDS and influenza. They have leveraged this expertise to design their current RS2-based COVID-19 vaccine candidate in collaboration with the startup Mynvax, which was, until recently, incubated at IISc.
According to the team, the vaccine candidate can be tailored to incorporate the RBD region of any new variant of SARS-CoV-2 that might emerge. Its high levels of expression and stability at room temperature can greatly reduce production and distribution costs, making it well suited for combating COVID-19.
The two-dose recombinant zoster vaccine (RZV; Shingrix) remained highly effective at preventing shingles over a 4-year period in real-world settings, according to a prospective cohort study.
Over 4 years, the two-dose regimen was 76% effective (95% CI 75-78), with one dose of the vaccine just 64% effective over the same time period (95% CI 62-67), underscoring the need for people to get both doses, Nicola P. Klein, MD, PhD, of Kaiser Permanente Northern California in Oakland, and colleagues reported in the Annals of Internal Medicine.
"The study findings are reassuring in confirming that the recombinant zoster vaccine is highly effective for at least 4 years," Klein told MedPage Today in an email. "The study also reaffirms the importance of getting the second dose of vaccine to maximize protection against shingles, which can be a painful and potentially dangerous condition."
Klein noted that vaccine effectiveness was the same in patients who received the second vaccine dose later than the recommended interval of 2 to 6 months between doses. "One of the main messages is that everyone for whom the vaccine is recommended should get two doses, but not to panic if the second dose ended up being delayed beyond 6 months."
The study included about 2 million people over the age of 50 who had never received RZV. During the study period from 2018 through 2022, 38% received at least one vaccine dose and 29% received two doses of RZV. After both doses, vaccine effectiveness was 79% during the first year, 75% during the second year, and 73% during the third and fourth years.
Although vaccine effectiveness after one dose was 70% effective during the first year, effectiveness waned substantially after that to 45% during the second year, 48% during the third year, and 52% after the third year.
Effectiveness also varied by age. The vaccine was slightly more effective in people who were vaccinated when they were younger than 65 years of age (81%) versus those who were older (74%).
Notably, in people who received corticosteroids -- a group at significantly higher risk for shingles -- the vaccine exhibited lower but substantial effectiveness (65%). The authors pointed out the number of shingles cases per 100 recipients prevented by the vaccine was about the same in corticosteroid users and nonusers.
"Our analysis can give clinicians additional support for urging adults in the recommended categories -- over age 50 or immunocompromised -- to get vaccinated against herpes zoster," Klein said.
The study's estimates of vaccine effectiveness were lower than those observed in the ZOE-50 and the ZOE-70 clinical trials, the authors noted. ZOE-50 found that the vaccine was 97% effective in people ages 50 and older and ZOE-70 found that the vaccine was 90% effective in those 70 years of age or older. A long-term follow-up study of those trials concluded that vaccine effectiveness held steady for at least 7 years, but long-term effectiveness of the vaccine in real-world settings hasn't been extensively evaluated, the authors said.
The prospective cohort study gathered data from patients in four healthcare systems within the Vaccine Safety Datalink, a collaboration between the CDC and nine integrated healthcare systems. RZV was offered free of charge to most eligible patients. Researchers excluded those who received a diagnosis of shingles in the year before the study began. Among participants, 38% were 65 years of age or older, 53% were female, and 59% were white. The outcome was incident herpes zoster infection.
During the study follow-up over 45,000 cases of shingles were diagnosed and most (94%) were in unvaccinated participants. Unadjusted incidence of herpes zoster was 1.7 per 1,000 person-years in fully vaccinated people versus 6.7 per 1,000 person-years in unvaccinated people.
One of the potential limitations of the study was that a diagnosis of shingles required both a herpes zoster diagnosis ICD code and an antiviral prescription, rather than PCR testing. This may have lowered vaccine effectiveness estimates, researchers wrote. Also, patients with milder illness may have not sought care, potentially overestimating vaccine effectiveness.
Katherine Kahn is a staff writer at MedPage Today, covering the infectious diseases beat. She has been a medical writer for over 15 years.
Disclosures
The study was funded by the CDC.
Klein reported prior institutional funding from Sanofi Pasteur, Merck, Pfizer, Seqirus, and GSK. A co-author became an employee at Pfizer after completion of this study.
Primary Source
Annals of Internal Medicine
Source Reference: Zerbo O, et al "Effectiveness of recombinant zoster vaccine against herpes zoster in a real-world setting" Ann Intern Med 2024; DOI: 10.7326/M23-2023.
One shot a year that targets the anticipated dominant strain of influenza. Thats the status quo for those looking to survive flu season.
But what if you could get one shot every few years that targeted all of the flu strains at once?
Thats the goal of Duke University scientists who are working on a universal flu vaccine.
What weve done is just simply ask the question: Is it possible to make an antibody that would bind to all sorts of flus, not just the flu of the season, said Garnett Kelsoe, an immunology professor at Duke University School of Medicine.
Kelsoes team, along with a group of researchers at Harvard University, have been working on the development of a universal flu vaccine for seven years.
Recently, the team discovered a group of antibodies in several unrelated humans that target all types of influenza. The antibodies were also found in some animals.
It was quite rare actually, Kelsoe said. It was two antibodies out of about 8,000 that bound to all sorts of different kinds of flu the flu that is circulating now, but also flu that has circulated in the past and kinds of flus that actually are only in animals.
Annual flu shots require some guesswork by public health experts who predict the prevailing flu strain. A universal shot, the thinking goes, could offer more protection and possibly reduce the severity of the illness, and perhaps reduce deaths.
The way that all human vaccines are developed right now is theyre developed for the strain that the World Health Organization basically bets is going to be the circulating strain the next year, so its always bet in advance. Sometimes theyre right, sometimes theyre not right, said Kelsoe.
To get the vaccines manufactured and into pharmacies on-time, the prediction has to be made several months in advance which leads to an average annual flu vaccine efficiency of about 50%.
A universal flu vaccine is designed to be more of a sure bet by defending against a wider array of flu strains not just those predicted by public health experts, Kelsoe said.
After the researchers discovered the antibodies, the team at Harvard used whats called cyro electron microscopy to determine where the antibody attaches to the flu virus.
The researchers at Duke then introduced the antibodies to mice and injected them with the flu.
You can give the mice hugely lethal doses of influenza virus, and the mice survive, Kelsoe said. In fact, they dont really get sick at all.
The recent rise in North Carolina flu deaths comes as the CDC says flu vaccinations are the lowest in the last five years.
If people could get just one shot that protected against all strains rather than just one, it could greatly combat vaccine hesitancy, Kelsoe says.
If a shot is really good and it lasts for multiple years, you have great faith in that its terrific, he said. If you have to get a shot every year and its only about 50% effective, that reduces peoples faith. One of the goals of the universal vaccine is to regain peoples faith and the efficacy of vaccines.
The team will now move forward with their findings to test in primates sometime over the next two years. If the vaccine proves to be effective in primates, then human trials could begin.
Kelsoe said its still important for people to get their annual flu shot while the universal vaccine is being developed.
Even the vaccines that are not 100% effective reduce sickness and significantly reduce death. Theyre very, very valuable.
Flu activity remains elevated in most of the country, but the latest data from the Centers for Disease Control and Prevention shows "a single week of decrease" for the first time in months. Despite the dip, experts say not to let your guard down just yet.
After several weeks of increases, the agency's weekly influenza report Friday showed some key indicators are down, but health officials say an "upsurge" is expected.
"Folks try not to seek care during the holiday season, so we see these divots in the surveillance graphs each year, but it is very probable that during the next weeks, we'll see an upsurge of cases," said Dr. Eduardo Azziz-Baumgartner of the CDC's Influenza Division.
click to expand
Dr. Cline Gounder, a CBS News medical contributor and editor-at-large for public health at KFF Health News, says it's pretty typical to see two dips in flu numbers one that comes after the Thanksgiving holiday and another after Christmas and New Years.
"Just because we've seen cases go down a little bit in the last week doesn't mean we don't still have another bump in cases yet to come," she says. "Later in January, February is very often the peak of the influenza season, so just because we've see a recent drop in flu cases doesn't mean that there aren't more to come. In fact, I think we're probably in a lull between increases resulting from Thanksgiving, and then afterwards Christmas and New Years."
So far this season, the CDC says the flu has caused at least 14 million illnesses 150,000 hospitalizations, and 9,400 deaths. An additional 13 pediatric deaths were reported this week, bringing the total number to 40 this season.
The increase in deaths among kids from flu is concerning, Gounder says, adding many people don't realize that, after the elderly, children are the group at highest risk for complications and even death from respiratory illnesses.
"Unfortunately, I think a lot of people coming out of the COVID pandemic are fatigued and tired of talking about vaccinations, getting vaccinated, but kids under 5 are very much at risk for hospitalization and even death from respiratory illnesses, including influenza COVID and RSV, and this is because they have less mature immune systems and smaller airways," she said.
So while death from respiratory illnesses is relatively rare among young kids, Gounder says, "it's really important to keep up to date with vaccinations in those youngest," as it can "dramatically reduce the risk of these terrible consequences."
The CDC's Azziz-Baumgartner noted that the flu vaccine is beneficial for anyone looking for protection.
"Anyone who hasn't gotten vaccinated against influenza should go get their vaccines so that they're protected," he said.
Sara Moniuszko is a health and lifestyle reporter at CBSNews.com. Previously, she wrote for USA Today, where she was selected to help launch the newspaper's wellness vertical. She now covers breaking and trending news for CBS News' HealthWatch.
