New Delhi: British-Swedish pharma giant AstraZeneca's Covid-19 vaccine, made in collaboration with Oxford University has been found to raise the risk of vaccine-induced immune thrombocytopenia and thrombosis (VITT) - a rare but fatal blood clotting disorder - claimed researchers on Thursday. While not new, VITT emerged as a new disease following the adenovirus vector-based Oxford-AstraZeneca vaccine - sold as Covishield in India and Vaxzevria in Europe - at the height of the Covid-19 pandemic in 2021.
"An unusually dangerous blood autoantibody directed against a protein termed platelet factor 4 (or PF4)" was found as the reason for VITT. In separate research in 2023, scientists from Canada, North America, Germany and Italy described a virtually identical disorder with the same PF4 antibody that was fatal in some cases after natural adenovirus (common cold) infection.
Now in a new research, Flinders University in Australia and other international experts found that the PF4 antibodies in both adenovirus infection-associated VITT and classic adenoviral vector VITT share identical molecular fingerprints or signatures. "Indeed, the pathways of lethal antibody production in these disorders must be virtually identical and have similar genetic risk factors, said Professor Tom Gordon from Flinders
The researcher noted that the "findings have the important clinical implication that lessons learned from VITT are applicable to rare cases of blood clotting after adenovirus (a common cold) infections, as well as having implications for vaccine development". The same team had in a 2022 study "cracked the molecular code of the PF4 antibody and identified a genetic risk factor". Their new findings, published in the New England Journal of Medicine, also have important implications for improving vaccine safety.
The research comes after AstraZeneca "accepted, in a legal document submitted to the High Court in February, that its Covid-19 vaccine 'can, in very rare cases, cause Thrombotic Thrombocytopenic Syndrome (TTS)'." TTS is a rare side effect that can cause people to have blood clots and a low blood platelet count. It has been linked to the death of at least 81 people in the UK as well as hundreds of serious injuries. The company has also voluntarily withdrawn "marketing authorisation" of its Covid-19 vaccine from Europe and other global markets.
Updated May 16, 2024, 11:08 IST
Doctors say AESIs need to be carefully monitored and confirmed by further research studies
A new study has found adolescent females and those with a history of allergy are at a higher risk of adverse events of special interest or AESI after receiving Covaxin India's first indigenous COVID-19 vaccine. According to a report on SpringerLink, an integrated platform for journals and other materials published by Springer, the observational research, conducted by Banaras Hindu University said nearly a third of the participants jabbed with Covaxin has the condition.
The Economic Times reported that of 1,024 individuals enrolled, 635 adolescents and 291 adults could be contacted during the year-long follow-up. According to the study, viral upper respiratory tract infections were reported by at least 47.9 per cent of adolescents and 42.6 per cent of adults.
According to experts, AESI is a defined condition or event that occurs in some people following immunization, with the potential to be causally associated with a vaccine product. AESIs include anaphylaxis, myocarditis, and more recently TTS or thrombosis with thrombocytopenia syndrome, characterized by blood clots and low levels of platelets.
Read Full Article
Doctors say AESIs need to be carefully monitored and confirmed by further research studies.
The report said there have been cases of skin and subcutaneous disorders, and nervous system disorders, along with a high percentage of common AESIs in adolescents, including musculoskeletal disorders, menstrual abnormalities, and hypothyroidism in women.
Also, a few serious AESIs included cases of stroke and Guillain-Barre syndrome, identified in 0.3 per cent and 0.1 per cent of participants, respectively. The study said a majority of AESIs in women and adolescents with pre-vaccination COVID-19, those with comorbidities, and those with post-vaccination typhoid had 1.6, 2, 2.7 and 3.2-times higher odds of persistent AESIs, respectively.
According to researchers, there is a need for extended surveillance of those who have been vaccinated with COVID-19 jabs to understand the course and outcomes of late-onset adverse events. "Focused monitoring for persistent AESIs is warranted for individuals with a pre-vaccination history of Covid," researchers said. "Adults with comorbidities, hypertension, are at a higher risk of AESIs and persistent AESIs after BBV152 administration."
Covaxin, developed by Bharat Biotech, is also known as BBV152 and is a type of whole-virus vaccine called an inactivated vaccine. It incorporates a modified or dead version of the virus, in this case, SARS-CoV-2, which cannot replicate and so cannot cause disease.
It is a two-dose vaccine with an efficacy rate of 78 per cent, according to clinical data. Indias drug regulatory authority, the Central Drugs Standard Control Organization, authorized the vaccine for emergency use on January 3, 2021.
[InTime News]
There has been a lukewarm response from people aged 60 and over in Greece to the call of the scientific community and health authorities to get the updated vaccine against the coronavirus.
According to the data published by the European Center for Disease Control and Prevention, just 7.1% of people aged 60-69, 11.6% between 70 and 79 and 8.8% aged 80 and above received the jab between September 1 and April 15.
Based on the data posted on emvolio.gov.gr, during this period a total of 337,000 doses of the Covid-19 vaccine were administered in Greece regardless of age group.
A total of 37,869 people have died after contracting Covid since it started.
On May 15, 2024, X user @DiedSuddenly_posted a 7-second video clip showing Meta CEO Mark Zuckerberg saying, "We just don't know the long-term side effects of basically modifying people's DNA and RNA." The date displayed on screen was July 16, 2020.
The X user's handle refers to a documentary and a movement. Both promote a conspiracy theory claiming mRNA-based COVID-19 vaccines caused a significant number of deaths since their introduction in 2020 (a claim not supported by scientific data).
The caption in the user's post read, "Never forget how Mark Zuckerberg knew the effects of the mRNA Vaccine, and continued to censor the truth about it on Facebook anyway."
The user sourced the brief clip from an internal Q&A for Facebook employees that took place in July 2020, in the early days of the pandemic. At the time, COVID-19 vaccines were months away from becoming available to the public.
More importantly, this clip lacked context. At the time, Zuckerberg lacked a proper understanding of how mRNA vaccines (the type then being developed by Moderna and Pfizer) work.
Project Veritas published a longer version of the leaked video on its website on Feb. 16, 2021. Project Veritas founder James O'Keefe also posted a shorter version on Twitter, apparently to fit into the social media platform's video time limit of two minutes and twenty seconds.
"We would know none of this, but not for the fact that we have a brave Facebook insider that continues to leak and transmit videotape of Facebook executives to Project Veritas," O'Keefe said in the video. "It's not that the insider is betraying Mark Zuckerberg. It's that Mark Zuckerberg is betraying what Facebook ought to stand for."
In February 2023, Snopes obtained a transcript of Zuckerberg's full answer, which showed context was missing from the original video.
In Zuckerberg's full remarks on vaccine progress, which were not shared by Project Veritas, he referenced positive news about Moderna's vaccine trial, a development MarketWatch.com covered on July 15, 2020:
There are some good there was a positive announcement by Moderna about their you know, their first round of trials this week. It was a safety trial for 45 people. No one has any bad side effects yet. But I have to say, there are a couple of different paths to a vaccine here. There's sort of the traditional path, where you modify a virus to make it a little less to make it harmless, or at least less harmful, and then inject it in, and then have the body develop antibodies to fight it. There's a new approach that people are trying, which is called an RNA vaccine, which is what this Moderna vaccine is basically attempting to do, which is just basically injecting RNA directly into a person to turn a person's own cells directly into a factory for producing antibodies by basically appending the genetic code to create antibodies into your own genome rather than just kind of exposing your body to the virus and have it fight and develop an immune response on its own, and I think that if this is possible and safe, then I think it would be a huge breakthrough, and it would be a great path going forward for more rapidly developing, basically, vaccines for a whole lot of other viruses that come in the future
Then came the brief moment appearing in the Project Veritas video, which has been bolded below:
but I do just want to make sure that I share some caution on this, because we just don't know the long-term side effects of basically modifying people's DNA and RNA to directly encode in a person's DNA and RNA, basically, the ability to produce those antibodies, and whether that causes other mutations or other risks downstream. So there's work on both paths of vaccine development. Certainly, the initial Moderna results are good. But I also wouldn't get over-hyped by that. I think we're still unlikely to have a vaccine sometime before the middle of next year. But certainly, I don't think we've gotten any particularly bad news yet that would suggest that it has to take longer than we thought in the past.
However, Zuckerberg was incorrect about his "caution" regarding vaccines "modifying people's DNA and RNA," a point on which he soon apparently found clarity, as we'll explain in the next section.
On Nov. 30, 2020, weeks before COVID-19 vaccines began to become available to some members of the general public, Zuckerberg spoke for an hour in a publicly broadcast live video session with Dr. Anthony Fauci. When Fauci retired, The Associated Press called him the nation's top infectious-disease expert. Project Veritas included a portion of this discussion between Zuckerberg and Fauci in its article and video.
During the remarks, Zuckerberg asked Fauci for clarification regarding the claim vaccines "alter" DNA and RNA, beginning at the 31:44 mark in this video.
Here's a transcript of the relevant portion of the discussion:
Zuckerberg: So I've heard from a lot of people who have questions about a new type of vaccine that involves RNA or DNA and why we can expect that this can be safe without having any issues down the line. So I'm curious to hear, you know, how you would explain that scientifically and your thoughts on that concern overall.
Fauci: Yeah, because we know what happens from a lot of work in the animal models, so that RNA that pumps it out pumps it out for a very limited period of time, enough to get a good immune response and then the RNA degrades the way RNA generally degrades under most circumstances, so what the FDA has done is that they are not going to consider an EUA until 60 days following the time that half the people in the trial have received their last dose, and the reason the 60 days is the magic number, because when you look at the experience over decades with vaccines, the intermediate and long-term adverse events almost all occur between 30 and 45 days. So if you wait 60 days, you cushion it a little and overshoot a little and if you don't see severe events during that time, it's extremely unlikely that you're going to see severe adverse events.
Zuckerberg: And just to clear up one point. My understanding is that these vaccines do not modify your DNA or RNA. So I think that's just an important make to clarify. If I'm getting anything wrong here, of course correct me, but just to make that clear.
Fauci: No. First of all, DNA is inherent in your own nucleus cell. Sticking in anything foreign will ultimately get cleared. Messenger RNA is the messenger. It comes from the DNA to the RNA to the protein. Sticking in mRNA into you has absolutely nothing to do with your own DNA or your own RNA. It's going to perform its function and then it's going to be degraded and it's gone. It doesn't have any imprint on any genetic material of your own.
Mark Zuckerberg: Good, well I'm glad we could clear that up.
Since the time this discussion took place in November 2020, Meta launched what it called "the largest worldwide campaign to promote authoritative information about COVID-19 vaccines." Zuckerberg at least twice posted about being vaccinated himself. "CBS This Morning" host Gayle King also interviewed Zuckerberg in a discussion including the topic of vaccine mandates for Meta employees.
Additionally, a search of Zuckerberg's Facebook feed also revealed, in December 2022, the Chan Zuckerberg Biohub posted it, along with Stanford University had "developed a promising new COVID vaccine that, in experiments, [showed] a robust protection against all variants of concern."
Here is a sampling of organizations, publications, and institutions disproving the claim mRNA COVID-19 vaccines alter a person's DNA or RNA: U.S. Centers for Disease Control and Prevention, World Health Organization, Mayo Clinic, Britannica, Children's Hospital of Philadelphia, Nebraska Medicine, First Nations Health Authority, the National Human Genome Research Institute, Cincinnati Children's Hospital Medical Center and Harvard T.H. Chan School of Public Health at Harvard University.
The Associated Press interviewed Dr. Daniel Kuritzkes, chief of infectious diseases at Brigham and Women's Hospital, who explained why the rumor is a "complete fallacy."
The Washington Post spoke with Jason L. Schwartz, an assistant professor of health policy at the Yale School of Public Health, who said, "There literally is no physical connection between the RNA in these vaccines and the DNA in our cellular nuclei, so there's no possibility for that connection, let alone for effects or adaptations."
We found similar reporting from Reuters and The New York Times also putting this false rumor to bed.
Assis, Claudia. "Moderna Stock Surges 17% on Coronavirus Vaccine Trial News." MarketWatch, 15 July 2020, https://www.marketwatch.com/story/moderna-stock-surges-17-on-coronavirus-vaccine-trial-news-2020-07-14.
Chiu, Allyson, and Lindsey Bever. "Are They Experimental? Can They Alter DNA? Experts Tackle Lingering Coronavirus Vaccine Fears." Washington Post, 14 May 2021, https://www.washingtonpost.com/lifestyle/2021/05/14/safe-fast-vaccine-fear-infertility-dna/.
"Facebook CEO Mark Zuckerberg Takes 'Anti-Vax' Stance in Violation of His Own Platform's New Policy 'I Share Some Caution on This [Vaccine] Because We Just Don't Know the Long-Term Side Effects of Basically Modifying People's DNA and RNA.'" Project Veritas, 16 Feb. 2021, https://www.projectveritas.com/news/facebook-ceo-mark-zuckerberg-takes-anti-vax-stance-in-violation-of-his-own/.
"Fact Check-MRNA Vaccines Do Not Turn Humans into 'Hybrids' or Alter Recipients' DNA." Reuters, 13 Apr. 2021, https://www.reuters.com/article/factcheck-mrna-megamix-idUSL1N2M61HW.
Fichera, Angelo. "No, COVID Shots Don't Change Human DNA to a 'Triple Helix.'" The Associated Press, 5 Oct. 2022, https://apnews.com/article/fact-check-covid-vaccines-dna-triple-helix-599297225659.
HealthGuard. "The Top COVID-19 Vaccine Myths Spreading Online." Britannica, https://www.britannica.com/list/the-top-covid-19-vaccine-myths-spreading-online.
Kasprak, Alex. "Did CDC Confirm That Thousands 'Died Suddenly' as a Result of COVID Vaccines?" Snopes, 20 Dec. 2022, https://www.snopes.com/fact-check/cdc-died-suddenly-covid-vaccines/.
Mayo Clinic Staff. "Different Types of COVID-19 Vaccines: How They Work." Mayo Clinic, https://www.mayoclinic.org/diseases-conditions/coronavirus/in-depth/different-types-of-covid-19-vaccines/art-20506465.
"Myths and Facts about COVID-19 Vaccines." Centers for Disease Control and Prevention, https://www.cdc.gov/coronavirus/2019-ncov/vaccines/facts.html.
"Myths and Truths | Coronavirus (COVID-19) Vaccines." Cincinnati Children's Hospital Medical Center, https://www.cincinnatichildrens.org/patients/coronavirus-information/vaccines/busting-myths.
Neergaard, Lauran, and Zeke Miller. "Fauci to Step down after Decades as Top US Infection Expert." The Associated Press, 22 Aug. 2022, https://apnews.com/article/anthony-fauci-announces-retirement-7efdacac6a9ff7aa6e2f870b551fe508.
Offit, Dr. Paul. "Can MRNA Vaccines Alter a Person's DNA?" Children's Hospital of Philadelphia, 10 Feb. 2021, https://www.chop.edu/centers-programs/vaccine-education-center/video/can-mrna-vaccines-alter-a-persons-dna.
O'Keefe, James.Twitter, https://twitter.com/JamesOKeefeIII/.
Ovide, Shira. "How to Reach the Unvaccinated." The New York Times, 10 Mar. 2021, https://www.nytimes.com/2021/03/10/technology/vaccine-misinformation-access.html.
"Reaching Billions of People With COVID-19 Vaccine Information." Meta, 8 Feb. 2021, https://about.fb.com/news/2021/02/reaching-billions-of-people-with-covid-19-vaccine-information/.
The Different Types of COVID-19 Vaccines. https://www.who.int/news-room/feature-stories/detail/the-race-for-a-covid-19-vaccine-explained.
Tulp, Sophia. "Swedish Study on COVID Vaccines and DNA Misinterpreted." The Associated Press, 20 July 2022, https://apnews.com/article/Fact-Check-COVID-Vaccine-Sweden-Study-986569377766.
"Understanding COVID-19 MRNA Vaccines." National Human Genome Research Institute, https://www.genome.gov/about-genomics/fact-sheets/Understanding-COVID-19-mRNA-Vaccines.
Weidenbacher, Payton A. B., et al. A Ferritin-Based COVID-19 Nanoparticle Vaccine That Elicits Robust, Durable, Broad-Spectrum Neutralizing Antisera in Non-Human Primates. bioRxiv, 26 Dec. 2022. bioRxiv, https://doi.org/10.1101/2022.12.25.521784.
"You Asked, We Answered: Can MRNA Vaccines Alter Human DNA?" Nebraska Medicine, 21 Dec. 2020, https://www.nebraskamed.com/COVID/you-asked-we-answered-can-mrna-vaccines-alter-human-dna.
Zuckerberg, Mark. Facebook, https://www.facebook.com/zuck.
England's human papillomavirus (HPV) vaccination program has remained highly effective in reducing cases of cervical cancer and grade 3 cervical intraepithelial neoplasia (CIN3) across socioeconomic deprivation groups, according to an observational study.
In a birth cohort of women offered HPV vaccination routinely at ages 12-13 years, the adjusted age-standardized incidence rates of cervical cancer and CIN3 over the additional 12 months of follow-up were 83.9% and 94.3% lower than in the reference cohort of women who were never offered HPV vaccination, reported Peter Sasieni, PhD, of Queen Mary University of London, and colleagues in The BMJ.
The highest incidence rates for invasive cervical cancer remained among women living in the most deprived areas, but the authors noted that the HPV vaccination program had a large effect in all five deprivation levels.
"HPV vaccination really does work in preventing cervical cancer, but to be highly effective at a population level, it is vitally important to achieve high coverage in all sectors of society," Sasieni told MedPage Today. "That is not easy, but it is possible, as has been demonstrated with the HPV immunization program in England."
"The success of HPV immunization in England should encourage us all to redouble efforts to ensure high HPV vaccination coverage throughout the world," he added. "The burden of cervical cancer falls most heavily on low- and middle-income countries. We cannot leave them behind."
In an accompanying editorial, Kalyani Sonawane, PhD, of the MUSC Hollings Cancer Center in Charleston, South Carolina, and colleagues noted that "the human and monetary consequences of cervical cancer and treatment averted through HPV vaccination outweigh the costs of making it accessible to all age-eligible individuals."
The findings of the study suggest that "marginalized groups may benefit from the HPV vaccine despite poor social determinants of health or higher prevalence of risk factors such as smoking, alcohol consumption, and reduced uptake of cancer screening," the editorialists wrote. "To successfully eliminate cervical cancers, policy makers must develop, implement, or redesign programs to ensure equal access to the HPV vaccine for all individuals, regardless of their income."
England's vaccination program began in 2008 and initially used the bivalent HPV 16/18 vaccine (Cervarix), before switching to the quadrivalent HPV 6/11/16/18 vaccine (Gardasil) in 2012.
A study of the program was previously published in 2019 and showed that it was highly effective in preventing cervical cancer and CIN3. The current study looked at an additional 12 months of follow-up data -- from July 2019 through June 2020 -- but the researchers also evaluated the effectiveness of the vaccine across different levels of socioeconomic deprivation.
"In England, the social-class gradient for cervical cancer is one of the steepest of any cancers," Sasieni and colleagues wrote, noting that women in the most deprived area have had double the risk of those in the least deprived area.
Due to this higher incidence in more deprived groups, the researchers found that the most cases were prevented in the most deprived areas -- 192 and 199 for the first and second fifths -- compared with the least deprived group, for whom the vaccine prevented an estimated 61 cancers.
The number of prevented cases of CIN3 was high across all deprivation groups, but was highest for women living in more deprived areas. However, there were some differences depending on when women received the HPV vaccine. In women offered the vaccine at ages 16 to 18, the proportion of CIN3 cases prevented was 29.6% in those from the most deprived areas compared with 40.6% from the least deprived areas. There were also differences for women who received the vaccine at ages 14 to 16 and at ages 12 to 13, and between most and least deprived areas, but these differences were not as apparent.
The percentage of cancers prevented also depended on what age the women were offered the vaccine. Those offered the vaccine at ages 16 to 18 had about 26% to 29% of cancers prevented. If offered the vaccine at ages 14 to 16, about 67% to 68% of cancers were prevented, and if offered the vaccine at ages 12 to 13, about 84% to 85% of cancers were prevented.
For this study, Sasieni and colleagues analyzed the records of all women ages 20-64 living in England who were diagnosed with invasive cervical cancer or CIN3 from January 2006 through June 2020. Overall, there were 231.1 million women-years of observation over that time period, and the researchers identified 29,968 women with a diagnosis of invasive cervical cancer and 335,228 women with a diagnosis of CIN3.
Data on the women with cancer or CIN3 were aggregated by date of birth into seven birth cohorts ranging from August 1984 to June 2000. Three of the birth cohorts were eligible to receive the vaccine and were vaccinated at ages 12 to 13, 14 to 16, and 16 to 18. The older cohorts were not offered the vaccine, but were invited for screening. Vaccine coverage ranged from about 39% to 48% in the cohort that was 16 to 18 years old at vaccination, 71% to 76% in the cohort ages 14 to 16, and 81% to 88% in the cohort ages 12 to 13.
The researchers estimated that by mid-2020, HPV vaccination had prevented 687 cervical cancers and 23,192 cases of CIN3.
The main limitation of the study was that it was observational, and individual-level data on vaccination status were not available.
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 Cancer Research UK.
The study authors reported no relevant financial disclosures.
Sonawane reported consulting for Value Analytics Labs on unrelated projects.
Primary Source
The BMJ
Source Reference: Falcaro M, et al "Effect of the HPV vaccination programme on incidence of cervical cancer and grade 3 cervical intraepithelial neoplasia by socioeconomic deprivation in England: population based observational study" BMJ 2024; DOI: 10.1136/bmj-2023-077341.
Secondary Source
The BMJ
Source Reference: Amboree TL, et al "HPV vaccine: the key to eliminating cervical cancer inequities" BMJ 2024; DOI: 10.1136/bmj.q996.
Last weeks announcement that AstraZeneca would no longer market its Covid vaccine brings an end to one of the centurys most remarkable medical stories. Created within a year of the arrival of the pandemic, the AZ vaccine was cheap, easily stored and transported, and helped stave off humanitarian crises in Asia and Latin America, where many countries could not afford the more expensive mRNA vaccines that were being snapped up by rich western nations. It is estimated that it saved 6.3 million lives in 2021 alone.
Yet from the start the vaccine created by research teams led by Professor Andy Pollard and Professor Sarah Gilbert at the Oxford Vaccine Centre was dogged by controversy. It was linked to blood clots, US observers criticised protocols for its trials, and French president Emmanuel Macron claimed it was quasi-ineffective for people over 65. In fact, the vaccine is particularly effective for the elderly.
In very rare cases, the AZ vaccine can cause blood clots. According to the British Heart Foundation, one study in the BMJ showed that for every 10 million people vaccinated with AstraZeneca there would be a total of 73 extra cases of blood clots. By contrast 10 million Covid cases would trigger thousands of extra blood clot cases.
Many of the anxieties about the vaccine stemmed from national self-interests. However, others derive from the nature of vaccines themselves, and this raises issues that are likely to re-emerge with the arrival of any new pandemic in coming years, scientists have warned.
A vaccine is unlike any other type of medicine because it works by stimulating a persons anti-pathogen defences, arming them in advance of a future infection. However, this preparation goes beyond helping one individual and can aid the general population, a point stressed by Professor Stephen Evans, of the London School of Medicine and Tropical Hygiene.
If I take a preventative drug such as a statin then I am the only one who benefits, said Evans. However, there are people who cannot mount responses to a vaccine because they are ill or have a weakened immune system. They remain vulnerable. However, if you can build up herd immunity by ensuring the maximum number of people are inoculated, virus levels will drop and the vulnerable will be protected. If we believe we have responsibilities to help others, being vaccinated achieves that. There are moral concerns about being inoculated, in other words.
Convincing the public which has witnessed a rise in anti-vax propaganda in recent years of this may not be easy. In addition, there is a second crucial difference between standard medical treatments and vaccines, added Professor Sir David Spiegelhalter, of the University of Cambridge. We never know the identities of those who benefit [from a vaccine] they are statistical people while those who are harmed can be named and their stories told.
AstraZenecas Covid vaccine provides an example. We only know those who were harmed by it but cannot pinpoint those who benefited. Again, this makes it trickier to pinpoint a vaccines success and assure people of its efficacy. To a certain extent, you can get round this and assess the impact of Covid vaccines by looking at the deaths of frontline workers in the health service during the pandemics early days, added Evans. Hundreds died, but if we had had a vaccine then it is now clear most would probably have survived.
Most virologists and vaccine experts agree: when you look at the AstraZeneca vaccine from a global perspective, it probably benefited tens of millions of people, preventing deaths and reducing long-term consequences of Covid. It was a remarkable success, yet its passing has been marked by many who stressed its side-effects but never touched on its achievements.
The paradox of vaccines is that people forget how important they are, said Professor Adam Finn, of Bristol University. They are like democracy. You enjoy it for a while and then forget how important it is to preserve it. Its a problem.
Analysis and opinion on the week's news and culture brought to you by the best Observer writers
after newsletter promotion
On the other hand, it is also clear politicians and officials will have to be careful about the claims they make, added Fiona Fox, head of the Science Media Centre. Public trust in vaccines will come from open and honest communication. The benefits massively outweigh the risks as they did with this vaccine.
But you wont win any arguments by claiming that vaccines are 100% safe or running for the hills at the first reports of problems, which unfortunately too many government and NHS communications officers tend to do.
Downplaying risks is always tempting when you need people to take a mostly safe vaccine but its ultimately self-defeating because it erodes trust in the longer term.
Robin McKie is science and environment editor for the Observer
With a severe version of mpox breaking out in the Democratic Republic of Congo, officials with the U.S. Centers for Disease Control and Prevention are warning that it could spread and that people at risk should be vaccinated as soon as possible.
High-risk populations include men who have sex with men, although anyone can contract the disease, which is largely spread by skin-to-skin contact sexual relations, for instance, but also in crowds at outdoor festivals. Thousands of gay and bisexual men developed mpox in a 2022 outbreak. People with compromised immune systems, such as those living with HIV, are at high risk for serious cases and death.
There are two main types of mpox: Clade I, the type that is dominant in Congo, and Clade II, a version of which caused the 2022 global outbreak, The New York Times reports. Clade I is deadlier than Clade II, the Times notes, explaining that a clade is a genetically and clinically distinct group of viruses.
No Clade I cases have been documented outside of Congo yet, but a global spread is possible, as the 2022 outbreak that affected Europe and North America originated in Nigeria.
This is a very important example of how an infection anywhere is potentially an infection everywhere, and why we need to continue to improve disease surveillance globally, Anne Rimoin, an epidemiologist at the University of California, Los Angeles, told the Times.
Many of the cases in Congo were among sex workers, both male and female, and their clients, plus men who have sex with men, according to the CDC. The symptoms of mpox infection include fever, severe headache, back pain, a rash, and sometimes sores at the infection site.
There were about 30,000 cases of mpox in the U.S. in 2022 but only 1,700 last year, thanks to vaccines and changes in behavior, the CDC reports. However, only 23 percent of at-risk Americans have gotten both necessary doses of the Jynneos vaccine against mpox, so CDC scientists are urging all those at risk to be vaccinated. The vaccine is now available at pharmacies in the U.S., making it easier to access than previously.
A recent Government Accountability Office report found serious flaws in the federal governments response to the 2022 outbreak. The Department of Health and Human Services internal communication was poor, hampering coordination of efforts to fight mpox, according to the report. Democratic U.S. Rep. Ritchie Torres of New York, a gay man, has introduced legislation to improve communication within federal agencies and messaging to at-risk populations.
The federal government and HHS were catastrophically unprepared for the mpox outbreak, Torres told The Advocatein April.
WHO approves TAK-003 (Qdenga) as 2nd dengue vaccine for children aged 6-16 in high-burden areas. Takeda in talks to launch in Indi... Read More WHO approves TAK-003 (Qdenga) as 2nd dengue vaccine for children aged 6-16 in high-burden areas. Takeda in talks to launch in India. Panacea Biotec & Serum Institute collaborate on indigenous vaccine trials. Read Less World Health Organization has approved a second dengue vaccine, TAK-003 (Qdenga), for use among children aged 6-16 years in places with high case burden and transmission intensity. The vaccine, developed by Japanese pharma giant Takeda, can be administered in a two-dose schedule with a three-month interval between doses . The first dengue vaccine to be approved by WHO was Sanofi Pasteur's Dengvaxia. Both dengue vaccines are at present not available in India. But, sources said, Takeda is in talks with an Indian firm to launch TAK-003 (Qdenga) in the country. Also, Panacea Biotec and Serum Institute of India - the two leading vaccine manufacturing firms in India - are collaborating to conduct human trials of an indigenous dengue vaccine that has already successfully completed initial trials.
Popular from World
'A wake-up call to West': Europe on edge after assassination attempt on Slovakian PM Robert Fico
France: Troops deployed, TikTok banned as deadly unrest rocks New Caledonia
'India landed on moon, while we ... ': Pakistani lawmaker highlights lack of amenities in Karachi
Gujarati careworkers face destitution and deportation in Britain after being scammed
After samosas, golgappas appears on White House menu
end of article
Earlier this month, the U.S. Department of Health and Human Services Office of the Assistant Secretary for Planning and Evaluation (ASPE) released new numbers showing how Inflation Reduction Act (IRA) provisions have increased uptake of Part D-covered vaccines and saved beneficiaries over $400 million in 2023.
Starting in January of 2023, the IRA made recommended Part D vaccines free of charge for enrollees. ASPEs data show this led to a 42% increase in uptake of the shingles vaccine and a 114% increase in the Tdap (tetanus, diphtheria, and pertussis) vaccine compared to 2021. Over 6 million beneficiaries also received the newly available respiratory syncytial virus (RSV) vaccine without cost sharing. The report breaks out numbers by state as well as by various populations and demographics, including those eligible for the Low-Income Subsidy, or Extra Help, which may help identify opportunities for future outreach and engagement.
The vaccine uptake increase mirrors the increase in insulin fills that followed implementation of the IRAs $35 monthly cap on covered products, underscoring the importance of these critical updates.
While these data demonstrate that millions of Medicare beneficiaries have been able to access more affordable care as a result of the IRA, many are missing out, and large shares of people are still unaware of the laws various provisions. A new KFF tracking poll shows that only 35% of all registered voters and 52% of Medicare-age voters know about the IRAs insulin cap. This pattern holds true for most of KFFs questions on the IRAs other reforms: 27% of voters and 40% of older voters know that the IRA places an annual limit on out-of-pocket Part D prescription drug costs for people with Medicare; 36% of voters and 48% of older voters know that the IRA requires the federal government to negotiate the price of some prescription drugs for people with Medicare; and 14% of voters and 15% of older voters know that the IRA penalizes drug companies for increasing prices faster than the rate of inflation.
These numbers have improved slightly since the last tracking poll when, for example, 32% of respondents and 35% of older adults knew about drug price negotiation. Some of this increase may be due to news reports about litigation.
As more IRA reforms take effectlike the $2,000 out-of-pocket cap in Part D starting in 2025more people are likely to become aware of the laws improvements.
Medicare Rights applauds each of these important IRA changes. We continue to urge Congress to build upon them and do even more to help people with Medicare, other coverage, or no coverage obtain high-quality care. If you or someone you know has questions about navigating or affording Medicare, call Medicare Rights national helpline at 800-333-4114 or your local State Health Insurance Assistance Program (SHIP).
Read the ASPE report.
Read the KFF tracking poll.
Read more about the IRAs Medicare reforms.
England's human papillomavirus (HPV) vaccination program is linked to dramatically lower rates of cervical cancer and precancerous lesions in all socioeconomic groups, reveals astudy led by Queen Mary University of London researchers.
For the observational study, published yesterday in BMJ, the researchers analyzed the effect of the country's school-based HPV vaccination program on the incidence of cervical cancer and grade 3 cervical intraepithelial neoplasia (CIN3) in English women aged 20 to 64 years from January 2006 to June 2020. The cohort included29,968 diagnosed as having cervical cancer and 335,228 with CIN3.
The aim was toreplicate previous analyses based on National Health Service cancer registry data, add another 12 months of follow-up (July 2019 to June 2020), and investigate vaccination-program effectiveness across levels of socioeconomic deprivation.
"Human papillomavirus (HPV) comprises a family of viruses, a subset of which are responsible for virtually all cervical and some anogenital and oropharyngeal cancers," the study authors wrote. "In England, HPV vaccination was introduced nationally in 2008 and was offered routinely to girls aged 12-13 years, with catch-up campaigns during 2008-10 targeting older teenagers aged <19 years."
Initially, the bivalent (two-strain) Cervarix vaccine was offered before being supplanted by the quadrivalent (four-strain) Gardasil vaccine in 2012. The program was broadened to include boys aged 12 and 13 years in 2019.
The low rates of cancerous and precancerous cervical lesions and the estimated high effectiveness of the HPV immunization program seen in the previous study continued during the additional year of follow-up among women born after September 1990.
In women offered HPV vaccination at age 12 and/or 13 years, adjusted age-standardized rates of cervical cancer and CIN3 in the extended follow-up period were a respective83.9% and 94.3% lower than in those never offered HPV vaccination.
HPV vaccination averted an estimated 687 cervical cancers and 23,192 cases of CIN3 by 2020. The highest rates of averted cancer and precancerous lesions were still observed in women living in the most socioeconomically deprived areas, but the vaccination program substantially reduced rates in women at all five levels of deprivation.
For example, the greatest number of cervical cancer cases were prevented in women in the most-deprived areas (192 and 199 cancers prevented in the first and second fifths of deprivation, respectively) and the fewest in women in the least-deprived fifth (61).
Prevented cases of CIN3 were greatest among women in the more deprived areas (5,121 and 5,773 for first and second fifths, respectively, compared with 4,173 and 3,309 in the fourth and fifth fifths, respectively.
In women offered catch-up vaccination, rates of CIN3 fell more in the least-deprived areas than the most-deprived areas (respective reductions of 40.6%vs29.6% and 72.8%v67.7% for women offered vaccination at ages 16 to 18 and 14 to 16 years). "The strong downward gradient in cervical cancer incidence from high to low deprivation in the reference unvaccinated group was no longer present among those offered the vaccine," the researchers wrote.
In a Cancer Research UKnews release, senior author Peter Sasieni, PhD, of Queen Mary University, said,"In the UK, the elimination of cervical cancer as a public health problem in our lifetime is possible with continued action to improve access to vaccination and screening for all."
In a relatedcommentary, Trisha Amboree, MD, MPH, of the University of Texas MD Anderson Cancer Center in Houston, and colleaguesnoted that poorer women shoulder a disproportionate burden of cervical cancer incidence and death in high-, middle-, and low-income countries.
This finding suggests that marginalized groups may benefit from the HPV vaccine despite poor social determinants of health or higher prevalence of risk factors such as smoking, alcohol consumption, and reduced uptake of cancer screening.
"Interestingly, vaccine effectiveness (the proportion of cervical cancers averted) was consistent regardless of socioeconomic status," they wrote. "This finding suggests that marginalized groups may benefit from the HPV vaccine despite poor social determinants of health or higher prevalence of risk factors such as smoking, alcohol consumption, and reduced uptake of cancer screening."
The findings also underscorethe importance of reaching the 90% HPV vaccination uptake goal recommended by the World Health Organization:"Currently, HPV vaccine coverage is below target in many countries despite being offered for several years," they said.
"Inequities in vaccine access, hesitancy, and variation in the extent to which healthcare providers recommend vaccination create a major challenge to target attainment in countries with existing HPV vaccine programmes," they added. "Additionally, upstream factors (finances, health system capacity, supply, and vaccine prioritization) can deter introduction and scale-up in countries with no programmes."
Amboreeand colleagues urge collective efforts of government, community stakeholders, and healthcare professionals in these countries to work together to eliminate cervical cancer inequalities. "An equity driven approach is critical for the success of HPV vaccination programmes," they wrote.
