Category: Covid-19 Vaccine

February 06, 2024

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The updated COVID-19 vaccines were 54% effective against symptomatic SARS-CoV-2 infection and offered protection against JN.1 and XBB viral lineages, according to early estimates published by the CDC.

Updated COVID-19 vaccines provide protection against symptomatic infection, including against currently circulating lineages, CDC epidemiologist Ruth Link-Gelles, PhD, and colleagues wrote in MMWR. CDC will continue monitoring [vaccine efficacy], including for expected waning and against severe disease.

It was the top story in infectious disease last week.

In another top story, Healio checked in with experts about how ID care is delivered in rural America and how facilities are working to close the gap in coverage using technology and lessons learned from the COVID-19 pandemic.

We're all kind of clustered in more suburban or urban areas, Caitlyn Hollingshead, MD, assistant professor of medicine and director of telemedicine for the division of infectious diseases at the University of Toledo College of Medicine and Life Sciences in Ohio, said in an interview. The singular challenge is to get a physician to rural areas, and there are many, many places that don't have any access to [ID care] whatsoever and are kind of just left to their own devices.

Read these and more top stories in infectious disease below:

Updated COVID-19 vaccines effective against variants, new data show

The updated COVID-19 vaccines were approximately 54% effective against symptomatic SARS-CoV-2 infection and offered protection against JN.1 and XBB viral lineages, according to early estimates published last week by the CDC. Read more.

There arent many of us: The challenges of delivering rural ID care

Despite the importance of the specialty of infectious diseases in modern medicine made all the more evident by the COVID-19 pandemic many rural areas of the United States do not have access to specialized ID care. Read more.

Hundreds of foodborne outbreaks may go undetected in US each year

Researchers estimated that hundreds of small foodborne disease outbreaks may go undetected in the United States each year, based on a statistical analysis of data from the last 2-plus decades. Read more.

Oral therapy noninferior to IV for treating low-risk S. aureus bloodstream infections

Making an early switch to oral antibiotic therapy from IV therapy is safe and effective for patients with low-risk Staphylococcus aureus bloodstream infection, researchers determined. Read more.

Gonorrhea cases decline for first time in decade, but syphilis continues to surge

Reported cases of gonorrhea in the United States declined for the first time in at least a decade in 2022 while cases of chlamydia remained stagnant and syphilis continued its years-long surge, data released by the CDC on Tuesday showed. Read more.

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Top in ID: Efficacy of updated COVID-19 vaccines; challenges of delivering rural ID care - Healio

A team of University of Michigan researchers analyzed over 80 studies to assess the effectiveness of COVID-19 vaccine doses beyond the primary series. Their findings, based on 150 million patient observations, support the efficacy of both monovalent and bivalent boosters in preventing severe outcomes and underline the importance of annual vaccine updates.

New research highlighted the significant benefits of monovalent and bivalent COVID-19 boosters in preventing hospitalization and death, advocating for the periodic update of vaccines to match circulating virus variants.

First boosters, second boosters, monovalent, bivalent. Just like the SARS-CoV-2 virus strain, the vaccines to combat the virus are always changingand perhaps confusing.

With the goal of better understanding the variety of vaccines, their effectiveness and taking a look at the methods used globally to study vaccines effectiveness, a group of University of Michigan researchers, led by Sabir Meah and Bhramar Mukherjee, evaluated some 80 studies and 150 million observations from patient datasets across the world to understand the various designs and methods that were used to study effectiveness of COVID-19 vaccine doses following the primary series vaccination.

They then applied all the methods used in those studies to patient data from Michigan Medicine.

Meah is a School of Public Health alumnus with a masters degree in Biostatistics and currently a biostatistician in Urology at Michigan Medicine. Mukherjee is the John D. Kalbfleish Distinguished University Professor of Biostatistics, the Sioban Harlow Collegiate Professor of Public Health, and assistant vice president for research in the Office of the Vice President for Research.

What we have been able to create is a repository of methods that can be applied for future annual vaccines, Mukherjee said. It is important to have robust and reproducible results and reliable estimates of vaccine effectiveness to solidify public trust and fight misinformation.

Their full study is available in Science Advances. Meah explains more.

From the patient data you reviewed, could you explain your findings around bivalent and monovalent boosters?

In our study, we evaluated three different vaccination regimens: 1) the monovalent booster targeting the original strain, 2) the second monovalent booster also with the original formulation, and 3) the new bivalent vaccine updated in fall 2022 to target newer Omicron variants. We saw that all sequential doses provided a substantial benefit in terms of preventing hospitalization and death, and the estimates from the fall 2022 Omicron-specific vaccine dose were stronger from worldwide studies we looked at.

These findings support the practice of periodically updating the COVID-19 vaccines for currently circulating variants. Fortunately, it appears that in the U.S. and many other countries, such as those in the European Union, we will be getting updated COVID-19 vaccines on an annual frequency. The fall 2022 vaccine has already been succeeded by a new updated vaccine in fall 2023, which you can still get now in early 2024, if you havent already, targeting the even newer XBB1.5 Omicron variant.

We expect that our conclusions on the utility of updating vaccines should generalize to any updated COVID-19 vaccine, not just the fall 2022 bivalent vaccine, but additional monitoring and study of the real-world effectiveness of an annual vaccine is still necessary, and we hope that the findings of our research can aid these studies. What we have been able to do is to establish an analytic pipeline where researchers can study the vaccine effectiveness of future annual vaccine formulations.

Could you describe what biostatistics brings to the table on this topic?

Biostatistics and epidemiology provide a toolbox for the complex process of evaluating vaccine effectiveness in scientific observational studies. However, there are quite a number of different approachesboth in study design and methods that researchers have employed in vaccine effectiveness studies conducted all over the world, which is what motivated us to conduct our review of their methodology and results and subsequent case study of these methods using Michigan Medicine data.

Quite fortunately, a key finding of our study was that vaccine effectiveness estimates remain relatively stable and do not depend heavily on choice of methods for the outcomes of hospitalization and mortality. We did not observe this advantageous property for infection outcomes, but hospitalization and death are arguably much more important points of study as we advance further into the endemic stage of the pandemic.

Given what your research says about the power of COVID-19 boosters to prevent severe illness and hospitalization, what would you like this study to convey to the public?

COVID-19 vaccines examined in our study, including the fall 2022 bivalent vaccine, provided strong protection against hospitalization and death. We expect this pattern to continue with additional annual vaccines approved by the FDA, but continued study of future vaccines is warranted, and our findings provide some important points of consideration for these future studies.

Reference: Design and analysis heterogeneity in observational studies of COVID-19 booster effectiveness: A review and case study by Sabir Meah, Xu Shi, Lars G. Fritsche, Maxwell Salvatore, Abram Wagner, Emily T. Martin and Bhramar Mukherjee, 20 December 2023, Science Advances. DOI: 10.1126/sciadv.adj3747

Co-authors: Xu Shi, Lars Fritsche, Maxwell Salvatore, Abram Wagner, Emily Martin, all of U-M. Their cross-discipline collaboration is part of the School of Public Healths IDEAS, Interdisciplinary Discovery, Engagement + Actions for Society initiative.

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Vaccine Effectiveness: Which COVID-19 Shots Offer the Most Protection? - SciTechDaily

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COVID-19 Vaccination in a Patient With Gluten Enteropathy: A Case Report - Cureus

During the 2022-2023 respiratory season, the bivalent COVID vaccines had an effectiveness of 54% against infection and 49% against symptomatic COVID in children and adolescents ages 5 to 17 years, a new study in JAMA showed.

In this interview, Melissa Briggs Hagen, MD, MPH, of the CDC's Coronavirus and Other Respiratory Viruses Division, discusses the data.

The following is a transcript of her remarks:

This study was designed to assess how well the bivalent vaccine protected children from infection -- both general SARS-CoV-2 infection and symptomatic illness -- during the last respiratory virus season.

For this study, the groups that we were really assessing were those who had received the bivalent vaccine and those who had not. Those who had not received the bivalent vaccine may have received the monovalent vaccine or may have had prior infection, so they weren't completely non-immune, but they hadn't received the bivalent. Those were our two comparator groups.

This study did show that among the almost 3,000 children from the six different sites that were enrolled and monitored that the bivalent vaccine protected against all infections with an effectiveness of 54%, and was 49% effective at protecting them from COVID-19 illness or symptomatic infection.

We did, in the study, stratify by age and look at those who were 5 to 11 versus 12 to 17. We also stratified by history of prior infection, as that's been a big question -- how well the vaccine works if you've been previously infected. So we separately looked at those who'd been infected in the past and those who had not. Then we also looked within a specific subset of people who were from the largest site, because we wanted to make sure there wasn't any kind of bias based on our different sites and the different vaccine uptake.

Every different way that we sliced this, we found that the vaccine was effective in preventing infection, both overall infection and symptomatic infection.

We think it's important because the bivalent vaccine did provide protection against infection during a time period in which Omicron and some very, very transmissible sublineages of Omicron were circulating. So, this wasn't completely known.

We've had a lot of studies that have shown that COVID-19 vaccination in general works to prevent severe disease. That is the main goal of the vaccination program, and so many of the studies that come out are really looking at medically-attended outcomes such as urgent care visits, emergency department visits, hospitalization. Those are both easier to study -- because you can do a case-control design or a test-negative design -- and they're also more what's driving the vaccine policy. Many of the studies that have come out have been focused on those outcomes.

There have been some studies on the outcomes that we looked at -- these milder outcomes like infection and like symptomatic illness -- but not specifically in school-aged children and during this timeframe of the bivalent vaccine being available and all of these new sublineages of Omicron circulating. So, we thought it was important to analyze it.

We also thought it was important that we do it with this very rigorous study design. We knew that we didn't miss any infections. We were swabbing weekly, there was very high compliance -- over 90% throughout the study period -- and then we also had antibody tests at the start of the study to know if they were prior-infected. So we really had a lot of data in this study to understand well how the vaccine was working.

This was not a study that looked specifically at the latest vaccine. The 2023/2024 monovalent vaccine that's now been released and is available for people to receive today is being studied at CDC. CDC just recently put out an MMWR [Morbidity and Mortality Weekly Report] last week that found very similar findings to what we found. It was looking at symptomatic illness and testing positive for COVID-19, and it was 54% protection against infection in that study as well. So we think that's very encouraging that we're continuing to see the vaccine work even as new variants arise, including the new JN.1 variant.

Still, uptake of the vaccine is quite low. Perhaps families, parents, providers feel like they're not at risk for severe disease or they're not at risk for the outcomes that the vaccine is really targeting.

But we know that COVID-19 infection is very common in children, that it does result in a lot of missed school and a lot of parents having to take off work, and potentially transmission to more susceptible, older adults. So the fact that the vaccine does work against this milder outcome, I think, is relevant. I think it's an important tool for families and for providers and for policymakers to be aware of.

The last thing I would say is that the current COVID-19 season is still quite high-circulation in lots of parts of the country and the current vaccine is still available. I would encourage you to read the study, to evaluate it for yourself. We, again, believe that it's really well-designed, and it's information that you can stand on when talking to your patients or informing other members of the public what the benefits are of this vaccine.

Emily Hutto is an Associate Video Producer & Editor for MedPage Today. She is based in Manhattan.

Disclosures

The study was conducted by the CDC and others.

Briggs Hagen had no disclosures. Some authors reported being employees of Abt Associates and other co-authors had relationships with the Florida Firefighter Cancer Initiative, Florida Department of Health, AbbVie, Ark Biopharma, AstraZeneca, the Burroughs Wellcome Fund, Clinical Care Options, Ellume, Flu Lab, GSK, Merck, Meissa Vaccines, Moderna, Novavax, Pfizer, Roche, Sanofi Pasteur, Shinogi, Vindico, and Vir.

Primary Source

JAMA

Source Reference: Feldstein LR, et al "Effectiveness of bivalent mRNA COVID-19 vaccines in preventing SARS-CoV-2 infection in children and adolescents aged 5 to 17 Years" JAMA 2024; DOI: 10.1001/jama.2023.27022.

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Bivalent Vax Protected Kids From Symptomatic COVID - Medpage Today

Senior Biden administration aides summoned Amazon officials to the White House during the height of the pandemic to discuss propaganda and misinformation in books for sale on the retail giants website that questioned the safety and efficacy of COVID-19 vaccines.

White House officials spent a week berating Amazon in March 2021 over books related to vaccine misinformation and asked what steps company officials could take to reduce the visibility of these titles, according to Amazon emails released Monday by House Judiciary Committee Chairman Jim Jordan, Ohio Republican.

The Amazon pressure campaign overseen by Andy Slavitt, who was Mr. Bidens senior adviser on the administrations COVID-19 task force, appears to have been successful.

On March 9, the same day Amazon officials agreed to meet with Biden administration aides at the White House about its COVID-19 books, Amazon enabled a do not promote policy for anti-vax books whose primary purpose is to persuade readers vaccines are unsafe or ineffective.

It also weighed policies to reduce the visibility of other COVID-related books that the White House opposed.

Amazon officials, the emails disclosed, werent worried only about the White House. Internal Amazon emails flagged negative stories by the now-defunct BuzzFeed News that highlighted books for sale on Amazon that questioned vaccines.

Amazon officials responded quickly when top Biden advisers contacted them about problematic books for sale on the site.

White House officials flagged one book authored in 2019 by Dr. Vernon Coleman titled Anyone Who Tells You Vaccines Are Safe and Effective Is Lying.

The title was discovered in an Amazon search by White House officials, including Mr. Slavitt, who immediately wrote to a top Amazon executive.

If you search for vaccines under books, I see what comes up, Mr. Slavitt wrote to the Amazon executive. I havent looked beyond that, but if thats whats on the surface, its concerning.

In an email dated March 12, 2021, an Amazon official said the company was feeling pressure from the White House Taskforce on reducing the visibility of books that questioned the vaccine.

Ahead of the March 9 White House meeting, Amazons talking points included finding out whether White House officials were asking us to remove books, or are they more concerned about search results/order (or both)?!

Mr. Jordan said the Judiciary panel and the Judiciary subcommittee investigating the weaponization of government will investigate the matter.

Amazon caved to the pressure from the Biden White House to censor speech, Mr. Jordan said.

Mr. Slavitts name has surfaced in other efforts to censor social media.

Court documents made public in July revealed that Mr. Slavitt and other White House officials leaned on Twitter, Facebook, YouTube and other sites to remove posts and ban users whose content they opposed. Mr. Slavitt ramped up the effort by threatening the social media platforms with federal action.

Mr. Slavitt also played a role in coercing Twitter to deplatform Alex Berenson, a former New York Times reporter who posted questions, concerns and research about the mRNA-based vaccines side effects and weak efficacy.

Although the Centers for Disease Control and Prevention continues to promote the COVID-19 vaccine, officials acknowledge it does not prevent sickness or the spread of the virus. Medical professionals say myocarditis, or inflammation of the heart, is a recognized complication from the vaccine, especially in adolescents and young men.

Dr. Coleman, the author of the book flagged by Mr. Slavitt, currently sells dozens of health-related books on Amazon, some of them questioning traditional medicine and vaccines.

He describes himself as a former doctor in the United Kingdom who has sold more than 2 million books and campaigned on many issues involving both people and animals and has as a result made many enemies among powerful pressure groups defending the interests of drug and food companies.

Mr. Slavitt announced his departure from the White House in June 2021.

For more information, visit The Washington Times COVID-19 resource page.

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Biden administration pressured Amazon to censor books that questioned COVID vaccines - Washington Times

In December, the journalVaccinespublished an analysis of COVID-19 vaccination coverage among people with HIV in Catalonia between December 2020 and July 2022. Thearticle, resulting from a study funded by the Fundaci La Marat de TV3 and led by theCentre for Epidemiological Studies on HIV/AIDS and STI of Catalonia (CEEISCAT), a group from the Germans Trias i Pujol Research Institute (IGTP), in collaboration with researchers from thePISCIS Cohortgroup, evaluates the primary, monovalent, and booster doses. This research aims to develop concrete action plans tailored to specific profiles to facilitate and promote vaccination.

The study included a sample of over 200,000 individuals, 18,330 of whom have HIV and were vaccinated against COVID-19. The researchers observed a lower rate of complete primary vaccination schedule in people living with HIV (78.2%) compared to those without this condition (81.8%), with the difference being more pronounced among migrant populations. However, people living with HIV received more booster doses than the rest.

The authors identified several factors that may contribute to the lower complete vaccination rates: having a previous diagnosis of SARS-CoV-2, the status of HIV infection, being a migrant, or having a complicated socioeconomic situation. These factors reflect barriers to vaccine access and healthcare.

The analysis has helped identify patterns and contexts that encourage vaccination against SARS-CoV-2 among people living with HIV, as well as determining the need to improve vaccine access and address the hesitancy of vulnerable populations in taking the doses, highlighting their efficacy and safety.

The same group of researchers has publishedanother articlein theOpen Forum Infectious Diseasesjournal, this time focusing on migrant individuals with HIV. The findings indicate that these individuals (over 3,000 in the sample) have undergone fewer SARS-CoV-2 tests, yet they have a similar cumulative diagnosis rate as local natives. Their vaccination rate, both in terms of the complete schedule and booster doses, is lower compared to those born in Catalonia. In contrast, there were more hospitalisations and admissions to the Intensive Care Unit (ICU) among migrants, even with similar durations of stays and mortality rates. Moreover, having two or more comorbidities in migrant individuals has been associated as a risk factor for severe COVID-19.

The study suggests possible impediments that could justify these results, such as economic inequalities, lack of information, structural discrimination, language barriers, or distrust in the healthcare system. With this data, strategies are expected to be developed to reach the migrant population and promote vaccination, as it is crucial for protecting the individual and curbing future epidemics at a social level.

Source:

Journal reference:

Nomah, D. K., et al. (2023). Comparative Analysis of Primary and Monovalent Booster SARS-CoV-2 Vaccination Coverage in Adults with and without HIV in Catalonia, Spain.Vaccines. doi.org/10.3390/vaccines12010044.

More:

HIV patients have been less vaccinated with the full initial regimen against COVID-19 - News-Medical.Net

A recent large-scale cohort study conducted in Sweden and Norway has provided reassuring evidence about the safety of maternal mRNA COVID-19 vaccines for newborns. The study found that newborns whose mothers received at least one mRNA COVID-19 vaccine during pregnancy did not have worse outcomes than those whose mothers were unvaccinated during pregnancy. These findings add to the growing body of evidence supporting the safety of COVID-19 vaccinations during pregnancy, offering hope and assurance to expectant mothers worldwide.

The study analyzed data from 196,470 newborns, of whom 48% had mothers who received one or more doses of an mRNA COVID-19 vaccine during pregnancy. The unadjusted mortality rates for vaccine-exposed neonates were about half of those for unexposed neonates. This difference remained significant even after adjusting for factors such as maternal age, BMI, education, smoking status, and gestational age. Furthermore, there were no cases of neonatal pericarditis, myocarditis, or other inflammatory neonatal diseases among infants after maternal vaccination during pregnancy.

In addition to these encouraging findings, the study also revealed a lower risk of two serious complications nontraumatic intracranial hemorrhage and hypoxic-ischemic encephalopathy in infants born to vaccinated mothers. This suggests that maternal vaccination could potentially offer some protection against these conditions, although the mechanisms behind this are not yet fully understood.

The results of this study carry significant implications for healthcare professionals, public health authorities, and expectant mothers. Healthcare professionals can use these findings to counsel pregnant women about the safety and potential benefits of receiving a COVID-19 vaccine during pregnancy. This is particularly important given the heightened vulnerability of pregnant women to severe COVID-19 and the potential for adverse pregnancy outcomes associated with COVID-19 infection.

For public health authorities, these findings could help inform policy decisions and vaccination recommendations. And for pregnant women, this study provides further reassurance of the safety of mRNA COVID-19 vaccines not just for themselves, but also for their unborn children.

This study represents a significant step forward in our understanding of the impact of maternal mRNA COVID-19 vaccination on newborn health. It provides compelling evidence that these vaccines are safe for newborns and could potentially lower their risk of certain serious complications. As we continue to battle the COVID-19 pandemic, these findings underscore the importance of vaccination as a key strategy to protect not just ourselves, but also our future generations.

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Maternal mRNA COVID-19 Vaccination Safety Study: Reassuring Evidence for Newborns - Medriva

New OHSU study of nearly 1,000 vaccine recipients found unexpected gains when patients switched between right and left

Alternating arms between COVID shots can make the vaccine up to four times more effective, according to new research.

Researchers at Oregon Health & Science University in Portland studied how antibodies responded in the blood of 947 people who received two vaccinations against COVID-19 early in the pandemic.

Published last month,the studyfound antibodies responded more vigorously and thoroughly when people received a shot in one arm and a subsequent shot in another arm.

Three weeks after the second shot, researchers found heightened immunity to the original SARS-CoV-2 strain, and an even stronger immune response to the Omicron variant that emerged roughly a year after the second shot. The effect lasted more than 13 months.

The researchers hypothesize that spreading the immune responses between lymph nodes explains the difference.

By switching arms, you basically have memory formation in two locations instead of one, Dr. Marcel Curlin, the lead researcher and medical director of OHSU Occupational Health, said in a press release Feb. 6.

Particippants in the study included OHSU employees who agreed to enroll in research while getting vaccinated. They were randomized to get the second dose in either the same or the opposite arm as the first dose.

Some participants wondered if it made a difference if they alternated arms, Curlin said in the press release. Historically, clinicians thought arm choice didnt matter.

"This question hasnt really been extensively studied, so we decided to check it out," Curlin said. "It turned out to be one of the more significant things weve found."

Curlin and his team matched 54 pairs for age, gender and time between vaccinations and exposures. Half received two doses in just one arm. The other half alternated arms.

Researchers didnt see much of a difference at first. After three weeks, however, they measured significantly greater numbers of antibodies attacking the virus in blood samples. The rates progressively increased over four weeks by as much as four times.

Most people have been exposed to COVID at this point, Curlin said.

However, he added, the study could have ripple effects far beyond the pandemic. "Its probably not limited to just COVID vaccines," he said. "We may be seeing an important immunologic function."

Researchers who coauthored the study included Sedigheh Fazli, Archana Thomas, Abram Estrada, David Xthona Lee, Steven Kazmierczak, Mark Slifka, Bill Messer, Hiro Ross and David Montefiori.

The study was supported by the M.J. Murdock Charitable Trust and OHSU Foundation as well as the National Institutes of Health.

Curlin and his colleagues want further research to determine whether switching arms improves responses for other vaccines -- especially among children.

Personally, Curlin said, he's convinced. "Im going to switch up my arms," he said.

The difference doesn't have to be huge to be important, given the number of people receiving vaccines, he said. "Any incremental improvement might save a lot of lives."

Read more here:

Alternating arms could make COVID vaccination more effective - The Lund Report

Understanding the Impact of COVID-19 on Our Immune System

The COVID-19 pandemic has significantly tested our immune systems. Novel in nature, the coronavirus has placed a high demand on our bodies to develop immunity. This immunity can either be acquired through infection or more preferably, through vaccination. However, the journey doesnt end there; the emergence of new variants continues to challenge our immune systems.

According to a web page on the Centers for Disease Control and Prevention (CDC) website, the 2023-2024 monovalent XBB 1.5 COVID-19 vaccine has been shown to provide approximately 54% increased protection against symptomatic SARS-CoV-2 infection compared to no vaccination. This highlights the crucial role of vaccination in reducing the risk of infection and its potential in controlling the pandemic.

As the virus mutates and evolves, variants of concern (VoCs) such as Omicron have emerged, posing an additional challenge to our immune responses. However, advances in vaccine development are proving instrumental in tackling this issue. A research article published in ScienceDirect discusses the development of a polyvalent RNA vaccine, LION/RepRNA Polyvalent, composed of mRNA from five VoCs. This vaccine has been successful in inducing neutralizing antibodies in mice previously immunized with LION/RepRNA D614G and reduced the imprinted phenotype associated with low neutralization capacity of Omicron B.1.1.529 pseudoviruses.

Aside from protecting against the virus, COVID-19 vaccination has other potential benefits. An article published in Nature highlights that COVID-19 vaccination may help mitigate the dysregulation of IL-1 and IL-18, as well as gastrointestinal symptoms in individuals with post-COVID-19 condition. It also emphasizes the safety and efficacy of mRNA-based COVID-19 vaccines in generating strong antibody responses without causing cytokine dysregulation or worsening symptoms.

An interesting study on the Infectious Disease Advisor website found that hybrid immunity from COVID-19 vaccination and prior infection among pregnant individuals provides more durable protection among infants compared to prior infection alone. Conducted at the University of Washington, the study showed that maternal vaccination before delivery was the strongest predictor of maternally-derived antibody persistence through 6 months of age. This reinforces the importance of vaccination not only for individual protection, but also for the protection it offers to others, especially vulnerable populations such as infants.

In conclusion, the COVID-19 pandemic has underscored the vital role of vaccination in our global health response. Vaccines not only reduce the risk of infection, but they also aid in controlling the spread of variants, provide potential health benefits to recipients, and even offer extended protection to vulnerable populations. With the potential for a yearly vaccination schedule similar to the flu vaccine, its clear that vaccines will continue to play an integral role in our battle against COVID-19.

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Understanding the Impact of COVID-19 on Our Immune System - Medriva

Preterm infants born to people who have been vaccinated for COVID-19 had roughly the same levels of antibodies to the spike protein of SARS-CoV-2 as term infants born to vaccinated people, according to a study funded by the National Institutes of Health (NIH). Moreover, in all infants, antibodies to the spike protein were higher among those born to individuals who had received three or more vaccine doses before delivery, compared to those who had only two prior vaccine doses. The findings may help allay concerns that fewer antibodies might pass to preterm infants than term infants.

The study was conducted by Alisa Kachikis, M.D., M.S., of the University of Washington, and colleagues. It appears in JAMA Network Open. NIH funding was provided by the Eunice Kennedy Shriver National Institute of Child Health and Human Development, the Office of Research on Womens Health, the National Institute of Allergy and Infectious Diseases, and the National Center for Advancing Translational Sciences.

Pregnant individuals who are vaccinated against COVID-19 have lower rates of severe COVID-19 illness and pregnancy complications than unvaccinated pregnant people. COVID-19 vaccines protect against the disease by stimulating production of antibodies to the spike protein, which SARS-CoV-2 uses to infect cells. Previous research has shown that anti-spike antibodies pass from pregnant individuals through the placenta to the fetus and may protect infants from severe COVID-19 illness. However, little is known about how well anti-spike antibodies are transferred to preterm infants.

For the current study, researchers compared levels of anti-spike antibodies in 1) the blood of pregnant individuals with no history of COVID-19 infection who received mRNA vaccines and then gave birth and 2) the umbilical cord blood of these infants, who were born at term and preterm. The team also compared anti-spike antibody levels from those who had been vaccinated twice before delivery (including before pregnancy) and those who were vaccinated three or more times before delivery.

Of the 220 participants, 184 delivered full-term infants and 36 delivered preterm, while 121 had been vaccinated twice and 99 had been vaccinated three or more times. For those receiving 2 vaccine doses, the average concentration of anti-spike antibodies was 674. The average concentration was 8,159 among those who received 3 or more doses. For cord blood samples, the average was 1,000 after 2 doses and 9,992 after 3 or more doses. The researchers did not find a significant difference in umbilical cord antibody levels between infants delivered at term and preterm.

The findings provide assurance that preterm infants receive similar levels of maternal antibody protection as term infants after maternal COVID-19 vaccination. In addition, compared to receiving two doses of a vaccine, receiving 3 or more doses resulted in 10 times the level of anti-spike antibodies in umbilical cord blood. The authors concluded that policies should be considered for the administration and timing of COVID-19 vaccines for those at risk of preterm delivery.

Given that the two-dose vaccine series is no longer available and the current recommendation is for a single vaccine dose, additional research is needed to determine the ideal number of doses for pregnant individuals with and without a history of COVID-19 infection.

Kachikis, A, et al. Timing of maternal COVID-19 vaccine and antibody concentrations in infants born preterm. JAMA Network Open. 2024.

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Science Update: Preterm infants protected by maternal COVID-19 vaccination, NIH-funded study suggests - National Institute of Child Health and Human...