The World Trade Organization (WTO) approved a politically important deal Friday to water down intellectual property restrictions for the manufacture of COVID-19 vaccines after an almost two-year effort involving scores of high-level meetings and much political arm twisting. During the early morning hours in Geneva, WTO ministers approved a package of agreements that included the vaccine patent waiver, which Director-General Ngozi Okonjo-Iweala previously said was necessary to end the “morally unacceptable” inequity of access to COVID-19 vaccines. The WTO’s last-minute deal — secured after an all-night negotiating session in Geneva — is an important victory for Okonjo-Iweala, the former head of Gavi – the vaccine alliance, who actively stumped for the accord during her first year as the WTO’s top trade official.
US Centers for Disease Control and Prevention (CDC) Director Dr Rochelle Walensky signed off on COVID-19 vaccinations for children under 5 on Saturday, clearing the way for vaccinations to be administered soon.
This move comes after vaccine advisers to the CDC voted unanimously on Saturday in support of recommending the Moderna and Pfizer/BioNTech COVID-19 vaccines to children as young as 6 months.
“Together, with science leading the charge, we have taken another important step forward in our nation’s fight against COVID-19. We know millions of parents and caregivers are eager to get their young children vaccinated, and with today’s decision, they can,” Walensky said in a statement.
Millions worldwide have already had COVID-19 and some if not all may be wondering how long they will have immunity from the coronavirus. Earlier in the pandemic, most people assumed that getting infected had at least one upside: that you would be protected against future encounters with the virus. But as the latest wave heads toward the Western region of the country and the virus shows no signs of easing up, reinfections seem to have become common. Already, many people are reporting second or even third infections with newer variants.
Experts have warned that exposure to the coronavirus — through vaccination or infection — does not mean that you are completely protected from future infections. Rather, the coronavirus is evolving to behave more like its closely related cousins, which cause common colds and infect people repeatedly throughout their lives.
However, the coronavirus doesn’t yet fit into clear seasonal patterns like the other common cold viruses. It can also cause debilitating symptoms that persist for months or years in some people, and has claimed the lives of millions of others. So what can you do to protect yourself, not only from infection but also reinfection?
Before Omicron, reinfections were rare. A team of scientists, led by Laith Abu-Raddad at Weill Cornell Medicine-Qatar, estimated that a bout with Delta or an earlier coronavirus strain was roughly 90 percent effective in preventing a reinfection in both vaccinated and unvaccinated people. “But Omicron really changed that calculus,” said Dr Abu-Raddad, an infectious disease epidemiologist.
After Omicron emerged, prior infections only provided about 50% protection against reinfection, Dr Abu-Raddad’s study showed. The coronavirus had acquired so many mutations in its spike protein that newer versions became more transmissible and better able to evade immunity. That means you can catch a version of Omicron after recovering from an older, non-Omicron variant. You can even get sick with one of the newer Omicron subvariants after getting over a different version of it.
Other factors also increase your vulnerability to reinfection, starting with how long it has been since you had COVID. Immune defences tend to wane after an infection. A study published in October 2021 estimated that reinfection could occur as soon as 3 months after contracting COVID-19.
The good news is that your body can call on immune cells, like T cells and B cells, to quash a reinfection if the virus sneaks past your initial antibody defences. T cells and B cells can take a few days to get activated and start working, but they tend to remember how to battle the virus based on previous encounters.
The result is that second or third infections are likely to be shorter and less severe.
Twelve years after the HPV vaccination program was introduced in the United States (US), the overall prevalence of cancer-causing HPV strains covered by the vaccine dropped by 85% among females (90% among vaccinated females and 74% among unvaccinated females), which is a strong sign of herd immunity, a new analysis of a nationally representative database in the US shows.
The study has been published online in the Annals of Internal Medicine.
The authors used data from the National Health and Nutrition Examination Survey (NHANES) to examine the 4 HPV types in the quadrivalent vaccine before 2003 and 2006 (the pre-vaccine era) and then again between 2007 to 2010, 2011 to 2014, and 2015 to 2018 (the vaccine era). For females, the authors analysed demographic and HPV prevalence data across each 4-year era.
“Analyses were limited to sexually experienced participants to ensure that all those included had an opportunity for HPV exposure and to participants aged 14 to 24 years with adequate self-collected cervicovaginal specimens,” the authors explain.
This resulted in a sample size of 3197 females. Demographic and HPV prevalence data were also collected from males, but only during the 2013 to 2016 era, because those are the only years for which male HPV typing data are available in NHANES. Again, analyses were limited to sexually experienced males aged 14 to 24 years with adequate self-collected penile specimens, which resulted in a sample size of 661 males.
During the 12 years of follow-up for females, there was a steady increase in females reporting having received at least 1 dose of the HPV vaccine, increasing from slightly more than 25% during 2007 to 2010 to 59% during 2015 to 2018. The percentage of males who reported having at least 1 HPV dose also increased.
Commenting on the findings, Rebecca Perkins, MD, from the Boston University School of Medicine, and colleagues point out that the COVID-19 pandemic has led to disruptions in HPV vaccination programs and has reversed much of the progress made in recent years. “During the pandemic, providers and health systems have deprioritized adolescent vaccination and particularly HPV vaccination, which in turn has led to more severe drops for HPV vaccination than for other adolescent vaccinations, and for adolescent vaccination compared with early childhood and adult vaccinations,” Dr Perkins and colleagues write in an accompanying editorial.
Thus, the need to compensate for the cumulative deficit of missed vaccinations during the past 2 years has created a “serious and urgent threat” to cancer prevention efforts–“a shortfall from which it may take a decade to recover,” the editorialists predict. To try and reverse this trend, several practices have been shown to improve HPV vaccination rates.
The first is a strong provider recommendation, such as, “Your child is due for an HPV vaccine today.” The second is to give standing orders to allow nurses and medical assistants to administer vaccinations without requiring intervention by a physician. Last, programs to remind patients when vaccines are due; recalling them for appointments also works well.
Beijing, the capital, and Shanghai have both endured months of intermittent, but severe, local lockdowns. And despite some improvement in the COVID numbers, the official strategy of “micro-lockdowns” and mass testing looks like a new norm. They are meant to replace economically destructive citywide closures, but people’s patience with the constant disruption and government interference in their lives is already wearing thin.
One test of how quickly China’s economy might bounce back from covid-19 comes on June 18, the date of the “618” shopping festival. This is promoted by JD.Com, an online retail giant founded on the same day in 1998. The signs are not good. For many Chinese, it seems, consumption has been forgone, not merely postponed. Indeed, consumer confidence is at a record low. Retail sales fell by almost 10% in real terms in May, compared with a year earlier.
Lalita Panicker is Consulting Editor, Views and Editor, Insight, Hindustan Times, New Delhi
Lalita Panicker is consulting editor, views, Hindustan Times, New Delhi