Article by Lalita Panicker, Consulting Editor, Views and Editor, Insight, Hindustan Times, New Delhi
A new COVID vaccine is due out next month, but health experts and analysts say it is likely to be coolly received even as hospitalizations from “Eris”, a variant of the Omicron form of the coronavirus, rise around the country. https://www.reuters.com/business/healthcare-pharmaceuticals/new-covid-vaccines-are-way-eris-variant-rises-2023-08-14/
Fortunately, early data suggests that the new shots will still be effective against Eris. For instance, clinical trial data published by Moderna on August 17 showed that their updated vaccines increased the number of neutralizing antibodies against Eris, as well as the FL.1.5.1 variant.
Some public health experts hope that Americans will welcome the new shot as they would a flu jab. But demand for the vaccine has dropped sharply since 2021 when it first became available and more than 240 million people in the U.S., or 73% of the population, received at least one shot.
In the fall of 2022, by which time most people had either had the COVID virus or the vaccine, fewer than 50 million people got the shots.
Healthcare providers and pharmacies such as CVS Health (CVS.N) will start next month to offer the shot.
COVID-19 vaccine makers have pared back expectations for this fall’s vaccination campaign, with Pfizer – the largest maker of mRNA shots with BioNTech – recently warning that it might need to cut jobs if it does not do well. Its biggest rival, Moderna, conceded demand could be as few as 50 million shots.
Last year, Pfizer and Moderna’s vaccine sales topped $56 billion worldwide; analysts project around $20 billion for this year.
Jefferies analyst Michael Yee said he does not expect the autumn campaign to reach last year’s.
The COVID public health emergency ended in May and the government has handed much of the duty of vaccinating America to the private sector. Over 1.1 million people in the United States have died from COVID, according to the U.S. Centres for Disease Control and Prevention (CDC).
CDC Director Mandy Cohen said last week in a podcast that she expects the shots – which still need to be authorized by the U.S. Food and Drug Administration and recommended by the CDC – to be rolled out in the third or fourth week of September. She suggested Americans should view these shots as an annual measure to protect oneself, in line with the annual flu shot. As with the flu, Pfizer (PFE.N)/BioNTech SE (22UAy.DE), Moderna (MRNA.O) and Novavax (NVAX.O), have created versions of the COVID vaccine to try to match the variant they believe will be circulating this fall. The shots are aimed at XBB.1.5, a subvariant that is similar to EG.5 and also a sub-lineage of the still dominant Omicron variant.
COVID-19 related hospitalizations are up more than 40% off of recent lows hit in June, but are still more than 90% below peak levels hit during the January 2022 Omicron outbreak, according to CDC data.
Some doctors suggest that annual shots should be targeted at the elderly and other high risk people, who are most likely to have dire outcomes if they catch COVID-19.
Dr William Schaffner, an infectious diseases specialist at Vanderbilt University and a liaison to the CDC’s Advisory Committee on Immunization practices, said it is possible that the ACIP could make a weaker recommendation for younger, healthier people. That could also affect demand.
The CDC recommended children get a single dose of last year’s updated vaccine for those aged 6 and older.
The chikungunya count in South America this year is already up to a quarter of a million new cases. The outbreak is at its fiercest in Paraguay, which has seen over 100,000 diagnoses. www.npr.org/sections/goatsandsoda/2023/08/18/1194392519/chikungunya-virus-surges-in-south-america-but-a-new-discovery-could-help-outfox-?
Dr Susana Lloveras, an infectious disease physician at Hospital Muñiz in Buenos Aires, Argentina says she has seen cases of chikungunya in Buenos Aires “but it is not common for us. No more than one or two cases each year.” And always from people bringing the mosquito-borne virus with them from other countries.
But earlier this year, she says, “We receive every day patients with chikungunya including some with no travel history.” Which means, for the first time, mosquitoes within Buenos Aires were transmitting the disease.
Why is the disease’s footprint growing? “Wherever the mosquitoes go, we will have chikungunya — it’s a global concern,” says Nischay Mishra, a virologist at Columbia University. With the climate changing and temperatures getting warmer, “there are more chances mosquitoes can survive everywhere,” he says.
Besides South America, Chikungunya is a problem in other parts of the globe: India, China and numerous countries in Africa. Even in the US, Texas and Florida have reported local transmission of the disease in previous years.
Lloveras prescribes medicine to ease the fever and pain, but she tells her patients the disease just has to run its course.
That can be challenging because some people suffer from the joint pain for months or even years, even though their immune systems have created antibodies to clear the virus. Now, in a new study conducted in mice and published in Nature Microbiology, Dr Margaret Kielian and her colleagues of the Albert Einstein College of Medicine in New York found something that could bring us a step closer to solving this mystery.
Most viruses make us sick by turning our cells into virus-making machines. They release loads of new viral particles that can go on to infect new cells. Chikungunya does that, but it’s got another trick.
“The virus induces the infected cell to generate these very dramatic long extensions that can go from the infected cell to neighbouring cells,” says Kielian.
One or two tendrils, sometimes as long as the cell itself, snake outwards, at times toward uninfected cells. And these tendrils can escape attack by the immune system. “That contact between the infected cell and the uninfected cell shields the virus from the antibodies,” says Kielian. “And that’s how that cell gets infected.”
“It’s early days,” says Kielian, “but it suggests this might be one mechanism by which the virus can get established, maybe in joint tissues. That may be important in causing the arthritis. We’ll see.”
Several vaccine efforts are underway and Mishra says one may be approved as soon as the end of this year. It would be a welcome development in a place like Hospital Muñiz in Buenos Aires.
“We need a vaccine because this is another tool [to] treat this kind of disease,” says Dr Lloveras. She adds that in the future, she and her team will need every tool they can get to fight all manner of mosquito-borne viruses, including chikungunya.
China last week confirmed 491 cases of mpox in July, a monthly high and nearly five times June’s total. Cases of the infectious disease, formerly known as monkeypox, have also increased in other Asian countries after plummeting in the Americas and Europe. www.science.org/content/article/news-glance-win-young-climate-activists-research-suspension-and-china-s-mpox-surge?
The disease is spread through intimate personal contact and has particularly affected men who have sex with men; more than 96% of the infections in China were among this group, according to a 9 August announcement by the Chinese Centre for Disease Control and Prevention. The agency reported no severe cases or deaths. Officials believe China’s strict COVID-19 restrictions on international travel, in place until this spring, kept the disease at bay during the 10 months starting in July 2022 when the World Health Organization designated mpox a Public Health Emergency of International Concern. With no vaccine yet available domestically, China is relying on raising public awareness and changes in behaviour to limit the outbreak.