Why Vaccines May Be Helping Some With Long Covid
As more people get vaccinated against COVID-19, a surprise discovery has been that vaccines seem to provide some relief for some patients with whats being called long COVID. A prominent Yale researcher is working with colleagues to launch what she predicts will be a large collaborative study to learn more.
Can I Mix And Match The First Two Shots
No, the health officials’ allowance for mixing COVID-19 vaccines applies only to boosters. As of now, the FDA has only authorized a mixed-series booster, meaning the first coronavirus vaccine series must be two doses of Moderna or Pfizer or one dose of Johnson & Johnson.
More data on mixing for boosters will inform decisions on primary coronavirus vaccine series being used together, which could make it easier to reach underserved communities and possibly reduce health care and vaccine inequity.
The information contained in this article is for educational and informational purposes only and is not intended as health or medical advice. Always consult a physician or other qualified health provider regarding any questions you may have about a medical condition or health objectives.
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Johnson & Johnson And Guillain
Guillain-Barré syndrome is a rare neurological disorder in which the immune system attacks the nerves. It can cause muscle weakness and sometimes paralysis. People usually recover from it, but it can lead to hospitalization and, sometimes, permanent damage to nerve cells.
So, its not surprising that people have questions upon hearing that about 100 suspected cases of GBS have been identified among 12.8 million people who have received the Johnson & Johnson vaccine. While this figure is low enough to categorize the occurrences as rare, the Food and Drug Administration has now attached a warning to the Johnson & Johnson shot about the increased risk of developing GBS in the 42 days after vaccination.
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How Much Benefit Is There From The First Dose Of A Covid Vaccine
This article was originally published in the Montreal Gazette
How effective is a single dose of a COVID vaccine? The U.S. Centers for Disease Control data in the Morbidity and Mortality Weekly Report suggests that one dose is not as good as two doses. However, the Public Health Agency of Canada has stated that only a tiny minority of Canadas COVID-19 cases involved people who had received only one dose of vaccine, compared with no vaccine. Meanwhile, a study conducted in Qatar suggested that one dose was only 30 per cent effective against COVID-19 variants. If true, that would be disastrous in our current situation. People are understandably confused about just how much protection a single shot of Pfizers, Modernas, or AstraZenecas vaccine truly provides.
The CDC data were based on hospitalization records from 24 hospitals across 14 U.S. states in patients age 65 and older. The report found that people who received one dose of either Pfizer or Moderna were 64 per cent less likely to be hospitalized than people who were unvaccinated. Those who received both doses were 94 per cent less likely than unvaccinated people to need hospitalization.
So how protective is a single dose? One dose undeniably offers significant protection against COVID-19, but infections, especially with the rise of new variants are still possible, though rare. Maintaining public health measures even after one dose remains necessary. While one dose is good, two are better.
Whats The Recommended Dosage
SAGE recommends the use of BIBP vaccine as 2 doses given intramuscularly.
SAGE recommends that a third, additional dose of the Sinopharm vaccine be offered to persons aged 60 and above as part of an extension of the primary series. Current data does not indicate the need for an additional dose in persons under 60 years of age.
SAGE recommends that severe and moderately immunocompromised persons should be offered an additional dose of vaccine. This is due to the fact that this group is less likely to respond adequately to vaccination following a standard primary vaccination series and are at higher risk of severe COVID-19 disease.
WHO recommends an interval of 34 weeks between the first and second dose of primary series. If the second dose is administered less than 3 weeks after the first, the dose does not need to be repeated. If administration of the second dose is delayed beyond 4 weeks, it should be given at the earliest possible opportunity. When administering an additional dose to over 60s, SAGE recommends countries should initially aim at maximizing 2-dose coverage in that population, and thereafter administer the third dose, starting with the oldest age groups.
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First Authorizations Of Rna Vaccines
In the United States, an Emergency Use Authorization is “a mechanism to facilitate the availability and use of medical countermeasures, including vaccines, during public health emergencies, such as the current COVID19 pandemic.” Once an EUA is issued by the FDA, the vaccine developer is expected to continue the Phase III clinical trial to finalize safety and efficacy data, leading to application for licensure in the United States. In mid-2020, concerns that the FDA might grant a vaccine EUA before full evidence from a Phase III clinical trial was available raised broad concerns about the potential for lowered standards in the face of political pressure. On 8 September 2020, nine leading pharmaceutical companies involved in COVID19 vaccine research signed a letter, pledging that they would submit their vaccines for emergency use authorization only after Phase III trials had demonstrated safety and efficacy.
As of December 2020, many countries and the European Union have authorized or approved the Pfizer-BioNTech COVID19 vaccine. Bahrain and the United Arab Emirates granted emergency marketing authorization for the Sinopharm BIBP vaccine. In the United Kingdom, 138,000 people had received the Pfizer-BioNTech COVID19 vaccine Comirnaty by 16 December, during the first week of the UK vaccination programme. On 18 December 2020, the US FDA granted an EUA for mRNA-1273, the Moderna vaccine. Vaccine manufacturers are awaiting full approvals to name their vaccines.
Who Should Not Take The Vaccine
Individuals with a history of severe allergic reaction to any component of the vaccine should not take this or any other mRNA vaccine.
While vaccination is recommended for older persons due to the high risk of severe COVID-19 and death, very frail older persons with an anticipated life expectancy of less than 3 months should be individually assessed.
The vaccine should not be administered to persons younger than 18 years of age pending the results of further studies.
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Who Should Be Vaccinated First
While COVID-19 vaccine supplies are limited, health workers at high risk of exposure and older people should be prioritized for vaccination.
The vaccine is not recommended for persons younger than 18 years of age, pending the results of further studies in that age group.
Do The Vaccines Prevent You From Spreading Coronavirus
We know that vaccination can stop you from getting seriously ill if you catch the virus, but an early worry was that it might not stop you from carrying the virus and spreading it to others. Now, evidence is coming in showing that vaccination can also reduce the spread of infection.
According to Public Health Englands review of evidence, the Pfizer-BioNTech and Oxford-AstraZeneca vaccines both offer moderate protection against infection from the first dose. A second dose of Pfizer-BioNTech increases this protection further, but there isnt yet enough data on whether a second dose of Oxford-AstraZeneca does the same.
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When Does It Start Working
The Pfizer vaccine is given in two doses scheduled three weeks apart. It’s not ideal but, according to the Centers for Disease Control and Prevention , the second dose may be given up to 6 weeks after the first dose, if necessary. You should not get the second dose early.
These doses are given as injections and offer full protection two weeks after the second dose, the CDC says. The data suggest that after the first dose, some immune response is present in about two weeks.
A CDC report that tracked almost 4,000 healthcare personnel, first responders, and other frontline workers under real-world conditions found that the mRNA vaccines were 80% effective at least 14 days following the first dose and 90% effective at least two weeks after the second dose.
Preclinical Trials Would Have Shown That They Didn’t Think There Was Enough Immunity After One Shot So They’ve Gone For Both Deborah Dunn
However, this early protection comes with some important caveats. First, the protection doesn’t kick in until at least day 12 until then, there was no difference between the two groups. Secondly, one dose is still significantly less protective than two. The latter is 95% effective at preventing the disease after a week.
But there is also another figure that has been circulating on the internet, and anecdotally, being fed to patients by certain doctors the suggestion that the first dose is around 90% effective. And this is where it gets a little more complicated.
The second estimate comes from the UK’s Vaccine Committee, the JCVI, who decided to calculate the efficacy of the vaccine differently. Instead of using all the data on the number of infections, including from days when the first dose hadn’t yet started to work, they only looked at days 15-21. Using this method, the efficacy of the vaccine jumps up to 89%, because it’s not being diluted by the relatively high number of infections before the vaccine begins to have an effect. Taking things even further and only looking at the first seven days after the second dose because the second dose might not have kicked in yet by then it’s 92%.
However, these calculations are controversial.
A vaccine developed to fight Ebola is the only one that uses the same technology as the Russian and Oxford-AstraZeneca Covid-19 jabs
Can you skip the second vaccine dose?
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Recent Israeli Study Finds That Pfizer Vaccine Booster Dose Provides Added Benefit
Recently, Pfizer has started the process to get their booster doses FDA-approved.
Some of Pfizers supporting data for boosters comes from a recent large study in Israel. The study found that 12 days after adults over the age of 60 received a Pfizer booster vaccine, they were about 11 times less likely to be infected with COVID-19 and about 10 times less likely to have severe illness compared to those who only received 2 doses. This study included more than 1.1 million older adults, and it was conducted in August 2021.
The U.S. Department of Health and Human Services announced a plan to offer booster shots starting on September 20, but newer reports suggest this timeline could be delayed. The plan mentions that these vaccines would be available 8 months after someones second dose of an mRNA vaccine . But this plan is tentative if and when supporting data is confirmed in a meeting by healthcare experts in the coming days.
Its expected that the J& J vaccine may also need a booster, but this is still being evaluated.
What this means: Recent data from Israel shows that a Pfizer vaccine booster dose helps lower the risk of COVID-19 infection and severe illness.
What this doesnt mean: Everyone needs a booster dose at this time. All of this information is still under review, and the FDA will announce if and when booster doses are recommended for the general public.
To read more about this report, click or tap here.
Astrazeneca: More Than 70%
Evans said it was harder to ascertain a figure for AstraZeneca’s vaccine because late-stage trials used differing study designs, and a large US study was ongoing. The FDA also has not yet presented the data for the shot in the same way it has done for other vaccines.
A single dose of AstraZeneca’s shot was 76% effective at protecting against COVID-19 with symptoms for at least 90 days, according to late-stage-trial data on February 19. The study authors also reported that one dose provided 100% protection against hospitalization, but the numbers were small.
Based on his reading of existing studies, Evans said the single-dose efficacy for AstraZeneca’s vaccine was probably at least 70% against COVID-19 with symptoms for the first 90 days. After this time period, it’s unclear, he said.
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The Johnson & Johnson Vaccine And Blood Clots: What You Need To Know
In the minds of many, the halt of the Johnson & Johnson vaccine in April delivered doubt just as the mass COVID-19 vaccinations were making progress. There are three vaccines authorized for use in the United States, but Johnson & Johnsons was a particularly important one, partly because its one-shot dose made it seem as though we might achieve herd immunity faster. Then, the government recommended pausing the companys vaccine after six women who received it developed rare blood clotsand one woman died.
We spoke to Yale Medicine infectious diseases expert Jaimie Meyer, MD, MS, and Yale Medicine hematologist Robert Bona, MDthey shared insights about the pause and answered commonly asked questions.
What Other Restrictions Apply
Medicare only pays the additional amount for administering the COVID-19 vaccine in the home if the sole purpose of the visit is to administer a COVID-19 vaccine. Medicare doesnt pay the additional amount if you provide another Medicare service in the same home on the same date. In those situations, Medicare pays for administering the COVID-19 vaccine at the standard amount .
If you administer the COVID-19 vaccine to more than 1 Medicare patient in a single home in the same multi-unit or communal living arrangement on the same day, Medicare pays:
- Approximately $40 to administer each dose of the COVID-19 vaccine, including additional doses and booster doses
- For dates of service between June 8, 2021 and August 24, 2021, Medicare pays the additional payment amount of approximately $35 only once per date of service in that home regardless of how many Medicare patients receive the vaccine
- Effective on August 24, 2021, Medicare pays the additional payment amount , for up to a maximum of 5 vaccine administration services per home unit or communal space within a single group living location but only when fewer than 10 Medicare patients receive a COVID-19 vaccine dose on the same day at the same group living location. When 10 or more Medicare patients receive a COVID-19 vaccine dose at a group living location on the same day, the additional payment can only be billed once per home .
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Pfizers Vaccine Offers Strong Protection After First Dose
The Food and Drug Administrations first analysis of the clinical trial data also found that the coronavirus vaccine worked well regardless of a volunteers race, weight or age.
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WASHINGTON The coronavirus vaccine made by Pfizer and BioNTech provides strong protection against Covid-19 within about 10 days of the first dose, according to documents published on Tuesday by the Food and Drug Administration before a meeting of its vaccine advisory group.
The finding is one of several significant new results featured in the briefing materials, which include more than 100 pages of data analyses from the agency and from Pfizer. Last month, Pfizer and BioNTech announced that their two-dose vaccine had an efficacy rate of 95 percent after two doses administered three weeks apart. The new analyses show that the protection starts kicking in far earlier.
Whats more, the vaccine worked well regardless of a volunteers race, weight or age. While the trial did not find any serious adverse events caused by the vaccine, many participants did experience aches, fevers and other side effects.
This is what an A+ report card looks like for a vaccine, said Akiko Iwasaki, an immunologist at Yale University.
Early Authorizations In China And Russia
On 24 June 2020, China approved the CanSino vaccine for limited use in the military and two inactivated virus vaccines for emergency use in high-risk occupations. On 11 August 2020, Russia announced the approval of its Sputnik V vaccine for emergency use, though one month later only small amounts of the vaccine had been distributed for use outside of the phase 3 trial. In September, the United Arab Emirates approved emergency use of the Sinopharm BIBP vaccine for healthcare workers, followed by similar emergency use approval from Bahrain in November.
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How Well Had The Vaccines Been Working
Soon after the Pfizer COVID-19 vaccine was authorized in December 2020, researchers in Israel found that a single dose was highly effective in one medical centers thousands of vaccinated health care workers. A single dose reduced the rate of infection by up to 85% after four weeks post-shot compared to those who were not vaccinated.
This real-world finding was consistent with an analysis of Pfizers clinical trial data reported in 2020 in the New England Journal of Medicine. In that study, the 52% protection from the first dose included infections that occurred in the first 12 days after vaccination, when one would not expect the vaccine to have had time to generate protective antibodies.
Another real-world study of adults ages 70 and older conducted by Public Health England in early 2021 determined that a single dose of the Pfizer vaccine was 61% effective at preventing symptomatic disease 28 days after vaccination. Two doses increased effectiveness to 85%-90%.