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 Do We Know About The Astrazeneca Adenovirus Covid
An analysis of Phase 3 clinical trial data suggests that the COVID-19 vaccine developed by AstraZeneca and the University of Oxford is effective and safe. AstraZeneca presented interim results in a press release on March 22, 2021. Within a day, however, the National Institutes of Allergy and Infectious Diseases released a statement expressing concern that AstraZeneca’s analysis may contain outdated information and may provide “an incomplete view of the efficacy data.” On March 25th, AstraZeneca released a new analysis, also in a press release, that included more recent trial data. The FDA will have the opportunity to carefully examine and conduct its own analysis of all of the trial data when AstraZeneca applies for emergency use authorization , which is expected to happen in the coming weeks.
According to AstraZeneca’s most recent analysis, vaccine recipients were 76% less likely to develop symptomatic COVID infection than those who received a placebo. The vaccine was also 100% effective for protecting against severe COVID and hospitalization; there were eight cases of severe COVID in the placebo group, compared to none in the vaccine group.
The analysis looked at results from a trial of about 32,000 participants from the US, France, Chile, and Peru. Two-thirds of the study participants were randomly selected to received two doses of the vaccine, spaced four weeks apart. The remaining one-third of participants got a saltwater placebo.
Why Are Vaccines Somewhat Less Effective Against Infection Than Before
The CDC researchers were careful to say the reasons for diminishing vaccine effectiveness are uncertain, but there are some things theyre confident about. The delta variant causes a substantially higher viral load than its predecessors there is more of the virus when a person gets infected and the sheer amount of the virus a person contracts may play a role. At the same time, people are now taking fewer precautions against Covid-19 than they were last fall and winter, the researchers said, making it more likely that theyll be exposed to a high viral load.
Or to think of it another way: The rapid spread of delta in the unvaccinated population means vaccinated people are getting exposed to the virus more often, and being exposed to more of it than they were before.
Data from other countries shows a wide range of vaccine effectiveness against infection with the delta variant, but studies have generally found the protection is less robust than it was against the alpha variant. Still, in all cases, the vaccines available in the US continue to impress in their ability to prevent the worst outcomes.
A second CDC study examined national data to determine whether the vaccines are becoming less effective at stopping severe illness over time. Like the New York study, it found that vaccines are extremely effective about 90 percent at preventing hospitalization due to Covid-19.
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The Best Vaccine Is The One You Can Get Now
It is entirely rational to want the best vaccine available. But the best vaccine is the one available to you right now because it stops you from catching COVID-19, reduces transmission to vulnerable members of our community and substantially reduces your risk of severe disease.
All available vaccines do this job and do it well. From a collective perspective, these benefits are compounded. The more people get vaccinated, the more the community becomes immune , further curtailing the spread of COVID-19.
The global pandemic is a highly dynamic situation, with emerging viral variants of concern, uncertain global vaccine supply, patchy governmental action and potential for explosive outbreaks in many regions.
So waiting for the perfect vaccine is an unattainable ambition. Every vaccine delivered is a small but significant step towards global normality.
/9if You Have The Choice Which Vaccine Should You Choose
Each vaccine we have, passes the WHO standard of approval, has tolerable efficacy rates and mitigates dangers. Yet, some may be more reliable than others and carry benefits too. So, when you have the choice- what should you pick?
If you are yet to get vaccinated, heres a comparison of the different vaccines we have
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The Link Between Myocarditis And Covid
Myocarditis, an inflammation of the heart muscle, became a trending topic this spring when the Centers for Disease Control and Prevention reported that it is monitoring;a small number of cases of heart inflammation that have arisen in young adults not long after mRNA;COVID-19 vaccination. The side effect is considered important but uncommonarising in about 12.6 cases per million second doses administered. And now the Food and Drug Administration has announced it will place a warning on the mRNA vaccines. Its important to note that the vaccination is still recommended for everyone who is eligible.
Could The Vaccine Cause Issues If Im Getting A Mammogram
Getting a COVID-19 vaccine might result in swollen lymph nodes under the arm in which the injection was given. ;
Swollen lymph nodes under the arm might show up on a mammogram done to screen for breast cancer, which could cause concern and might lead to the need for further tests.;
If youre scheduled for a mammogram soon after you get a COVID-19 vaccine, its important to tell your doctor when and in which arm you received the injection. Based on your situation, they can discuss with you if you should change your mammogram appointment. Do not delay your mammogram without speaking to your doctor first.
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How Long With Coronavirus Vaccines Last
If you are fully vaccinated, you may be excited about gathering with family and friends this summer. But there are still nagging questions about how long protection from the coronavirus vaccines will last. Will it wear off gradually or suddenly? Will you need a booster shot? Unfortunately, we cant answer these questions with certainty yet. Though researchers know the vaccines have been effective against COVID-19 thus far, there is no track record to provide data for the future, which is the only way to know for sure.
We can only say that a vaccine is protective as long as we are measuring it, says Yale Medicine infectious diseases specialist Jaimie Meyer, MD, MS.;
In the meantime, there are a few things we do know.
Amazon Established A Foothold In Diagnostics During Covid
There have been reports of severe allergic reactions to the mRNA vaccines. Both the Pfizer and Moderna vaccines appear, on rare occasions, to;trigger anaphylaxis, a severe and potentially life-threatening reaction. People who develop anaphylaxis must be treated with epinephrine the drug in EpiPens and may need to be hospitalized to ensure their airways remain open. The CDC says people should be monitored for 15 minutes after getting a Covid-19 shot, and 30 minutes if they have a history of severe allergies. J&J recently revealed that a single case of anaphylaxis has been reported in someone who received its vaccine.
It will take time to come up with a firm estimate of how frequently this side effect occurs. The most recent data from the CDC suggest that anaphylaxis occurs at a rate of about 2.5 cases per one million doses given of the Moderna vaccine, and 4.7 cases per million doses of the Pfizer. Many of the people who have developed anaphylaxis have a history of severe allergies and some have had previous episodes of anaphylaxis.
The mRNA vaccines carry a small risk of myocarditis and pericarditis, two types of heart inflammation that are most commonly seen soon after people receive their second shots, health officials have said. Men under 40 seem to be at highest risk, particularly those aged 12 to 17. Most cases reported have been mild and resolved.
Why Experts Are So Concerned About The Rise Of The Delta Variant
- The delta variant is spreading globally.
- Experts think that this version is more infectious than earlier variants of the virus.
- While some vaccinated people have developed COVID-19 from the delta variant, they appear to have less severe symptoms than unvaccinated people.
The delta variant of the novel coronavirus is quickly spreading globally, leading to lockdowns in some countries that previously had few reported COVID-19 cases. This variant first identified in India is said to be even more contagious than the British variant .
At this point, the delta variant comprises roughly 25 percent of new infections , said Dr. David Hirschwerk, an attending infectious diseases specialist at Northwell Health in Manhasset, N.Y. In some regions of the country, the percentage is higher, and over the coming weeks, it will very likely be the dominant strain in the U.S.
So what exactly is the delta variant of COVID-19 and what do we need to know about it right now? We reached out to experts to help shed some light on the subject.
What Do I Need To Know About The Delta Variant
The Delta variant is different from previous SARS-CoV-2 variants that have made their way to the US. Its highly contagious and may cause more severe disease. It is also more likely than previous variants to be spread by vaccinated people experiencing breakthrough infections.
Evidence presented to the CDC showed the Delta variant to be much more contagious than previous variants, with a risk of transmission similar to chickenpox. It also appears that people who are infected can spread the virus for longer periods of time.
In addition, people who are vaccinated and then get infected can also spread the virus to others, perhaps to the same extent as those who are unvaccinated. This is also new; vaccinated people were much less likely to spread previous variants.
Finally, international studies point to the Delta variant being more likely to cause severe disease.
The good news is that while vaccination may be less effective at preventing infection and spread of the Delta variant, it is still highly protective against severe disease, hospitalization, and death. Get the COVID-19 vaccine if you have not already done so.
In July 2021, the CDC advised all people vaccinated and unvaccinated to wear masks in public indoor places, in areas of the country with substantial or high transmission of the virus. Given the threat posed by the Delta variant, its reasonable for everyone to start wearing a mask in indoor public spaces, regardless of the level of virus in your area.
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Q: Whats The Best Covid
A:The one that you can get.
Clinical trials, like those for the new COVID-19 vaccines, generate a lot of numbers. But media reports about the results of these vaccine trials have focused almost entirely on a single data point efficacy. Is this a mistake?
Associate Medical Director Shawn Ferullo thinks so. Efficacy is far from the whole story, he says.
A vaccines efficacy is a measure of how effective it is at preventing any illness at all, however mild. Efficacy values for COVID-19 vaccines were computed by comparing the relative difference between the fraction of individuals in Phase Three vaccine and placebo groups who developed symptoms and tested positive.
If you look at efficacy numbers alone, the newly approved Johnson & Johnson vaccine, with a 66 percent efficacy rate, looks substantially worse than the Pfizer or Moderna vaccines, which both came in at around 95 percent, Ferullo acknowledges. But we need to look at these numbers in context. This context includes differences in how each clinical trial was conducted and a more practical view of what efficacy actually means.
So why get a flu shot? Because even if you get the flu after being vaccinated, youre likely to be a lot less sick than you would otherwise have been. By CDC calculations, the 20192020 flu vaccine, which had an efficacy value of just 45 percent, prevented an estimated 7.52 million illnesses, 3.69 million medical visits, 105,000 hospitalizations, and 6,300 deaths.
Does Age Matter For Vaccinations
Pfizer’s vaccine is also currently the only vaccine authorized for emergency use in children as young as 12. Both Moderna and J&J’s vaccines can only be used on people 18 and older.
What about younger kids? According to experts, those under 12 likely won’t be able to receive the COVID vaccine until later this year or early next year.
Both Pfizer and Moderna have started studies in the U.S. surrounding the vaccine and children ages 6 months to 11 years. Results on those studies could come sometime in the fall.
How Have The Vaccines Performed The Real World Are They Working As Well As They Did In Clinical Trials
In a study published online in MMWR, the CDC reported that people who had received both doses of either mRNA vaccine were 90% less likely to get infected with COVID-19 than people who were not vaccinated. In clinical trials, the vaccines were 95% and 94.1% effective.
The MMWR study enrolled 3950 adults who were at high risk of exposure to the virus due to their jobs and followed them for 13 weeks, beginning in mid-December 2020. About 63% of the study participants received both doses of vaccine during the study period and an additional 12% received one dose during the study. Each week, the study participants sent a nasal swab for PCR testing, and they reported any symptoms, allowing the researchers to identify both symptomatic and asymptomatic infections.
A total of 180 COVID-19 infections occurred during the study period. Of these, 161 infections were in people who were unvaccinated, compared to three infections in people who were fully vaccinated. Sixteen people who had received only their first vaccine dose at least two weeks earlier were infected. While this translates to one dose preventing 80% of infections, the study did not measure how well the vaccine protects people who do not get the second dose.
The researchers did not comment on variants, and the study was not designed to measure the effectiveness of the vaccines against them. However, its worth noting that several viral variants were circulating during the study period.
How Is Cerebral Venous Sinus Thrombosis Treated
The main treatment for CVST is the anticoagulation drug heparin. Heparin and other anticoagulantsor blood thinnersare used to treat CVST because they help to prevent new blood clots from forming in blood vessels throughout the body, including the venous sinuses of the brain, and can keep existing clots from getting larger. Blood thinners, however, cannot dissolve existing clots. Heparin is delivered to the body intravenously or via injection.
If patients do not improve upon administration of heparin or another blood thinner, the doctor may administer thrombolytic enzymes, which can dissolve existing blood clots. Because they may cause hemorrhage, these medications are typically used only in severe cases. Alternatively, a surgeon may perform a procedure known as a thrombectomy to remove the blood clot. The goal of thrombolytic enzymes and thrombectomy is the same: to remove the blood clot and restore blood flow.
Once the acute phase of CVST has been controlled, doctors will transition the patient to an oral blood thinner, such as warfarin. Anticoagulation therapy is continued to prevent recurrence of CVST or other clotting disorders. Patients will typically stay on oral blood thinners for three or more months. Pregnant women, however, should not take warfarin because it may cause birth defects.
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As A Teen Who Is Already Vaccinated Against Covid
You will probably need a COVID-19 booster shot at some point, say doctors who are tracking the pandemic, but it may not be any time soon.
So far, the best evidence suggests that people who are fully vaccinated even those who got their shots way back in December or even earlier are well-protected from getting very sick or dying from COVID-19.
Still, health officials are particularly watching for any sign of lowered protection in a couple of different groups, especially the elderly and the immunocompromised.
If boosters are needed, they’ll likely be recommended for specific groups first based on when you got your vaccine and whether you’re at special risk for getting very sick from COVID-19 yourself or accidentally spreading it to vulnerable people .
Moderna May Be Superior To Pfizer Against Delta Variant Breakthrough Odds Rise With Time
- The mRNA vaccine from Pfizer;and BioNTech;may be less effective than Moderna’s against the delta variant of the coronavirus, according to two reports posted on medRxiv on Sunday ahead of peer review.
- People who received their second dose of the Pfizer/BioNTech vaccine five or more months ago are more likely to test positive for Covid-19 than people who were fully vaccinated less than five months ago, new data suggest.
In this article
The following is a roundup of some of the latest scientific studies on the novel coronavirus and efforts to find treatments and vaccines for Covid-19.
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