Antibody Response After Third mRNA-1273 SARS-CoV-2 Vaccine Dose in Kidney Transplant Recipients
This study examines the antibody responses to a third dose (100 μg) of the mRNA-1273 SARS-CoV-2 vaccine among kidney transplant recipients in France who had not responded to 2 doses of the vaccine.
OK ich wage mich nochmal an ein schwieriges Thema. Bitte erst zu Ende lesen und dann kommentieren.Wenn es darum geht, dass wir irgendwann Infektionen zulassen müssen damit die Normalität wieder einkehren kann wird oft darauf hingewiesen, dass es Patienten mit Immunsuppression— ECMO_Doc (@doc_ecmo) January 29, 2022
Immunstatus nach SARS-CoV-2-Infektion: Genesene offenbar gut geschützt
Wer eine Infektion mit SARS-CoV-2 überstanden hat, kann erneute Attacken des Virus erstaunlich effektiv abwenden. Dies gilt auch für den Fall, dass der Verlauf nur milde oder sogar asymptomatisch war. Das Potenzial der Genesenen könnte sich zudem als...
📌Not a good signal—somehow in the original 🇿🇦 epicenter of #Omicron, #BA2 subvariant has suddenly become dominant ~58% now, displacing old BA1 strain. Same thing happened in Denmark 🇩🇰 where BA2 is now over 65% dominant. HT @JosetteSchoenma #COVID19 pic.twitter.com/Mf0bChrc89— Eric Feigl-Ding (@DrEricDing) January 28, 2022
Three exposures to the spike protein of SARS-CoV-2 by either infection or vaccination elicit superior neutralizing immunity to all variants of concern
Nature Medicine - High levels of neutralizing antibodies are successfully elicited against SARS-CoV-2 variants of concern, including omicron, after three exposures to the viral spike protein,...
Long COVID symptoms and duration in SARS-CoV-2 positive children — a nationwide cohort study
European Journal of Pediatrics - Most children have a mild course of acute COVID-19. Only few mainly non-controlled studies with small sample size have evaluated long-term recovery from SARS-CoV-2...
Omicron infection enhances neutralizing immunity against the Delta variant
Omicron has been shown to be highly transmissible and have extensive evasion of neutralizing
antibody immunity elicited by vaccination and previous SARS-CoV-2 infection. Omicron infections
are rapidly expanding worldwide often in the face of high levels of Delta infections. Here we
characterized developing immunity to Omicron and investigated whether neutralizing immunity
elicited by Omicron also enhances neutralizing immunity of the Delta variant. We enrolled both
previously vaccinated and unvaccinated individuals who were infected with SARS-CoV-2 in the
Omicron infection wave in South Africa soon after symptom onset. We then measured their ability
to neutralize both Omicron and Delta virus at enrollment versus a median of 14 days after
enrollment. Neutralization of Omicron increased 14-fold over this time, showing a developing
antibody response to the variant. Importantly, there was an enhancement of Delta virus
neutralization, which increased 4.4-fold. The increase in Delta variant neutralization in individuals
infected with Omicron may result in decreased ability of Delta to re-infect those individuals. Along
with emerging data indicating that Omicron, at this time in the pandemic, is less pathogenic than
Delta, such an outcome may have positive implications in terms of decreasing the Covid-19 burden
of severe disease.
Efficacy of face mask in preventing respiratory virus transmission: A systematic review and meta-analysis
Conflicting recommendations exist related to whether masks have a protective effect on the spread of respiratory viruses.The Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) statement was consulted to report this systematic ...
Close relatives of MERS-CoV in bats use ACE2 as their functional receptors
Middle East Respiratory Syndrome coronavirus (MERS-CoV) and several bat coronaviruses employ Dipeptidyl peptidase-4 (DPP4) as their functional receptors[1][1]–[4][2]. However, the receptor for NeoCoV, the closest MERS-CoV relative yet discovered in bats, remains enigmatic[5][3]. In this study, we unexpectedly found that NeoCoV and its close relative, PDF-2180-CoV, can efficiently use some types of bat Angiotensin-converting enzyme 2 (ACE2) and, less favorably, human ACE2 for entry. The two viruses use their spikes’ S1 subunit carboxyl-terminal domains (S1-CTD) for high-affinity and species-specific ACE2 binding. Cryo-electron microscopy analysis revealed a novel coronavirus-ACE2 binding interface and a protein-glycan interaction, distinct from other known ACE2-using viruses. We identified a molecular determinant close to the viral binding interface that restricts human ACE2 from supporting NeoCoV infection, especially around residue Asp338. Conversely, NeoCoV efficiently infects human ACE2 expressing cells after a T510F mutation on the receptor-binding motif (RBM). Notably, the infection could not be cross-neutralized by antibodies targeting SARS-CoV-2 or MERS-CoV. Our study demonstrates the first case of ACE2 usage in MERS-related viruses, shedding light on a potential bio-safety threat of the human emergence of an ACE2 using “MERS-CoV-2” with both high fatality and transmission rate. ### Competing Interest Statement The authors have declared no competing interest. [1]: #ref-1 [2]: #ref-4 [3]: #ref-5
COVID-19 Cases and Hospitalizations by COVID-19 ...
This report describes COVID-19 cases and hospitalizations by vaccination status and previous COVID-19 diagnosis before and after the Delta variant became predominant.
This filtered @Nextstrain build gives a nice visual display of how distant the Omicron family is from everything else, & how different BA.1 (21K) & BA.2 (21L) are from each other. Distance is in mutations.https://t.co/mrPRngyQFv pic.twitter.com/IXOOFZ9yy4— Dr Emma Hodcroft (@firefoxx66) January 27, 2022
As the SARS-CoV-2 pandemic enters its third year, vaccines that not only prevent disease, but also prevent transmission are needed to help reduce global disease burden. Currently approved parenteral vaccines induce robust systemic immunity, but poor immunity at the respiratory mucosa. Here we describe the development of a novel vaccine strategy, Prime and Spike, based on unadjuvanted intranasal spike boosting that leverages existing immunity generated by primary vaccination to elicit mucosal immune memory within the respiratory tract. We show that Prime and Spike induces robust T resident memory cells, B resident memory cells and IgA at the respiratory mucosa, boosts systemic immunity, and completely protects mice with partial immunity from lethal SARS-CoV-2 infection. Using divergent spike proteins, Prime and Spike enables induction of cross-reactive immunity against sarbecoviruses without invoking original antigenic sin. ### Competing Interest Statement W.M.S. and A.I. are cofounders of Xanadu Bio. A.I., B.I., and T.M. are listed as inventors on patent applications relating to intranasal spike-based SARS-CoV-2 vaccines filed by the Yale University. A.I., W.M.S., B.I., T.M, A.S., and M.H. are listed as inventors on patent applications relating to intranasal PACE nanoparticle delivery-based vaccines filed by Yale University.
To assess differences in the risk of hospitalisation between the Omicron variant of concern (1) and the
Delta variant, we analysed data from all PCR-confirmed SARS-CoV-2 cases in England with last test
specimen dates between 1st and 14th December inclusive. Variant was defined using a combination of S-
gene Target Failure (SGTF) and genetic data. Case data were linked by National Health service (NHS)
number to the National Immunisation Management System (NIMS) database, the NHS Emergency Care
(ECDS) and Secondary Use Services (SUS) hospital episode datasets. Hospital attendance was defined as
any record of attendance at a hospital by a case in the 14 days following their last positive PCR test, up to
and including the day of attendance. A secondary analysis examined the subset of attendances with a
length of stay of one or more days. We used stratified conditional Poisson regression to predict
hospitalisation status, with demographic strata defined by age, sex, ethnicity, region, specimen date,
index of multiple deprivation and in some analyses, vaccination status. Predictor variables were variant
(Omicron or Delta), reinfection status and vaccination status.
Overall, we find evidence of a reduction in the risk of hospitalisation for Omicron relative to Delta
infections, averaging over all cases in the study period. The extent of reduction is sensitive to the inclusion
criteria used for cases and hospitalisation, being in the range 20-25% when using any attendance at
hospital as the endpoint, and 40-45% when using hospitalisation lasting 1 day or longer or hospitalisations
with the ECDS discharge field recorded as “admitted” as the endpoint (Table 1). These reductions must
be balanced against the larger risk of infection with Omicron, due to the reduction in protection provided
by both vaccination and natural infection. A previous infection reduces the risk of any hospitalisation by
approximately 50% (Table 2) and the risk of a hospital stay of 1+ days by 61% (95%CI:55-65%) (before
adjustments for under ascertainment of reinfections).
High historical infection attack rates and observed reinfection rates with Omicron mean it is necessary to
correct hazard ratio estimates to accurately quantify intrinsic differences in severity between Omicron
and Delta and to assess the protection afforded by past infection. The resulting adjustments are moderate
(typically less than an increase of 0.2 in the hazard ratio for Omicron vs Delta and a reduction of
approximately 0.1 in the hazard ratio for reinfections vs primary infections) but significant for evaluating
severity overall. Using a hospital stay of 1+ days as the endpoint, the adjusted estimate of the relative
risk of reinfections versus primary cases is 0.31, a 69% reduction in hospitalisation risk (Table 2).
Stratifying hospitalisation risk by vaccination state reveals a more complex overall picture, albeit
consistent with the unstratified analysis. This showed an apparent difference between those who
received AstraZenca (AZ) vaccine versus Pfizer or Moderna (PF/MD) for their primary series (doses 1 and
2). Hazard ratios for hospital attendance with Omicron for PF/MD are similar to those seen for Delta in
those vaccination categories, while Omicron hazard ratios are generally lower than for Delta for the AZ
vaccination categories. Given the limited samples sizes to date, we caution about over-interpreting these
trends, but they are compatible with previous findings that while protection afforded against mild
infection from AZ was substantially reduced with the emergency of Delta, protection against more severe
outcomes was sustained (2,3). We emphasise that these are estimates which condition upon infection;
net vaccine effectiveness against hospital attendance may not vary between the vaccines, given that
PF/MD maintain higher effectiveness against symptomatic infection with Omicron than AZ (4).
Our estimates will assist in refining mathematical models of potential healthcare demand associated with
the unfolding European Omicron wave. The hazard ratios provided in Table 3 can be translated into
estimates of vaccine effectiveness (VE) against hospitalisation, given estimates of VE against infection (4).
In broad terms, our estimates suggest that individuals who have received at least 2 vaccine doses remain
substantially protected against hospitalisation, even if protection against infection has been largely lost
against the Omicron variant (4,5).
Vaccines that reduce infection & disease are needed to combat the pandemic. Here, @tianyangmao @BenIsraelow et al. describe our new mucosal booster strategy, Prime and Spike, to induce such immunity via nasal delivery of unadjuvanted spike vaccine 🧵 (1/)https://t.co/J4NuUgiI7e pic.twitter.com/bcB5MFph9F— Prof. Akiko Iwasaki (@VirusesImmunity) January 27, 2022
Data from Denmark indicate low risk, with important differences between vaccines The mRNA vaccines from Pfizer-BioNTech (BNT162b2) and Moderna (mRNA-1273) are a stunning success of science. They have saved countless lives and have a demonstrated safety record in a billion administered doses worldwide. No drug in history, however, has been completely free of adverse events. Myocarditis, although rare, is a known side effect of the mRNA vaccines and has been a barrier to uptake primarily because of uncertainty around its severity and frequency. Much of the pharmacovigilance data identifying myocarditis has been from passive reports and could be incomplete. There have also been a handful of case reports. What has been missing are complete population based studies that can give a less biased assessment of incidence. It is in this context that the linked study by Husby and colleagues (doi:10.1136/bmj-2021-068665) is considered.1 These authors reviewed data from all five million residents of Denmark age 12 and older, four million of whom received one of the mRNA vaccines from October 2020 to October 2021. They identified all cases of myocarditis or myopericarditis, defined as a hospital diagnosis of myocarditis or pericarditis plus an increased troponin level and admission lasting 24 hours. The …
What can lead to impaired neurogenesis in hippocampus? We looked into a chemokine called CCL11 (eotaxin-1) which was shown to reduce neurogenesis (Villeda et al). In our mice, CCL11 was elevated in the CSF 7 weeks after mild respiratory infection. (10/)https://t.co/yYKCdqhdMf pic.twitter.com/jtBfByh74z— Prof. Akiko Iwasaki (@VirusesImmunity) January 16, 2022
Outcomes of laboratory-confirmed SARS-CoV-2 infection in the Omicron-driven fourth wave compared with previous waves in the Western Cape Province, South Africa
Objectives We aimed to compare COVID-19 outcomes in the Omicron-driven fourth wave with prior waves in the Western Cape, the contribution of undiagnosed prior infection to differences in outcomes in a context of high seroprevalence due to prior infection, and whether protection against severe disease conferred by prior infection and/or vaccination was maintained. Methods In this cohort study, we included public sector patients aged ≥20 years with a laboratory confirmed COVID-19 diagnosis between 14 November-11 December 2021 (wave four) and equivalent prior wave periods. We compared the risk between waves of the following outcomes using Cox regression: death, severe hospitalization or death and any hospitalization or death (all ≤14 days after diagnosis) adjusted for age, sex, comorbidities, geography, vaccination and prior infection. Results We included 5,144 patients from wave four and 11,609 from prior waves. Risk of all outcomes was lower in wave four compared to the Delta-driven wave three (adjusted Hazard Ratio (aHR) [95% confidence interval (CI)] for death 0.27 [0.19; 0.38]. Risk reduction was lower when adjusting for vaccination and prior diagnosed infection (aHR:0.41, 95% CI: 0.29; 0.59) and reduced further when accounting for unascertained prior infections (aHR: 0.72). Vaccine protection was maintained in wave four (aHR for outcome of death: 0.24; 95% CI: 0.10; 0.58). Conclusions In the Omicron-driven wave, severe COVID-19 outcomes were reduced mostly due to protection conferred by prior infection and/or vaccination, but intrinsically reduced virulence may account for an approximately 25% reduced risk of severe hospitalization or death compared to Delta. ### Competing Interest Statement The authors have declared no competing interest. ### Funding Statement We acknowledge funding for the Western Cape Provincial Health Data Centre from the Western Cape Department of Health, the US National Institutes for Health (R01 HD080465, U01 AI069924), the Bill and Melinda Gates Foundation (1164272, 119327), the United States Agency for International Development (72067418CA00023), the European Union (101045989), the Wellcome Trust (203135/Z/16/Z, 222574) and the Medical Research Council of South Africa. RJW receives support from the Francis Crick Institute which is funded by Wellcome (FC0010218), MRC (UK) (FC0010218) and Cancer Research UK (FC0010218). He also receives support from Wellcome (203135, 222574) and the Medical Research Council of South Africa. ### Author Declarations I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained. Yes The details of the IRB/oversight body that provided approval or exemption for the research described are given below: Human Research Ethics Committee, University of Cape Town Faculty of Health Sciences, South Africa I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals. Yes I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Yes I have followed all appropriate research reporting guidelines and uploaded the relevant EQUATOR Network research reporting checklist(s) and other pertinent material as supplementary files, if applicable. Yes All data produced in the present study are available upon reasonable request to the authors.
Reported Cases of Multisystem Inflammatory Syndrome in Children (MIS-C) Aged 12–20 Years in the United States Who Received COVID-19 Vaccine, December 2020 through August 2021
Background Multisystem inflammatory syndrome in children (MIS-C) is a hyperinflammatory condition associated with antecedent SARS-CoV-2 infection. In the United States, reporting of MIS-C after vaccination is required under COVID-19 vaccine emergency use authorizations. This case series describes persons aged 12–20 years with MIS-C following COVID-19 vaccination reported to passive surveillance systems or through clinician outreach to CDC. Methods We investigated potential cases of MIS-C after COVID-19 vaccination reported to CDC’s health department-based national MIS-C surveillance, the Vaccine Adverse Event Reporting System (VAERS, co-administered by CDC and the U.S. FDA), and CDC’s Clinical Immunization Safety Assessment Project (CISA) from December 14, 2020, to August 31, 2021. We describe cases meeting the CDC MIS-C case definition. Any positive SARS-CoV-2 serology test satisfied the case criteria although anti-nucleocapsid antibody indicates SARS-CoV-2 infection, while anti-spike protein antibody indicates either infection or COVID-19 vaccination. Findings We identified 21 persons with MIS-C after COVID-19 vaccination. Of these 21 persons, median age was 16 years (range, 12–20 years); 13 (62%) were male. All were hospitalized; 12 (57%) had intensive care unit admission, and all were discharged home. Fifteen (71%) of the 21 had laboratory evidence of past or recent SARS-CoV-2 infection, and six (29%) did not. Through August 2021, 21,335,331 persons aged 12–20 years had received ≥1 dose of COVID-19 vaccine, making the overall reporting rate for MIS-C following vaccination 1·0 case per million persons receiving ≥1 vaccine dose in this age group. The reporting rate for those without evidence of SARS-CoV-2 infection was 0·3 cases per million vaccinated persons. Interpretation In our case series, we describe a small number of persons with MIS-C who had received ≥1 COVID-19 vaccine dose before illness onset. Continued reporting of potential cases and surveillance for MIS-C illnesses after COVID-19 vaccination is warranted. Funding This work was supported by the Centers for Disease Control and Prevention Clinical Immunization Safety Assessment (CISA] Project contracts 200-2012-50430-0005 to Vanderbilt University Medical Center and 200-2012-53661 to Cincinnati Children’s Hospital Medical Center. Evidence before this study Multisystem inflammatory syndrome in children (MIS-C), also known as paediatric inflammatory multisystem syndrome temporally associated with SARS-CoV-2 (PIMS-TS), is an uncommon, but serious, complication described after SARS-CoV-2 infection that is characterized by a generalized hyperinflammatory response. A review of the literature using PubMed identified reports of six persons aged 12–20 years who developed MIS-C following COVID-19 vaccination. Search terms used to identify these reports were: “multisystem inflammatory syndrome in children”, “MIS-C”, “MISC”, “multisystem inflammatory syndrome in adults”, “MIS-A”, “MISA”, “paediatric inflammatory multisystem syndrome”, and “PIMS-TS” each with any COVID-19 vaccine type. There were no exclusion criteria (i.e., all ages and languages). Added value of this study We conducted integrated surveillance for MIS-C after COVID-19 vaccination using two passive surveillance systems, CDC’s MIS-C national surveillance and the Vaccine Adverse Event Reporting System (VAERS), and clinician or health department outreach to CDC, including through Clinical Immunization Safety Assessment (CISA) Project consultations. We investigated reports of potential MIS-C occurring from December 14, 2020, to August 31, 2021, in persons aged 12–20 years any time after receipt of COVID-19 vaccine to identify those that met the CDC MIS-C case definition. Any positive serology test was accepted as meeting the CDC MIS-C case definition, although anti- nucleocapsid antibody is indicative of SARS-CoV-2 infection, while anti-spike protein antibody may be induced either by SARS-CoV-2 infection or by COVID-19 vaccination. We investigated 47 reports and identified 21 persons with MIS-C after receipt of COVID-19 vaccine. Of the 21 persons with MIS-C, median age was 16 years (range 12–20 years), and 13 (62%) were male. Fifteen (71%) had laboratory evidence of past or recent SARS-CoV-2 infection (positive SARS-CoV-2 nucleic acid amplification test [NAAT], viral antigen, or serology test before or during MIS-C illness evaluation), and 5 (33%) of those 15 had illness onset after their second vaccine dose. Six (29%) of 21 persons had no laboratory evidence of past or recent SARS-CoV-2 infection, and five of those six (83%) had onset of MIS-C after the second vaccine dose. Implications of all the available evidence During the first nine months of the COVID-19 vaccination program in the United States, 21 million persons aged 12 to 20 years received ≥1 dose of COVID-19 vaccine as of August 31, 2021. This case series describes MIS-C in 21 persons following vaccine receipt during this time period; the majority of persons reported also had evidence of SARS-CoV-2 infection. The surveillance has limitations, but our findings suggest that MIS-C as identified in this report following COVID-19 vaccination is rare. In evaluating persons with a clinical presentation consistent with MIS-C after COVID-19 vaccination it is important to consider alternative diagnoses, and anti-nucleocapsid antibody testing may be helpful. Continued surveillance for MIS-C illness after COVID-19 vaccination is warranted, especially as pediatric COVID-19 vaccination expands. Providers are encouraged to report potential MIS-C cases after COVID-19 vaccination to VAERS. ### Competing Interest Statement The authors have declared no competing interest. ### Funding Statement This work was supported by Centers for Disease Control and Prevention Clinical Immunization Safety Assessment (CISA] Project contracts to Vanderbilt University Medical Center and to Cincinnati Childrens Hospital Medical Center. ### Author Declarations I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained. Yes The details of the IRB/oversight body that provided approval or exemption for the research described are given below: This activity reviewed by CDC IRB and determined to be a non-research public health surveillance activity. I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals. Yes I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Yes I have followed all appropriate research reporting guidelines and uploaded the relevant EQUATOR Network research reporting checklist(s) and other pertinent material as supplementary files, if applicable. Yes All data produced in the present study are available upon reasonable request to the authors
Sex disparities in COVID-19 outcomes in the United States: Quantifying and contextualizing variation
This paper presents the first longitudinal study of sex disparities in COVID-19 cases and mortalities across U.S. states, derived from the unique 13-m…
The BA.2 assessment has not been made public and I don't know whether it is completed. There was a reassuring news item on the 19th stating that hospitalization rates seem identical. https://t.co/Bc4pp4mLMTNext meeting is on the 27th, so I guess some info will be ready by then.— Uffe Poulsen (@uffe1974) January 23, 2022
A statistical model for the dynamics of COVID‐19 infections and their case detection ratio in 2020
The case detection ratio of coronavirus disease 2019 (COVID-19) infections varies over time due to changing testing capacities, different testing strategies, and the evolving underlying number of inf...
On assessing excess mortality in Germany during the COVID-19 pandemic
AStA Wirtschafts- und Sozialstatistisches Archiv - Coronavirus disease 2019 (COVID-19) is associated with a very high number of casualties in the general population. Assessing the exact...
Nach Studie aus SA ist intrinsischer Schweregrad von Omikron gegenüber Delta um 25% reduziert. Deckt sich genau mit @imperialcollege Daten (24%) und bedeutet dass Omikron ziemlich genau zwischen Alpha und Delta liegt. (Alpha 1.4x WT, Delta 1.9x Alpha)https://t.co/httBsSvKLX pic.twitter.com/RFoJixKxtP— Jan Hartmann (@pelagicbird) January 13, 2022
Omicron variant of SARS-CoV-2 exhibits an increased resilience to the antiviral type I interferon response
The new variant of concern (VOC) of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), Omicron (B.1.1.529), is genetically very different from other VOCs. We compared Omicron with the preceding VOC Delta (B.1.617.2) and the wildtype strain (B.1) with respect to their interactions with the antiviral type I interferon (IFN-alpha/beta) response in infected cells. Our data indicate that Omicron has gained an elevated capability to suppress IFN-beta induction upon infection and to better withstand the antiviral state imposed by exogenously added IFN-alpha. ### Competing Interest Statement The authors have declared no competing interest.