Why the variant’s spread may be less pervasive than we currently expect.

This week, you’re likely to encounter a lot of commentary on PRRI and Interfaith Youth Core’s new report on religious groups and vaccine acceptance, most of it optimistic. And to be sure, there are good reasons for optimism relative to the majority of faith communities in the United States, where in

Objectives Highly effective vaccines against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) have been developed but variants of concerns (VOCs) with mutations in the spike protein are worrisome, especially B.1.617.2 (Delta) which has rapidly spread across the world. We aim to study if vaccination alters virological and serological kinetics in breakthrough infections. Methods We conducted a multi-centre retrospective cohort study of patients in Singapore who had received a licensed mRNA vaccine and been admitted to hospital with B.1.617.2 SARS-CoV-2 infection. We compared the clinical features, virological and serological kinetics (anti-nucleocapsid, anti-spike and surrogate virus neutralization titres) between fully vaccinated and unvaccinated individuals. Results Of 218 individuals with B.1.617.2 infection, 84 had received a mRNA vaccine of which 71 were fully vaccinated, 130 were unvaccinated and 4 received a non-mRNA. Despite significantly older age in the vaccine breakthrough group, the odds of severe COVID-19 requiring oxygen supplementation was significantly lower following vaccination (adjusted odds ratio 0.07 95%CI: 0.015-0.335, p=0.001). PCR cycle threshold (Ct) values were similar between both vaccinated and unvaccinated groups at diagnosis, but viral loads decreased faster in vaccinated individuals. Early, robust boosting of anti-spike protein antibodies was observed in vaccinated patients, however, these titers were significantly lower against B.1.617.2 as compared with the wildtype vaccine strain. Conclusion The mRNA vaccines are highly effective at preventing symptomatic and severe COVID-19 associated with B.1.617.2 infection. Vaccination is associated with faster decline in viral RNA load and a robust serological response. Vaccination remains a key strategy for control of COVID-19 pandemic. ### Competing Interest Statement BEY reports personal fees from Roche and Sanofi, outside the submitted work. All other authors declare no competing interests. ### Funding Statement This study was funded by grants from the Singapore National Medical Research Council (COVID19RF-001, COVID19RF-008). The funders had no role in the design and conduct of the study; collection, management, analysis and interpretation of the data; preparation, review or approval of the manuscript; and decision to submit the manuscript for publication. ### 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: Written informed consent was obtained from study participants of the multi-centre study approved by National Healthcare Group Domain Specific Review Board (NHG-DSRB) (Study Reference 2012/00917). Informed consent for retrospective data collection at National Centre for Infectious Diseases (NCID) was waived (NHG-DSRB reference number 2020/01122). All necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived. 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 The datasets generated during and/or analysed during the current study are available from the corresponding author on reasonable request.

A third dose of the Pfizer/BioNTech Covid-19 vaccine can "strongly" boost protection against the Delta variant -- beyond the protection afforded by the standard two doses, suggests new data released by Pfizer on Wednesday.

The document captures the struggle of the nation’s top public health agency to persuade the public to embrace vaccination and prevention measures, including mask-wearing, as cases surge across the United States and new research suggests vaccinated people can spread the virus.

CNN’s Aya Elamroussi reports on people in Missouri who have gotten the covid vaccine secretly because they fear their friends and families will ostracize them. To get vaccinated against the k…

The CDC's eviction moratorium expires on July 31, and an extension is unlikely, leaving renters uncertain about their future in an economy still recovering from COVID.

The decline, from a peak of 96% efficacy, could fuel Pfizer’s case that a third dose will eventually be required.

The undocumented migrant family at Whataburger told a police officer that Border Patrol had released them because they had COVID-19.

A new analysis finds several counties with above-average vaccination rates also have higher COVID case rates, while case rates are falling in counties with below-average vaccination rates.

The rate of weekly Covid-19 case acceleration is a reasonable indicator of how intense that wave might be and how long it might last.

We offer advice about how to think about the cases.

The total number of COVID-19 cases in an ongoing Provincetown cluster has increased to 430, with 342 coming from Mass. residents.

Our vaccines are extraordinary, but right now they need all the help they can get.

The United States Update

They’re not all anti-vaxxers, and treating them as such is making things worse.

That’s a question that’s on a lot of people’s minds, because frankly, we have answers that seem to disagree with each other. Let’s have a look: For one, there’s this letter in the NEJM from researchers at Beth Israel Deaconess hospital and from Janssen (J&J’s pharma branch). That’s a look at immunity in 20 patients

The rate of fully vaccinated people ending up in the hospital remains low.

Back last summer, I was writing blog posts about possible side effects of mass vaccination. For readers who’ve shown up more recently and might have me filed as Defender of Vaccines, that might seem surprising, but remember, I’ve been in drug discovery for a long time now. All drugs, all therapies have side effects. It’s

Why we should rethink COVID safety protocols for children — and everyone else.

As emergency provisions end, patients are scrambling — in some cases, driving across state lines — to keep their telehealth appointments.

The big issue right now is the delta variant and increasing infection rates mainly among people who aren't vaccinated.

The guidance generally leaves it to local officials to figure out how to ensure the unvaccinated are using precautions while letting those who are fully protected go mask-free.

The huge success of the mRNA vaccination platform during the pandemic has set a lot of people to thinking about what comes next. Moderna and BioNTech, of course, have been thinking this way for quite some time. But Sanofi now says that they’ll be investing large amounts into the technology, and this previously hadn’t been

Here’s a new paper (open access) from a large multi-center team of authors urging caution on many of the reports of small-molecule repurposing screens against coronavirus activity. The list of drugs that has shown activity in vitro is long, and the list of potential targets is as well. But when you look at those targets,

There have been 175 cases of the variant in Massachusetts.

There is strong evidence for brain-related pathologies in COVID-19, some of which could be a consequence of viral neurotropism. The vast majority of brain imaging studies so far have focused on qualitative, gross pathology of moderate to severe cases, often carried out on hospitalised patients. It remains unknown however whether the impact of COVID-19 can be detected in milder cases, in a quantitative and automated manner, and whether this can reveal a possible mechanism for the spread of the disease. UK Biobank scanned over 40,000 participants before the start of the COVID-19 pandemic, making it possible to invite back in 2021 hundreds of previously-imaged participants for a second imaging visit. Here, we studied the effects of the disease in the brain using multimodal data from 782 participants from the UK Biobank COVID-19 re-imaging study, with 394 participants having tested positive for SARS-CoV-2 infection between their two scans. We used structural and functional brain scans from before and after infection, to compare longitudinal brain changes between these 394 COVID-19 patients and 388 controls who were matched for age, sex, ethnicity and interval between scans. We identified significant effects of COVID-19 in the brain with a loss of grey matter in the left parahippocampal gyrus, the left lateral orbitofrontal cortex and the left insula. When looking over the entire cortical surface, these results extended to the anterior cingulate cortex, supramarginal gyrus and temporal pole. We further compared COVID-19 patients who had been hospitalised (n=15) with those who had not (n=379), and while results were not significant, we found comparatively similar findings to the COVID-19 vs control group comparison, with, in addition, a greater loss of grey matter in the cingulate cortex, central nucleus of the amygdala and hippocampal cornu ammonis (all |Z|>3). Our findings thus consistently relate to loss of grey matter in limbic cortical areas directly linked to the primary olfactory and gustatory system. Unlike in post hoc disease studies, the availability of pre-infection imaging data helps avoid the danger of pre-existing risk factors or clinical conditions being mis-interpreted as disease effects. Since a possible entry point of the virus to the central nervous system might be via the olfactory mucosa and the olfactory bulb, these brain imaging results might be the in vivo hallmark of the spread of the disease (or the virus itself) via olfactory and gustatory pathways. ### Competing Interest Statement The authors have declared no competing interest. ### Funding Statement This work was primarily supported by a Wellcome Trust Collaborative Award 215573/Z/19/Z. KLM is supported by a Wellcome Trust Senior Research Fellowship 202788/Z/16/Z. The Wellcome Centre for Integrative Neuroimaging (WIN FMRIB) is supported by centre funding from the Wellcome Trust (203139/Z/16/Z). This research has been conducted in part using the UK Biobank Resource under Application Number 8107. ### 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 subjects: UK Biobank has approval from the North West Multi-centre Research Ethics Committee (MREC) to obtain and disseminate data and samples from the participants (), and these ethical regulations cover the work in this study. Written informed consent was obtained from all participants. All necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived. 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 Data can be accessed through the UK Biobank.

1. Novavax Clinical Data Word came yesterday that Novavax had very good safety and efficacy in the trial of their recombinant protein vaccine. This is good news. By this point, the vaccine is much less needed here in the US, but it could be a very important part of getting many other countries vaccinated, due to

Researchers have found more evidence that coronavirus was circulating at low levels across the United States as early as December 2019 -- weeks before the first officially reported cases.