week ending 2022-09-01 General

Vaccines

This article says that Health Canada approved a BA.1 booster from Moderna today for adults and immunocompromised children over 12. 780K are supposed to arrive in-country tomorrow, with another 10.5M at the end of September.


There isn’t good data from random clinical trials in humans yet for the new bivalent vaccines. This preprint from Australia modelled what we should expect in humans based on animal studies and human antigen studies. They found that the biggest effect was from getting any booster, period. Getting an old vax booster gave ~11x improvement. Getting a new vax booster gave an additional ~1.3x against a different variant than the booster targeted, and a ~1.7x improvement against the same variant.


This slide from a presentation today to ACIP, the US CDC’s vaccine advisory board says that vaccine protection against symptomatic infection is practically non-existent after six months across ages:

I think dashed lines show ranges and solid lines show the average for that age.

Hospitalization is better, but still pretty crappy:

This slide says that a BA.1 booster works slightly better than a COVID Classic booster against BA.5:

Compare light blue to dark blue.

The bivalent boosters seem to be slightly better than the originals, but it’s not dramatic. Here’s one article (discussing this preprint) which talks about that.

If you want a booster, go get yourself a Novavax booster. They give you broader protection.


This preprint from the USA found that people who had had a pre-Omicron infection then got a booster (infected on average ~5 months before the booster) had weaker responses to any variant after the booster than people who had never been infected (and got a booster).

Note the variant headers at the top. Bluish-purple is for people who were never infected; teal is for people who were infected before their booster; orange is people who were infected after their booster.

I find this data from the USA to be really strange. It shows a big difference between one booster and two, but not that big a difference between unboosted and first booster:

I would have thought that there would be a much bigger difference between no booster and first booster than between first and second boosters. I cannot think of a reason why a second booster would make more of a difference than the first.

Pathology

This paper from the USA found that the level of nucleotide antigens in blood correlated well with the severity of hospitalized COVID-19 patients. (Reminder: the nucleotide is the envelope that holds the COVID-19 DNA.)

Variants

This paper from the USA did mix&match of variant spikes with variant non-spikes and infected mice with the frankenviruses. While most of the focus has been on spike proteins, they found that the non-spike proteins affected the pathology. For example, mice infected with standard P.1 didn’t lose much weight, but mice infected with P.1 on top of a COVID Classic backbone lost 12% of their weight on average.


I have been keeping my eyes out for “the next variant”, and I don’t see it… yet. People have been keeping an eye on BA.2.75, which is spreading in India right now, but it doesn’t look like it has a big jump in scariness level. This correspondence says that it’s not more immune-evasive than BA.5, for example.

Long COVID

This article says that a test for Long COVID has been approved in Europe. I can’t decide how I feel about that. I’m happy that people will be able to prove that there is something wrong with them, so the healthcare professionals stop gaslighting them. I also worry about all the false negatives — because there will be some false negatives — being told Ha! See, it is all in your head!

Treatments

This review paper from Italy looked into using a treatment algorithm which started patients on non-steroidal anti-inflammatories immediately — even before results of a COVID-19 test came back — and the progressed to dexamethasone, anticoagulants, and oxygen if the patient did not respond. The treatment algorithm dropped

  • the time to resolve major symptoms from 18 days to 14 days,
  • the percent of people to have lingering symptoms from 73.3% to 23.3%, and
  • dropped the hospitalization rate by 85.6%.

Recommended Reading

This is an entertaining blog post about the sheer numbers of different vaccines that have been approved and even more which are in the pipeline.