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Open Roads Forum  >  Around the Campfire  >  General Topics

 > 2019–2022 CORONAVIRUS PANDEMIC POSTINGS

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Posted: 10/25/21 07:04am Link  |  Quote  |  Print  |  Notify Moderator

We always have to do the best we can and have hope. [emoticon]

BCSnob

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Posted: 10/25/21 07:16am Link  |  Quote  |  Print  |  Notify Moderator

Agreed
One last comment; this mask effectiveness study is analogous to the “real world” vaccine effectiveness studies coming from places like Israel.

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Posted: 10/25/21 07:22am Link  |  Quote  |  Print  |  Notify Moderator

Very much so, again if we don't continue emphasizing masks and vaccinations are our major weapons against Covid multiple thousands of lives will continue to be needlessly lost. Anyway, please continue.

MEXICOWANDERER

las peñas, michoacan, mexico

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Posted: 10/25/21 06:16pm Link  |  Quote  |  Print  |  Notify Moderator

Question
Has the Pfizer vs Moderna comparison been peer reviewed and confirmed? Some of the statements were vague and confusing.

BCSnob

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Posted: 10/26/21 07:36am Link  |  Quote  |  Print  |  Notify Moderator

This study from Japan investigated if breakthrough infections from Delta were due to waning immunity (lower amounts of antibodies) or if the Pfizer vaccine is just less effective against Delta.

COVID-19 breakthrough infections and pre-infection neutralizing antibody
MedRxiv Preprint 20Oct2021

The researchers measured antibodies and virus neutralization titers in healthcare workers after vaccination and through several waves of Covid-19; one wave was due to Alpha (1-2 months post vaccination) another wave was due to Delta (2-4 months post vaccination).

There were no breakthrough infections due to Alpha; there were 18 breakthrough cases due to Delta. There were no differences in antibody titers against the wild type (Wuhan), Alpha, and Delta variants between the breakthrough infection cases and matched vaccinated coworkers with no infection. All virus neutralization titers were lower for Alpha and Delta than the wild type (the antigen used in vaccines). These results are contrary to those from the study conducted in Israel. One difference between this study and the one from Israel is when the serum samples were collected from the controls and cases; this study collected prior to infection (>62days post vaccination) while the study from Israel collected after infection.

I think the contradictory results from studies (this one, the ones from Israel and Vietnam, and the US VA) correlating breakthrough infections to vaccination time, antibody titers, neutralization assays, and circulating variants suggest we don’t have the full picture on what leads to a breakthrough infection. Taking all of the studies together suggest it may be more than just waning immunity.

* This post was last edited 10/26/21 08:08am by BCSnob *   View edit history

BCSnob

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Posted: 10/26/21 08:26am Link  |  Quote  |  Print  |  Notify Moderator

MEXICOWANDERER wrote:

Question
Has the Pfizer vs Moderna comparison been peer reviewed and confirmed? Some of the statements were vague and confusing.

When a manuscript is updated and upload to MedRxiv and BioRxiv these sites provide a link to to newer version. When it is published (peer reviewed) MedRxiv/BioRxiv provides a citation to the publication.

BCSnob

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Posted: 10/26/21 08:43am Link  |  Quote  |  Print  |  Notify Moderator

Long-term health-related quality of life in non-hospitalised COVID-19 cases with confirmed SARS-CoV-2 infection in England: Longitudinal analysis and cross-sectional comparison with controls
MedRxiv Preprint 25 Oct 2021

Quote:

Prospective cohort study of SARS-CoV-2(+) cases aged 12-85 years and followed up for six months from 01 December 2020, with cross-sectional comparison to SARS-CoV-2(-) controls.

Results: Of 548 cases (mean age 41.1 years; 61.5% female), 16.8% reported physical symptoms at month 6 (most frequently extreme tiredness, headache, loss of taste and/or smell, and shortness of breath). Cases reported more limitations with doing usual activities than controls.

Conclusions: One in 6 cases report ongoing symptoms at 6 months, and 10% report prolonged loss of function compared to pre-COVID-19 baselines.


This study followed non hospitalized Covid-19 cases (which occurred while the wild type and Alpha were the dominate variants) for 6 months to assess the impact of the infections on their quality of life. It has been oft reported that most people survive this infection; however, this study suggests that a significant number people have lingering health issues (6months) caused by this infection. Lingering issues for much longer than the flu.

BCSnob

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Posted: 10/26/21 09:17am Link  |  Quote  |  Print  |  Notify Moderator

Here is a good example of a study that the popular press would love to report. But also an example where "the devil is in the details".

Outbreak of SARS-CoV-2 B.1.617.2 (Delta) variant in a Nursing Home 28 weeks after two doses of mRNA anti-Covid-19 vaccines: evidence of a waning immunity
MedRxiv preprint 26 Oct 2021

At this nursing home where there was high vaccination rates among the staff and residents (82% and 91%) there was a breakthrough infection 28 weeks after full vaccination which lead to additional breakthrough infections. Antibody testing was performed within 48hrs of the first breakthrough case on all residents and staff. The titer levels were corrected to whether or not a breakthrough infection occurred; lower antibody titers correlated to higher risks of breakthrough infections.

The authors claim this as evidence of waning vaccine effectiveness from decreasing antibody titers.
Quote:

Conclusion Low levels of SARS-CoV-2 neutralizing anti-Spike IgG in serum 28 weeks after the administration of the second dose parallels the waning of vaccine protection.

But they did not present data showing the antibody titers post vaccination; only the titer levels 28 weeks after vaccination. So, did the titer levels decrease overtime or were they stable but low post vaccination (weak seroconversion)? Did the breakthrough infection occur because of low antibody titers to the wild type virus spike (what is used in this antibody test) or did they occur because the vaccine is less effective to the variant in circulation at the time of infections (Delta)? Or some combination of decreasing antibody titers and a more infectious variant.

* This post was edited 10/26/21 12:01pm by BCSnob *

BCSnob

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Posted: 10/27/21 06:37am Link  |  Quote  |  Print  |  Notify Moderator

I don’t have time today to carefully read this study. I am posting it now because it addresses a question that has been raised here: what effect does changing the time between prime and boost have on vaccine effectiveness.

Two-dose SARS-CoV-2 vaccine effectiveness with mixed schedules and extended dosing intervals: test-negative design studies from British Columbia and Quebec, Canada
MedRxiv preprint 26Oct2021
Quote:

Background The Canadian COVID-19 immunization strategy deferred second doses and allowed mixed schedules. We compared two-dose vaccine effectiveness (VE) by vaccine type (mRNA and/or ChAdOx1), interval between doses, and time since second dose in two of Canada's larger provinces. Methods Two-dose VE against infections and hospitalizations due to SARS-CoV-2, including variants of concern, was assessed between May 30 and October 2, 2021 using test-negative designs separately conducted among community-dwelling adults =18-years-old in British Columbia (BC) and Quebec, Canada. Findings In both provinces, two doses of homologous or heterologous SARS-CoV-2 vaccines were associated with ~95% reduction in the risk of hospitalization. VE exceeded 90% against SARS-CoV-2 infection when at least one dose was an mRNA vaccine, but was lower at ~70% when both doses were ChAdOx1. Estimates were similar by age group (including adults =70-years-old) and for Delta-variant outcomes. VE was significantly higher against both infection and hospitalization with longer 7-8-week vs. manufacturer-specified 3-4-week interval between doses. Two-dose mRNA VE was maintained against hospitalization for the 5-7-month monitoring period and while showing some decline against infection, remained =80%. Interpretation Two doses of mRNA and/or ChAdOx1 vaccines gave excellent protection against hospitalization, with no sign of decline by 5-7 months post-vaccination. A 7-8-week interval between doses improved VE and may be optimal in most circumstances. Findings indicate prolonged two-dose protection and support the use of mixed schedules and longer intervals between doses, with global health, equity and access implications in the context of recent third-dose proposals.


I also wonder if the shorter time between prime boost plus a later 3rd shot booster is a good compromise between more effective longer time between prime boost and getting the population to full vaccination faster during an ongoing pandemic (since just the prime has lower effectiveness).

MEXICOWANDERER

las peñas, michoacan, mexico

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Posted: 10/27/21 02:29pm Link  |  Quote  |  Print  |  Notify Moderator

Yet another mystery is whether inversing the Prime Boost protocol with mRNA prime and Adeno.. second (Boost) achieves a similar total neutralizing efficacy. I am incapable of keeping up with the latest findings but early on, both Pfizer and Moderna claimed primer inoculation levels >90%. The first jab. The Janssen vaccine would serve as a Boost role. Simply repeating mRNA jabs may end up with a declining efficacy in both total Titer count and longevity. Only time will tell.

Dealing with this plus individual immunosuppression responses is a most daunting and challenging area.

Your contributions are priceless. Again, thank you.

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