Researchers at Michigan Medicine say they found an association between the flu shot and fewer, less severe coronavirus cases. The study, which reviewed medical charts for more than 27,000 patients, also found that nobody included in the data tested positive for both viruses at the same time.
“It is possible that patients who receive their flu vaccine are also people who are practicing more social distancing and following CDC guidelines,” Marion Hofmann Bowman, M.D., senior author and associate professor of internal medicine and a cardiologist at the Michigan Medicine Frankel Cardiovascular Center, said in a news release. “However, it is also plausible that there could be a direct biological effect of the flu vaccine on the immune system relevant for the fight against SARS-CoV-2 virus.”
WHAT HAPPENED TO CORONAVIRUS, FLU ‘TWIN-DEMIC’? EXPERT WEIGHS IN
The researchers found that between March and mid-July 2020, of the nearly 13,000 who got a flu shot the previous year, 4% tested positive for COVID-19, while nearly 5% of the 14,000 who forwent the flu shot tested positive COVID-19. Those who received the shot were also “significantly” less likely to require hospitalization, according to the news release posted to Eurekalert.org.
Hofmann noted that the underlying cause of the apparent association is not yet clear.
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“Instead of a concerning connection between COVID-19 and the flu shot, our publication provides more confidence that getting your flu shot is associated with staying out of the hospital for COVID-19,” Hofmann said.
The very first vertebrates to walk on our planet might have done so in the great ocean deep, millions of years before their later relatives transitioned to the land.
In 2018, scientists were shocked to find the little skate fish (Leucoraja erinacea) and some basal sharks were capable of footing it along the ocean floor using many of the same neural circuits that we use to walk today.
Generally, it’s thought that vertebrates only learned to walk when they began to eschew the sea for the shore, roughly 380 million years ago. But further models based on the little skate fish – one of the most primitive animals with a backbone – suggest a much deeper origin, possibly more than 400 million years ago.
Using published video data on the scuttling dynamics of this benthic creature, mathematicians have developed a model to investigate how early leg-like motions might have evolved in the deep sea.
The simple model they have created predicts the most efficient, controlled, and balanced type of walking in a neutrally buoyant environment: The best result requires a left foot-right foot alternating pattern very similar to the little skate’s waddle.
What’s more, this type of trudging does not require any extra energetic cost and could be reinforced over time using a simple learning scheme.
“In the context of our model, these results suggest that, despite the vast solution space of gaits, a left-right alternating bipedal control strategy can and will be discovered and is the optimal solution for energy efficient locomotion,” the study authors write.
Finding a real-world example of this ancient organism is akin to discovering a “needle in a haystack”, the team admits, but they say only rudimentary legs would be needed to achieve this pattern of foot placement. After those feet-like fins evolved, the ancient creature would then have needed to gain only minimal neuronal control over their new and improved limbs.
After four episodes of learning in the model, a one-legged locomotion strategy began to emerge. After 200 episodes, a two-legged walking pattern took over. By the 600th episode, the modeled creature began to alternate between left and right steps.
Running roughly 50 instances of learning for 5,000 episodes, including various learning parameters and rewards, the authors found the best solution matches the little skate’s walking gait in 70 percent of all cases.
This simple control strategy suggests walking in the deep sea is a robust and efficient behavior similar to passive walking, like the slinky toy that “walks” down a slope without the need for complex control, just gravity.
The little skate, of course, is not a completely passive plodder. Its brain cells still control six muscles for motion, but the authors say this system exploits the same principles as a passive one: “Sustained locomotion under a constant energy source without feedback control.”
The authors aren’t sure why the little skate developed a slow seafloor walk, but they suggest it is more efficient and cost-effective than swimming at a similar pace. Further metabolic studies on the deep sea creature will need to verify this idea.
Sometimes in the wild, the little skate will use both its legs at the same time to “punt” forward and quickly kick-start its left-right walking pattern. This sort of movement was not found in the model, but the authors think it might be favored when faster acceleration is needed and energy efficiency isn’t as important. This unusual punt requires a bit more work.
“The combination of a reliable low gravity environment and a legged-body morphology may well have helped pave the way for bipedal gaits before our aquatic ancestors transitioned to terra firma,” says applied mathematician Lakshminarayanan Mahadevan from Harvard University.
“As our ancient ancestors transitioned to land, the control strategy likely became more complex. But in reliably homogeneous environments, like the sea floor, perhaps a simple strategy was all that was needed.”
To complement this theoretical model, researchers even built a simple bipedal robot based on similar deep sea conditions. In the end, the behavior of this robot showed striking similarities to their model’s ideal walker. Its regular footstep pattern requires no extra energy and undulates on both sides of the body for stability.
The robot, however, tends to walk slightly faster than what is seen in the little skate.
The authors admit they may never know exactly how the first walking gait arose, but their model helps refine some of the passive dynamics and neural circuits seen in living organisms.
“Understanding how the brain, body and environment worked together in heterogeneous aquatic and terrestrial environments likely needed to include proprioceptive feedback,” the authors suggest.
“But in reliably homogeneous environments, perhaps the simple strategy quantified here was where it all started.”
The study was published in the Journal of the Royal Society Interface.
The study included 257 patients with early symptomatic Alzheimer’s disease; 131 received donanemab, while 126 received a placebo. The researchers found donanemab slowed the decline of cognition and daily function in Alzheimer’s patients by 32% after 76 weeks, compared to those who received a placebo.
Taken over 18 months, that 32% slowing of decline could be noticeably impactful for Alzheimer’s patients, noted Maria Carrillo, chief science officer at the Alzheimer’s Association, who was not involved in the study.
“Out of 18 months, in comparison to the people that did not get the drug, these folks were declining six months slower,” Carrillo said. “That’s six more months of better cognition, better memories, better enjoyable times with your family.”
Decline was measured using the Integrated Alzheimer’s Disease Rating Scale, which measures both cognitive and functional ability, like memory and the ability to perform daily tasks.
Carrillo said the Phase 2 trial results are early but promising, and represent some of the most robust data on a single drug’s ability to slow the progression of Alzheimer’s disease.
“This has a lot of potential,” Carrillo added. “It could be a first step towards slowing more significantly, or stopping, cognitive decline in these earlier stages, which would really be transformational for our field.”
The researchers also looked at the drug’s impact on the buildup of amyloid beta plaque and tau proteins, which are considered hallmarks of Alzheimer’s disease.
At 52 weeks, almost 60% of participants had reached amyloid-negative status, meaning their levels were at those of otherwise healthy people. At 76 weeks, amyloid plaque levels — measured in centiloids — decreased by 85 centiloids more than in those who received the placebo, the researchers reported.
Patients who reached these low levels of amyloid beta plaque were taken off of donanemab and given the placebo.
Slowing down disease
“Once these participants were cleared of amyloid in the brain, the drug was taken away, and that slowing still continued,” Carrillo. “That is important because then you don’t have the continued monitoring of any safety or adverse events.”
Participants who received donanemab also showed a greater reduction in the overall tau load than those who received the placebo.
Carrillo said this study was unique in that it screened participants for the presence of both amyloid beta plaque and tau before they entered the trial.
Some researchers in the field believe that “if you stop amyloid early enough, and you slow down that tau, you might be able to slow Alzheimer’s,” Carrillo. “That’s what this paper is trying to show, and it is one of the very first times we’ve seen this.”
The research on donanemab is still early, and the researchers say that longer and larger trials are needed to determine the safety and efficacy of the drug.
“We are extremely pleased about these positive findings for donanemab as a potential therapy for people living with Alzheimer’s disease, the only leading cause of death without a treatment that slows disease progression,” Dr. Mark Mintun, Eli Lilly’s vice president of pain and neurodegeneration, said in a January statement announcing the trial results. Mintun said additional, ongoing research would aim to replicate the findings.
No new approved treatments since 2004
The US Food and Drug Administration has not approved a new Alzheimer’s drug since 2004. The experimental Alzheimer’s drug aducanumab, developed by the pharmaceutical company Biogen and its Japanese partner Eisai, is currently under review by the FDA.
Many of the most promising Alzheimer’s drug candidates aim to target amyloid beta plaques and tau proteins, since the buildup of these correlates with the progression of Alzheimer’s disease. The goal with drugs such as donanemab isn’t to cure the disease, but to preserve a person’s memory and cognition for longer.
Alzheimer’s disease is the most common form of dementia, and currently affects 6.2 million Americans age 65 and older, according to the Alzheimer’s Association. The US Centers for Disease Control and Prevention says that number is expected to rise to at least 14 million people by 2060.
Enlarge / A staff member of the N’zerekore hospital lifts his shirt sleeve as he prepares to get his anti-ebola vaccination in N’zerekore on February 24, 2021. Nzerekore Hospital was where the first cases of Ebola were found at the end of January 2021.
The Ebola viruses behind a new outbreak in Guinea are stunningly similar to viruses identified during the massive West Africa outbreak that spanned 2013 to 2016, according to a new genetic analysis. The finding suggests that virus may have silently persisted in a survivor for at least five years and that the current outbreak was sparked by that unlucky person, rather than a spillover from an animal reservoir.
In the genetic analysis posted online Friday, a group of international researchers report that Ebola viruses collected from the current outbreak in Guinea have only a dozen or so genetic differences from Ebola variants collected from the same area of Guinea in 2014. Based on what researchers know about the pace at which Ebola collects such genetic substitutions—its evolutionary rate—that number of accumulated differences should have totaled over 110 in that timespan, not 12.
“This number of substitutions is far less than what would be expected during sustained human-to-human transmission,” they researchers write in their analysis. Instead, they note such a sluggish evolutionary rate is a “hallmark of persistent infections.”
“Therefore, the index case of the 2021 Guinea cluster was likely infected from a persistent source, such as via sexual transmission from an [Ebola] survivor,” they conclude.
The Ebola virus is known to persist in some survivors, particularly in places where it can lay low from the immune system, such as the testicles or eyeballs. A 2016 study reported resurgence of the virus in a survivor’s seminal fluid more than 500 days after the initial infection.
Still, the more than five-year span was “shocking” to many virologists and public health experts. And it raises a variety of concerns for the many survivors of past outbreaks, some of whom may have had mild cases of Ebola without realizing it. In particular, many people known to have survived Ebola face stigmatization, and the possibility of years-long persistence is likely to amplify that problem.
In the 2013-2016 West Africa outbreak, more than 28,000 people were infected with the virus, and over 11,000 died. It is the largest Ebola outbreak in history. Most of the cases and deaths were in Guinea, Liberia, and Sierra Leone. The outbreak began with a case reported in an 18-month old boy in December 2013; the boy is believed to have caught the virus from bats.
The current outbreak, which was declared February 14, has sickened at least 18 and killed nine. Vaccination efforts are now underway to stop the spread of the virus.
An Israeli health worker of the Maccabi Healthcare Services prepares to administer a dose of the Pfizer-BioNtech vaccine on February 24, 2021 in Tel Aviv.
Jack Guez | AFP | Getty Images
Data from Israel, which has vaccinated the overwhelming majority of its elderly population with the Pfizer Covid-19 vaccine, suggests that mass vaccinations have prevented people from becoming severely sick, according to a new study from the Centers for Disease Control and Prevention.
While clinical trials have found the Pfizer-BioNTech vaccine to be 95% effective in preventing Covid-19, the Israeli data offers an early glimpse into how effective the vaccine is in an uncontrolled, real-world setting.
The study, which was published Friday in the CDC’s Morbidity and Mortality Weekly Report, found that among the part of the Israeli population that has been vaccinated the most, the percentage of patients requiring ventilation drastically dropped, suggesting a reduction in severe sickness.
“Taken together, these results suggest reduced rates of severe COVID-19 following vaccination,” wrote the researchers from Ben Gurion University of the Negev, Tel-Aviv University and Maccabi Healthcare Services.
Israel launched its national vaccination campaign in December prioritizing people 60 and older, health-care workers, and people with comorbid conditions. By February, the researchers said, 84% of the population 70 and older had been fully immunized with the Pfizer-BioNTech two-shot vaccine. Only 10% of the population under 50 years old had been vaccinated by the same time, the researchers said.
The researchers compared the number of Covid-19 patients 70 and older who required a mechanical ventilator to those younger than 50 who need a ventilator. The researchers said they used the need for a ventilator, a medical instrument used to help patients breathe, to measure severe Covid-19.
Between October and February, the number of patients 70 and older who needed a ventilator fell. At the same time, the number of people under 50, a population that generally wasn’t vaccinated, who needed a ventilator rose, the study found. The country began administering shots to mostly older people Dec. 20, with a second round of shots following three weeks later.
The researchers noted a few limitations of the study. Israel implemented a strict national stay-at-home order on Jan. 8, weeks after the beginning of the vaccination campaign, that could have led to a decrease in severely sick patients who would have needed ventilators. The introduction of new variants of the coronavirus also could have affected the data, they said.
The researchers said their findings are preliminary, “important evidence of the effectiveness of vaccines in preventing severe cases of COVID-19 at the national level in Israel.”
“Receipt of COVID-19 vaccines by eligible persons can help limit spread of disease and potentially reduce the occurrence of severe disease,” they wrote.
For the study, researchers at Pfizer and the University of Texas Medical Branch genetically engineered versions of the virus to carry some of the mutations found in B.1.351. They tested them against blood samples taken from 15 people who had received two doses of the Pfizer/BioNTech vaccine as part of a clinical trial.
While the blood serum samples produced less neutralizing antibody activity, it was still enough to neutralize the virus, they wrote in a letter to the journal. This is in line with other studies. And it’s well within what is seen with other viruses, one of the researchers said.
“Although we do not yet know exactly what level of neutralization is required for protection against COVID-19 disease or infection, our experience with other vaccines tells us that it is likely that the Pfizer vaccine offers relatively good protection against this new variant,” Scott Weaver, director of the Institute for Human Infections and Immunity at the University of Texas Medical Branch and an author of the study, told CNN.
“The reduction in the levels of neutralization against the South African variant of about 2/3 is fairly small compared to variations in neutralization levels generated by vaccines against other viruses that have even more variability in their protein sequences than SARS-CoV-2,” Weaver added.
Pfizer said there is no evidence in real life that the variant escapes the protection offered by its vaccine. “Nevertheless, Pfizer and BioNTech are taking the necessary steps, making the right investments, and engaging in the appropriate conversations with regulators to be in a position to develop and seek authorization for an updated mRNA vaccine or booster once a strain that significantly reduces the protection from the vaccine is identified,” Pfizer said in a statement.
Separately, a team at the National Institutes of Health and Moderna published a letter in the same journal outlining findings from an experiment they reported last month. They also reported a reduction in the antibody response to viruses genetically engineered to look like the B.1.351 variant — but not enough of a reduction to make the vaccine work any less effectively.
“Despite this reduction, neutralizing titer levels with (the variant discovered in South Africa) remain above levels that are expected to be protective,” the company said in a statement.
They found no reduction in efficacy against a variant first seen in the UK and known as B.1.1.7.
A growing body of evidence suggests that the Covid-19 vaccine can slow the spread of the coronavirus, Dr. Anthony Fauci said Wednesday.
Whether vaccination can prevent transmission of the virus is “the looming question,” Fauci, director of the National Institute of Allergy and Infectious Diseases, said during a White House coronavirus response team briefing. “If a person gets infected despite being vaccinated — we refer to that as a ‘breakthrough’ infection — does that person have the capability of transmitting to another person?”
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“There have been some studies that are pointing in a very favorable direction,” he said, adding that these studies will have to be corroborated by additional research.
Fauci highlighted two recent studies that looked at a person’s viral load — that is, how much virus he or she has in the body — and transmissibility.
One study from Spain, published Feb. 2 in The Lancet, found a direct correlation between viral load and transmissibility. The higher the viral load, the greater the transmissibility of the virus.
That’s in line with what years of research on HIV have shown: there’s a direct link between the viral load in someone’s blood and the likelihood that individual will transmit HIV to a sexual partner, Fauci said.
For SARS-CoV-2, the virus that causes Covid-19, researchers are focused on how much virus is found the nasopharynx, the upper part of the throat behind the nose that’s reached with a long, skinny swab.
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The second study Fauci described — a paper that has not undergone peer review that was posted last week to the preprint server medRvix — looked at coronavirus infections in Israel, a country with very high rates of vaccination.
That paper found that individuals who were infected after receiving their first dose of the Pfizer-BioNTech vaccination had a “markedly diminished” viral load compared with unvaccinated people.
It’s another example of “scientific data starting to point to the fact that [the vaccine] … has very important implications from a public health standpoint for interfering and diminishing the dynamics of the outbreak,” Fauci said.
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Dr. John Anthony Vanchiere, chief of pediatric infectious diseases at Ochsner LSU Health Shreveport in Louisiana, said that the two studies “go nicely together hand in hand.”
“We know that it is the case for flu and other respiratory viruses that higher viral loads are associated with increased transmission,” he said. “The fact that the vaccine reduces the viral load, even shortly after getting your first dose, it’s very important data to have.”
Both Pfizer-BioNTech and Moderna are currently studying how vaccination affects transmissibility, Fauci said.
“The bottom line message,” he said, is “when your turn to get vaccinated comes up, get vaccinated. It’s not only good for you and your family and community, it will have a very important impact on the dynamics of the outbreak in our country.”
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Sara G. Miller
Sara G. Miller is the health editor for NBC News, Health & Medical Unit.
