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Tag Archives: vaccination
Maternal mRNA covid-19 vaccination during pregnancy and delta or omicron infection or hospital admission in infants: test negative design study – The BMJ
- Maternal mRNA covid-19 vaccination during pregnancy and delta or omicron infection or hospital admission in infants: test negative design study The BMJ
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- Protecting infants through covid-19 vaccination during pregnancy The BMJ
- COVID-19 vaccination during pregnancy helps protect newborns, Canadian study suggests CBC News
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Covid booster? No thanks! Staggering 96 per cent of NHS appointments for mRNA top-up jab still available with just days of latest vaccination campaign to go – GB News
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JCVI statement on the COVID-19 vaccination programme for 2023: 8 November 2022
Overview
Since the first COVID-19 vaccine was authorised for use in the UK in December 2020, the aim of the COVID-19 vaccination programme has been, and continues to be, the reduction of severe disease (hospitalisation and mortality) across the population, while protecting the NHS.
As the transition continues away from a pandemic emergency response towards pandemic recovery, the Joint Committee on Vaccination and Immunisation (JCVI) has begun to consider the 2023 COVID-19 vaccination programme. The current Omicron era is characterised by:
- high levels of population immunity acquired through vaccination and/or natural infection
- lower disease severity compared to infection due to previous SARS-CoV-2 variants
During this time, the risk of severe COVID-19 continues to be disproportionately greater in those from older age groups, residents in care homes for older adults, and persons with certain underlying health conditions. Compared to the initial phases of the pandemic, much more is now understood regarding SARS-CoV2 infection. However, there remains ongoing uncertainty regarding virus evolution, the durability and breadth of immunity, and the epidemiology of infection. These uncertainties limit the immediate development of a routine immunisation programme against COVID-19.
Advice
JCVI’s interim advice for planning purposes ahead of 2023 is that:
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in autumn 2023, persons at higher risk of severe COVID-19 could be offered a booster vaccine dose in preparation for winter 2023 to 2024
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in addition, for a smaller group of persons (such as persons of older age and those who are immunosuppressed) an extra booster vaccine dose may be offered in spring 2023
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emergency surge vaccine responses may be required should a novel variant of concern emerge with clinically significant biological differences compared to the Omicron variant
JCVI also advises that:
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the 2021 booster offer (third dose) for persons aged 16 to 49 years who are not in a clinical risk group should close in alignment with the close of the autumn 2022 vaccination campaign[footnote 1]
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otherwise healthy persons aged 5 to 49 years who develop a new health condition in 2023 that places them in a clinical risk group would be offered primary vaccination and/or a booster vaccine during the next seasonal vaccination campaign, as appropriate. Vaccination outside these campaign periods would be subject to individual clinical judgement
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primary course COVID-19 vaccination should move, over the course of 2023, towards a more targeted offer during vaccination campaigns to protect those persons at higher risk of severe COVID-19. This would include:
- residents in a care home for older adults and staff working in care homes for older adults
- frontline health and social care workers
- all adults aged 50 years and over
- persons aged 5 to 49 years in a clinical risk group, as set out in the Green Book
- persons aged 12 to 49 years who are household contacts of people with immunosuppression
- persons aged 16 to 49 years who are carers, as set out in the Green Book
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research should be considered to inform the optimal timing of booster vaccinations to protect against severe COVID-19 (hospitalisations and deaths) for groups who are at different levels of clinical risk
Considerations
It is estimated that over 97% of adults in England had SARS-CoV-2 antibodies, either from infection or vaccination, by the end of August 2022 (reference 1). In Great Britain, an estimated 93 to 99% of children aged 12 to 15 years, and 74 to 98% of children aged 8 to 11 years, had antibodies against SARS-CoV-2 at the end of August 2022 (references 1 and 2). Natural immunity alone provides good levels of protection against severe COVID-19 while the combination of natural and vaccine-induced immunity (hybrid immunity) is associated with even higher levels of protection (references 3,4 and 5). This high level of strong population immunity developed over the past 2 and a half years is under regular monitoring through UK Health Security Agency (UKHSA) public health surveillance programmes.
Not all hospitalisations and deaths ascribed to SARS-CoV-2 infection are vaccine-preventable events. Due to the high transmissibility of the Omicron variant, together with infection that can be asymptomatic or only mildly symptomatic, persons who require hospital care for non-COVID-19 reasons may be coincidentally infected with SARS-CoV-2. Such hospitalisations are not preventable through COVID-19 vaccination. In contrast, some highly vulnerable individuals may develop severe COVID-19 despite being vaccinated; these individuals often have underlying health conditions that confer high susceptibility to severe disease from other infections as well. In the UK, during the Omicron era (up to week 43, 2022), the highest rates of hospitalisations were consistently observed in persons aged 75 years and over, while rates of infection (non-severe illness) were high across all ages and especially among younger persons (references 6 and 7).
Revised estimates of the number needed to vaccinate (NNV) to prevent one hospitalisation during the Omicron era indicate that 800 persons aged 70 years and above would need to be given a booster in autumn 2022 (a fourth dose) to prevent one hospitalisation from COVID-19. The corresponding NNV for persons aged 50 to 59 years is 8,000 and for persons aged 40 to 49 years who are not in a clinical risk group is 92,500 (Appendix 1).
In November 2021, JCVI advised boosters for healthy adults aged 40 to 49 years due to the epidemiology at the time. With the emergence of the Omicron variant in late November 2021, the offer was extended to healthy individuals aged 16 to 39 years as part of an emergency surge response (see JCVI update on advice for COVID-19 vaccination of children and young people and UK vaccine response to the Omicron variant: JCVI advice). Since April 2022, uptake of the initial booster dose of COVID-19 vaccine has been less than 0.1% per week in all eligible people under 50 years of age (Figure 62c in reference 8). Based on the current data, keeping the booster (third dose) offer open to these groups is considered of limited ongoing value and the overall impact on vaccine coverage is negligible.
The offers of primary course vaccination have been widely available since 2021. Uptake of these vaccine offers have plateaued in recent months across all age groups (Figure 62a in reference 8). Since the beginning of 2022, less than 0.01% of eligible individuals per week over the age of 12 years, received a first COVID-19 vaccine dose. A more targeted offer of primary course vaccination during vaccination campaign periods will enable these efforts to be more focused and allow more efficient use of NHS resources.
Although the COVID-19 vaccination programme has been very successful overall, there are some socioeconomic and ethnic groups where vaccine coverage remains lower (reference 6). Addressing health inequalities is a long-term effort that is relevant to all UK immunisation programmes. Building trust, and specifically vaccine confidence, requires steady determined investments of time, resources and persons. Appropriate and adequate communication should be provided in advance of changes to the primary course vaccination offer to optimise uptake among those who are eligible but have yet to accept the offer of vaccination.
Future variants and their impact on epidemiology
As the virulence of any new emergent variant cannot be reliably predicted, rapid response measures may be required should there be substantial changes in population immunity against the dominant circulating variant, including any new variant of concern.
JCVI will keep the epidemiology of COVID-19 under review and will provide advice for a surge response, as required.
References
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Office for National Statistics (ONS) Coronavirus (COVID-19) latest insights: antibodies.
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UK Health Security Agency unpublished data.
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Protective effectiveness of prior SARS-CoV-2 infection and hybrid immunity against Omicron infection and severe disease: a systematic review and meta-regression.
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Risk of SARS-CoV-2 reinfection and COVID-19 hospitalisation in individuals with natural and hybrid immunity: a retrospective, total population cohort study in Sweden.
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Protection against Omicron (B.1.1.529) BA.2 reinfection conferred by primary Omicron BA.1 or pre-Omicron SARS-CoV-2 infection among health-care workers with and without mRNA vaccination: a test-negative case-control study.
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National flu and COVID-19 surveillance reports: 2022 to 2023 season.
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Coronavirus (COVID-19) in the UK dashboard.
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National flu and COVID-19 surveillance report: 27 October 2022 (week 43).
VP Harris required people to sign ‘attestation of vaccination’ paper to attend her Florida speech: reports
Vice President Kamala Harris required all attendees of her event on Sunday in Tallahassee, Florida to sign a form confirming whether they have been vaccinated or not, according to reports.
The requirement is a counter-approach to Florida Gov. Ron DeSantis’s claims that the vaccine is being used as a weapon. The governor plans to propose protections for residents, such as a ban on vaccine and mask requirements, during the next legislative session.
Vice President Kamala Harris called her husband in a fit of rage after the Supreme Court overturned Roe v. Wade earlier this year.
(Reuters/Hannah Beier)
The form was titled, ‘Attestation of Vaccination,” and it required guest to indicate whether they are unvaccinated, partially vaccinated or vaccinated.
RON DESANTIS PUSHES FOR SWEEPING PROTECTIONS AGAINST COVID-19 MANDATES IN FLORIDA
Those who decline to indicate either were required provide proof that they completed a COVID-19 test within three days of the event and received a negative result, wear a mask and socially distance themselves from others.
Anyone who was fully vaccinated and attending the event could mask, social distance and follow any other protocols set by the Centers for Disease Control and Prevention, or CDC, if they so choose.
A nurse prepares to administer a COVID vaccine.
(REUTERS/Ronen Zvulun/File Photo)
The Republican National Committee Research Twitter handle @RNCResearch tweeted about the form on Sunday.
FLORIDA GOV. RON DESANTIS SAYS THERE WILL BE NO CHILDREN’S COVID VACCINE MANDATE
“Kamala Harris made people sign an ‘attestation of vaccination’ to attend her incoherent speech in Florida today,” the tweet read.
Followers of the page had mixed responses, with some agreeing for the necessity of the form, and many others mocking the requirement on the basis that vaccines do not stop transmission.
Representatives for the Vice President did not immediately respond to requests seeking additional information about the “Attestation for Vaccination” requirement.
Harris was in Florida on Sunday to deliver President Biden’s memorandum on the 50th anniversary of Roe v. Wade, to protect access to abortion pills across the country.
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The vice president also gave remarks about the administration’s efforts to expand abortion rights.
Harris’ remarks come several months after the U.S. Supreme Court overturned the landmark decision in June 2022, ending the constitutional right to abortion and handing states the individual power to allow, limit, or ban abortion altogether. The ruling came in the Dobbs v. Jackson Women’s Health Organization opinion, wherein the state of Mississippi asked the Supreme Court to strike down a lower court ruling that stopped a 15-week abortion ban from taking place.
Natural Immunity Superior to Vaccination Against Infection in Children: Study
Children with natural immunity were better protected from COVID-19 infection and hospitalization than children who were vaccinated, according to a new study.
Children aged 5 to 11 with post-infection protection, or natural immunity from an infection with Omicron or a subvariant, and no vaccination had 88.4 percent protection against reinfection, researchers in North Carolina found. That was compared to 59.7 percent protection against Omicron from a primary series of a messenger RNA vaccine, or two doses of vaccine from Pfizer or Moderna, among the uninfected.
The protection remained higher over time until month eight when the protection from natural immunity among the unvaccinated was estimated to be 18.8 percent and the protection from vaccination was pegged at 22.5 percent.
Fifty percent effectiveness is considered the threshold for an effective vaccine, according to the U.S. Food and Drug Administration and the World Health Organization, but the effectiveness of the shots remained above that bar for just one month, the researchers found.
A monovalent booster, or a discontinued booster, elevated the protection for the vaccinated, including children with a previous infection, by just 24.4 percent after one month, dipping to 19.3 percent after five months. A bivalent booster, or one of the new shots cleared in the fall of 2022, boosted the protection by 76.7 percent after one month but the shielding fell to 47.3 percent on top of the original series after one more month.
Researchers did not provide separate estimates for the naturally immune and unvaccinated, and the vaccinated and infected, against hospitalization and death.
They pegged natural immunity for the 5 to 11 group against hospitalization and death at 87.5 percent after one month, compared with 73.3 percent from a primary series. After three months, natural immunity was estimated at 83.8 percent protection versus 39.3 percent from vaccination; after six months, natural immunity was pegged at 76.2 percent, compared to 2.9 percent for vaccination.
Even though the vaccines are authorized for the prevention of COVID-19, they have become increasingly worse at preventing infection. Authorities have shifted to promoting them as a tool to prevent severe disease, but that protection has also become subpar against Omicron and its subvariants, real-world data and studies show.
The waning effectiveness prompted not only the authorization of boosters with the same formulation as the primary series, but, later, the authorization without clinical data of new boosters aimed at the BA.4 and BA.5 subvariants of Omicron for all Americans aged 6 months and older.
The North Carolina researchers drew from The North Carolina COVID-19 Surveillance System, which contains testing data and COVID-related hospitalization and death information, as well as the COVID-19 Vaccine Management System, which holds vaccination records. The study focused on North Carolina residents 11 years of age and younger, from Oct. 29, 2021, to Jan. 6, 2023. They estimated the effectiveness of vaccination and natural immunity against infection, hospitalization, and death.
Researchers did not provide estimates of booster effectiveness against hospitalization and death. They said there was only one hospitalization and no deaths after receipt of a booster dose.
The study population was primarily unvaccinated because most children in the United States have not received a vaccine.
0–4 Year-Olds
Data from children aged up to 4 years was also analyzed.
The protection from Omicron infection against reinfection among all children was estimated at 83.1 percent after one month. It was pegged at 55.7 percent one month after two doses of a vaccine among the uninfected. At five months, the former was 69.6 percent and the latter was 58.6 percent.
Natural immunity in the youngest age group after an Omicron infection was estimated at 63.3 percent against hospitalization and death one month later, remaining above 50 percent after 10 months.
Researchers included both the vaccinated and unvaccinated in the naturally immune group and did not provide a separate estimate of the protection the unvaccinated and naturally immune enjoyed.
Researchers did not provide an estimate of effectiveness for a primary series or boosters among the population against hospitalization and death.
The study was published as a preprint on Jan. 19.
Researchers said the study showed that “previous SARS-CoV-2 infection induced strong immunity against future infection, although the immunity waned gradually over time” and that “omicron infection induced strong immunity in both vaccinated and unvaccinated children.” SARS-CoV-2 causes COVID-19.
The researchers also said the results showed vaccination “was effective against omicron infection, hospitalization, and death, although the effectiveness waned over time” and that boosters “were effective.”
“Our study showed that the additional benefits of vaccination were similar between previously infected and previous uninfected children,” Dan-yu Lin, a professor in the University of North Carolina’s Department of Biostatistics, told The Epoch Times via email.
“Serious side effects are very rare. The benefits of vaccination outweighs the risk of side effects,” he added. The study did not evaluate vaccine safety or COVID-19 symptoms and Lin declined to provide evidence for the risk-benefit statement.
Limitations of the research include researchers wrongly believing that the Pfizer primary series for children aged 0 to 4 is only two doses. It’s actually three doses (pdf), because a two-dose regimen didn’t induce an adequate immune response, according to Pfizer. The third dose is a bivalent as of late 2022.
Vaccination to prevent dementia? New research suggests one way viral infections can accelerate neurodegeneration
One in nine Americans ages 65 and over had Alzheimer’s disease in 2022, and countless others were indirectly affected as caregivers, health care providers and taxpayers. There is currently no cure – available treatments primarily focus on prevention by encouraging protective factors, such as exercise and healthy diet, and reducing aggravating factors, such as diabetes and high blood pressure.
One of these aggravating factors is viral infections. Researchers have identified that certain viruses such as herpes simplex virus type 1 (HSV-1, which causes cold sores), varicella zoster virus (VZV, which causes chickenpox and shingles) and SARS-CoV-2 (which causes COVID-19) can lead to a higher risk of Alzheimer’s disease and dementia following infection.
Figuring out how and when these viruses contribute to disease could help scientists develop new therapies to prevent dementia. However, researchers have been unable to consistently detect suspect viruses in brains of people who died of Alzheimer’s. Because the Alzheimer’s disease process can start decades before symptoms, some researchers have proposed that viruses act early in a “hit-and-run” manner; they trigger a cascade of events that lead to dementia but have already taken off. In other words, by the time researchers analyze patient brains, any detectable viral components are gone and causation is difficult to establish.
We are a neurovirologist, neurologist and neuroscientist team interested in the role viruses play in neurodegenerative diseases. In our recently published research, we use new technology to search for the tire tracks of these viruses in Alzheimer’s patients. By focusing on the most vulnerable entry point to the brain, the nose, we discovered a genetic network that provides evidence of a robust viral response.
Focusing on the olfactory system
Many of the viruses implicated in dementia, including herpesviruses and the virus that causes COVID-19, enter the nose and interact with the olfactory system.
The olfactory system is constantly bombarded with odors, pollutants and pathogens. Particles inhaled through the nostrils bind to specific olfactory receptor cells in the tissue lining the nasal cavity. These receptors send messages to other cells in what’s called the olfactory bulb, which acts like a relay station that transmits these messages down the long nerves of the olfactory tract. These messages are then transferred to the area of the brain responsible for learning and memory, the hippocampus.
The hippocampus plays a critical role assigning contextual information to odors, such as danger from the foul smell of propane or comfort from the smell of lavender. This area of the brain is also dramatically damaged in Alzheimer’s disease, causing devastating learning and memory deficits. For as many as 85% to 90% of Alzheimer’s patients, loss of smell is an early sign of disease.
The mechanism leading to smell loss in Alzheimer’s disease is relatively unknown. Like muscles that atrophy from lack of use, sensory deprivation is thought to lead to atrophy of the brain regions that specialize in interpreting sensory information. Strong sensory input to these regions is critical to maintain general brain health.
Olfactory inflammation and Alzheimer’s disease
We hypothesize that viral infections throughout life are both contributors to and potential drug targets in Alzheimers’s disease. To test this idea, we used emerging, state-of-the-art technology to investigate the mRNA and protein networks of the olfactory system of Alzheimer’s disease patients.
The body uses mRNA, which is transcribed from DNA, to translate genetic material into proteins. The body uses specific mRNA sequences to produce a network of proteins that are used to fight against certain viruses. In some cases, the body continues to activate these pathways even after the the virus is cleared, leading to chronic inflammation and tissue damage. Identifying which mRNA sequences and protein networks are present can allow us to infer, to a degree, whether the body is or was responding to a viral pathogen at some point.
Previously, sequencing mRNA in tissue samples was difficult because the molecules degrade very quickly. However, new technology specifically addresses that issue by measuring small subsections of mRNA at a time instead of trying to reconstruct the whole mRNA sequence at once.
We leveraged this technology to sequence the mRNA of olfactory bulb and olfactory tract samples from six people with familial Alzheimer’s, an inherited form of the disease, and six people without Alzheimer’s. We focused on familial Alzheimer’s because there is less variability in disease than in the sporadic, or nonfamilial, form of the disease, which can result from a number of different individual and environmental factors.
In the familial Alzheimer’s samples, we found altered gene expression indicating signs of a past viral infection in the olfactory bulb, as well as inflammatory immune responses in the olfactory tract. We also found higher levels of proteins involved in demyelination in the olfactory tract of familial Alzheimer’s samples than in the controls. Myelin is a protective fatty layer around nerves that allows electrical impulses to move quickly and smoothly from one area of the brain to another. Damage to myelin stalls signal transduction, resulting in impaired neural communication and, by extension, neurodegeneration.
Based on these findings, we hypothesize that viral infections, and the resulting inflammation and demyelination within the olfactory system, may disrupt the function of the hippocampus by impairing communication from the olfactory bulb. This scenario could contribute to the accelerated neurodegeneration seen in Alzheimer’s disease.
Implications for patient health
Epidemiological data supports the role of viral infections in the development of Alzheimer’s disease. For example, the varicella zoster virus is linked to a nearly threefold risk of developing dementia within five years of infection for patients with a shingles rash on their face. A recent report also found a nearly 70% increased risk of getting diagnosed with Alzheimer’s within a year of a COVID-19 diagnosis for people over 65.
These studies suggest that vaccination may be a potential measure to prevent dementia. For example, vaccination against the seasonal flu virus and herpes zoster is associated with an up to 29% and 30% reduced risk of developing dementia, respectively.
Further research investigating how viral infections can trigger neurodegeneration could aid in the development of antiviral drugs and vaccines against the viruses implicated in Alzheimer’s disease.
Report written by Andrew Bubak, Assistant Research Professor of Neurology; Diego Restrepo, Professor of Cell and Developmental Biology; and Maria Nagel, Professor of Neurology and Ophthalmology, all from the University of Colorado Anschutz Medical Campus. This article is republished from The Conversation under a Creative Commons license. Read the original article.
250,000 kindergartners are vulnerable due to drop in vaccination rate
Nearly a quarter of a million kindergartners are vulnerable to measles due to a dip in vaccination coverage during the pandemic, according to the Centers for Disease Control and Prevention.
The CDC, in a report published Thursday, found that 93% of kindergartners were up to date with state-required vaccines during the 2021-22 school year, a decline of 2% from 2019-20.
“While this might not sound significant, it means nearly 250,000 kindergartners are potentially not protected against measles,” Dr. Georgina Peacock, head of the CDC’s immunization services division, said during a call with reporters Thursday.
“And we know that measles, mumps and rubella vaccination coverage for kindergartners is the lowest it has been in over a decade,” Peacock said.
Kindergartners are required to be vaccinated against measles, mumps and rubella; chickenpox; polio; and diphtheria, tetanus and pertussis. The vaccination rate for measles, mumps and rubella was 93.5% during the 2021-22 school year, below the target coverage of 95% to prevent outbreaks.
An ongoing measles outbreak in Columbus, Ohio, has spread to 83 children, 33 of whom were hospitalized. None of the children have died. The overwhelming majority of the kids, 78, were not vaccinated.
“These outbreaks harm children and cause significant disruptions in their opportunities to learn and grow and thrive,” said Dr. Sean O’Leary, who heads the American Academy of Pediatrics committee on infectious disease. “This is alarming and it should be a call to action for all of us.”
The CDC report looked at whether the kindergartners had received the second dose of their measles, mumps and rubella vaccine. Two doses are 97% effective at preventing disease and one dose is about 93% effective, according to the CDC.
Measles is a highly contagious virus that spreads when someone coughs or sneezes and contaminates the air, where the virus can linger for up to two hours. It can also spread when a person touches a contaminated surface and then touches their eyes, nose or mouth.
The virus is so contagious that a single person can spread the virus to 90% of people close to them who do not have immunity through vaccination or a previous infection, according to the CDC.
Measles can be dangerous for children younger than 5, adults older than 20, pregnant women, and people with compromised immune systems.
About 1 in 5 unvaccinated people who catch it are hospitalized. About 1 in 20 kids get pneumonia, and one in 1,000 have brain swelling that can cause disabilities. Symptoms begin with a high fever, cough, runny nose and red eyes. White spots appear in the mouth two to three days later, and a rash breaks out on the body.
CDC officials said disruptions to schools and the health-care system during the Covid pandemic are largely responsible for the decline in vaccination rates.
“We know that the pandemic really had a disruption to health-care systems,” Peacock said. “Part of it is that well-child visits maybe were missed and people are still trying to catch up on those well-child visits.”
“We know that the schools had a lot of things to focus on and in some cases maybe they were not able to gather all that documentation on the vaccinations,” Peacock said. “Or because children were at home for a lot of the pandemic, that may have not been the emphasis while they were focused on testing and doing all those other things related to the pandemic.”
In a separate report published Thursday, the CDC found that coverage for what’s known as the combined seven-vaccine series actually increased slightly among children born in 2018-19 by the time they turned two, compared with kids born in 2016-17.
This seven-vaccine series includes shots against measles, chickenpox, polio, hepatitis B, streptococcus pneumoniae, haemophilus influenzae or Hib, and diphtheria, tetanus and pertussis.
However, the CDC found that there were major income and racial disparities. Vaccination coverage declined by up to 5% during the pandemic for those living below the poverty level or in rural areas. Black and Hispanic children had lower vaccination rates than white children.
O’Leary said that while misinformation about vaccines is a problem, the vast majority of parents are still getting their kids vaccinated. He said inequality is the bigger issue.
“The things we really need to focus on are addressing access and child poverty,” O’Leary said.
New Research Links COVID-19 Infection – and Vaccination – to a Debilitating Heart Condition
Postural Orthostatic Tachycardia Syndrome (POTS) is a disorder that affects the autonomic nervous system and is characterized by an abnormal increase in heart rate upon standing up. This can cause symptoms such as lightheadedness, fainting, fatigue, and headaches.
Smidt Heart Institute researchers show the risk of developing postural orthostatic tachycardia syndrome, or POTS, is five times higher after
The study suggests that a small proportion of individuals who have been vaccinated against COVID-19 may develop POTS, which is a debilitating heart condition characterized by an abnormal increase in heart rate upon standing. Furthermore, their findings indicate that people diagnosed with COVID-19 are five times more likely to develop POTS after contracting the virus than after vaccination, emphasizing the importance of receiving the vaccine.
“The main message here is that while we see a potential link between COVID-19 vaccination and POTS, preventing COVID-19 through vaccination is still the best way to reduce your risk of developing POTS,” said Alan C. Kwan, MD, first and corresponding author of the study and a cardiovascular specialist at Cedars-Sinai.
Postural orthostatic tachycardia syndrome is a nervous system-related condition that most commonly affects young women of childbearing age. The most identifiable POTS symptom is a rapid increase in the heartbeat of more than 30 beats per minute or a heart rate that exceeds 120 beats per minute, within 10 minutes of standing.
Other symptoms include fainting, dizziness, and fatigue, although some patients with severe disease may also experience migraine, increased urination, sweaty extremities, anxiety, and tremor.
To validate their findings, the study authors used data from 284,592 vaccinated patients treated within the broader Cedars-Sinai Health System between the years 2020 and 2022, as well as 12,460 Cedars-Sinai patients with COVID-19.
“From this analysis, we found that the odds of developing POTS are higher 90 days after vaccine exposure than the 90 days prior to exposure,” said Kwan. “We also found that the relative odds of POTS were higher than would be explained by increases in visits to physicians after vaccination or infection.”
Kwan emphasizes that despite this finding, the rates of POTS after vaccination were much lower than rates of new POTS diagnosis after COVID-19.
“This knowledge identifies a possible—yet still relatively slim—association between COVID-19 vaccination and POTS,” said Kwan.
Many patients—especially those who developed POTS prior to the COVID-19 pandemic—spent years trying to get properly diagnosed. This is because many healthcare providers are unfamiliar with the disease and its symptoms, which often can be incorrectly attributed to chronic fatigue syndrome or other conditions. However, COVID-19 has expanded the medical field’s understanding of POTS.
“In an unexpected but important way, the COVID-19 pandemic brought a great deal of awareness to POTS—both to patients and providers,” said Peng-Sheng Chen, MD, an expert on the condition who leads one of only a few POTS specialty clinics in the nation. “Given a broader understanding of the disease, many patients can be diagnosed more quickly permitting earlier interventions that can greatly improve their symptoms.”
Many effective interventions involve lifestyle modifications, Chen says, including avoiding triggers such as prolonged standing, extreme heat, extreme cold, and alcoholic beverages. Additional recommended measures may include eating a high-sodium diet and wearing abdominal or lower-body compression garments. Certain medical therapies can also be considered.
Patients treated for POTS at the Smidt Heart Institute often are encouraged to join the cardiac rehabilitation program, which aims to strengthen the body and heart.
While the Nature Cardiovascular Research study sheds important light on vaccinations and POTS, researchers say it has its limitations. The hope, however, is this new knowledge will help improve conversations around COVID-19 and vaccines.
“We recognize as clinicians that side effects from vaccines can vary in type and severity, even if still uncommon overall. We hope that clearer data and improved understanding will eventually enhance medical trust and quality of care as well as communications around vaccines,” said Kwan. “Ultimately, our goal is to optimize vaccine uptake.”
Reference: “Apparent risks of postural orthostatic tachycardia syndrome diagnoses after COVID-19 vaccination and SARS-Cov-2 Infection” by Alan C. Kwan, Joseph E. Ebinger, Janet Wei, Catherine N. Le, Jillian R. Oft, Rachel Zabner, Debbie Teodorescu, Patrick G. Botting, Jesse Navarrette, David Ouyang, Matthew Driver, Brian Claggett, Brittany N. Weber, Peng-Sheng Chen and Susan Cheng, 12 December 2022, Nature Cardiovascular Research.
DOI: 10.1038/s44161-022-00177-8
World vaccination rates have reached their lowest point in years. Could COVID be to blame?
Skepticism surrounding COVID vaccines remains abundant as uproar to overturn still-lingering mandates subsist across the U.S., but experts are pointing to a trend that is manifesting across multiple vaccine types worldwide.
A November study from the U.S. Centers for Disease Control and Prevention found a decline in the number of infants receiving measles vaccines, which is tied to the onset of the COVID-19 pandemic.
The study found a steady decline in the percentage of young children receiving measles immunizations, with 2021 numbers reaching their lowest point since 2008.
“One of the impacts of the COVID pandemic has resulted in a backsliding of the performance, the ability of immunization programs to reach the people who need to be vaccinated and the result of that is that we now have about 23 million children around the world who have not received the vaccines that they should have received and, of those 23 million children, about 17 million of them have never even gotten a single dose of vaccine through the routine immunization program,” Kate O’Brien, leader of the World Health Organization’s immunization program, said during an April Q&A for World Immunization Week.
CORONAVIRUS VACCINE SKEPTICISM AND HOW TO FIGHT IT, ACCORDING TO EXPERTS
A health professional administers a dose of a vaccine.
(iStock)
“We’re in a bit of a hole right now where there’s been the loss of about a decade’s worth of progress in immunization programs around the world,” she added.
The problem surfaced in Zimbabwe earlier this year, where the country battled a devastating measles outbreak that the Ministry of Health said claimed over 700 lives.
In South Africa, National Institute of Communicable Diseases (NICD) raised concerns over 57 outbreaks in two provinces in a report last month.
In Europe, the war between Russia and Ukraine and low vaccination rates are believed to be behind a stark tripling of measles cases among Ukrainian citizens, according to data from the World Health Organization, and CDC data shows a small number of outbreaks in the U.S., including one which took Columbus, Ohio, by storm this year.
CDC: RECORD MEASLES OUTBREAK FUELED BY ANTI-VACCINATION PROPAGANDA
A patient inflicted with measles.
(iStock)
Data from UNICEF, in partnership with the World Health Organization, found declines in vaccine percentages for other ailments as well, including diphtheria-tetanus-pertussis (DTP3), a “marker for immunization coverage within and across countries” which fell by 5 percentage points to 81 percent between 2019 and 2021 and reached its lowest level since 2008.
“Global vaccination continues to decline in 2021 with 25 million children missing out on lifesaving vaccines, 2 million more than in 2020, and 6 million more than in 2019,” the agency wrote in July.
“The latest WHO/UNICEF estimates of national immunization coverage (WUENIC) also show that 112 countries experienced stagnant or declining DTP3 coverage since 2019 with 62 of those countries declining by at least 5 percentage points. As a result, 25 million children were un- or under-vaccinated in 2021…” the article continued.
The CDC brought declines in other global immunization coverage estimates into focus last month.
MORE THAN TWO-THIRDS OF AFRICAN NATIONS FALL SHORT OF 10% COVID VACCINATION GOAL: WHO
This photograph taken on March 5, 2021 shows a sign of the World Health Organization (WHO) at the entrance of their headquarters in Geneva amid the Covid-19 coronavirus outbreak.
(FABRICE COFFRINI/AFP via Getty Images)
“Global coverage estimates were also lower in 2021 than in 2020 and 2019 for bacillus Calmette-Guérin vaccine (BCG) as well as for the completed series of Haemophilus influenzae type b vaccine (Hib), hepatitis B vaccine (HepB), polio vaccine (Pol), and rubella-containing vaccine (RCV).”
But problems with vaccine administration are worsening, even as the pandemic appears in the rearview mirror most Americans, leaving health experts to find a culprit behind the dilemma.
Many are pointing to supply chain issues brought on by the COVID-19 pandemic, particularly shortages in disadvantaged nations or communities worldwide.
In the realm of COVID-19 vaccines, UNICEF, echoing sentiments from the CDC, laid out the possible culprits for lackluster administration in some areas, including COVID-related “service and supply chain disruptions, resource diversion to response efforts, and containment measures that limited immunization service access and availability.”
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Income emerged as another culprit, with high-income nations receiving more doses than those in lower-income nations.
“Only 16 percent of people in low-income countries have received a single vaccine dose – compared to 80 percent in high-income countries,” the report said.
The agency also indicated other issues, including living in “fragile settings” and vaccine “misinformation” as possible factors.
Other ailments wreaked havoc on children in the U.S. this year, including an epidemic of influenza and RSV.
Fox News medical contributor Dr. Marc Siegel highlighted the topic of “vaccine fatigue” on “Fox & Friends” last month, pointing to an additional decrease in the number of Americans getting the flu vaccine this year.
“The flu vaccine has been around in some shape or form since the 1950s,” he said, addressing criticism that COVID vaccines are new. “There’s been 23,000 hospitalizations, according to CDC Director Walensky… so flu is zooming up to COVID levels and, again, the flu shot can help keep you out of the hospital.”