COVID-19 Update: Contradictory J&J Data and a 4th Shot Likely for 50 Plus
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In many ways, the currently authorized or approved COVID-19 vaccines are the most-studied vaccines in history, with billions of people receiving them globally in a very short period and thousands of research studies being conducted on their effectiveness and potential side effects. This is partly why some of the data can seem so contradictory. For those and more COVID-19 stories, continue reading.
Inconsistent Data on J&J COVID-19 Vaccine Effectiveness
Since its emergency use authorization, the Johnson & Johnson COVID-19 vaccine has generally been viewed as lagging behind the Pfizer-BioNTech and Moderna vaccines in terms of efficacy. Overall, all three are very good vaccines, but the one-shot J&J vaccine’s effectiveness against the original Wuhan strain was lower than the two mRNA vaccines. However, J&J and other studies have suggested that the J&J vaccine provides more “durable” protection than the competitors, such as a recent study from J&J estimating effectiveness against hospitalization was 81% against the Delta variant. Another study suggested the Pfizer-BioNTech and Moderna vaccine efficacy was waning, but the J&J was not. However, the Centers for Disease Control and Prevention research suggests that COVID-19 deaths among people who received the J&J vaccine may have been double that of other vaccinated people in the U.S. during the Omicron wave. The death rate among people receiving Pfizer-BioNTech or Moderna vaccines was about 2 deaths per 100,000 people; for J&J it was more than 5 out of every 100,000. For comparison, it was almost 20 deaths per 100,000 people for the unvaccinated.
4th Shot Likely to Be Available for People 50 and Older
The U.S. Food and Drug Administration is expected to authorize a fourth COVID-19 booster shot as early as this week. They will likely be made available to people in the U.S. over the age of 50, but not formally recommended, according to two agency insiders who spoke off the record with ABC News. The expectation is that after the FDA grants authorization, the CDC will make them available to people over 50, who can make the decision on their own based on their own risk profiles rather than make an actual recommendation.
Two Studies: No Connection Between COVID-19 Vaccines and Adverse Pregnancy Outcomes
A study out of Sweden and Norway and a separate study in Ontario, Canada, found no association between COVID-19 vaccination during pregnancy and adverse outcomes. The first, from the Norwegian Institute of Public Health in Oslo and the Karolinska Institute in Stockholm, evaluated 157,521 singleton pregnancies ending after 22 weeks gestation in vaccination and unvaccinated pregnant women.
In the unvaccinated women, 8.5% were infected with COVID-19 while pregnant, compared to 3.4% of those vaccinated during pregnancy. Vaccination was not associated with an increased risk of preterm birth, stillbirth, small size, low Apgar scores or NICU admission. The second study was led by the University of Ottawa and evaluated the risk of postpartum hemorrhage, chorioamnionitis, C-section, NICU admission or low 5-minute Apgar score in 97,590 pregnant women. There were no significantly increased risks of any of the issues measured compared to unvaccinated women in the vaccinated group.
COVID-19 Appears to Damage the Heart
Evidence is accumulating that COVID-19 may damage the heart more than previously thought, in addition to longer-term respiratory and lung damage. And for patients with a previous heart condition, the threat is even higher. A September 2020 study found the risk of a first heart attack increased by three to eight times in the first week after a COVID-19 infection. More research published in February in Nature Medicine suggested veterans had an elevated risk of several heart conditions for as long as a year after COVID-19 infection. There appear to be at least two mechanisms involved: the same receptors the SARS-CoV-2 virus uses to attach to lung cells are in heart muscle, so the virus can directly attack the heart; and the body’s immune response that increases inflammation can injure heart tissue. In addition, COVID-19 also increases the risk of blood clots that can cause heart attacks.
Will the COVID-19 Vaccine be Authorized for Kids Under 5 Before an Omicron BA.2 Surge?
While the FDA evaluates Moderna’s request for an emergency use authorization for its COVID-19 vaccine for children under the age of 5, there are concerns the so-called “stealth” variant, Omicron BA.2, will surge before they can get shots. BA.2, a subvariant of Omicron BA.1, appears to be about 30% more infectious than BA.1. It has surged in other parts of the world, such as Denmark, where it quickly receded, and in the U.K. It is rapidly becoming the dominant strain in infections in the U.S., although there does not appear to be a parallel increase in hospitalizations and deaths. Moderna currently expects its authorization by early summer, and Pfizer-BioNTech has yet to request a EUA but expects its extended clinical trial to finish by early April.
Dr. David Wohl, a professor of medicine at the University of North Carolina’s division of infectious diseases suggests it’s going to be a tight race. “Vaccinating children is really key. All the ingredients are there to see an uptick starting in very young people, and so that’s what we have to pay attention to.”
As Federal Funds for COVID-19 Dries Up, Health Care Experts Worry
Congress is currently dropping funding for many COVID-19-related programs, including testing and treatment for the uninsured. Health care experts and leaders believe this will result in uninsured patients ignoring testing and treatment, which will only make matters worse.
“From a public health and a community health perspective, anything that puts a damper on testing and treatment is really a bad idea because the consequences are increased (infection) rates and higher degree of transmission,” said BJC HealthCare’s Dr. Clay Dunagan, speaking for the St. Louis Metropolitan Pandemic Task Force. “The health systems, as always, will do what’s clinically appropriate for the patient sitting in front of us. It will become just another unfunded mandate on the health system for taking care of uninsured patients.”
In a related story, several COVID-19 test providers say they will begin charging $100 to $195 for PCR tests for COVID-19 for the uninsured. Quest Diagnostics, for example, indicated it will charge $125 per PCR test if the patient is not on Medicare, Medicaid or private insurance. Other clinics run by Northwell GoHealth Urgent Care will charge $120 to $195. Walgreens and CVS haven’t made a decision yet but are hoping that Congress will find the funding.