Coronavirus updates April 2022

[Lookinagain]

A family member that is double vaxxed and had symptoms tested negative multiple times and then his GF tested pozitive (LFT test). Obviously he had it.
Not saying everyone testing negative (with cold symptoms) has it, but I think it is possible.

I think those tests are less accurate and can give false negatives. My company requires PCR tests for anyone with symptoms. And the at home tests often depend on the test taker following directions. I hope you and your family are okay.

 

[Gloria27]

I think those tests are less accurate and can give false negatives. My company requires PCR tests for anyone with symptoms. And the at home tests often depend on the test taker following directions. I hope you and your family are okay.

Thanks!

I am on the third day of symtoms and feel better than my hubby who's been sick since Sunday. It hit him harder (flu usually hits him harder too ). I did get a bit worried for him at first to be honest.
It helped to have a smart watch to check our heart rates and oxygen levels all the time.

You are right about the tests, but it's curious, we never got false pozitives with them.

 

[missy]

@Gloria27 I'm sorry you came down with Covid and glad you are on the mend. Healing vibes to you and your husband.

 

[missy]

"​

​

Fourth Pfizer Dose Averts Most Severe COVID Outcomes in Older Adults​

— But expert questions what the ultimate goal of boosters should be​

by Molly Walker, Deputy Managing Editor, MedPage Today April 13, 2022

A fourth dose of the Pfizer COVID-19 vaccine provided modest protection against infection in older adults, as well as greater protection against more severe outcomes, real-world data from Israel showed.
In a cohort of 182,122 matched pairs of adults ages 60 and up, relative vaccine effectiveness ranged from 52% against asymptomatic infection to 76% against COVID-related death 14 to 30 days after the fourth dose, reported Noa Dagan, MD, of Clalit Health Services in Tel Aviv, and colleagues in the New England Journal of Medicine.

This study filled in some gaps about the effectiveness of a fourth dose that were not covered by other recent real-world studies from Israel, mainly regarding protection against more severe outcomes, such as COVID-related death.
Dagan's group examined data from January 3 to February 18 on adults ages 60 and up who were eligible to receive a fourth dose of Pfizer vaccine and had no prior PCR-confirmed SARS-CoV-2 infection using the largest healthcare database in Israel. Healthcare workers, long-term care facility residents, and people who "interacted with the health system" during the previous 3 days were excluded.
Those who received a fourth dose (cases) were matched with those yet to receive a fourth dose (controls). Among both groups, median age was 72 years, 53% were women, and 37% had three or more CDC-defined risk factors for severe COVID.
Not surprisingly, protection against all clinical outcomes increased as days after vaccination increased, with the highest protection at days 14 to 30 after the fourth dose:

• Asymptomatic infection: 52% (95% CI 49-54)
• Symptomatic COVID: 61% (95% CI 58-64)
• COVID-related hospitalization: 72% (95% CI 63-79)
• Severe COVID: 64% (95% CI 48-77)
• COVID-related death: 76% (95% CI 48-91)

An accompanying editorial from Paul Offit, MD, of the Children's Hospital of Philadelphia, noted that the findings of this study "were considered by the FDA and CDC in their decision-making process" for a second booster of mRNA vaccine for adults ages 50 and up.
Offit is also a member of the FDA's Vaccines and Related Biological Products Advisory Committee (VRBPAC), which recently met to discuss considerationsaround subsequent booster doses for a larger swath of the U.S. population. In his editorial, Offit made his views clear about the confusion surrounding boosters.
One mistake that he pointed out was labeling mild illnesses or asymptomatic infections as "breakthrough" infections.
"The term 'breakthrough,' which implies failure, created unrealistic expectations and led to the adoption of a zero-tolerance strategy for this virus," Offit wrote. "If we are to move from pandemic to endemic, at some point we are going to have to accept that vaccination or natural infection or a combination of the two will not offer long-term protection against mild illness."

Boosters are "not risk-free," as "all age groups are at risk for the theoretical problem of an 'original antigenic sin' -- a decreased ability to respond to a new immunogen because the immune system has locked onto the original immunogen," he added.
Dagan's group acknowledged that they were unable to assess the longer-term effects of boosters, as well as the potential for unmeasured confounders, and "interpretation of the results should be made with respect to the population analyzed."
It is important that the CDC educate the public "about the limits of mucosal vaccines," Offit emphasized. "Otherwise, a zero-tolerance strategy for mild or asymptomatic infection, which can be implemented only with frequent booster doses, will continue to mislead the public about what COVID-19 vaccines can and cannot do."


"

 

[missy]

"

Pfizer Seeks Kid Booster EUA; Travel Mask Mandate Extended; BA.2 Subvariants in N.Y.​

— A daily roundup of news on COVID-19 and the rest of medicine​

by Mike Bassett, Staff Writer, MedPage Today April 14, 2022

Pfizer/BioNTech announced that a booster dose of its COVID-19 vaccine in children ages 5 to 11 increased neutralizing antibody levels against Omicron; the companies plan to seek an FDA emergency use authorization (EUA) in the coming days.
An uptick in cases prompted the CDC to extend the federal travel mask mandate by another 15 days -- it now expires May 3 barring any other extensions.

At the same time, HHS extended the COVID-19 public health emergency by at least another 3 months.
Speaking of which, most states don't plan to use texting to warn Medicaid enrollees that their coverage is at risk of expiring when the emergency declaration ends. (KHN)
As of Thursday at 8:00 a.m. EDT, the unofficial COVID toll in the U.S. reached 80,551,977 infections and 988,759 deaths, increases of 58,891, and 1,057, respectively, since this time a day ago.
New York health officials warned that two new Omicron BA.2 subvariants -- BA.2.12 and BA.2.12.1 -- are spreading rapidly across the state.
The CDC plans to drastically reduce the number of nations on its travel avoidance list over COVID-19 activity. (Reuters)
U.K. regulators have authorized Moderna's COVID vaccine for kids ages 6 to 11 years.
They also authorized the Valneva COVID-19 vaccine for use, though the government recently canceled its order for 100 million doses of the inactivated whole-virus vaccine. (BBC)

Also in the U.K., scientists are investigating a puzzling spike in liver disease in children. (AP)
Prices are soaring, but healthcare inflation is hovering around its historical trend of 2%. (CNN)
A Chicago hospital CEO is out of a job amid reports he authorized improper COVID-19 vaccinations. (Becker's Hospital Review)
In an effort to boost clinical trial diversity, the FDA issued new guidance that calls on companies to submit plans on how they will boost enrollment among underrepresented groups early on in clinical development.
As of today, the FDA now has the authority to regulate synthetic nicotine, opening the door to a potential complete ban on flavored nicotine products. (Daily Mail)
At a town hall with voters, Sen. Chuck Grassley (R-Iowa) suggested that Republicans won't try to repeal the Affordable Care Act if they retake the Senate. (Washington Post)
Kentucky lawmakers overrode Gov. Andy Beshear's (D) veto of a bill that bans abortions after 15 weeks of pregnancy, and includes no exceptions for incest or rape. (Axios)

"

 

[Gloria27]

@Gloria27 I'm sorry you came down with Covid and glad you are on the mend. Healing vibes to you and your husband.

Thanks, Missy.
I'm not sure I'm on the mend yet (but I hope), this thing comes and goes in waves.

I thought that after all that debate about vaccines, would be nice to share my experience. I knew I would get it eventully but I feel lucky this is not like the previous variants.

 

[missy]

Thanks, Missy.
I'm not sure I'm on the mend yet (but I hope), this thing comes and goes in waves.

I thought that after all that debate about vaccines, would be nice to share my experience. I knew I would get it eventully but I feel lucky this is not like the previous variants.

That's true. You are fortunate and your husband too. Hopefully as time goes on the variants will cause less severe symptoms. It is still scary though. Stay home, take care of yourself and your husband and hopefully soon you and your DH will be fully recovered.

 

[Gloria27]

That's true. You are fortunate and your husband too. Hopefully as time goes on the variants will cause less severe symptoms. It is still scary though. Stay home, take care of yourself and your husband and hopefully soon you and your DH will be fully recovered.

Fingers crossed!
I hope it will give us long lasting immunity (without long haul issues), cause it would suck to get it again.
Yeah, we are self isolating and just ordered all the food online.

 

[missy]

Fingers crossed!
I hope it will give us long lasting immunity (without long haul issues), cause it would suck to get it again.
Yeah, we are self isolating and just ordered all the food online.

Fingers crossed. Here's an interesting article FYI

More Evidence Hybrid Immunity Confers Highest Level of COVID Protection

Brazil, Sweden find fewest reinfections, severe disease cases among those infected and vaccinated

www.medpagetoday.com

"
Hybrid immunity from a COVID-19 infection plus a vaccine provided an immune boost against symptomatic disease, as well as severe outcomes, Brazilian researchers found.

Among people who survived a COVID infection from Feb. 24, 2020 to Nov. 11, 2021, vaccine effectiveness against symptomatic disease at least 14 days after series completion was 44.0% (95% CI 31.5-54.2) for Johnson & Johnson's vaccine and 64.8% (95% CI 54.9-72.4) after two doses of Pfizer's vaccine, reported Julio Croda, MD, PhD, of Universidade Federal de Mato Grosso do Sul in Brazil, and colleagues.



Moreover, vaccine effectiveness against COVID-related hospitalization or death was 57.7% (95% CI -2.6 to 82.5) for Johnson & Johnson's vaccine, and 89.7% (95% CI 54.3-97.7) for Pfizer's, the authors wrote in Lancet Infectious Diseases.

While four COVID vaccines in total were evaluated (including AstraZeneca's vaccine and CoronaVac), only Johnson & Johnson's and Pfizer's are authorized for use in the U.S.

"There has been ongoing public debate about whether previously infected individuals need to be vaccinated," said Croda in a statement. "Our results suggest that vaccine benefits far outweigh any potential risk and support the case for vaccination, including the full vaccine series, among individuals with prior SARS-CoV-2 infection."

However, the authors noted that this analysis was done prior to the emergence of the Omicron variant.

Using national data, Croda and team identified 30,910 people (5.4% of the total 213,457 individuals who tested positive for COVID at least 90 days after the start of the vaccination program) who had a subsequent positive test "consistent with reinfection"; 22,566 were matched with 68,426 controls who tested negative.



Median age of the matched population was 36, and about 60% were women. Median time between first infection and a subsequent positive test was 216 to 223 days. About 65% of cases and 57% of controls were unvaccinated. Overall, 39,717 people were vaccinated -- about 80% were vaccinated with either AstraZeneca's vaccine or CoronaVac, 15% were vaccinated with Pfizer's vaccine, and 2% with Johnson & Johnson's.

Of the four examined vaccines, only Pfizer's vaccine showed a significant increase in effectiveness against symptomatic disease when given 180 days after the first infection versus 91 to 180 days (70.7% vs 35.3%, P=0.011).

An accompanying editorial by Pramod Kumar Garg, MBBS, MD, and Ramachandran Thiruvengadam, MD, of the Translational Health Science and Technology Institute in Faridabad, India, noted that the vaccine effectiveness estimates in this study are "generally lower than those in naive populations reported earlier," but added that these "estimates were for additional protection provided by vaccination over and above that offered by immunity resulting from natural infection."



This study "challenges the concept of population-level herd immunity through natural infection alone" and suggests that "vaccinating individuals who were previously infected provides further protection, particularly against severe disease," they noted.

"Understanding the duration and effectiveness of immunity for those vaccinated with a previous COVID-19 diagnosis becomes increasingly important as ... surges in new cases ... occur as a result of more transmissible variants," Croda said in a statement. "Further research on the need for vaccination for those with a previous COVID-19 infection is a vital step to pandemic policy intervention."

Even Sweden Finds Hybrid Immunity Is Best

A second study in Lancet Infectious Diseases found the lowest number of reinfections and hospitalizations among those with hybrid immunity.

Two-dose vaccination plus prior immunity resulted in a 66% lower risk of COVID reinfection versus infection alone (adjusted HR 0.34, 95% CI 0.31-0.39, P<0.001), with a non-significant trend towards attenuation after 9 months (P=0.07), reported Peter Nordström, MD, PhD, of Umeå University in Sweden, and colleagues.



In addition, two-dose hybrid immunity was linked with a significantly lower risk of COVID hospitalization compared with infection alone (aHR 0.10, 95% CI 0.04-0.22, P<0.001).

One dose of vaccine had similar results, albeit on a smaller scale. Hybrid immunity with one-dose vaccination resulted in a 58% lower risk of reinfection (aHR 0.42, 95% CI 0.38-0.47, P<0.001), with significant attenuation after 9 months. One-dose hybrid immunity also resulted in a lower risk of hospitalization (aHR 0.06, 95% CI 0.03-0.12, P<0.001).

Nordström and team examined data from Swedish nationwide registries, looking at infections from March 20, 2020 to Oct. 4, 2021, and hospitalizations with COVID from March 30, 2020 to Sept. 5, 2021. Cohort 1 included 2,039,106 unvaccinated individuals with prior infection who were matched with unvaccinated individuals without prior infection. Cohort 2 included 2,962,318 individuals with prior infection and one vaccine dose and cohort 3 included 567,810 individuals with prior infection and two vaccine doses, both matched to individuals with "natural immunity." Median age in all cohorts was 38 to 40.



Compared with unvaccinated individuals without infection, prior infection was associated with a 95% lower risk of reinfection at 3 months and a 87% lower risk of COVID hospitalization for up to 20 months of follow-up, the authors said.

During a mean follow-up of 66 days, 438 people with two-dose hybrid immunity were reinfected with COVID versus 808 with natural immunity. After a median follow-up of 52 days, there were 639 reinfections among those with one-dose hybrid immunity versus 1,662 reinfections in those with natural immunity.

Due to Omicron plus varying recommendations for boosters, hybrid immunity may result from "vaccination followed by infection," rather than vice-versa, noted Hyon-Xhi Tan, PhD, and Jennifer A. Juno, PhD, of the University of Melbourne in Australia, in an accompanying editorial.

However, they cited research that indicated that regardless of the order of infection and vaccination, "the quantity, quality, and breadth of the humoral immune response were vastly improved."

"This finding further supports the notion that infection histories should be an important consideration in determining whether individuals are protected against SARS-CoV-2," Tan and Juno wrote.


"

 

[Gloria27]

Fingers crossed. Here's an interesting article FYI

More Evidence Hybrid Immunity Confers Highest Level of COVID Protection

Brazil, Sweden find fewest reinfections, severe disease cases among those infected and vaccinated

www.medpagetoday.com

"
Hybrid immunity from a COVID-19 infection plus a vaccine provided an immune boost against symptomatic disease, as well as severe outcomes, Brazilian researchers found.

Among people who survived a COVID infection from Feb. 24, 2020 to Nov. 11, 2021, vaccine effectiveness against symptomatic disease at least 14 days after series completion was 44.0% (95% CI 31.5-54.2) for Johnson & Johnson's vaccine and 64.8% (95% CI 54.9-72.4) after two doses of Pfizer's vaccine, reported Julio Croda, MD, PhD, of Universidade Federal de Mato Grosso do Sul in Brazil, and colleagues.



Moreover, vaccine effectiveness against COVID-related hospitalization or death was 57.7% (95% CI -2.6 to 82.5) for Johnson & Johnson's vaccine, and 89.7% (95% CI 54.3-97.7) for Pfizer's, the authors wrote in Lancet Infectious Diseases.

While four COVID vaccines in total were evaluated (including AstraZeneca's vaccine and CoronaVac), only Johnson & Johnson's and Pfizer's are authorized for use in the U.S.

"There has been ongoing public debate about whether previously infected individuals need to be vaccinated," said Croda in a statement. "Our results suggest that vaccine benefits far outweigh any potential risk and support the case for vaccination, including the full vaccine series, among individuals with prior SARS-CoV-2 infection."

However, the authors noted that this analysis was done prior to the emergence of the Omicron variant.

Using national data, Croda and team identified 30,910 people (5.4% of the total 213,457 individuals who tested positive for COVID at least 90 days after the start of the vaccination program) who had a subsequent positive test "consistent with reinfection"; 22,566 were matched with 68,426 controls who tested negative.



Median age of the matched population was 36, and about 60% were women. Median time between first infection and a subsequent positive test was 216 to 223 days. About 65% of cases and 57% of controls were unvaccinated. Overall, 39,717 people were vaccinated -- about 80% were vaccinated with either AstraZeneca's vaccine or CoronaVac, 15% were vaccinated with Pfizer's vaccine, and 2% with Johnson & Johnson's.

Of the four examined vaccines, only Pfizer's vaccine showed a significant increase in effectiveness against symptomatic disease when given 180 days after the first infection versus 91 to 180 days (70.7% vs 35.3%, P=0.011).

An accompanying editorial by Pramod Kumar Garg, MBBS, MD, and Ramachandran Thiruvengadam, MD, of the Translational Health Science and Technology Institute in Faridabad, India, noted that the vaccine effectiveness estimates in this study are "generally lower than those in naive populations reported earlier," but added that these "estimates were for additional protection provided by vaccination over and above that offered by immunity resulting from natural infection."



This study "challenges the concept of population-level herd immunity through natural infection alone" and suggests that "vaccinating individuals who were previously infected provides further protection, particularly against severe disease," they noted.

"Understanding the duration and effectiveness of immunity for those vaccinated with a previous COVID-19 diagnosis becomes increasingly important as ... surges in new cases ... occur as a result of more transmissible variants," Croda said in a statement. "Further research on the need for vaccination for those with a previous COVID-19 infection is a vital step to pandemic policy intervention."

Even Sweden Finds Hybrid Immunity Is Best

A second study in Lancet Infectious Diseases found the lowest number of reinfections and hospitalizations among those with hybrid immunity.

Two-dose vaccination plus prior immunity resulted in a 66% lower risk of COVID reinfection versus infection alone (adjusted HR 0.34, 95% CI 0.31-0.39, P<0.001), with a non-significant trend towards attenuation after 9 months (P=0.07), reported Peter Nordström, MD, PhD, of Umeå University in Sweden, and colleagues.



In addition, two-dose hybrid immunity was linked with a significantly lower risk of COVID hospitalization compared with infection alone (aHR 0.10, 95% CI 0.04-0.22, P<0.001).

One dose of vaccine had similar results, albeit on a smaller scale. Hybrid immunity with one-dose vaccination resulted in a 58% lower risk of reinfection (aHR 0.42, 95% CI 0.38-0.47, P<0.001), with significant attenuation after 9 months. One-dose hybrid immunity also resulted in a lower risk of hospitalization (aHR 0.06, 95% CI 0.03-0.12, P<0.001).

Nordström and team examined data from Swedish nationwide registries, looking at infections from March 20, 2020 to Oct. 4, 2021, and hospitalizations with COVID from March 30, 2020 to Sept. 5, 2021. Cohort 1 included 2,039,106 unvaccinated individuals with prior infection who were matched with unvaccinated individuals without prior infection. Cohort 2 included 2,962,318 individuals with prior infection and one vaccine dose and cohort 3 included 567,810 individuals with prior infection and two vaccine doses, both matched to individuals with "natural immunity." Median age in all cohorts was 38 to 40.



Compared with unvaccinated individuals without infection, prior infection was associated with a 95% lower risk of reinfection at 3 months and a 87% lower risk of COVID hospitalization for up to 20 months of follow-up, the authors said.

During a mean follow-up of 66 days, 438 people with two-dose hybrid immunity were reinfected with COVID versus 808 with natural immunity. After a median follow-up of 52 days, there were 639 reinfections among those with one-dose hybrid immunity versus 1,662 reinfections in those with natural immunity.

Due to Omicron plus varying recommendations for boosters, hybrid immunity may result from "vaccination followed by infection," rather than vice-versa, noted Hyon-Xhi Tan, PhD, and Jennifer A. Juno, PhD, of the University of Melbourne in Australia, in an accompanying editorial.

However, they cited research that indicated that regardless of the order of infection and vaccination, "the quantity, quality, and breadth of the humoral immune response were vastly improved."

"This finding further supports the notion that infection histories should be an important consideration in determining whether individuals are protected against SARS-CoV-2," Tan and Juno wrote.


"

I'll show this to hubby, personally I can't take it, I have some health issues and can't risk it.
Another family member got the vaccine after having a nasty variant at the beginning of the pandemic. He considered it was worth it after all the suffering, I told him to do whatever he thinks it's best for his health. He was ok, no side effects but he doesn't have my issues.

 

[Karl_K]

Still feeling blasted, sore arm, chills and hot spells and just overall blah.
Got to wondering if I picked up covid while out getting my shot because I had just a sore arm with all my other shots so did a home test. It was negative!

 

[DRSAMURAI]

Still feeling blasted, sore arm, chills and hot spells and just overall blah.
Got to wondering if I picked up covid while out getting my shot because I had just a sore arm with all my other shots so did a home test. It was negative!

It sounds like a very robust immune response that will serve you well down the road especially with emerging new sub - variants. Hopefully there is cross immunogenicity for all booster recipients.

 

[missy]

Lots of things in the works.
Vaccines, tests, etc.

"

FDA OKs First Breath Test for COVID-19​

— With high sensitivity and specificity, results returned in under 3 minutes​

by Ian Ingram, Managing Editor, MedPage Today April 15, 2022

The FDA granted an emergency use authorization (EUA) to the first COVID-19 test that can detect the virus in breath samples, the agency announced on Thursday.
Dubbed the InspectIR COVID-19 Breathalyzer, the test uses gas chromatography-mass spectrometry to rapidly detect volatile organic compounds associated with SARS-CoV-2. Patients breathe into a disposable straw on the device -- which is about the size of a piece of carry-on luggage, according to the agency -- and results are returned in less than 3 minutes. The test is intended for healthcare settings where samples can be collected and analyzed, such as mobile testing sites, doctor's offices, and hospitals.

"Today's authorization is yet another example of the rapid innovation occurring with diagnostic tests for COVID-19," said Jeff Shuren, MD, JD, director of the FDA's Center for Devices and Radiological Health, in a statement. "The FDA continues to support the development of novel COVID-19 tests with the goal of advancing technologies that can help address the current pandemic and better position the U.S. for the next public health emergency."
In its news release, the FDA noted that positive test results with the breathalyzer should be considered presumptive and confirmed with a molecular test.
"Negative results should be considered in the context of a patient's recent exposures, history and the presence of clinical signs and symptoms consistent with COVID-19, as they do not rule out SARS-CoV-2 infection and should not be used as the sole basis for treatment or patient management decisions, including infection control decisions," the agency said.

Primary support for the EUA came from a study of 2,409 individuals with and without symptoms, conducted in four U.S. states. The breathalyzer test was found to have a sensitivity of 91.2% (90% CI 85.4-94. and specificity of 99.3% (95% CI 98.8-99.5) when compared with a PCR test. This yielded a negative predictive value of 99.6%, the agency noted, "meaning that people who receive a negative test result are likely truly negative in areas of low disease prevalence."
A follow-up trial of 12 symptomatic individuals in Texas, conducted in February when Omicron accounted for nearly all cases there, showed a similar sensitivity of 90.9% (90% CI 67.7-98.0).
The company expects to produce 100 units each week, with each unit estimated to be able to analyze 160 samples each day, according to the FDA."

 

[missy]

"

Vision-Threatening Retinal Condition Linked to COVID-19​

— Rates of rare retinal vein occlusion jumped after infection, although overall numbers remain low​

by Randy Dotinga, Contributing Writer, MedPage Today April 14, 2022

COVID-19 infection may be boosting the numbers of a rare ocular condition in which vision is threatened when veins in the retina are blocked, eye specialists in Southern California report.
Risk of retinal vein occlusion was higher in the 6 months after infection than in the 6 months prior (adjusted incidence rate ratio [IRR] 1.54, 95% CI 1.05-2.26, P=0.03), according to Bobeck Modjtahedi, MD, a vitreoretinal surgeon at Kaiser Permanente Southern California in Baldwin Park, California, and colleagues.

The number of cases reported was still very small, with crude rates of 8.3 cases per million patients in the 6 months before an infection and 12.2 per million in the 6 months after, and the link to COVID-19 isn't definitive, the group cautioned in JAMA Ophthalmology.
However, "these results are compelling and fit in with the general trends we have seen in COVID-19 and systemic vascular disease," Modjtahedi told MedPage Today. "Although retinal vein occlusion remains an uncommon event after COVID-19 infection, these events can result in irreversible vision loss."
Researchers have linked a long list of neuro-ophthalmic/retina conditions to COVID-19, including photophobia, retinal hemorrhage, and optic neuritis.
For the new study, Modjtahedi's group retrospectively tracked 432,515 patients in Kaiser Permanente Southern California's health system who tested positive for COVID-19 from January 2020 to May 2021 to examine changes in the incidence of retinal artery and vein occlusions following an infection.

According to Modjtahedi, retinal artery and vein occlusions occur when blockages disrupt blood flow either in or out of the eye.
"Patients can suffer vision loss, which is often permanent, although there are treatments for secondary associated events like macular edema," he said. "These conditions are often seen in patients who have systemic vascular diseases like diabetes and hypertension."
For retinal artery occlusions, the group found no significant difference in the incidence before (2.3 cases per million) or after (3.0 cases per million) a COVID-19 infection (adjusted IRR 1.35, 95% CI 0.64-2.85).
As for a potential cause between infection and retinal vein occlusion, Modjtahedi noted that COVID-19 can induce clotting.
"The associations we observed could also be from secondary events not directly related to the virus, such as worsening blood pressure or lack of physical activity after infection," he added. "This is something to consider because the peak incidence of retinal vein occlusion after COVID-19 was 6 to 8 weeks after the infection. There may be a delay in diagnosis, the pro-thrombotic state might last several weeks, or patients may have the condition due to secondary events."

The study "further strengthens the association between COVID-19 and retinal vascular occlusion," wrote K. Thiran Jayasundera, MD, MS, of the University of Michigan in Ann Arbor, and colleagues, in an accompanying commentary. "However, the strength and consistency of this association would be enhanced by further evaluation including studies that access other large databases now available to provide a robust basis for causality and help determine recommended strategies for prevention and surveillance."
Jayasundera's group also noted that "one would expect that a severe COVID-19 infection would lead to more vascular occlusions; however, this may be negated by the anticoagulation regimens initiated in hospitalized patients with severe COVID-19."
Overall, the study found 12 cases of retinal artery occlusion and 43 cases of retinal vein occlusion in the 6 months before a COVID-19 infection. In the 6 months following infection, these numbers were 16 and 65, respectively.
Patients in the study were an average age of 41 years, 53.6% were women, 60.7% were Hispanic, and 20.3% were white. For comorbidities, 15.3% had a history of diabetes, 24.3% had hypertension, 20.6% were overweight, and 31.9% had obesity. Most of the patients (93.7%) did not require hospitalization for their COVID-19 infection.
COVID hospitalization was associated with an increased risk of retinal vein occlusion only in unadjusted analyses. Adjustments for the main analyses were made for various confounders, such as race, body mass index, and diabetes, and other factors.
"

 

[missy]

"

Fourth Pfizer Dose Better for Severe Than Symptomatic COVID: Study​

Marcia Frellick





A fourth dose of the Pfizer-BioNTech vaccine is effective in reducing the short-term risk for COVID-19 infection, hospitalization, and death in people who got a third dose at least 4 months before, a large study published Wednesday shows.
However, Paul Offit, MD, author of an editorial accompanying the study, told Medscape Medical News, "I would argue, without fear of contradiction, that this is going to have no impact on this pandemic."
"We are still in the midst of a zero-tolerance policy for this virus. We don't accept mild illness and if we're not going to accept mild illness, we think we have to boost it away, which would mean probably about two doses every year. That's not a reasonable public health strategy," Offit, director of the Vaccine Education Center at Children's Hospital of Philadelphia (CHOP) in Pennsylvania, said.

Booster Confusion​

Results of the research out of Israel published Wednesday in the New England Journal of Medicine make a case for a fourth booster for people 60 and over.

Researchers, led by Ori Magen, MD, Clalit Research Institute, Innovation Division, Clalit Health Services, Tel Aviv, Israel, analyzed data comparing 182,122 matched pairs recorded by the largest healthcare organization in Israel from January 3 to February 18, 2022. With more than 4.7 million members, Clalit Health Services covers more than half of the population of Israel.
The researchers compared outcomes in people 60 or older (average age 72) who got a fourth dose with outcomes in those who had only a third dose. They individually matched people from the two groups, considering factors such as age, health status, and ethnicity.

Relative vaccine effectiveness in days 7 to 30 after the fourth dose was estimated to be 45% (95% confidence interval [CI], 44 to 47) against confirmed SARS-CoV-2 infection, 55% (95% CI, 53 to 5 against symptomatic COVID-19, 68% (95% CI, 59 to 74) against hospitalization, 62% (95% CI, 50 to 74) against severe COVID, and 74% (95% CI, 50 to 90) against COVID-related death.
Several countries, including the United States, have begun offering a fourth vaccine dose for higher-risk populations in light of evidence of waning immunity after the third dose and waves of infection, driven by Omicron and its variants, in some parts of the world. But the recommended age groups differ considerably.


In the United States, for instance, the US Food and Drug Administration in late March approved a fourth dose of the Pfizer or Moderna vaccine for anyone over 50 and people over 18 who have gotten a solid organ transplant or have a similar level of immune risk.

Offit points out that Israel offers the fourth vaccine for people 60 and over and the European Medical Association offers it for those over 80. No surprise that confusion over the fourth dose is rampant, he said.

Booster Advice​

Offit offers this perspective:

People who are immunocompromised could reasonably get a fourth dose, he said, depending on the manner in which they are compromised.

"Someone who has a solid organ transplant is not the same as someone who is getting a monoclonal antibody for their rheumatoid arthritis," Offit said.

He said that people could also make a reasonable argument for the fourth dose if they are over 65 and have multiple comorbidities.

"I'm over 65," Offit said. "I'm generally healthy. I'm not going to get a fourth dose."

People with multiple comorbidities over age 12 could reasonably get a third dose, he said.
"For everybody else — healthy people less than 65 — I would argue this is a two-dose vaccine," Offit said.

CHOP, he noted as an example, mandates the vaccine but doesn't mandate three doses and he says that's not unusual for hospital systems.

"How many lives are you really saving with that fourth dose? If you really want to have an effect on this pandemic, vaccinate the unvaccinated," Offit said.

Focus on the Memory Cells​

Offit writes in the editorial, "Arguably, the most disappointing error surrounding the use of Covid-19 vaccines was the labeling of mild illnesses or asymptomatic infections after vaccination as 'breakthroughs.' As is true for all mucosal vaccines, the goal is to protect against serious illness — to keep people out of the hospital, intensive care unit, and morgue. The term 'breakthrough,' which implies failure, created unrealistic expectations and led to the adoption of a zero-tolerance strategy for this virus."

Offit said that the focus should be on the memory cells, not the neutralizing antibodies.

Regarding mRNA vaccines, Offit said "The surprise of this vaccine — it surprised me and other vaccine researchers — is that with these two doses of mRNA separated by 3 to 4 weeks, you actually appear to have long-lived memory response.

"That's not the history of vaccines. If you look at the inactivated polio vaccine or the inactivated hepatitis A vaccine, you really do need a 4- to 6-month interval between doses to get high frequencies of memory cells. That doesn't appear to be the case here. It looks like two doses given close together do just that. Memory cells last for years if not, sometimes, decades."

Neutralizing antibodies, on the other hand, protect against mild illness and their effectiveness wanes after months.

"At some point we are going to have to get used to mild illness," Offit said.

The Centers for Disease Control and Prevention must now determine who will benefit most from booster dosing and educate the public about the limits of mucosal vaccines, Offit writes in the editorial.

"Otherwise, a zero-tolerance strategy for mild or asymptomatic infection, which can be implemented only with frequent booster doses, will continue to mislead the public about what Covid-19 vaccines can and cannot do."

The work was funded by the Ivan and Francesca Berkowitz Family Living Laboratory Collaboration at Harvard Medical School and Clalit Research Institute.

Marcia Frellick is a freelance journalist based in Chicago. She has previously written for the Chicago Tribune, Science News, and Nurse.com, and was an editor at the Chicago Sun-Times, the Cincinnati Enquirer, and the St. Cloud (Minnesota) Times. Follow her on Twitter at @mfrellick.
"

 

[Gloria27]

We are on the mend!

Yesterday after commenting here I went outside and did some light gardening as it's 20 degrees for the first time this year and also because I can't be still not even when sick, that's how I'm wired.
Hubby on the other hand feels fatigued all the time so I'm the carer. He actually just dozed off on his office chair.

Anyway, it seems to get gradually better for the both of us. YEEEY!

 

[GreenPapaya]

I woke up with body aches, but thought that was my usual allergies. Took a home test and it’s positive have body aches, cough, fever (100-102) headache and general crabbiness. Like why couldn’t it happen in May so I can stay home longer. I have to go in 2x days a week in May. And so hard to isolate in an almost 1000 sqft apartment with 3 other people. I wonder if I have to get a pcr test to confirm but I feel pretty crappy. Thankfully we’re all vaccinated and all got one booster.
I don’t like being ill and kinda scared/anxious since so many family members have died since 2020 (not all from Covid-last month one of my sisters got bitten by a bug and died within 24 hours, like wth). And this weekend is my new year so I can’t go out to light incense for the deceased or eat new year food

 

[Gloria27]

I woke up with body aches, but thought that was my usual allergies. Took a home test and it’s positive have body aches, cough, fever (100-102) headache and general crabbiness. Like why couldn’t it happen in May so I can stay home longer. I have to go in 2x days a week in May. And so hard to isolate in an almost 1000 sqft apartment with 3 other people. I wonder if I have to get a pcr test to confirm but I feel pretty crappy. Thankfully we’re all vaccinated and all got one booster.
I don’t like being ill and kinda scared/anxious since so many family members have died since 2020 (not all from Covid-last month one of my sisters got bitten by a bug and died within 24 hours, like wth). And this weekend is my new year so I can’t go out to light incense for the deceased or eat new year food

Condoleances for the death of your loved ones. You've been through a lot...

Knowing it's Covid certainly adds a fear factor but try not to despair.

 

[mellowyellowgirl]

I just had to share this because it made me laugh.

So I saw my dad today and he told me that the entire side of his family had Covid in Vietnam. Fortunately they were all vaccinated with Astrazeneca.

Me: How are they? Are they ok?

Dad: oh yeah they're fine. Your Aunts stayed in bed for a day but some of your cousins were weak. They took two days to recover. Your Aunts went and worked on the farm the very next day.

I just cracked up because my Aunts are 70 and NEVER rest. Their mother, my grandmother was like that too. My dad was motoring through chores when he had Covid and was in lockdown. I'm hoping I inherited some of those mad genes!!!

They all tested positive on rapids so I'm wondering if it was Covid but there was an outbreak in their village and I'm told that false positives are rare.

 

[Gloria27]

Day 4 from testing pozitive for me, day 5 of symptoms, I only have a stuffy nose and some cough. Yesterday was good too, the peak was in day 2 and day 3 of symptoms.

Hubby worked for 5 hours in the garage yesterday after his power nap so all good.

 

[Gloria27]

I woke up with body aches,....

How are you feeling today ?

 

[GreenPapaya]

I hope I'm like you @Gloria27! I feel better in the morning and then fever again in the evenings. Everything still hurts a lot. I was able to get up today to shower, so that's something. My oxygen has been dipping to 75% for a few mins once or twice overnight but I feel fine. I think I need a new oximeter.
I did feel well enough to yell at my husband and kids for ordering pizza for me when I was sick, then making spaghetti the next day. I don't know what's wrong with them, argh, I made chicken soup from scratch and rice porridge when they were sick. Luckily I have ramen and ready made broth. I mean, I'm lactose intolerant and don't even eat pizza normally.

 

[Gloria27]

I hope I'm like you @Gloria27! I feel better in the morning and then fever again in the evenings. Everything still hurts a lot. I was able to get up today to shower, so that's something. My oxygen has been dipping to 75% for a few mins once or twice overnight but I feel fine. I think I need a new oximeter.
I did feel well enough to yell at my husband and kids for ordering pizza for me when I was sick, then making spaghetti the next day. I don't know what's wrong with them, argh, I made chicken soup from scratch and rice porridge when they were sick. Luckily I have ramen and ready made broth. I mean, I'm lactose intolerant and don't even eat pizza normally.

Glad you're ok, speedy recovery!

 

[Gloria27]

Genetic relative got Covid again, after having the nastier variant and two Pfizer shots after...

This is why blaming the pandemic on the unvaxxed is lunacy.

 

[Gloria27]

@seaurchin, back to stalking I see.

 

[seaurchin]

@seaurchin, back to stalking I see.

Sorry but I'm not that interested in you. You should stop spreading ill-informed falsehoods about Covid though. It's gotten very old. Actually, you should probably be banned for trolling.

 

[Gloria27]

Sorry but I'm not that interested in you. You should stop spreading ill-informed falsehoods about Covid though. It's gotten very old. Actually, you should probably be banned for trolling.

You are not interested in me Really? this caption is from 17th February, there were like 10 posts in a row where you couldn't contain yourself:

 

[missy]

@Gloria27 I agree with @seaurchin you are spreading falsehoods about Covid.

" The large number of unvaccinated people means that Covid is still killing about 500 Americans a day."

Yes, this pandemic continues because not everyone (the great majority that is) got vaccinated. Had that happened we would be past this pandemic. Now it is too late and variants have been unleashed. But all who can get vaccinated would be wise to do so because the evidence is there. Vaccinated people have a much lower risk of getting severely ill and/or dying.

You may (or may not) have valid reasons for not getting vaccinated. But you have zero acceptable reasons for spreading misinformation.

 

[Gloria27]

@Gloria27 I agree with @seaurchin you are spreading falsehoods about Covid.

" The large number of unvaccinated people means that Covid is still killing about 500 Americans a day."

Yes, this pandemic continues because not everyone (the great majority that is) got vaccinated. Had that happened we would be past this pandemic. Now it is too late and variants have been unleashed. But all who can get vaccinated would be wise to do so because the evidence is there. Vaccinated people have a much lower risk of getting severely ill and/or dying.

You may (or may not) have valid reasons for not getting vaccinated. But you have zero acceptable reasons for spreading misinformation.

Well the vaccine doesn't protect from getting and spreading it so how does it make sense to you that it would have stopped it in the first place?
Where is the freaking logic?

Hubby got the virus at work where he is literally the only unvaxxed person!
So we got this from vaccinated people!

I don't need reasons not to get vaxxed, I need reasons to get vaxxed.

 

[missy]

Well the vaccine doesn't protect from getting and spreading it so how does it make sense to you that it would have stopped it in the first place?
Where is the freaking logic?

Hubby got the virus at work where he is literally the only unvaxxed person!
So we got this from vaccinated people!

I don't need reasons not to get vaxxed, I need reasons to get vaxxed.

Let me try to explain this as simply as I can. No attitude from me at all. Just truly want to try to help you understand.

1. If everyone got vaccinated the virus would have died out.
2. Because so many did not get vaccinated the virus was able to survive and mutate.
3. Getting vaccinated helps lower the risk of getting Covid and then transferring it to others.

You wrote: "I don't need reasons not to get vaxxed, I need reasons to get vaxxed."
I thought you said you couldn't get vaccinated for medical reasons. But now the truth comes out. No offense to anyone who actually could not get vaccinated for medical reasons. The pandemic lives because of those who selfishly refused to get vaccinated. Not because of those who have a valid medical reason.

Anyway, I do not care why you did not get vaccinated. It is none of my business. You brought it up. I just don't want misinformation being spread. This thread exists to share info and facts.