Connect with us

Spread & Containment

A year of COVID vaccines: how the UK pinned its hopes on the jab – and why those hopes are under threat

The UK has been rolling out COVID vaccines for a year. It’s been quite a ride.

Published

on

A year ago, Margaret Keenan made history. On December 8 2020, she became the first person in the world to receive the Pfizer/BioNTech vaccine outside of a clinical trial. Ninety-year-old Keenan described it as the “best early birthday present”. It was a moment of shining hope in what had been a dark year of deaths, lockdowns and disrupted lives.

Before the vaccines, death rates from COVID were very high, especially in older adults, with rates between 5% and 15% in people over the age of 75 years. Other than pursuing a zero-COVID elimination strategy – an exceedingly difficult task in a globalised world with such an infectious virus – the only other option was to control and delay the spread of the coronavirus until vaccines arrived.


Read more: Zero COVID worked for some countries – but high vaccine coverage is now key


There was no guarantee in the early days of the pandemic that an effective vaccine could be developed in time to make a difference. However, we have seen not just one but several vaccines developed. Better yet, most of these vaccines are highly effective at protecting against severe disease and death from COVID.

The UK was among the first countries in the world to start vaccinating its population, and a herculean effort was mounted to immunise the elderly and vulnerable adults, as well as health and care workers. From a standing start, the NHS rapidly ramped up vaccine deployment, aided to a large extent by the efforts of thousands of GPs, community health professionals and volunteers.

In the early months, the UK out-vaccinated most of the rest of the world. The pace of the rollout was phenomenal. The highest number of new vaccinations reported in one day in the UK was 844,285 (March 20 2021) - the equivalent of vaccinating the entire population of Liverpool.

However, rates of immunisation have slowed, and other nations, such as Spain, Japan and Canada, have overtaken the UK. One year on, though, it is still an amazing achievement. Almost 90% of people aged 12 and over in the UK has had at least one dose.

In the first ten months of the vaccination programme, it is estimated the UK immunisation programme saved 127,500 lives and averted more than 24 million infections.

But the journey has not been smooth.

Our World In Data, CC BY

Vaccine scares

Not long after the first jab was administered at University Hospital in Coventry, controversies and issues began to emerge. One of the earliest was concerns about the vaccine dosing interval.

The interval between the first and second dose of the Pfizer vaccine was meant to be three to four weeks. But faced with a rapidly spreading third wave of infections driven by the new alpha variant, the UK government decided to delay second-dose jabs to 12 weeks to maximise vaccine coverage and to “protect the greatest number of at-risk people overall in the shortest possible time”. The decision created a furore as it went against the vaccine manufacturers’ advised schedules.

There were concerns that vulnerable people who had only received a single dose would be less protected and that immune protection would not last as long. Fortunately, it was the right call and those fears have not transpired. Indeed, studies suggest the longer interval improved the vaccines’ effectiveness.

There were also safety concerns about the vaccine, and two examples stand out.

First, in February 2021, it emerged that there was the risk of a rare blood-clotting disorder called cerebral venous sinus thrombosis (CVST) following vaccination with the Oxford/AstraZeneca vaccine. This led to many countries restricting the use of the vaccine to older adults where the risk was lower. In the UK, people under the age of 30 were offered an alternative to the AstraZeneca vaccine.

CVST, however, remains a rare event. Despite 25 million first doses of the vaccine being administered, to date, only 154 cases have been reported to the UK’s Medicines and Healthcare Regulatory Authority.

Second, there were concerns about the elevated risk of myocarditis (inflammation and damage to the heart muscle) particularly in males aged 12 to 29 following the Pfizer and Moderna vaccines. However, the actual risk of myocarditis was again very small and the benefits of vaccination far outweighed the risk. What’s more, the risk of myocarditis was much greater with COVID infection (220 per million) than from vaccination. In the US where the vaccine is more extensively used in younger adults, the incidence of myocarditis after vaccination was reported to be four per million doses.

Nonetheless, safety concerns and uncertainties of the risks and benefits of immunising children have led the UK to adopt a much more cautious approach to rolling out vaccines to the entire population, particularly to younger age groups where cases of severe COVID are rare. Some have argued that caution is needed because, in the long run, the loss of public trust in national vaccination programmes could take a long time to regain.

However, the caution of rolling out vaccination to school-aged children meant an opportunity was missed to immunise children over the summer. Belatedly, the UK’s chief medical officers advised the government to vaccinate children aged 12-15 years in September. This meant most children were susceptible to infection at the start of the school year. For many, the vaccines would come too late.

In the absence of adequate mitigation measures, such as more mask-wearing, isolation of contacts and better ventilation in schools, infections spread rapidly in schools in England over the next few months. By mid-November, rates of infection were highest in young children and secondary school children.


Read more: Vaccinating teenagers is beneficial, even if their vulnerability to COVID-19 is low


Vaccination uptake rates in the under 18s still lag behind the adult population quite considerably, with less than half of 12- to 15-year-olds having received their first dose so far.

Vaccine disparities

Despite the enthusiastic roll out of vaccines by the NHS in early 2021, disparities in the coverage and uptake of vaccines emerged. This particularly affected minority ethnic groups, people living in deprived areas and those with severe mental illness or learning disabilities.

Issues with the accessibility and acceptability of vaccines for these groups are possible explanations. In the pursuit of achieving high population vaccine coverage, this may come at the cost of bypassing underserved groups and risks further entrenching health inequalities.

Vaccine hesitancy is also more likely in these groups. There are several reasons for vaccine hesitancy, including vaccine safety concerns and misperceptions about the risk of getting COVID and of becoming seriously ill. To this end, the NHS, local authorities and community-based organisations have made considerable effort to contact and promote vaccine uptake in many of these groups where uptake is low. But it remains a persistent issue.

Social media, as well as some mainstream media, have also had a negative influence on vaccine uptake through misinformation, disinformation or the spread of conspiracy theories. At the extreme end, an anti-vaccination movement has emerged, some with links to anti-lockdown and COVID-denialists views. Some of their activities have become increasingly aggressive, including targeting schools, children, parents and health professionals.

Separately, to protect vulnerable patients and care home residents, the government has made it mandatory for health and social care workers to be vaccinated in England. This has been a controversial decision, not least from an ethical and civil liberties perspective. Apart from concerns about the loss of personal choice in the matter, there are also concerns that such an approach may backfire, undermining trust in the establishment, potentially increasing marginalisation and vaccine scepticism.


Read more: Why the UK shouldn’t introduce mandatory COVID vaccination


Vaccine passports

A person’s vaccination status has not just been used as a requirement for certain occupations, it has also been used as a qualifier for international travel and entry to sporting events, music festivals and theatres. The so-called vaccine passport is not a new idea, having parallels with the International Certificate of Vaccination or Prophylaxis, created by the World Health Organization for diseases such as cholera, yellow fever, plague and typhoid.

Vaccine passports have enabled many of these events to take place and have made international tourism possible once again. While many countries have taken up the idea of vaccine passports, there is no universal vaccine passport accepted by all of them, and debates continue as to which vaccines qualify and the number of jabs needed.

There have also been questions about whether they actually work, fears about the loss of privacy and concerns that they discriminate against those who can’t or won’t be vaccinated. In particular, low- and middle-income countries are disadvantaged as they have lower vaccine coverage.

Global vaccine inequity

Indeed, the global disparities in access to vaccines is stark. Over 54% of the world’s population has been vaccinated, but only 6% of the population in poor countries. Achieving high levels of vaccine coverage in rich countries would allow a degree of normality to return to them – but it would be a fragile normality.

While infections spread uncontrolled elsewhere in the world, there is a possibility that new variants of the virus will emerge, some of which might carry genetic mutations that allow it to evade vaccine immunity. These variants could easily be imported back into rich countries. This risk appears to be materialising in the form of the latest variant of concern, omicron, that emerged in late November. Initially reported in southern Africa, it has now been detected in many countries around the world.

If the aim is to achieve more enduring security, infections have to be tackled elsewhere, and this requires fairer distribution of vaccines. This echoes UN secretary-general Antonio Guterres’ message back in May 2020 that, “None of us is safe until we all are.”

Boosters

The other worrying trend that has emerged since Keenan had that first COVID jab back in December 2020, is waning vaccine protection, especially in older adults. Thankfully, vaccine protection against severe disease and death appears to remain high. That said, a small drop in vaccine protection could still lead to many infected people ending up in hospitals.

This led to the UK government recommending booster doses of the vaccine in September, initially for the elderly and the clinically vulnerable. Boosters will top up protection and help to prevent infections, especially for the most vulnerable.

Going into winter, there is the added threat of other seasonal infections. Many of these infectious diseases had initially been kept at bay by COVID measures. But with the relaxation of these measures since the summer and more population mixing, this enables the spread of these diseases as well as COVID.

This will place considerable pressure on overstretched health services dealing with a backlog of health activity due to COVID as well as continued high levels of COVID infections. Maximising vaccine protection against COVID to reduce the effect on health services is therefore vital. However, it will be difficult for the NHS to mount a similar immunisation programme to the one we witnessed in early 2021.

Omicron – a worrying development

Just as the world should have been getting ready to celebrate the first anniversary of the COVID vaccine rollouts, omicron came along to spoil the party.

The recent emergence of this latest variant of concern is worrying. It has many mutations that make it potentially more infectious and able to evade immunity from vaccines and previous infection – indeed, reinfection rates appear to be three times that of the delta variant. It is spreading rapidly in South Africa and beyond, including in vaccinated people.

This new threat prompted the UK government to extend booster jabs to all adults. Whether the boosters will provide enough protection against the new variant is not certain. To date, the government has relied on vaccine protection as the “wall of defence” against COVID. Against omicron, the current vaccines might not be enough, and further public health measures could be needed to buy time until newer vaccines can be developed.

Vaccines offer the best protection, but as good as they are, no vaccine gives total protection. Looking to the future, the threat of new variants of the virus emerging has not gone away. Whether we need more vaccine boosters will depend on how lethal the infections are, whether there is vaccine escape (that is, the immunity from vaccines is less effective against infection), and how long immunity from past infection or vaccination lasts.

Like the seasonal flu vaccines, regular COVID vaccines may be needed, and the vaccines themselves may have to be adapted to protect against the latest variant. Don’t be surprised if annual COVID vaccinations, particularly for the elderly and vulnerable, become a regular feature.

But, before we get too downhearted, let’s pause for a moment to celebrate this past year of COVID vaccines – 8.24 billion doses administered globally – and the countless lives they have saved.

Andrew Lee has previously received research funding from the National Institute for Health Research. He is a member of the UK Faculty of Public Health and the Royal Society for Public Health.

Read More

Continue Reading

Spread & Containment

A dog has caught monkeypox from one of its owners, highlighting risk of the virus infecting pets and wild animals

The monkeypox virus can easily spread between humans and animals. A veterinary virologist explains how the virus could go from people to wild animals in…

Published

on

A dog in Paris has become the first case of a pet contracting monkeypox from its owners. Cavan Images via Getty Images

A dog in Paris has caught monkeypox from one of its owners, both of whom were infected with the virus, according to a scientific paper published on Aug. 10, 2022. This is the first case of a dog contracting the monkeypox virus through direct contact with skin lesions on a human.

I am a veterinary pathologist and virologist who has been working with poxviruses for over 20 years. I study how these viruses evade the immune system and am working on modifying poxviruses to prevent infection as well as treat other diseases, including cancer.

With monkeypox spreading in humans throughout the world, my colleagues and I have begun to worry about the increased risk of monkeypox spreading from humans to animals. If monkeypox spreads to wildlife species in the U.S. and Europe, the virus could become endemic in these places – where it has historically been absent – resulting in more frequent outbreaks. The report of the infected dog shows that there is a decent chance these fears could become a reality.

A microscope image of a bunch blue circles in a brown-colored cell.
The monkeypox virus – the blue circles in this image of an infected cell – is a poxvirus similar to smallpox and cowpox and can easily infect many different species. NIAID/Wikimedia Commons, CC BY

A species-jumping virus

Monkeypox is a poxvirus in the same family as variola – the virus that causes smallpox – and cowpox viruses and likely evolved in animals before jumping to humans. Monkeypox causes painful lesions in both humans and animals and, in rare cases, can be deadly. Researchers have found the monkeypox virus in several species of wild rodents, squirrels and primates in Africa, where the virus is endemic. Monkeypox does not need to mutate or evolve at all to be able to infect many different species. It can easily spread from animals to people and back again.

Though there is a fair bit of research on monkeypox, a lot more work has been done on cowpox, a similar zoonotic poxvirus that is endemic in Europe. Over the years, there have been several reports of cowpox infection spreading from animals to humans in Europe.

From people to animals

Until recently, most monkeypox infections occurred in specific areas of Africa where some wildlife species act as reservoirs for the virus. These outbreaks are usually contained quickly through isolation of infected individuals and vaccinating people around the infected individual. The current situation is very different though.

With nearly 40,000 cases globally as of Aug. 17, 2022 – and more than 12,500 cases in the U.S. alone – monkeypox is now widespread within the human population. The risk of any one person transmitting the virus to an animal – particularly a wild one – is small, but the more people are infected, the greater the chances. It’s a numbers game.

There are a number of ways viruses can transfer from animals to people – called spillover – and from people back to animals – called spillback. Since monkeypox is most easily spread through direct skin-to-skin contact, it is a bit more difficult to transmit between species than COVID-19, but certainly possible.

The case of the dog in Paris provides a clear example of how cuddling or being close to a pet can spread the virus. Previous studies on poxviruses like monkeypox have shown that they can stay active in fecal matter. This means that there is a risk of wild animals, likely rodents, catching it from human waste.

A grey rat.
There are a number of species that host monkeypox in Africa – like this gambian rat. Monkeypox can spread from humans to many other animals, including dogs and likely cats and other species of rodents. Louisvarley/Wikimedia Commons, CC BY-SA

The monkeypox virus is also present in saliva. While more research needs to be done, it is potentially possible that an infected person could discard food that would then be eaten by a rodent.

The chances of any one of these events happening is extremely low. But I and other virologists worry that with more people becoming infected, there is a greater risk that rodents or other animals will come into contact with urine, feces or saliva that is contaminated with the virus.

Finally, there is the risk of people giving monkeypox to a pet, which then passes it on to other animals. One case study in Germany described an outbreak of cowpox that was caused when someone took an infected cat to a veterinary clinic and four other cats were subsequently infected. It is feasible that an infected household pet could spread the virus to wild animals somehow.

How to help

One of the key reasons that the World Health Organization was able to eradicate smallpox is that it only infects people, so there were no animal reservoirs that could re-introduce the virus to human populations.

Monkeypox is zoonotic and already has several animal reservoirs, though these are currently limited to Africa. But if monkeypox escapes into wild animal populations in the U.S., Europe or other locations, there will be always be potential for animals to spread it back to humans. With this in mind, there are a number of things people can do to reduce the risks with regard to animals.

As with any infectious disease, be informed about the signs and symptoms of monkeypox and how it is transmitted. If you suspect you have the virus, contact a doctor and isolate from other people.

As a veterinarian, I strongly encourage anyone with monkeypox to protect your pets. The case in Paris shows that dogs can get infected from contact with their owners, and it is likely that many other species, including cats, are susceptible, too. If you have monkeypox, try to have other people take care of your animals for as long as lesions are present. And if you think your pet has a monkeypox infection, be sure to contact a veterinarian so they can test the lesion and provide care when needed.

Even though monkeypox has been declared a public health emergency, it is unlikely to directly affect most people. Taking precautionary steps can protect you and your pets and will hopefully prevent monkeypox from getting into wildlife in the U.S., too.

Amy Macneill does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.

Read More

Continue Reading

Spread & Containment

UBC researchers discover ‘weak spot’ across major COVID-19 variants

Researchers at the University of British Columbia have discovered a key vulnerability across all major variants of the SARS-CoV-2 virus, including the…

Published

on

Researchers at the University of British Columbia have discovered a key vulnerability across all major variants of the SARS-CoV-2 virus, including the recently emerged BA.1 and BA.2 Omicron subvariants.

Credit: Dr. Sriram Subramaniam, UBC

Researchers at the University of British Columbia have discovered a key vulnerability across all major variants of the SARS-CoV-2 virus, including the recently emerged BA.1 and BA.2 Omicron subvariants.

The weakness can be targeted by neutralizing antibodies, potentially paving the way for treatments that would be universally effective across variants.

The findings, published today in Nature Communications, use cryo-electron microscopy (cryo-EM) to reveal the atomic-level structure of the vulnerable spot on the virus’ spike protein, known as an epitope. The paper further describes an antibody fragment called VH Ab6 that is able to attach to this site and neutralize each major variant. 

“This is a highly adaptable virus that has evolved to evade most existing antibody treatments, as well as much of the immunity conferred by vaccines and natural infection,” says Dr. Sriram Subramaniam (he/him), a professor at UBC’s faculty of medicine and the study’s senior author. “This study reveals a weak spot that is largely unchanged across variants and can be neutralized by an antibody fragment. It sets the stage for the design of pan-variant treatments that could potentially help a lot of vulnerable people.”

Identifying COVID-19 master keys

Antibodies are naturally produced by our bodies to fight infection, but can also be made in a laboratory and administered to patients as a treatment. While several antibody treatments have been developed for COVID-19, their effectiveness has waned in the face of highly-mutated variants like Omicron.

“Antibodies attach to a virus in a very specific manner, like a key going into a lock. But when the virus mutates, the key no longer fits,” says Dr. Subramaniam. “We’ve been looking for master keys — antibodies that continue to neutralize the virus even after extensive mutations.”

The ‘master key’ identified in this new paper is the antibody fragment VH Ab6, which was shown to be effective against the Alpha, Beta, Gamma, Delta, Kappa, Epsilon and Omicron variants. The fragment neutralizes SARS-CoV-2 by attaching to the epitope on the spike protein and blocking the virus from entering human cells.

The discovery is the latest from a longstanding and productive collaboration between Dr. Subramaniam’s team at UBC and colleagues at the University of Pittsburgh, led by Drs. Mitko Dimitrov and Wei Li. The team in Pittsburgh has been screening large antibody libraries and testing their effectiveness against COVID-19, while the UBC team has been using cryo-EM to study the molecular structure and characteristics of the spike protein.

Focusing in on COVID-19’s weak points

The UBC team is world-renowned for its expertise in using cryo-EM to visualize protein-protein and protein-antibody interactions at an atomic resolution. In another paper published earlier this year in Science, they were the first to report the structure of the contact zone between the Omicron spike protein and the human cell receptor ACE2, providing a molecular explanation for Omicron’s enhanced viral fitness.

By mapping the molecular structure of each spike protein, the team has been searching for areas of vulnerability that could inform new treatments.

“The epitope we describe in this paper is mostly removed from the hot spots for mutations, which is why it’s capabilities are preserved across variants,” says Dr. Subramaniam. “Now that we’ve described the structure of this site in detail, it unlocks a whole new realm of treatment possibilities.”

Dr. Subramaniam says this key vulnerability can now be exploited by drug makers, and because the site is relatively mutation-free, the resulting treatments could be effective against existing—and even future—variants.

“We now have a very clear picture of this vulnerable spot on the virus. We know every interaction the spike protein makes with the antibody at this site. We can work backwards from this, using intelligent design, to develop a slew of antibody treatments,” says Dr. Subramaniam. “Having broadly effective, variant-resistant treatments would be a game changer in the ongoing fight against COVID-19.”


Read More

Continue Reading

Spread & Containment

German Official Trashes Cost Of Living Protesters As “Enemies Of The State”

German Official Trashes Cost Of Living Protesters As "Enemies Of The State"

Authored by Paul Joseph Watson via Summit News,

A top German…

Published

on

German Official Trashes Cost Of Living Protesters As "Enemies Of The State"

Authored by Paul Joseph Watson via Summit News,

A top German official has trashed people who may be planning to protest against energy blackouts as “enemies of the state” and “extremists” who want to overthrow the government.

The interior minister of the German state of North Rhine-Westphalia (NRW), Herbert Reul (CDU), says that anti-mandatory vaxx and anti-lockdown demonstrators have found a new cause – the energy crisis.

In an interview with German news outlet NT, Reul revealed that German security services were keeping an eye on “extremists” who plan to infiltrate the protests and stage violence, with the unrest being planned via the Telegram messenger app, which German authorities have previously tried to ban.

“You can already tell from those who are out there,” said Reul. “The protesters no longer talk about coronavirus or vaccination. But they are now misusing people’s worries and fears in other fields. (…) It’s almost something like new enemies of the state that are establishing themselves.”

Despite the very real threat of potential blackouts, power grid failures and gas shortages, Reul claimed such issues were feeding “conspiracy theory narratives.”

However, it’s no “conspiracy theory” that Germans across the country have been panic buying stoves, firewood and electric heaters as the government tells them thermostats will be limited to 19C in public buildings and that sports arenas and exhibition halls will be used as ‘warm up spaces’ this winter to help freezing citizens who are unable to afford skyrocketing energy bills.

As Remix News reports, blaming right-wing conspiracy theorists for a crisis caused by Germany’s sanctions on Russia and is suicidal dependence on green energy is pretty rich.

“Reul, like the country’s federal interior minister, Nancy Faeser, is attempting to tie right-wing ideology and protests against Covid-19 policies to any potential protests in the winter.”

“While some on the right, such as the Alternative for Germany (AfD), have stressed that the government’s sanctions against Russia are the primary factor driving the current energy crisis, they have not advocated an “overthrow” of the government. Instead, they have stressed the need to restart the Nord Stream 2 pipeline, end energy sanctions against Russia, and push for a peaceful solution to end the war.”

Indeed, energy shortages and the cost of living crisis are issues that are of major concern to everyone, no matter where they are on the political spectrum.

To claim that people worried about heating their homes and putting food on the table this winter are all “enemies of the state” is an utter outrage.

As we highlighted last week, the president of the Thuringian Office for the Protection of the Constitution, Stephan Kramer, said energy crisis riots would make anti-lockdown unrest look like a “children’s birthday party.”

“Mass protests and riots are just as conceivable as concrete acts of violence against things and people, as well as classic terrorism to overthrow it,” Kramer told ZDF.

*  *  *

Brand new merch now available! Get it at https://www.pjwshop.com/

In the age of mass Silicon Valley censorship It is crucial that we stay in touch. I need you to sign up for my free newsletter here. Support my sponsor – Turbo Force – a supercharged boost of clean energy without the comedown. Get early access, exclusive content and behinds the scenes stuff by following me on Locals.

Tyler Durden Thu, 08/18/2022 - 03:30

Read More

Continue Reading

Trending