Posts tagged with "JAMA"

Belgian study: Moderna creates more than twice as many COVID antibodies as Pfizer vaccine

September 2, 2021

Moderna’s COVID vaccine generated more than double the antibodies of a similar shot made by Pfizer and BioNTech SE in research that compared immune responses evoked by the two inoculations, Bloomberg reports.

The study is one of the first to compare levels of antibodies produced by the two vaccines, which are thought to be one of the important components of the immune response. It didn’t examine whether the antibody differences led to a difference in efficacy over time between the two shots—which both were more than 90% effective in final-stage clinical trials.

The research looked at antibody levels against the coronavirus spike protein in about 1,600 workers at a major Belgium hospital system whose blood samples were analyzed 6 weeks to 10 weeks after vaccination.

The participants hadn’t been infected with the coronavirus before getting vaccinated. Levels among those who got two doses of the Moderna vaccine averaged 2,881 units per milliliter, compared with 1,108 units per milliliter among those who received two Pfizer doses. 

The results—published on September 30 in a letter to the Journal of the American Medical Association (JAMA—suggested that the differences might be explained by the higher amount of active ingredient in the Moderna vaccine — 100 micrograms,versus 30 micrograms in Pfizer-BioNTech—or the slightly longer interval between doses of the Moderna vaccine —four weeks, versus three weeks for Pfizer-BioNTech.

Outside researchers said it was premature to conclude that the difference in antibody levels was medically important. Bloomberg notes.

“I would urge caution in making the conclusion that because Moderna demonstrated a slightly higher peak on average that its efficacy will be slower to wane,” said David Benkeser, a biostatistician at Emory University, in an email. “Such a conclusion requires a host of assumptions that have not yet been evaluated.”

Both vaccines produce high levels of antibodies, he noted, and other studies have shown even relatively low levels of antibodies are protective.

Still, it’s possible that higher initial antibody levels might correlate with longer duration of protection against mild breakthrough infections, said Deborah Steensels, a microbiologist at Ziekenhuis Oost-Limburg, a large hospital in Belgium, who was lead author on the study.  Also, if higher antibody levels are confirmed to be important, then the Moderna vaccine might be better for immunocompromised people who don’t respond well to vaccines, she said.

Pfizer said in a statement that its vaccine “continues to be highly efficacious” in preventing Covid-19, including against severe cases and hospitalization. A continuing analysis of its final-stage study has shown a decline of efficacy against symptomatic infection over time, the drugmaker said, but initial trial data also show that a third dose of the existing vaccine at least six months after the first two significantly raises neutralizing antibody levels.

Moderna’s vaccine was associated with a two-fold risk reduction against breakthrough SARS-CoV-2 infections compared to Pfizer’s in a review of people in the Mayo Clinic Health System in the United States from January to July. The results were reported in a separate study released ahead of publication and peer review on August 9.

Research contact: @business

After COVID, Bryan Cranston isn’t stopping to smell the roses

December 9, 2020

Bryan Cranston, 64—still celebrated for his memorable acting turn in Breaking Bad and now appearing in Your Honor—still can’t fully taste or smell after getting the coronavirus back in March, the actor shared December 4 on The Ellen Show.

Both Cranston and his wife, actor Robin Dearden, came down with the illness, Self Magazine reports.

As he told DeGeneres: “She got it first. She gave it to me because we share.”

Overall, Cranston and his wife had a mild experience with the virus. “We had a few days of achiness, but not enough to keep you in bed, and I had a temperature of about 99 [degrees] for about three hours. And then just exhaustion for a week after that,” he explained. “We were very lucky, in all seriousness.”

The majority of the couple’s symptoms lasted for about ten days, Cranston said. But his sense of taste and smell still aren’t what they used to be. “The only thing that lingered and still to this day is I lost a percentage of my ability to taste and smell,” the actor told DeGeneres. “I think about 75% has come back. But if someone was brewing coffee, and I walk into a kitchen, I cannot smell it.”

A loss of taste or smell is one of the strange but not uncommon symptoms of this novel coronavirus. One small study published by JAMA Otolaryngology Head & Neck Surgery last June surveyed 204 people who had been diagnosed with coronavirus and found that 55.4% of them reported a loss of taste, while 41.7% reported a loss of smell.

Then an August 2020 systematic review and meta-analysis by the Mayo Clinic looked at 24 studies with a collective 8,438 test-confirmed COVID-19 patients and found an average of 41% of patients had a loss of smell, while an average of 38.2% had a loss of taste.

According to the Centers for Disease Control and Prevention (CDC), COVID-19 symptoms run the gamut. In addition to a new loss of taste or smell, symptoms can include fevercough, shortness of breath or difficulty breathing, fatigue, muscle or body aches, headache, sore throat, congestion or runny nose, nausea or vomiting, and diarrhea.

The CDC continues to update the list as new symptoms emerge. If a person with the virus develops symptoms, signs of illness appear between 2 to 14 days after exposure, though asymptomatic people can and certainly do spread the illness as well. Experts also continue to look into “long-haulers” such as Cranston—who experience coronavirus symptoms weeks or months after first getting the disease.

Several other celebrities have been diagnosed with COVID-19. Neil Patrick Harris also experienced a loss of taste and smell back in March, which alerted him to the fact that he didn’t just have the flu. Hugh Grant sprayed his wife’s perfume directly in his face to try to trigger his sense of smell, but got nothing—and also struggled with a feeling of pressure on his chest. Rita Wilson initially thought her fatigue symptoms were just jet lag when she and her husband, Tom Hanks, were diagnosed.

“I was pretty strict in adhering to the protocols and still… I contracted the virus. Yep. it sounds daunting now that over 150,000 Americans are dead because of it,” Cranston wrote on his Instagram back in July. “I count my blessings and urge you to keep wearing the damn mask, keep washing your hands, and stay socially distant. We can prevail—but ONLY if we follow the rules together.”

Research contact: @SELFmagazine

Take cover: Are face shields even better than masks at preventing COVID-19 infection?

June 8, 2020

If you wear a face mask when you leave your home, you’re probably not doing it out of a sense of style Masks are awkward and uncomfortable, and they can be difficult to use correctly: If they aren’t applied and removed with clean hands, they can actually transmit infection rather than prevent it, Self magazine reports.

A growing number of researchers think there’s a better way. Face shields—which cover a person’s face with a clear curved plastic panel—are more comfortable, easier to put on and take off, reusable, and simple to clean.

But most importantly, “we feel face shields are far more effective,” Eli Perencevich, M.D., a professor of Internal Medicine and Epidemiology at the University of Iowa Carver College of Medicine, recently told Self in an interview. In April, Dr. Perencevich published a commentary in JAMA in favor of face shields with two of his colleagues.

Research on face shields is limited but promising. In a 2014 Journal of Occupational and Environmental Hygiene study, researchers at the National Institute for Occupational Safety and Health placed a face shield on a breathing robot and had another robot 18 inches away “cough out” flu virus. The shield prevented the breathing robot from inhaling 96% of the virus within five minutes. In additional tests, the shield’s effectiveness varied based on the size of droplets expelled, but the overall indication was that shields can protect their wearers from other people’s germs.

No studies have yet addressed whether face shields protect other people from your germs, however, and this makes some scientists wary. “We don’t have the research to say that they will offer protection for those around you, should you be sick,” Saskia Popescu, Ph.D., an infection prevention epidemiologist at George Mason University, tells Self.

But face shield proponents argue that based on the laws of physics, shields will likely protect others. Everything that flies out of your mouth is “going forward, and it’s hitting a giant piece of plastic,” Dr. Perencevich says. “It just physically can’t go through.”

Dr. Perencevich and others are now designing studies to help address this issue, but he says it’s difficult for research like this to get funded. “We’re more interested as a society in treatment than we are in prevention,” Michael Edmond, M.D., a hospital epidemiologist at the University of Iowa Carver College of Medicine, who co-authored the JAMA commentary with Dr. Perencevich, said in an interview with the magazine. “There’s never money to do this kind of work. It’s never been prioritized.”

Some people are skeptical of shields because they are open on the sides and bottom. But these openings may not pose much of a problem. Research suggests that the coronavirus usually spreads via large droplets expelled out of a person’s mouth or nose, which are pulled down by gravity within a radius of six feet. (Hence the six-foot rule.) Shields prevent close-by expelled viruses from hitting another person’s face before they fall.

To get in through the shield’s openings, the virus would need to linger around in the air in smaller particles known as aerosols and eventually meander around the shield’s sides. But “the patterns of spread of [COVID-19] suggest that aerosol is unusual,” David Fisman, M.D., an Infectious Disease epidemiologist at the University of Toronto, believes. Some studies have found that the virus can linger in the air, but epidemiological findings—such as surprising data suggesting that people often do not get sick even when other members of their household have the coronavirus—suggest that aerosol transmission is uncommon.

Still, for those who are concerned about the potential role of aerosols, or who might be at high-risk for complications from the coronavirus, one solution might be to wear shields and masks at the same time, suggests William Lindsley, Ph.D., a bioengineer with the National Institute for Occupational Safety and Health, who co-authored the 2014 robot coughing study. When robots wore both shields and masks in his study, the shields blocked 97%t of the virus from landing on the masks, keeping them much cleaner.

Research contact: @SELFmagazine

‘A distinctly American phenomenon’: Our workers die younger than those in other wealthy nations

November 27, 2019

Americans work hard and die young, according to findings of a study conducted at Virginia Commonwealth University.  In fact, the engine that powers the world’s most potent economy is succumbing at an alarming pace—a “distinctly American phenomenon’’ with no easily discernible cause or simple solution, USA Today reported on November 26.

Specifically, researchers determined that mortality rates for U.S. adults ages 25-64 continue to increase—driving down the general population’s life expectancy for the three consecutive years following 2014.

The report, Life Expectancy and Mortality Rates in the United States, 1959-2017,’’ was published on November 26  in the Journal of the American Medical Association (JAMA).

According to USA Today, it paints a bleak picture of a workforce plagued by drug overdoses, suicides, and organ-system diseases while grappling with economic stresses.

“This looks like an excellent paper—just what we needed to help unravel the overall decline in life expectancy in the United States’’ said Eileen Crimmins, the AARP Professor of Gerontology at the University of California-Leonard Davis. She’s who’s an expert on the link between health and socioeconomic factors.

In a trend that cuts across racial and ethnic boundaries, America has the worst midlife mortality rate among 17 high-income countries despite leading the world in per-capita spending on health care.

And while life expectancy in those other industrialized nations continues to inch up, ours has been going in the opposite direction—decreasing from a peak of 78.9 years in 2014 to 78.6 in 2017, the last year covered by the report.

By comparison, the news outlet reports, according to the Peterson-Kaiser Health System Tracker, the average longevity in similar countries is 82.2 years. Japan’s is 84.1; France’s, 82.4;and Canada’s, 81.9. They left the United States behind in the 1980s and increased the distance as the rate of progress in this country diminished and eventually halted in 2011.

Steven Woolf, director emeritus of the Virginia Commonwealth University Center on Society and Health and the study’s lead author, said the reasons for the decline go well beyond the lack of universal health care in America—in contrast with those other nations—although that’s a factor.

“It would be easier if we could blame this whole trend on one problem, like guns or obesity, or the opioid epidemic—all of which distinguish [the U.S.] from the other countries,’’ Woolf told USA Today. “But we found increases in death rates across 35 causes of death.’’

They were most pronounced in the industrial Midwest, the 13 Appalachian states, and upper New England, which Woolf attributed partly to the decline in manufacturing jobs and the opioid epidemic.

Of the top 10 states with the highest number of excess deaths in the 25-64 age range —meaning deaths above projections based on U.S. mortality rates—eight were in the Rust Belt or Appalachia. Half of the excess deaths were concentrated in the latter region. The Ohio Valley—comprising Indiana, Kentucky, Ohio, and Pennsylvania—accounted for one-third.

“Not only are employers more likely to see premature deaths in their workers, but also greater illness rates and greater disability, and that puts U.S. businesses at a disadvantage against businesses in other countries that have a healthier and more productive workforce,’’ Woolf said, adding that employers here are already saddled with high health care costs.

The report showed mortality rates among those younger than 25 and older than 64 have decreased. That might point a finger at the country’s dysfunctional health care system for working adults, because many in those other age groups can be covered by either the Children’s Health Insurance Program (CHIP) or Medicare.

Woolf told USA Today that he disputes that notion, saying only 10% to 20% of health outcomes can be attributed to medical care. He said the bigger culprit is a lack of social programs and support systems more common in other wealthy countries for when working families run into difficult times.

Those rough spells, often associated with a job loss, can lead to the kind of unhealthy behaviors – drug and alcohol abuse, smoking, overeating, suicide attempts—that result in what have become known as “deaths of despair.’’

“We’re making a huge mistake if we don’t step back and look at the root causes,’’ Woolf told the news oulet—ncluding a lack of educational opportunities and living wages among the likely causes. “The prescription for the country is we’ve got to help these people. And if we don’t, we’re literally going to pay with our lives.’’

Research contact: @USATODAY