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Covid-19 roundup: Booster protection against hospitalization drops after 3 months – The Daily Briefing

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The shortest known time between coronavirus infections is 20 days, the omicron subvariant BA.2.12.1 is gaining prevalence in the United States, and more in this week’s roundup of Covid-19 news.

Your top resources on the Covid-19 vaccines

  • Moderna on Thursday asked FDA to authorize its Covid-19 vaccine for children under 6. Based on clinical trial data, the company’s vaccine for children, which consists of two 25-microgram doses, was 51% effective against symptomatic infection for children between 6 months and 2 years and 37% effective for children ages 2 to 6. In addition to its vaccine for children under 6, Moderna has also requested FDA authorize its vaccine for children ages 6 to 11 and adolescents ages 12 to 17, with a spokesperson saying the company would complete its data submission for these groups in the next two weeks. During a Senate oversight heating, Peter Marks, who oversees vaccine regulation for FDA, suggested the agency might consider Moderna’s applications for children under 18 as a whole rather than individually. Separately, Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, said FDA may review children vaccine data from Moderna and Pfizer-BioNTech simultaneously to directly compare the two vaccines and not “confuse people.” According to the New York Times, federal regulators are unlikely to review Moderna’s application before June, when FDA’s outside advisory panel is scheduled to meet on vaccines for young children. (LaFraniere, New York Times, 4/28; Doherty, Axios, 4/28; AP/Modern Healthcare, 4/28; LaFraniere, New York Times, 4/26)
  • FDA on Monday expanded its approval for the IV antiviral Veklury, also known as remdesivir, to children under 12, making it the first Covid-19 treatment approved for this age group. According to MedPage Today, Veklury is now approved for use in children as young as 28 days who weigh at least three kilograms. The drug may be used for either hospitalized patients or those at risk of severe outcomes. “As COVID-19 can cause severe illness in children, some of whom do not currently have a vaccination option, there continues to be a need for safe and effective COVID-19 treatment options for this population,” said Patrizia Cavazzoni, director of the FDA’s Center for Drug Evaluation and Research. “Today’s approval of the first COVID-19 therapeutic for this population demonstrates the agency’s commitment to that need.” (Chen, Axios, 4/25; Reuters, 4/25; Walker, MedPage Today, 4/25)
  • Booster protection against hospitalization from Covid-19 declines after three months, according to a new Kaiser Permanente study published in The Lancet Respiratory Medicine. For the study, researchers analyzed Kaiser Permanente patient records between December 2021 and Feb. 6, 2022. In total, there were 11,123 hospital admissions or ED visits, and all patients included in the analysis had received at least three doses of the Pfizer-BioNTech vaccine. Overall, the researchers found that a booster dose was 80% to 90% protective against hospital admissions and ED visits caused by both the delta and omicron variants during the first three months of receiving it. However, after three months, protection against hospitalization from omicron decreased to 55%, while protection against ED visits decreased to 53%. “Pfizer BioNTech COVID-19 booster doses significantly improve protection against omicron, although that protection seems to wane after three months against emergency room visits, and even for hospitalization,” said Sara Tartof, an epidemiologist in Kaiser Permanente’s department of research and evaluation and the study’s lead author. “Trends in waning against delta-related outcomes were generally similar to omicron but with higher effectiveness at each time point than those seen for omicron.” (Carbajal, Becker’s Hospital Review, 4/25)
  • The shortest known time between separate coronavirus infections is 20 days, according to a case report presented at the European Congress of Clinical Microbiology & Infectious Diseases (ECCMID). According to researchers, a 31-year-old female health care worker in Spain first tested positive for Covid-19 on a PCR test on Dec. 20, 2021. She was fully vaccinated and had received a booster dose 12 days earlier. After this positive test, the patient, who was asymptomatic, self-isolated for 10 days before returning to work. Then, on Jan. 10, 2022, just 20 days after her original positive test, the patient began feeling unwell and tested positive on another PCR test. According to whole genome sequencing, there had been two different coronavirus variants, with the first being delta in December and the second being omicron in January. “This case highlights the potential of the omicron variant to evade the previous immunity acquired either from a natural infection with other variants or from vaccines,” said Gemma Recio, one of the study’s authors. “In other words, people who have had COVID-19 cannot assume they are protected against reinfection, even if they have been fully vaccinated.” (Gleeson, Becker’s Hospital Review, 4/21; ECCMID press release, 4/20)
  • Pfizer and BioNTech on Tuesday requested FDA authorize a booster dose of their Covid-19 vaccine for children ages 5 to 11. In an announcement, Pfizer said data from a Phase 2/3 trial indicated children in that group saw a “strong immune response” after receiving a booster dose six months after their primary vaccine series. If authorized, the dose would be the first booster available to children under 12. However, some health experts said a third dose may not be necessary for children at this point. “It may be that over time, those two doses don’t protect against serious illness, in which case one could reasonably [receive] a third dose,” said Paul Offit, who leads the Vaccine Education Center at Children’s Hospital at Philadelphia. “But for right now, protection against serious illness appears to be holding up.” In addition, it is not clear how much demand there will be for booster doses in this age group, according to NPR. Currently, CDC data shows that only 28.4% of children ages 5 to 11 are fully vaccinated, and only around 35% have received an initial dose. (Chen, Axios, 4/26; Stein, “Shots,” NPR, 4/26; Choi, The Hill, 4/26)
  • According to CDC data, the prevalence of the omicron subvariant BA.2 is decreasing in the United States as a new subvariant continues to spread. For the week ending April 23, BA.2 made up 68.1% of all new Covid-19 cases, down from 74.9% the week ending April 9. In comparison, the subvariant BA.2.12.1 made up 28.7% of new Covid-19 cases the week ending April 23, up from 13.7% the week ending April 9. Researchers estimate BA.2.12.1 has a 27% growth advantage over BA.2, which is already more transmissible than the original omicron BA.1 variant. BA.2.12.1, as well as a related subvariant BA.2.12, are currently driving a surge in Covid-19 cases in New York. Based on HHS data, Covid-19 cases nationwide have increased 53% over the past two weeks as of April 25. (Bean, Becker’s Hospital Review, 4/26)

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Health Canada approves updated Moderna COVID-19 vaccine

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TORONTO – Health Canada has authorized Moderna’s updated COVID-19 vaccine that protects against currently circulating variants of the virus.

The mRNA vaccine, called Spikevax, has been reformulated to target the KP.2 subvariant of Omicron.

It will replace the previous version of the vaccine that was released a year ago, which targeted the XBB.1.5 subvariant of Omicron.

Health Canada recently asked provinces and territories to get rid of their older COVID-19 vaccines to ensure the most current vaccine will be used during this fall’s respiratory virus season.

Health Canada is also reviewing two other updated COVID-19 vaccines but has not yet authorized them.

They are Pfizer’s Comirnaty, which is also an mRNA vaccine, as well as Novavax’s protein-based vaccine.

This report by The Canadian Press was first published Sept. 17, 2024.

Canadian Press health coverage receives support through a partnership with the Canadian Medical Association. CP is solely responsible for this content.

The Canadian Press. All rights reserved.

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These people say they got listeria after drinking recalled plant-based milks

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TORONTO – Sanniah Jabeen holds a sonogram of the unborn baby she lost after contracting listeria last December. Beneath, it says “love at first sight.”

Jabeen says she believes she and her baby were poisoned by a listeria outbreak linked to some plant-based milks and wants answers. An investigation continues into the recall declared July 8 of several Silk and Great Value plant-based beverages.

“I don’t even have the words. I’m still processing that,” Jabeen says of her loss. She was 18 weeks pregnant when she went into preterm labour.

The first infection linked to the recall was traced back to August 2023. One year later on Aug. 12, 2024, the Public Health Agency of Canada said three people had died and 20 were infected.

The number of cases is likely much higher, says Lawrence Goodridge, Canada Research Chair in foodborne pathogen dynamics at the University of Guelph: “For every person known, generally speaking, there’s typically 20 to 25 or maybe 30 people that are unknown.”

The case count has remained unchanged over the last month, but the Public Health Agency of Canada says it won’t declare the outbreak over until early October because of listeria’s 70-day incubation period and the reporting delays that accompany it.

Danone Canada’s head of communications said in an email Wednesday that the company is still investigating the “root cause” of the outbreak, which has been linked to a production line at a Pickering, Ont., packaging facility.

Pregnant people, adults over 60, and those with weakened immune systems are most at risk of becoming sick with severe listeriosis. If the infection spreads to an unborn baby, Health Canada says it can cause miscarriage, stillbirth, premature birth or life-threatening illness in a newborn.

The Canadian Press spoke to 10 people, from the parents of a toddler to an 89-year-old senior, who say they became sick with listeria after drinking from cartons of plant-based milk stamped with the recalled product code. Here’s a look at some of their experiences.

Sanniah Jabeen, 32, Toronto

Jabeen says she regularly drank Silk oat and almond milk in smoothies while pregnant, and began vomiting seven times a day and shivering at night in December 2023. She had “the worst headache of (her) life” when she went to the emergency room on Dec. 15.

“I just wasn’t functioning like a normal human being,” Jabeen says.

Told she was dehydrated, Jabeen was given fluids and a blood test and sent home. Four days later, she returned to hospital.

“They told me that since you’re 18 weeks, there’s nothing you can do to save your baby,” says Jabeen, who moved to Toronto from Pakistan five years ago.

Jabeen later learned she had listeriosis and an autopsy revealed her baby was infected, too.

“It broke my heart to read that report because I was just imagining my baby drinking poisoned amniotic fluid inside of me. The womb is a place where your baby is supposed to be the safest,” Jabeen said.

Jabeen’s case is likely not included in PHAC’s count. Jabeen says she was called by Health Canada and asked what dairy and fresh produce she ate – foods more commonly associated with listeria – but not asked about plant-based beverages.

She’s pregnant again, and is due in several months. At first, she was scared to eat, not knowing what caused the infection during her last pregnancy.

“Ever since I learned about the almond, oat milk situation, I’ve been feeling a bit better knowing that it wasn’t something that I did. It was something else that caused it. It wasn’t my fault,” Jabeen said.

She’s since joined a proposed class action lawsuit launched by LPC Avocates against the manufacturers and sellers of Silk and Great Value plant-based beverages. The lawsuit has not yet been certified by a judge.

Natalie Grant and her seven year-old daughter, Bowmanville, Ont.

Natalie Grant says she was in a hospital waiting room when she saw a television news report about the recall. She wondered if the dark chocolate almond milk her daughter drank daily was contaminated.

She had brought the girl to hospital because she was vomiting every half hour, constantly on the toilet with diarrhea, and had severe pain in her abdomen.

“I’m definitely thinking that this is a pretty solid chance that she’s got listeria at this point because I knew she had all the symptoms,” Grant says of seeing the news report.

Once her daughter could hold fluids, they went home and Grant cross-checked the recalled product code – 7825 – with the one on her carton. They matched.

“I called the emerg and I said I’m pretty confident she’s been exposed,” Grant said. She was told to return to the hospital if her daughter’s symptoms worsened. An hour and a half later, her fever spiked, the vomiting returned, her face flushed and her energy plummeted.

Grant says they were sent to a hospital in Ajax, Ont. and stayed two weeks while her daughter received antibiotics four times a day until she was discharged July 23.

“Knowing that my little one was just so affected and how it affected us as a family alone, there’s a bitterness left behind,” Grant said. She’s also joined the proposed class action.

Thelma Feldman, 89, Toronto

Thelma Feldman says she regularly taught yoga to friends in her condo building before getting sickened by listeria on July 2. Now, she has a walker and her body aches. She has headaches and digestive problems.

“I’m kind of depressed,” she says.

“It’s caused me a lot of physical and emotional pain.”

Much of the early days of her illness are a blur. She knows she boarded an ambulance with profuse diarrhea on July 2 and spent five days at North York General Hospital. Afterwards, she remembers Health Canada officials entering her apartment and removing Silk almond milk from her fridge, and volunteers from a community organization giving her sponge baths.

“At my age, 89, I’m not a kid anymore and healing takes longer,” Feldman says.

“I don’t even feel like being with people. I just sit at home.”

Jasmine Jiles and three-year-old Max, Kahnawake Mohawk Territory, Que.

Jasmine Jiles says her three-year-old son Max came down with flu-like symptoms and cradled his ears in what she interpreted as a sign of pain, like the one pounding in her own head, around early July.

When Jiles heard about the recall soon after, she called Danone Canada, the plant-based milk manufacturer, to find out if their Silk coconut milk was in the contaminated batch. It was, she says.

“My son is very small, he’s very young, so I asked what we do in terms of overall monitoring and she said someone from the company would get in touch within 24 to 48 hours,” Jiles says from a First Nations reserve near Montreal.

“I never got a call back. I never got an email”

At home, her son’s fever broke after three days, but gas pains stuck with him, she says. It took a couple weeks for him to get back to normal.

“In hindsight, I should have taken him (to the hospital) but we just tried to see if we could nurse him at home because wait times are pretty extreme,” Jiles says, “and I don’t have child care at the moment.”

Joseph Desmond, 50, Sydney, N.S.

Joseph Desmond says he suffered a seizure and fell off his sofa on July 9. He went to the emergency room, where they ran an electroencephalogram (EEG) test, and then returned home. Within hours, he had a second seizure and went back to hospital.

His third seizure happened the next morning while walking to the nurse’s station.

In severe cases of listeriosis, bacteria can spread to the central nervous system and cause seizures, according to Health Canada.

“The last two months have really been a nightmare,” says Desmond, who has joined the proposed lawsuit.

When he returned home from the hospital, his daughter took a carton of Silk dark chocolate almond milk out of the fridge and asked if he had heard about the recall. By that point, Desmond says he was on his second two-litre carton after finishing the first in June.

“It was pretty scary. Terrifying. I honestly thought I was going to die.”

Cheryl McCombe, 63, Haliburton, Ont.

The morning after suffering a second episode of vomiting, feverish sweats and diarrhea in the middle of the night in early July, Cheryl McCombe scrolled through the news on her phone and came across the recall.

A few years earlier, McCombe says she started drinking plant-based milks because it seemed like a healthier choice to splash in her morning coffee. On June 30, she bought two cartons of Silk cashew almond milk.

“It was on the (recall) list. I thought, ‘Oh my God, I got listeria,’” McCombe says. She called her doctor’s office and visited an urgent care clinic hoping to get tested and confirm her suspicion, but she says, “I was basically shut down at the door.”

Public Health Ontario does not recommend listeria testing for infected individuals with mild symptoms unless they are at risk of developing severe illness, such as people who are immunocompromised, elderly, pregnant or newborn.

“No wonder they couldn’t connect the dots,” she adds, referencing that it took close to a year for public health officials to find the source of the outbreak.

“I am a woman in my 60s and sometimes these signs are of, you know, when you’re vomiting and things like that, it can be a sign in women of a bigger issue,” McCombe says. She was seeking confirmation that wasn’t the case.

Disappointed, with her stomach still feeling off, she says she decided to boost her gut health with probiotics. After a couple weeks she started to feel like herself.

But since then, McCombe says, “I’m back on Kawartha Dairy cream in my coffee.”

This report by The Canadian Press was first published Sept. 16, 2024.

Canadian Press health coverage receives support through a partnership with the Canadian Medical Association. CP is solely responsible for this content.

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B.C. mayors seek ‘immediate action’ from federal government on mental health crisis

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VANCOUVER – Mayors and other leaders from several British Columbia communities say the provincial and federal governments need to take “immediate action” to tackle mental health and public safety issues that have reached crisis levels.

Vancouver Mayor Ken Sim says it’s become “abundantly clear” that mental health and addiction issues and public safety have caused crises that are “gripping” Vancouver, and he and other politicians, First Nations leaders and law enforcement officials are pleading for federal and provincial help.

In a letter to Prime Minister Justin Trudeau and Premier David Eby, mayors say there are “three critical fronts” that require action including “mandatory care” for people with severe mental health and addiction issues.

The letter says senior governments also need to bring in “meaningful bail reform” for repeat offenders, and the federal government must improve policing at Metro Vancouver ports to stop illicit drugs from coming in and stolen vehicles from being exported.

Sim says the “current system” has failed British Columbians, and the number of people dealing with severe mental health and addiction issues due to lack of proper care has “reached a critical point.”

Vancouver Police Chief Adam Palmer says repeat violent offenders are too often released on bail due to a “revolving door of justice,” and a new approach is needed to deal with mentally ill people who “pose a serious and immediate danger to themselves and others.”

This report by The Canadian Press was first published Sept. 16, 2024

The Canadian Press. All rights reserved.

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