Market moves indicate Covid-19 vaccine boosters will likely be a reality soon. Among many recent market developments, the E.U. is negotiating a contract with Pfizer/BioNTech to deliver 1.8 billion doses for the years 2021 to 2023. The U.K. has secured an additional 60 million doses of the Pfizer/BioNTech Covid-19 vaccine. And, Israel purchased 9 million more Pfizer/BioNTech vaccines to ensure capacity for boosters through 2022.
The other manufacturer of mRNA Covid-19 vaccines, Moderna, has committed itself to producing three billion doses annually.
Perhaps most telling that the world intends to booster up is a recently published IQVIA report which states that worldwide $157 billion will be spent on Covid-19 vaccines through 2025.
In a statement last month, Pfizer CEO Albert Bourla asserted boosters will be very likely 6 to 12 months following the initial two-dose regimen. Echoing Bourla’s comments, BioNTech co-founder and CMO Dr. Ozlem Tureci said an additional shot of the two-dose vaccine will be needed as immunity wanes over time. Tureci played a key role in developing the mRNA vaccine.
So far, both mRNA-based vaccines have reported remarkable efficacy at the 6-month mark, at more than 90%, with even greater protection against severe illness and death.
Beyond 6 months, however, the durability of immunity remains unclear. Furthermore, manufacturers must determine whether additional doses will be needed to combat certain new variants of concern, including the P.1 and B.1.617 variants that have wreaked havoc in Brazil and India, respectively.
Pfizer and BioNTech are investigating the efficacy of a third dose administered 6 to 12 months after the first two-dose regimen. Moderna is conducting a similar trial. The firms are also conducting trials to test vaccine efficacy against several of the variants of concern.
There may be a conflict of interest when the CEO of a company that manufactures boosters declares we need boosters. Nonetheless, cynicism aside, what we can safely assume, based in part on a large-scale Danish study of reinfections, is that following infection immunity diminishes over time. According to the study, the vast majority of people who recover from Covid-19 remain protected from the virus for at least six months. But the risk of reinfection appears to be higher among people over the age of 65. Prior infection with the coronavirus reduced the chances of a second bout by only about half in those older than 65.
What the Danish study did not investigate is whether the immunity conferred by way of vaccines is stronger than natural immunity. That would appear to be the case in clinical studies, at least for the mRNA vaccines which have more than 90% efficacy 6 months after a completed regimen. The findings showed only a small decrease in efficacy and a slight antibody decline.
Perhaps it’s no surprise then that at the time that Pfizer CEO Bourla said people will likely need a Covid-19 vaccine booster, and annual vaccinations akin to influenza shots are probable going forward, some public health and infectious disease experts expressed skepticism.
Dr. Paul Offit, a vaccine expert at Children’s Hospital of Philadelphia, said that there isn’t sufficient data yet to make that judgment call. Similarly, Dr. Monica Gandhi, epidemiologist and public health expert, suggested boosters may not be necessary. After all, the clinical studies haven’t shown an appreciable decrease in antibodies at 6 months.
Nevertheless, for real-world evidence that goes beyond a half year we still need to wait and see. The vaccine rollout began roughly five months ago. And so, the 6-month mark is fast approaching. Dr. Fauci, Director of the U.S. National Institute of Allergy and Infectious Diseases and the chief medical advisor to the President, is on record as saying that it should be known for sure by this autumn whether booster Covid-19 vaccines will be necessary and what timetable to expect.
Of course, there’s also the question of whether the necessity of boosters will depend on the vaccine type given to an individual. It may be that vaccines with potent immunity like the mRNA agents will require less frequent boosters than others. But it’s not been ascertained at this point.
Further, variants of concern remain a wildcard in Covid-19 transmission. It may be that how soon people ought to be re-vaccinated depends on how the novel coronavirus evolves in terms of its ability to elude current vaccines. The ongoing extraordinarily high numbers of daily cases and the fact that large swaths of the globe are unvaccinated are sure to spawn new variants, one or more of which could evade vaccines.
Boosters are a rather safe bet at this point, as market moves indicate. What’s less of a sure thing is how effective our current set of vaccines will be against certain variants of concern.
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Canada allows Pfizer COVID-19 vaccine for children aged 12-15
(Corrects headline and lead to make clear that Canada was not the first nation as stated by Canadian officials, adds context from Pfizer in fourth paragraph)
By David Ljunggren
OTTAWA (Reuters) –Canada is authorizing the use of Pfizer Inc’s COVID-19 vaccine for use in children aged 12 to 15, the first doses to be allowed in the country for people that young, the federal health ministry said on Wednesday.
Supriya Sharma, a senior adviser at the Canadian federal health ministry, said the Pfizer vaccine, produced with German partner BioNTech SE, was safe and effective in the younger age group.
“We are starting to see the light at the end of the tunnel,” she told reporters.
Sharma and a health ministry spokesman said Canada was the first country to grant such an approval, but a Canadian representative for Pfizer later said Algeria permitted use of the vaccine for this age group in April. The Canadian health ministry said it had no information about the discrepancy.
The U.S. Food and Drug Administration is expected to take a similar step “very soon,” U.S. health officials said.
Separately, authorities reported the third death of a Canadian from a rare blood clot condition after receiving AstraZeneca PLC’s’s COVID-19 vaccine. The man, who was in his sixties, lived in the Atlantic province of New Brunswick.
Jennifer Russell, the chief medical officer of health in New Brunswick, said the province would continue using the AstraZeneca vaccine. Alberta reported a death from clotting on Tuesday and Quebec announced one on April 27.
“There will be rare cases where thrombosis will occur. However, the risks remain minimal compared to the risks, complications and potential consequences of COVID-19,” Russell told reporters.
Canada‘s federal government has bought tens of millions of doses of vaccines but critics complain the pace of inoculation is lagging due to bottlenecks in the 10 provinces, which are responsible for administering the doses.
Alberta will become the first province to offer COVID-19 vaccines to everyone aged 12 and over from May 10, Premier Jason Kenney said on Wednesday, a day after he introduced tighter public health measures to combat a third wave of the pandemic.
Alberta, home to Canada‘s oil patch, has the highest rate per capita of COVID-19 in the country, with nearly 24,000 active cases and 150 people in intensive care.
Around 20% of the 1,249,950 cases of COVID-19 in Canada have been reported in people under the age of 19. Canada has recorded 24,396 deaths.
(Additional reporting by Allison Martell in Toronto and Nia Williams in Calgary;Editing by Chizu Nomiyama and Sonya Hepinstall)
Younger people filling up COVID-19 intensive care
By Anthony Boadle
BRASILIA (Reuters) –COVID-19 infections continue to spread fast across the Americas as a result of relaxed prevention measures and intensive care units are filling up with younger people, the director of the Pan American Health Organization (PAHO) said on Wednesday.
In Brazil, mortality rates have doubled among those younger than 39, quadrupled among those in their 40s and tripled for those in their 50s since December, Carissa Etienne said.
Hospitalization rates among those under 39 years have increased by more than 70% in Chile and in some areas of the United States more people in their 20s are now being hospitalized for COVID-19 than people in their 70s.
“Despite all we learned about this virus in a year, our control efforts are not as strict, and prevention is not as efficient,” Etienne said in a virtual briefing from Washington.
“We are seeing what happens when these measures are relaxed: COVID spreads, cases mount, our health systems become overwhelmed and people die,” she said.
Canada continues to report significant jumps in infections in highly populated provinces such as Ontario as well as in less populated territories of the North and Yukon, home to remote and indigenous communities, according to PAHO.
Puerto Rico and Cuba remain significant drivers of COVID-19 cases in the Caribbean, which is facing a new surge of the virus, PAHO directors said.
Cases are rapidly accelerating in the Guyanas and across Argentina and Colombia, where weekly case counts are five times higher today than they were this time last year and hospitals are reaching capacity in large Colombian cities.
In Central America, Guatemala is seeing significant spikes in cases and Costa Rica is reporting record-high infections.
While vaccines are being rolled out as fast as possible, they are not a short-term solution because they are in short supply, said Etienne, the World Health Organization’s regional director.
(Reporting by Anthony Boadle; Editing by Nick Macfie)
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