Oxford University study finds mixing a first dose of the Pfizer or Astrazeneca vaccine with a second Moderna shot yields higher antibodies.
A major British study into mixing COVID-19 vaccines has found that people had a better immune response when they received a first dose of AstraZeneca or Pfizer-BioNTech shots followed by Moderna nine weeks later, according to the results.
“We found a really good immune response across the board … in fact, higher than the threshold set by Oxford-AstraZeneca vaccine two doses,” Matthew Snape, the Oxford professor behind the Com-COV2 trial, told the Reuters news agency on Monday.
The findings supporting flexible dosing will offer some hope to low- and middle-income countries that may need to mix vaccines for first and second doses if supplies run low or become unstable.
“I think the data from this study will be especially interesting and valuable to low- and middle-income countries where they’re still rolling out the first two doses of vaccines,” Snape said.
“We’re showing … you don’t have to stick rigidly to receiving the same vaccine for a second dose … and that if the programme will be delivered more quickly by using multiple vaccines, then it is OK to do so.”
If the AstraZeneca-Oxford vaccine is followed by a Moderna or Novavax shot, higher antibodies and T-cell responses were induced versus two doses of AstraZeneca-Oxford, according to researchers at the University of Oxford.
The study of 1,070 volunteers also found that a dose of the Pfizer-BioNTech vaccine followed by a Moderna shot was better than two doses of Pfizer-BioNTech.
Pfizer-BioNTech followed by Novavax induced higher antibodies than the two-dose Oxford-AstraZeneca schedule, although this schedule induced lower antibody and T-cell responses than the two-dose Pfizer-BioNTech schedule.
No safety concerns were raised, according to the Oxford University study published in the Lancet medical journal.
Many countries have been deploying a mix-and-match approach well before robust data was available as they were faced with soaring infection numbers, low supplies and slow immunisation over some safety concerns.
The longevity of protection offered by vaccines has been under scrutiny, with booster doses being considered as well amid surging cases. The discovery of new variants, including Delta and Omicron, has increased the pressure to speed up vaccination campaigns.
Blood samples from participants were tested against the Wild-Type, Beta and Delta variants, researchers of the Com-COV2 study said, adding that vaccines’ efficacy against the variants had waned, but this was consistent across mixed courses.
Deploying vaccines using different technology – like Pfizer-BioNTech and Moderna’s mRNA, AstraZeneca’s viral vector and Novavax’s protein-based shot – within the same schedule is a relatively new approach.
The results may inform new approaches to immunisation against other diseases, Snape said.
The study also found that a first dose of the AstraZeneca-Oxford vaccine followed by any of the other candidates in the study generated a particularly robust response, consistent with findings in June.
The study was designed as a so-called “non-inferiority” study – the intent is to demonstrate that mixing is not substantially worse than the standard schedules – and compares the immune system responses to the gold-standard responses reported in previous clinical trials of each vaccine.
Separately on Monday, the World Health Organization advised against using the blood plasma of patients who have recovered from COVID-19 to treat those who are ill, saying current evidence shows it neither improves survival nor reduces the need for ventilators.
The method is also costly and time-consuming to administer, the WHO said in a statement.
The hypothesis for using plasma is that the antibodies it contains could stop the novel coronavirus from replicating and halt tissue damage. Several studies testing convalescent blood plasma have shown no apparent benefit for treating COVID-19 patients who are severely ill.
Omicron-specific vaccine likely to come too late to help in this wave: Sharma – Victoria News
Health Canada’s chief medical adviser says variant-specific vaccines can be approved faster than the general ones first issued to combat COVID-19, but one targeting the Omicron strain still likely won’t be ready in time to help with the latest wave.
Dr. Supriya Sharma said what is really needed are vaccines that can possibly stop more than one variant at a time, including those yet to come.
Omicron became the dominant variant in Canada in just over two weeks, and the Public Health Agency of Canada said Friday it’s now believed to be responsible for more than 90 per cent of all COVID-19 cases.
Studies suggest two doses of the existing mRNA vaccines from Pfizer-BioNTech and Moderna are not good at preventing infection from Omicron.
Multiple studies, however, suggest the vaccines are excellent at keeping symptoms mild, preventing hospitalizations, and shortening the stay and lowering the level of care for those who do get admitted to hospital. Fewer vaccinated Omicron patients, for example, need mechanical ventilation.
Both Pfizer and Moderna are working on new versions of their vaccines that specifically target the Omicron variant.
Moderna is hoping to get its product into trials early this year. Pfizer said it could have 100 million doses of theirs ready as early as March, and Canada has contracts for boosters from both companies that would include vaccines for variants too.
But Sharma said even with the expedited review process for vaccine variants, that’s “probably not” fast enough.
“By that time, based on what we’ve known about the Omicron wave, it might well and truly be through,” she said. “And then the question is always, ‘is there another variant that’s coming up?’”
The solution, she said, likely lies with vaccines that can target more than one variant at a time.
The COVID-19 vaccine technical committee of the World Health Organization said the same thing on Jan. 11, noting Omicron is the fifth variant of concern in two years and “is unlikely to be the last.”
Booster shots that heighten antibody development became the immediate response to Omicron for many governments, including Canada.
Dr. Srinivas Murthy, a British Columbia pediatrician and co-chair of the WHO’s clinical research committee on COVID-19, told The Canadian Press that boosters aren’t a long-term viable option.
“Boosting your way out of a pandemic is going to inevitably shoot you in the foot in the sense that you’re going to have a future variant that’s going to emerge that’s going to cause problems,” he said. “It’s going to evade your vaccines, and then you’re going to have to scramble.”
Omicron doesn’t evade the existing vaccines entirely but a future variant could, he said. The issue largely stems from the fact that the original vaccines train the body’s immune system to recognize what is called the spike protein found on the surface of a virus, and that spike protein is mutating significantly.
Think of the mutated spike protein as a bit of a disguise that makes it harder for the immune system to recognize the virus and mount a defence to kill it off.
Omicron has more than 50 mutations, and at least 36 are on the spike protein.
Multivalent vaccines that use the spike protein from more than one variant, or that target the genetic components of a virus rather than the spike protein, are possibly the ones that could offer protection for both this pandemic and the next novel coronavirus that emerges.
“It’s pan-coronavirus, where it’s looking at big broad neutralizing responses and you don’t have to update it every season and so on,” said Murthy. “That’s been the Holy Grail of flu vaccinology for the past number of decades. We haven’t achieved that yet, because flu is a bit tricky, but we think that it’s achievable for coronavirus, specifically.”
The United States Army has a version heading into Phase 2 trials that can attach multiple spike proteins. A vaccine with the specific spike proteins from all five COVID-19 variants of concern would likely be more successful, even against future variants, because they all share some of the same mutations and what one might miss another may catch.
Moderna is working on trials for multivalent vaccines using combinations of the spike proteins from the original virus and one of the variants, or two of the variants together. It’s not clear when they would be ready for use.
Sharma said even if the vaccines aren’t working as well against variants as they were against the original virus, to her “they’re still miraculous.”
“To have a vaccine that was developed that quickly, that still has, through multiple variants … with boosters, up to 70, 80 per cent effectiveness against serious disease, ailments, hospitalization and death,” she said. “That is miraculous for a new vaccine for a new virus.”
Mia Rabson, The Canadian Press
Canada approves Pfizer’s oral COVID-19 antiviral treatment, seeks supplies
Canada on Monday approved Pfizer Inc’s oral antiviral treatment for mild to moderate cases of COVID-19 in people aged 18 and older but said supply shortages would keep doses from being made available immediately.
Infections and hospitalizations due the Omicron variant have been rising in Canada, forcing provinces to put in restrictions and the federal government to support impacted businesses.
“(This) is particularly important, as access to easy to use treatments could help to reduce the severity of COVID-19 in adults who become newly infected at high risk of progressing to serious illness,” said chief public health officer Theresa Tam.
Pfizer’s two-drug antiviral regimen, Paxlovid, was nearly 90% effective in preventing hospitalizations and deaths in patients at high risk of severe illness, according to data from the company’s clinical trial.
It is meant to be taken at home for five days beginning shortly after onset of symptoms.
Ottawa said last month it had signed a deal with Pfizer for a million treatment courses, pending approval. But getting those supplies could face hurdles.
“While there is currently limited global supply of Paxlovid, we are working to firm up a delivery schedule with the intent of bringing treatment courses to Canada as quickly as possible,” Tam told a briefing.
Ontario, the most populous of the 10 provinces, is seeing signs that Omicron cases may have peaked, said chief medical officer Kieran Moore.
“I’m starting to have much more hope … the number of cases is decelerating instead of accelerating in terms of hospitalizations and (people admitted to) intensive care units,” he told an Ottawa radio station.
Official data show that as of Jan 8, 87.8% of Canadians aged 12 and above had received two doses of a COVID-19 vaccine.
The U.S. authorized the Pfizer treatment for people ages 12 and older last month.
Canada is still looking at whether to approve Merck & Co’s oral antiviral pill, molnupiravir, which had less impressive results than Paxlovid in its pivotal clinical trial.
(Reporting by David Ljunggren in Ottawa and Ismail Shakil in Bengaluru; Editing by Franklin Paul and Bill Berkrot)
January 16, 2022 coronavirus update for Oakville – Oakville News
This is Oakville’s coronavirus update for Sunday, Jan. 16, 2022. As children head back to school tomorrow, the main takeaway from today’s COVID-19 update is the increase in the number of outbreaks in long-term care, retirement, and hospital facilities. OTMH is now dealing with two outbreaks as a new one was declared at 5 South, and the province has 231 hospitals recording ongoing outbreaks, an increase nice.
A new outbreak at OTMH was declared but not shown on the region’s update of Friday, Jan. 14, 2022. Halton does not provide new information on weekends or holidays.
- Oakville – 70 patients – plus 6
- Halton – 126 patients – plus 10
- Ontario – 3,595 patients – minus 362 (ICU 563 plus 19, Ventilators 327 plus 19)
There are currently nine active outbreaks with 58 cases (LTC-41, retirement homes-13, hospitals-2) in Oakville.
Long-term care facilities status
- 424 ongoing outbreaks -plus 9
- 27,391 cases – plus 320
- 39,06 resident deaths – plus 9
- 319 ongoing outbreaks – plus 16
- 231 ongoing outbreaks – plus 16
- 1st Dose (5+) – 90%
- 2nd Dose (5+) – 83%
- Boosters (18+) – 48%
Ontario administered 117,300 vaccinations
- 1st Dose (5+) – 82%
- 2nd Dose (5+) – 3%
The number of confirmed new cases in Oakville, Halton and Ontario is under-reported since the province restricted access to testing, limiting it to high-risk individuals, healthcare providers, and patients.
- 36,184 cases – plus 552 or 5,962.2 cases per million
- 634.6 new weekly cases per 100,000, down 15.9 per cent from 2 weeks ago
- 948,086 total cases – plus 10,450 or 6,434.7 cases per million
- 503.1 new weekly cases per 100,000, down 22.4 per cent from 2 weeks ago
- 843,073 recoveries – plus 15,317
- 10,605 deaths – plus 40
- 94,408 active cases – minus 4,907
**Vaccine booking: Halton continues to book first and second-dose vaccinations for all residents age five and older, plus third-dose boosters for all adults age 18 and up.
Parents must make booster doses and appointments for children in advance, but first and second doses for those 12 and up are available on a walk-in basis.
All vaccines approved for use in Canada effectively protect you against COVID-19 and all known variants of concern.
The evidence is clear: vaccination is the best way to be protected. Local, provincial, national and international health units all affirm the same data that Canada’s approved vaccines effectively protect you from COVID-19 and significantly reduce your risks of getting sick, going to the hospital, and dying from the disease.
Pictured right is a graph from the Halton region showing how dramatically your risk of getting sick or being admitted to hospital is when vaccinated.
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