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 on Monday.
“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 trial dubbed Com-COV2, told Reuters.
The findings supporting flexible dosing will offer some hope to poor and middle income countries which may need to combine different brands between first and second shots 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 okay 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 the standard Pfizer-BioNTech course.
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 well before robust data was available as nations were faced with soaring infection numbers, low supplies and slow immunisation over some safety concerns.
Longevity of protection offered by vaccines has been under scrutiny, with booster doses being considered as well amid surging cases. New variants, including Delta and Omicron, have now 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 technology from different platforms – like Pfizer and Moderna’s mRNA, AstraZeneca’s viral vector and Novavax’s protein-based shot – and within the same schedule is new.
The results may inform new approaches to immunisation against other diseases, he 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.
(Reporting by Pushkala Aripaka in Bengaluru; Editing by Josephine Mason and Mark Heinrich)
Pakistan says trial of Chinese traditional medicine for COVID-19 successful
Pakistani health authorities on Monday announced the completion of a successful clinical trial of Chinese traditional herbal medicine for treating COVID-19, as the South Asian nation enters a fifth wave of the pandemic driven by the Omicron variant.
The Chinese medicine, Jinhua Qinggan Granules (JHQG) manufactured by Juxiechang (Beijing) pharmaceutical Co Ltd, is already being used in treatment of COVID-19 patients in China.
“Since it was tried on patients with different variants of COVID-19, we expect it to be effective on Omicron as on other variants,” Professor Iqbal Chaudhry, director of the International Center for Chemical and Biological Science (ICCBS) where trials were conducted, told reporters.
The trials were conducted on 300 patients who were treated at home, and would work on mild to moderate COVID-19 cases, Dr Raza Shah, principal investigator in the trials, told reporters, adding that the efficacy rate was around 82.67%.
The trials were approved by the Drug Regulatory Authority Pakistan.
Pakistan reported 4,340 COVID-19 cases on Monday, the highest recorded in a 24-hour period in three months. Karachi, the country’s largest city, recorded a positivity rate – the percentage of tests coming back positive – of 39.39% at the weekend, the highest so far.
“In the last seven days, COVID cases in Pakistan have increased by 170% while deaths have also increased by 62%,” the National Command Operation Centre (NCOC), which is overseeing the pandemic response, said in a tweet on Monday.
(Reporting by Syed Raza Hassan; Editing by Alex Richardson)
How (and why) to 'green' your Mediterranean diet – The Globe and Mail
A Mediterranean diet has been tied to better cognitive function, a lower rate of cognitive decline and a reduced risk of Alzheimer’s disease.
This eating pattern, plentiful in fruits and vegetables, whole grains, nuts and olive oil, has also been associated with lower rates of age-related brain atrophy, brain damage which can lead to cognitive impairment and dementia.
So far, though, there’s sparse data from randomized controlled trials on whether following a Mediterranean diet can preserve brain volume.
New research from Israel has shown that eating a Mediterranean diet slowed the age-related loss of brain tissue. What’s more, a new take on the diet, a “green” Mediterranean diet, had even greater brain-health benefits.
The latest study
The 18-month DIRECT PLUS trial, published Jan. 10 in the American Journal of Clinical Nutrition, investigated the effect of a high-polyphenol Mediterranean diet (a “green” Mediterranean diet) on age-related brain atrophy.
Polyphenols are naturally occurring compounds found in a wide range of plant foods. DIRECT PLUS stands for Dietary Intervention Randomized Controlled Trial – Polyphenols Unprocessed.
The researchers assigned 284 adults with abdominal obesity, average age 51, to one of three diet groups: 1) healthy diet guidelines, 2) a Mediterranean diet or, 3) a higher-polyphenol green Mediterranean diet.
Both Mediterranean diets were calorie-restricted and included 28 g of walnuts (e.g., 14 walnut halves), nuts high in polyphenols.
To boost polyphenols, the green Mediterranean diet included four to five cups of green tea daily and a green shake containing Mankai, a branded strain of an aquatic plant called duckweed (or water lentils). Those in the green Mediterranean diet group also further reduced their intake of processed and red meat.
All participants received free gym memberships and a program of aerobic and resistance exercise.
Participants underwent brain MRI (magnetic-resonance-imaging) scans before and after the trial. Specific areas of the brain were measured as indicators of brain atrophy and predictors of future dementia risk.
Over 18 months, participants in both Mediterranean diet groups had a significantly lower decline in brain atrophy compared to the healthy diet guideline group. The greatest decline in brain tissue loss, however, was observed among those consuming the green Mediterranean diet, especially in people over age 50.
The green Mediterranean diet components – green tea, Mankai and walnuts – were each associated with reduced brain atrophy, as was eating less red and processed meat.
Participants in both Mediterranean diet groups also had improvements in insulin sensitivity, which was also tied to less brain volume loss.
The study didn’t show a significant effect of either Mediterranean diet on cognition, perhaps because the study wasn’t long enough and/or it involved relatively young and healthy people.
All diet groups participated in physical exercise, which may have contributed to the slowdown of brain atrophy.
The strengths of this study include participants high adherence to their diets and that, to date, it’s the longest and largest brain MRI study investigating the effect diet on brain atrophy.
How polyphenols protect the brain
The beneficial effect of the Mediterranean diet on brain aging is thought to be due, at least in part, to its abundance of polyphenols, phytochemicals which have antioxidant and anti-inflammatory properties.
Polyphenols can cross the blood-brain barrier and have been shown to reduce nerve cell inflammation and stimulate an increase in brain cells.
Eating a Mediterranean diet rich in fish, vegetables and olive oil is also thought to protect the brain from a buildup of proteins that form plaques and destroy brain cells.
‘Greening’ your Mediterranean diet
Following a Mediterranean eating pattern means including vegetables, fruit, whole grains, pulses, nuts and olive oil in your daily diet.
Limit red meat to three meals a week. The green Mediterranean diet limits meat even further, getting more protein from beans, lentils and nuts. Flavour meals with polyphenol-rich herbs and spices.
Build on these staples by adding more polyphenol-rich foods to your daily diet, including 28 g of walnuts. Drink three or four cups of green tea each day (white and oolong tea also have polyphenols).
Drinking a Mankai green shake may be more challenging, though, at least for Canadians. In the U.S., frozen cubes of Mankai duckweed are sold online through Amazon and WW (Weight Watchers). Mankai duckweed powder is also available online.
Add other polyphenol-rich foods to your diet, too, such as berries, apples, kale, broccoli, spinach, cocoa, tofu, edamame, flaxseed and pecans.
Leslie Beck, a Toronto-based private practice dietitian, is director of food and nutrition at Medcan. Follow her on Twitter @LeslieBeckRD
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Moderna CEO says data for Omicron-specific shot likely available in March
Moderna Inc’s vaccine candidate against the Omicron coronavirus variant will enter clinical development in the next few weeks and the company expects to be able to share data with regulators around March, CEO Stephane Bancel said on Monday.
“The vaccine is being finished … it should be in the clinic in coming weeks. We are hoping in the March timeframe to be able to have data to share with regulators to figure out next steps,” Bancel said at the World Economic Forum’s virtual Davos Agenda conference.
Moderna is also developing a single vaccine that combines a booster dose against COVID-19 with its experimental flu shot. (https://reut.rs/3FAeyya)
Bancel said the best case scenario was the combined COVID/flu vaccine would be available by the fall of 2023, at least in some countries.
“Our goal is to be able to have a single annual booster so that we don’t have compliance issues where people don’t want to get two to three shots a winter.”
Many countries are already offering a third dose of a COVID-19 vaccine to their citizens, especially to older individuals and those who are immunocompromised, while Israel has started offering its citizens a fourth dose.
Earlier in January, Moderna’s CEO said people may need a fourth shot in the fall of 2022 as the efficacy of boosters against COVID-19 was likely to decline over the next few months.
However, booster programs have met with skepticism from some disease experts over whether, and how widely, additional doses should become available, including the European Union’s drug regulator, which has expressed doubts about the need for a fourth booster dose.
Speaking at the same event, top U.S. infectious disease expert Anthony Fauci said there was no evidence that repeat booster doses would overwhelm the immune system.
“Giving boosters at different times, there is really no evidence that’s going to hinder (immune response).”
Fauci said the goal should be to have a booster that induces a response against multiple potential variants.
(Reporting by Mrinalika Roy in Bengaluru; Editing by Mark Potter)
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