In a recent study published in The Laryngoscope, researchers assessed the incidence of new-onset tinnitus after coronavirus disease 2019 (COVID-19) vaccination.
The growing prevalence of vaccine hesitancy and anxiety about the messenger ribonucleic acid (mRNA) COVID-19 vaccine’s side effects has become an important global health concern. As a result, throughout the COVID-19 pandemic, extensive research has been conducted on the adverse effects of COVID-19 vaccination. Recently, tinnitus has drawn attention as a possible side effect of the mRNA COVID-19 vaccine. Following COVID-19 vaccination, patients have reported the development of life-altering tinnitus that may be accompanied by hearing loss, thus drastically damaging a patient’s quality of life.
About the study
In the present study, researchers determined the proportion of patients who experienced new-onset tinnitus within 21 days of receiving the COVID-19 vaccine compared to those who received influenza, polysaccharide pneumococcus, and Tdap (tetanus, diphtheria, and acellular pertussis) vaccines.
The TriNetX Analytics Network, a federated health research network, collected de-identified electronic health record (EHR) data from over 78 million patients across 45 health care organizations (HCOs) in the US. This data was employed to create a retrospective cohort design. In the US Collaborative Network of the TriNetX platform, there were 78,058,186 patients with any EHR.
Five patient groups were identified: (1) those who were administered the first mRNA COVID-19 vaccine dose between 15 December 2020 and 1 March 2022, (2) those who received their second mRNA COVID-19 vaccine dose between 15 December 2020 and 1 March 2022, (3) those who received the influenza vaccine between 1 January 2019 and 1 December 2019, (4) those who received Tdap vaccine between 1 January 2019 and 1 December 2019, and (5) those who received pneumococcal vaccine between 1 January 2019 and 1 December 2019.
The dates corresponding to the COVID-19 vaccination group ranged from the first day of COVID-19 vaccination in the US to a hypothetical date that provided a window of more than three weeks before the data was obtained. To rule out the likelihood of COVID-19 vaccination within these three groups, three additional common vaccination groups were evaluated throughout 2019.
The team defined a vaccination event as the first time a patient fulfilled the criteria in a specific time window, implying that the first COVID-19 dose was assessed in the first dose cohort. The COVID-19 second dosage group experienced precisely two documented vaccination procedures. The diagnosis of tinnitus in a patient with no prior history of the condition was referred to as new-onset tinnitus.
The study results showed that within 21 days of receiving their first and second dose of the mRNA COVID-19 vaccine, 0.038% of the 2,575,235 participants and 0.031% of the 1,477,890 participants were diagnosed with tinnitus. Following the second dose of the COVID-19 vaccine, there was a decreased likelihood of experiencing tinnitus than following the first dose. Compared to the influenza group, tinnitus was reported by 998,991 influenza vaccine patients and 1,009,935 first-dose COVID-19 vaccine patients. Furthermore, there were 720 cases of a new diagnosis of tinnitus in the influenza group and 374 cases in the first dose COVID-19 group.
As compared to the Tdap cohort, there were a total of 444,708 Tdap vaccine patients and 444,721 first-dose COVID-19 vaccine patients. These included 314 cases of a new tinnitus diagnosis in the Tdap group and 133 new tinnitus cases in the first dose COVID-19 group. in the case of the polysaccharide pneumococcal vaccine group, the team found 153,344 pneumococcal vaccine patients compared to 154,825 patients who received their first dose of the COVID-19 vaccine. Among these, there were 132 cases of a new encounter diagnosis of tinnitus in the pneumococcal vaccine patients, while 79 tinnitus cases occurred in the first dose COVID-19 group.
In comparing the COVID-19 second dose group, 1,516,282 patients received the second dose of the COVID-19 vaccine, while 1,516,282 patients received the first dose. These included 465 cases of a new diagnosis of tinnitus in the COVID-19 second dose group and 577 new tinnitus cases in the COVID-19 first dose group.
Overall the study findings showed that patients had a higher chance of experiencing tinnitus after receiving Tdap, influenza, and pneumococcus vaccines than after the first dose of the COVID-19 vaccine.
Hunting for Pi – the next variant after Omicron – in the toilet – Gavi, the Vaccine Alliance
Disease detectives are on the lookout for the next variant of COVID-19 and since the virus is still in such high circulation worldwide the virus is constantly mutating. This means it could be evolving to better evade vaccines and attack our immune systems. Although Omicron was milder than the variants came before it, scientists have warned the next variant – which will probably be called Pi – could be far more deadly.
“A lot of the lineages we are finding make Omicron look pedestrian.”
Sifting through sewage
As SARS-CoV-2 can be shed in faecal matter for weeks after the respiratory symptoms clear, wastewater is an obvious place to look for new variants.
Tracking circulating pathogens has long been an important way of finding early signals of the presence of a disease in a community – it was critical in the eradication of polio in India, for example. Researchers are also using these techniques to track the spread of monkeypox.
An initiative to look for SARS-CoV-2 in Bangalore, India, has provided early warnings of COVID-19 infection spikes, with the researchers able to identify which variants of SARS-CoV-2 are circulating, and in roughly what proportions.
Have you read
For much of this year, virologist Dr Dave O’Connor and colleagues at the University of Wisconsin-Madison have been tracking a heavily mutated version of SARS-CoV-2 that they narrowed down to one particular area of Wisconsin.
Scientists are starting to believe that chronic COVID-19 infections lingering for months in people who may have compromised immune systems are a hotbed of new variants, as the virus has a long time to mutate.
The variant Dr O’Connor’s team is tracking first appeared in sewage collected in January 2022, and though it shares numerous mutations with Omicron, it came from an entirely different part of the SARS-CoV-2 family tree. The team have tracked the lineage to a company of 30 employees and are now trying to determine their next move.
The next Omicron?
Dr Marc Johnson, a virologist at the University of Missouri in Columbia, is working with O’Connor to trace wastewater lineages in Wisconsin. With their colleagues, they are hunting so-called ‘cryptic lineages’, which are viral lineages in wastewater that didn’t match anything in global databases of millions of sequences.
These cryptic lineages were significant in that they often had several mutations in the spike protein that SARS-CoV-2 uses to enter our cells – and which our immune system targets. Dr O’Connor told Nature that such lineages could help forecast macro trends in SARS-CoV-2 evolution, which could in turn help the development of variant-proof vaccines and treatments.
For these virologists, a lot is riding on early detection of the next major COVID-19 variant. “A lot of the lineages we are finding make Omicron look pedestrian,” said Dr Johnson.
Canada has now ended its COVID-19 travel restrictions, mask mandates
OTTAWA — As of this morning, travellers to Canada do not need to show proof of vaccination against COVID-19 — and wearing a mask on planes and trains is now optional, though it is still recommended.
People entering the country are no longer subject to random mandatory tests for the virus, and those who are unvaccinated will not need to isolate upon arrival.
Anyone who entered Canada in the last two weeks and was subject to quarantine or testing is off the hook as of today.
And inbound travellers do not need to fill out the controversial ArriveCan app anymore, although they can still use it to fill out their customs declarations at certain airports.
Federal ministers announced the end of the COVID-19 public health restrictions earlier this week, saying the latest wave of the disease has largely passed and travel-related cases aren’t having a major impact.
But Health Minister Jean-Yves Duclos warned restrictions could be brought back again if they are needed.
This report by The Canadian Press was first published Oct. 1, 2022.
The Canadian Press
What do I need to know about this year's flu shot? – CBC.ca
Experts say it’s almost time to roll up your sleeve for the annual flu shot.
But this year, some pharmacists say people have questions about the influenza vaccine rollout, which will coincide with the rollout of COVID-19 vaccines that target Omicron strains — also known as bivalent vaccines.
Ashley Davidson, a pharmacist and associate owner of Shoppers Drug Mart in St. Albert, Alta., has fielded a lot of questions.
“So many people are asking about flu shots and I think a lot of that conversation comes around how do they time their vaccines and what does that look like?” she told Dr. Brian Goldman, host of CBC’s podcast The Dose.
Here’s what experts have to say about this year’s flu vaccines.
What do we know about the upcoming flu season?
The number of flu cases this year could look a little different than what we’ve seen over the last few years.
“What has changed in the last two years is we had historical lows throughout the pandemic and we’ve now been in the time of uncertainty about when is it going to come back, what is it going to look like,” said Dr. Robyn Harrison, vice-chair of the National Advisory Committee on Immunization (NACI) and infectious disease specialist, on Wednesday during a webinar on seasonal influenza.
An example of what could come is Australia’s recent flu season, which happens before Canada’s because it is in the southern hemisphere.
The country recently had its worst season in years, with data from Australia’s Department of Health and Aged Care showing influenza infections were higher than the five-year average and infections notably spiked, then dropped, earlier than usual.
Canadians also haven’t had much exposure to flu over the last couple of years because of mask mandates and other public health measures introduced during the pandemic, Davidson said.
“One thing that stands out to me this year is that we won’t have masks in schools. So that is going to increase the potential exposure for flu virus for children as well,” she said.
According to experts, influenza is a serious illness. Up until 2019, it is estimated that there are on average 12,000 hospital stays in Canada due to influenza every year, and about 3,500 deaths each year are caused by the flu, Harrison said.
Influenza is very contagious and spreads by respiratory droplets which cause an infection. Symptoms can vary but commonly include fever, sore throat, runny nose, cough, fatigue and muscle aches.
Who is eligible for a flu shot?
Experts say it’s important to get a flu shot each year as vaccine-induced immunity does wane over time.
There are three types of influenza vaccines approved in Canada, according to NACI:
- Inactivated influenza vaccine
- Recombinant influenza vaccines
- Live attenuated influenza vaccine
Anyone six months of age or older who does not have a known negative reaction to the vaccine should get a flu shot every year.
“The reason why children under six months of age are not included in that is because we know that they don’t mount a good immune response to influenza vaccines,” said Dr. Jesse Papenburg, a pediatric infectious disease and medical microbiology specialist, during Wednesday’s webinar. He is also the chair of the NACI influenza working group.
He said the suggested flu shot schedule for children nine and older and adults is one dose of the influenza vaccine at the beginning of flu season.
For kids aged six months to eight years who have yet to receive a flu shot, NACI recommends two doses given at least four weeks apart.
Who shouldn’t get a flu shot?
Papenburg said NACI recommendations for those who shouldn’t get any of the flu shots include:
- People who have had an anaphylactic reaction to any of the vaccine’s components, except for eggs.
- People who have developed Guillain-Barré syndrome (GBS) within six weeks of a previous flu vaccine (unless another cause has been found).
- Infants under six months of age.
NACI’s recommendations on who shouldn’t get the live attenuated influenza vaccine can be found here.
When should I get a flu shot?
Davidson recommends that people get the influenza vaccine as soon as it’s available.
Canada’s flu season typically lasts from mid-October to April or early May, Davidson said.
“I will often remind patients that although you can get your flu shot right away, it does take about two weeks to develop an immune response to that vaccination,” she said.
“It is important to get your shot as soon as you can to ensure that you have coverage through the flu season.”
Can I get a flu shot and a COVID-19 vaccine at the same time?
For most people, the short answer is yes.
For people age five and older, all seasonal influenza vaccines, including the live-attenuated influenza vaccine, may be given at the same time or before or after other vaccines, including COVID-19 vaccines, according to the most recent recommendations from NACI.
“It is important that you’re protected from both viruses throughout the winter,” said Davidson.
Daybreak Kamloops7:15Flu season expected to be more intense this year
However, kids aged six months to five years shouldn’t receive a COVID-19 vaccine and an influenza shot at the same time, according to NACI, which instead recommends those in this age group wait 14 days between COVID-19 shots and other vaccines.
It’s a precautionary approach “to prevent erroneous attribution of adverse events following immunization to one particular vaccine or the other,” reads the committee’s advice.
How effective are flu vaccines this year?
Experts say influenza vaccines have been proven to help prevent influenza, transmission, complications and hospitalizations.
The effectiveness of flu vaccines can vary year-to-year because it all depends on the strains circulating, Davidson and Harrison said.
For the 2004-2005 flu season to 2019-20, Harrison said the effectiveness of influenza vaccines in Canada has varied between around 40 to 70 per cent.
Every year, World Health Organization (WHO) experts make recommendations on which strains of the influenza virus should be targeted by the vaccines.
This year, WHO recommended three influenza strains — one influenza A (H1N1); one influenza A (H3N2) and one influenza B — for inclusion in the trivalent flu shot.
Although the flu vaccine’s effectiveness can vary, both Harrison and Davidson agree that it does offer protection.
“The effectiveness of the vaccine may not be 100 per cent and may not persist beyond a year, but has impact and that’s why it’s recommended,” Harrison said.
Written and produced by Stephanie Dubois
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