Stunning Effectiveness of the Covid Vaccines

[Ygggdrasil]

A study by the CDC of 12-18 year olds shows that the Pfizer vaccine is 90% effective at preventing multisystem inflammatory syndrome in children.

What is already known about this topic?

The Pfizer-BioNTech vaccine, currently authorized for persons aged ≥5 years, provides a high level of protection against severe COVID-19 in persons aged 12–18 years. Vaccine effectiveness against multisystem inflammatory syndrome in children (MIS-C), which can occur 2–6 weeks after SARS-CoV-2 infection, has remained uncharacterized.

What is added by this report?

Estimated effectiveness of 2 doses of Pfizer-BioNTech vaccine against MIS-C was 91% (95% CI = 78%–97%). Among critically ill MIS-C case-patients requiring life support, all were unvaccinated.

What are the implications for public health practice?

Receipt of 2 doses of Pfizer-BioNTech vaccine is highly effective in preventing MIS-C in persons aged 12–18 years. These findings further reinforce the COVID-19 vaccination recommendation for eligible children.

Effectiveness of BNT162b2 (Pfizer-BioNTech) mRNA Vaccination Against Multisystem Inflammatory Syndrome in Children Among Persons Aged 12–18 Years — United States, July–December 2021
https://www.cdc.gov/mmwr/volumes/71/wr/mm7102e1.htm

Popular press summary: https://www.reuters.com/business/he...st-rare-covid-19-complication-cdc-2022-01-07/

Two doses of the Pfizer Inc (PFE.N) and BioNTech (22UAy.DE) COVID-19 vaccine are highly protective against a rare but often serious condition in children that causes organ inflammation weeks after COVID-19 infections, a U.S. Centers for Disease Control and Prevention report said on Friday.

The vaccine was estimated to be 91% effective in preventing Multisystem Inflammatory Syndrome in Children (MIS-C) in 12- to 18-year-olds, the study said. MIS-C causes inflammation in children in organs including the heart, lungs, kidneys and brain two to six weeks after a mild or asymptomatic infection.

 

[Ygggdrasil]

Dr. Peter Hotez and Dr. Maria Elena Bottazzi of Texas Children's Hospital and Baylor College of Medicine have developed a COVID-19 vaccine that could prove beneficial to countries with fewer resources.

Protein subunit vaccines have been shown to have similar efficacy before (e.g. Novavax released data from a phase 3 trial of its protein subunit vaccine back in January 2021 which showed 90% efficacy against symptomatic infection; it also recently received emergency use authorization in India). However, despite being among the vaccine candidates selected for funding by the Coalition for Epidemic Preparedness Innovations (CEPI) and Project Warp Speed, it has fairly consistently failed to meet expectations in delivering its vaccine, in part due to many manufacturing issues. Whether these manufacturing issues are limited to Novavax or applies to other protein subunit vaccines (like the CORBEVAX vaccine) is not clear. However, these issues may stem from Novavax's lack of experience with production and manufacturing, an issue that would also likely apply to the CORBEVAX vaccine as well. Thus, having a working vaccine is not sufficient for making an impact on global vaccination; it is also important to have the experience to scale up production as well.

Here's a nice piece in the BMJ discussing some of the issues with the Novavax vaccine: https://www.bmj.com/content/375/bmj.n2965

Hopefully, Novavax and CORBEVAX are able to scale up production of their vaccines and deliver them around the globe as they would be sorely needed to ensure everyone in the world is able to get vaccinated, which may help slow the emergence of new variants.

 

[fresh_42]

I found an interesting analysis of virtual vaccine side-effects:

Question What was the frequency of adverse events (AEs) in the placebo groups of COVID-19 vaccine trials?

Findings In this systematic review and meta-analysis of 12 articles including AE reports for 45 380 trial participants, systemic AEs were experienced by 35% of placebo recipients after the first dose and 32% after the second. Significantly more AEs were reported in the vaccine groups, but AEs in placebo arms (“nocebo responses”) accounted for 76% of systemic AEs after the first COVID-19 vaccine dose and 52% after the second dose.

https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2788172

 

[Astronuc]

COVID-19 Incidence and Death Rates Among Unvaccinated and Fully Vaccinated Adults with and Without Booster Doses During Periods of Delta and Omicron Variant Emergence — 25 U.S. Jurisdictions, April 4–December 25, 2021​

https://www.cdc.gov/mmwr/volumes/71/wr/mm7104e2.htm?s_cid=mm7104e2_w

In 25 U.S. jurisdictions, decreases in case incidence rate ratios for unvaccinated versus fully vaccinated persons with and without booster vaccine doses were observed when the Omicron variant emerged in December 2021. Protection against infection and death during the Delta-predominant period against infection during Omicron emergence were higher among booster vaccine dose recipients, and especially among persons aged 50–64 and ≥65 years.

During the first two weeks of January 22 (1 Jan - 14 Jan), New York state reported the following mortality. Cumulative means from March 2020-present, Fraction = (1-14 Jan)/(Cumulative). Note the larger fractions for the 0-9 and 10-19 groups, which are mostly likely unvaccinated and may have underlying comorbities. Nevertheless, SARS-Cov-2 can result in mortality of children, adolescents, youth and young adults. The numbers represent those fatalities in health care or elder care facilities (i.e., confirmed). Not included in the cumulative are approximately 12,600 who died outside of medical facilities (so may or may not be confirmed, or are probable). There are no statistics/data (demographic, co-morbidity) on these cases. Also not included are 9 deaths for whom the age is unknown/not reported.

          Cumulative  1-14Jan,2022  Fraction of
Age Group   Deaths      Deaths      Cumulative
90 and Over  7,915         351       0.0443
80 to 89    13,480         541       0.0401
70 to 79    13,024         475       0.0365
60 to 69     9,207         336       0.0365
50 to 59     4,401         196       0.0445
40 to 49     1,575          72       0.0457
30 to 39       659          34       0.0516
20 to 29       203          12       0.0591
10 to 19        26           4       0.1538
0 to 9          23           5       0.2174
             50513        2026

Currently, New York State reports 51532 cumulative deaths (so more than 1100 deaths in past week) and a total reported to the CDC of 64120.

 

[bhobba]

Here in Queensland, with 90% double vaccinated, of the 50 in ICU, 40% were unvaccinated. Vaccination looks like it does provide significant protection. The number of deaths we are seeing is about the same, so far, as a bad flu season. Considering the large difference in R0, this is very positive. Fingers crossed, these early signs are maintained as the predicted peak is now occurring or nearing where I live.

Thanks
Bill

 

[atyy]

Here in Queensland, with 90% double vaccinated, of the 50 in ICU, 40% were unvaccinated. Vaccination looks like it does provide significant protection. The number of deaths we are seeing is about the same, so far, as a bad flu season. Considering the large difference in R0, this is very positive. Fingers crossed, these early signs are maintained as the predicted peak is now occurring or nearing where I live.

Thanks
Bill

Hmmm, like a very bad flu season ... is it still looking like triple vax is good enough, even among the elderly? It's sad to see so many deaths in Australia even with 99% of the elderly double vaccinated - triple vax was necessary and good enough (except for the immunocompromised) for Delta. Is triple vax still good enough for Omicron?

 

[bhobba]

Is triple vax still good enough for Omicron?

We will know when the peak is over.

Thanks
Bill

 

[fresh_42]

Is triple vax still good enough for Omicron?

I think the current opinion is that triple J&J does not work very well, but 2 Pfizer and 1 Moderna (or the other way around) work best.

I have read today that the reason why Omicron is less severe than Delta is, that Omicron can't stop the cells from interferon production.

 

[Ygggdrasil]

Is triple vax still good enough for Omicron?

Laboratory tests of serum from people with different vaccination statuses suggests that the booster shot does induce the development of antibodies against Omicron:

In this issue of Cell, three studies confirm that SARS-CoV-2 Omicron strongly evades a key immune defense—neutralizing antibodies. However, while one- or two-dose vaccine regimens fail to induce anti-Omicron neutralizing antibodies, a homologous third-dose booster rescues neutralization function in a way that highlights the adaptability of immune memory, where recalled immunity extends antibody reach across SARS-CoV-2 variants.

https://www.cell.com/cell/fulltext/S0092-8674(22)00006-X?rss=yes

Here are the three studies that the article references:
SARS-CoV-2 Omicron-B.1.1.529 leads to widespread escape from neutralizing antibody responses
https://www.cell.com/cell/fulltext/S0092-8674(21)01578-6

mRNA-based COVID-19 vaccine boosters induce neutralizing immunity against SARS-CoV-2 Omicron variant
https://www.cell.com/cell/fulltext/S0092-8674(21)01496-3

The Omicron variant is highly resistant against antibody-mediated neutralization: Implications for control of the COVID-19 pandemic
https://www.cell.com/cell/fulltext/S0092-8674(21)01495-1

This data from laboratory tests is backed up from observational data collected by the CDC showing that individuals who received boosters were less likely to be infected:

https://www.cdc.gov/mmwr/volumes/71/wr/mm7104e2.htm

The original vaccine series (without booster) still seems effective at preventing deaths from Omicron, which is consistent with data showing that vaccination can induce T-cells that target all major variants of the virus, and that memory T-cell responses were much more durable than neutralizing antibody and memory B-cell responses:

SARS-CoV-2 vaccination induces immunological T cell memory able to cross-recognize variants from Alpha to Omicron
https://www.cell.com/cell/fulltext/S0092-8674(22)00073-3

Abstract:

We address whether T cell responses induced by different vaccine platforms (mRNA-1273, BNT162b2, Ad26.COV2.S, NVX-CoV2373) cross-recognize early SARS-CoV-2 variants. T cell responses to early variants were preserved across vaccine platforms. By contrast, significant overall decreases were observed for memory B cells and neutralizing antibodies. In subjects ∼6 months post-vaccination, 90% (CD4+) and 87% (CD8+) of memory T cell responses were preserved against variants on average by AIM assay, and 84% (CD4+) and 85% (CD8+) preserved against Omicron. Omicron RBD memory B cell recognition was substantially reduced to 42% compared to other variants. T cell epitope repertoire analysis revealed a median of 11 and 10 spike epitopes recognized by CD4+ and CD8+ T cells, with average preservation > 80% for Omicron. Functional preservation of the majority of T cell responses may play an important role as second-level defenses against diverse variants.

 

[Ygggdrasil]

I think the current opinion is that triple J&J does not work very well, but 2 Pfizer and 1 Moderna (or the other way around) work best.

I have read today that the reason why Omicron is less severe than Delta is, that Omicron can't stop the cells from interferon production.

Do you have sources for these two statements? I would be interested in seeing the data.

 

[fresh_42]

Do you have sources for these two statements? I would be interested in seeing the data.

Not really. I read it in the news. They said today that triple J&J vaccination doesn't count as immune anymore over here, in the sense that additional tests are required to participate in certain events. The effectiveness of the combined vaccination had been in the news since they tried to push boosters a few months ago and omicron was on the rise. It made sense to me, as the vaccines and their mechanisms are significantly different, so I didn't search for a source. I was just happy that I had Pfizer/BionTech + Moderna.

The statement with the interferon was from today. A group of researchers from Frankfurt and Bristol Kent figured it out IIRC. I think it is
https://www.biorxiv.org/content/10.1101/2022.01.03.474773v1

Here are some old studies that interferon plays a central role:
https://www.science.org/doi/10.1126/science.abd4585
https://www.science.org/doi/10.1126/science.abd4570

 

[StevieTNZ]

"If the vaccine is so effective, then why are more vaccinated people currently in hospital in New Zealand with COVID?"
As Dr Leighton Watson explains, it's actually just a mathematical error.

- https://www.newshub.co.nz/home/new-...CUBu2hn_qDBMxuil_5rpgp7PU7cxy4Unqr4UAqIc_IlQk

 

[bhobba]

"If the vaccine is so effective, then why are more vaccinated people currently in hospital in New Zealand with COVID?"

I can't count the number of people that said when it was written in the paper of the 50 in intensive care, 40% was unvaccinated - this proves the vaccine is ineffective. We have 90% double vaccinated over 12 in Queensland. Those in intensive care are all over 12, so we can forget those under 12. If it was ineffective, what would the percentage be? 10% unvaccinated. It makes you wonder - it really does.

Thanks
Bill

 

[nsaspook]

Some interesting new data on how immunity has changed over time.

https://www.cdc.gov/mmwr/volumes/71/wr/mm7104e1.htm

The understanding and epidemiology of COVID-19 has shifted substantially over time with the emergence and circulation of new SARS-CoV-2 variants, introduction of vaccines, and changing immunity as a result. Similar to the early period of this study, two previous U.S. studies found more protection from vaccination than from previous infection during periods before Delta predominance (3,7). As was observed in the present study after July, recent international studies have also demonstrated increased protection in persons with previous infection, with or without vaccination, relative to vaccination alone†††, §§§ (4). This might be due to differential stimulation of the immune response by either exposure type.¶¶¶ Whereas French and Israeli population-based studies noted waning protection from previous infection, this was not apparent in the results from this or other large U.K. and U.S. studies**** (4,8). Further studies are needed to establish duration of protection from previous infection by variant type, severity, and symptomatology, including for the Omicron variant.

https://stacks.cdc.gov/view/cdc/113253

 

[atyy]

The original vaccine series (without booster) still seems effective at preventing deaths from Omicron, which is consistent with data showing that vaccination can induce T-cells that target all major variants of the virus, and that memory T-cell responses were much more durable than neutralizing antibody and memory B-cell responses:

I agree that the original double vax is highly protective against death due to Delta and Omicron. But already with Delta, double vax wasn't quite enough for us to remove all restrictions and have the number of Covid deaths be in the range of flu. For that, we needed triple vax. So I'm wondering whether triple vax is still enough for Omicron, if our goal is to have Covid deaths in the range of flu (or even fewer) - assuming of course nearly 100% vaccination, especially in the elderly.

For Omicron, it seems triple vax might do that, but vaccine effectiveness is lower than for Delta. So is it the case that triple vax is still fine against Omicron, but part of the reason is that the reduced vaccine effectiveness is compensated by Omicron being milder than Delta? For example, triple vax VE against Omicron hospitalization is about 90%, whereas triple vax VE against Delta hospitalization was about 98-99%.

 

[bhobba]

So I'm wondering whether triple vax is still enough for Omicron, if our goal is to have Covid deaths in the range of flu (or even fewer) - assuming of course nearly 100% vaccination, especially in the elderly.

In Queensland, Omicron is nearing its peak and perhaps past it in some places. 90% over 12 are at least double vaccinated, with 50% of those triple vaccinated - and growing. We are getting about ten deaths a day. In 2019 Queensland had 264 die from the flu. We need more data to say exactly how deadly it is compared to the flu. So far, not as many have died, but the outcome, I think, will depend on how fast the peak tapers off. I think we can say with three doses; it is comparable to the flu, but nothing definitive as yet. Note that people in Queensland, especially the risk groups, voluntarily are taking precautions even without mandating it. It is so obvious it makes you wonder why all the fuss about mandating it. I think history may have a different view than those that lived through it with all its arguments about protecting people and violating human rights. Only with time will we know.

The following link let me see the story using my google account:
https://www.brisbanetimes.com.au/na...-peak-of-omicron-sets-in-20220125-p59qyp.html

The precis is:
'Queensland falls silent as the peak of Omicron sets in. A silence is descending on Queensland as people avoid outings, shopping districts and public transport, and as businesses cancel Australia Day events while the peak of the highly contagious Omicron variant of Coronavirus sets in. The first school term has been delayed by two weeks, but 25,800 students returned to state schools on Monday as classrooms opened for essential workers’ children. People are avoiding shopping districts and public transport as Omicron nears its peak. Queensland recorded 10,212 new COVID cases in the past 24 hours, although experts admit the true number is higher. Of the 878 COVID patients in the hospital, 50 were in intensive care units. The state is no longer reporting how many people are in quarantine. Chief Health Officer John Gerrard said the Gold Coast was either “close to or past” the peak of the surge in Omicron, with Brisbane, marked next.'

Thanks
Bill

 

[nsaspook]

https://www.newsweek.com/denmark-end-most-covid-restrictions-welcome-life-we-knew-before-1673373

"We say goodbye to the restrictions and welcome the life we knew before," Frederiksen said. "As of Feb. 1, Denmark will be open."

According to Health Minister Magnus Heunicke, Denmark's recent cases of COVID were more than 46,000 daily on average; however, only 40 people are in hospital intensive care units.

"It may seem strange that we want to remove restrictions given the high infection rates," Frederiksen said. "But fewer people become seriously ill."

 

[bhobba]

https://www.newsweek.com/denmark-end-most-covid-restrictions-welcome-life-we-knew-before-1673373

Yes, it is, on the surface, strange. We are finding that Brisbane people voluntarily adhere to all the recommended restrictions without mandates. It could be a good one for future psychology researchers to look into. The group adhering least is the younger age group (under 40) which, of course, is to be expected. Surprise, surprise, that is the group that hospitalisations have increased compared to previous variants.

Thanks
Bill

 

[fresh_42]

It could be a good one for future psychology researchers to look into.

I have learned that there are three kinds of people. A minority that obeys the rules i.e. wears masks and keeps distance and a majority that does not. That majority splits into a major group of people who pretend as if there was no pandemic, and a minority that demonstrates, running around and insisting to tell the world how proud they are of their stupidity.

It's harder than usual to keep faith in mankind.

 

[BillTre]

If it were a more deadly virus, it would kill off the last group and change the mind of the second group.

 

[StevieTNZ]

This recent discussion reminds me of this article I saw earlier - https://www.forbes.com/sites/annaka...taurants-after-testing-positive-for-covid-19/

 

[berkeman]

A minority that obeys the rules i.e. wears masks and keeps distance and a majority that does not.

Goofball...

 

[atyy]

https://assets.publishing.service.g...050721/Vaccine-surveillance-report-week-4.pdf
In people aged above 50, triple vax reduces the risk of death by Omicron by 95%. I think this is less than it was for Delta (98-99%), but given that Omicron is about 25-75% (huge uncertainty about the value) milder than Delta, this partially makes up for the slightly lower vaccine effectiveness. So I think triple vax is looking effectively like it could get us to a death rate like that of flu, even if almost all restrictions are removed (maybe good to retain some, like isolation of sick people, testing of close contacts), if 100% of the population (especially the elderly and vulnerable) are vaccinated.

 

[atyy]

German health minister (mis?)quotes Hegel in support of a vaccination mandate

 

[Ygggdrasil]

Here are two studies published last week in the journal Science studying the effectiveness of COVID vaccines in reducing transmission of the virus:

Indirect protection of children from SARS-CoV-2 infection through parental vaccination
https://www.science.org/doi/full/10.1126/science.abm3087

Abstract:

Children unvaccinated against SARS-CoV-2 may still benefit through protection from vaccinated contacts. We estimated the protection provided to children through parental vaccination with the BNT162b2 vaccine. We studied households without prior infection, consisting of two parents and unvaccinated children, estimating the effect of parental vaccination on the risk of infection for unvaccinated children. We studied two periods separately– an early period (January 17, 2021 - March 28, 2021, Alpha variant, two doses vs. no vaccination) and a late period (July 11, 2021 - September 30, 2021, Delta variant, booster dose vs. two-vaccine doses). We found that having a single vaccinated parent was associated with a 26.0% and 20.8% decreased risk, and having two vaccinated parents was associated with a 71.7% and 58.1% decreased risk, in the early and late periods, respectively. To conclude, parental vaccination confers substantial protection for unvaccinated children in the household.

Vaccination with BNT162b2 reduces transmission of SARS-CoV-2 to household contacts in Israel
https://www.science.org/doi/full/10.1126/science.abl4292

Abstract:

The individual-level effectiveness of vaccines against COVID-19 is well established. However, few studies have examined vaccine effectiveness against transmission. We used a chain binomial model to estimate the effectiveness of vaccination with BNT162b2 (Pfizer-BioNTech mRNA-based vaccine) against household transmission of SARS-CoV-2 in Israel before and after the Delta variant emerged. Vaccination reduced susceptibility to infection by 89.4% [95% confidence interval (CI): 88.7%, 90.0%], whereas vaccine effectiveness against infectiousness given infection was 23.0% (95% CI: −11.3%, 46.7%) during days 10 to 90 after the second dose before June 1, 2021. Total vaccine effectiveness was 91.8% (95% CI: 88.1%, 94.3%). However, vaccine effectiveness is reduced over time as a result of the combined effect of waning of immunity and the emergence of the Delta variant.

Popular press summary from CIDRAP: https://www.cidrap.umn.edu/news-per...edly-cuts-household-transmission-studies-show

A pair of studies in yesterday in Science show the substantial benefit of COVID-19 vaccination to household contacts in Israel, including unvaccinated children. But one of the studies highlighted waning protection over time.

 

[Ygggdrasil]

Here's a nice animation from Twitter showing how vaccinations, improved treatments, and the Omicron variant have altered the mortality associated with COVID-19:



Of course, a caveat later in the twitter thread is worth re-iterating here:

NB: when it comes to Covid's overall burden, remember that IFR is multiplied by total number of infections, so with Covid (and particularly the most recent variants) being much more transmissible than flu, it's not as simple as "only 2x as lethal, great"

 

[Astronuc]

The human immune system’s ability to remember past infections is one of its hallmarks, but a durable response is not guaranteed. Some infections and immunizations elicit lifelong protection, but for others, the response is modest and requires regular reminders in the form of booster shots or new, reformulated vaccines. COVID-19 has forced on the world a chance to explore the intricacies of this complex and crucial biological phenomenon. “It’s an amazing natural experiment,” says Donna Farber, an immunologist at Columbia University in New York City. “It’s just this unbelievable opportunity to look at human immune responses in real time.”

What the Omicron wave is revealing about human immunity​

https://www.nature.com/articles/d41586-022-00214-3