UN OCHA – Current Emergencies Current Corporate Emergencies Afghanistan No new updates identified.
Northern Ethiopia Ethiopia – Northern Ethiopia Humanitarian Update Situation Report, 29 Apr 2022 HIGHLIGHTS
3,400 MT of food brought into Tigray between 1 and 25 April. At least 4,675 MT of food are required every day to complete current food distribution by mid-May.
More than 46,000 students across 144 schools in Wag Hemra Zone, South Wello, North Wello Oromia zones of Amhara Region received school feeding services during the reporting week.
Some 16,500 IDPs in Amhara Region have been assisted with essential NFI kits during this reporting week.
82,884 people received food assistance in Fanti Raise and Kilbati Rasu zones in Afar during the reporting period and overall 698,503 peopl assisted as of 25 April.
WHO & Regional Offices [to 30 Apr 2022] https://www.who.int/news News [Selected] 29 April 2022 Statement Quadripartite Memorandum of Understanding (MoU) signed for a new era of One Health collaboration
27 April 2022 Joint News Release UNICEF and WHO warn of perfect storm of conditions for measles outbreaks, affecting children [See Milestones above for detail]
27 April 2022 Departmental news WHO launches a second report of country success stories in mitigating the impact of the COVID-19 pandemic on TB services
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WHO Director General Speeches [selected] https://www.who.int/director-general/speeches Selected 27 April 2022 Speech WHO Director-General’s opening remarks at the 10th meeting of the Access to COVID-19 Tools Accelerator Facilitation Council – 26 April 2022
27 April 2022 Speech WHO Director-General’s remarks at the Investment Case for Polio Eradication – 26 April 2022
27 April 2022 Speech WHO Deputy Director-General’s speech at the OECD Council on the 2030 Agenda for Sustainable Development: Session 2: Global health challenges in the era of COVID-19
26 April 2022 Speech WHO Director-General’s opening remarks at the WHO press conference – 26 April 2022
25 April 2022 Speech WHO Director-General’s panel remarks at the Group of Friends of Global Health – 25 April 2022
25 April 2022 Speech WHO Director-General’s opening remarks at the Working Group on Sustainable Finance, final meeting – 25 April 2022
WHO Region of the Americas PAHO
:: 29 Apr 2022 Environmental surveillance – complementary tool for tracking COVID-19
Over 60 countries, including several in the Americas, are using wastewater monitoring to track SARS-CoV-2 in communities, with over 3,300 active sites. Washington, D.C., April 29, 2022 (PAHO) — New guidance from the World Health Organization (WHO) provides advice to countries on sampling and testing for the SARS-CoV2 virus in untreated…
:: 25 Apr 2022 PAHO Director calls for immunization gaps to be closed for all vaccines, including COVID-19
2.7 million children in the Americas did not receive the vaccines needed to keep them healthy in 2020, while around 230 million people have still not received a single dose of COVID-19 vaccine in the region Roseau, Dominica, 25 April 2022 (PAHO) – In 2020, 2.7 million children in the Americas did not receive the essential vaccines needed to keep…
:: 25 Apr 2022 World Malaria Day – More must be done to improve malaria response at the local level
Washington D.C., 25 April 2022 (PAHO) – On World Malaria Day, the Pan American Health Organization (PAHO) urges countries to step-up efforts to tackle malaria in the region, calling for prevention, diagnosis and treatment interventions that are data-led and tailored to local contexts. While in 2020, the 18 endemic countries of the Americas…
Disease Outbreak News (DONs)
Latest WHO Disease Outbreak News (DONs), providing information on confirmed acute public health events or potential events of concern. 28 April 2022 | Ebola virus disease – Democratic Republic of the Congo
27 April 2022 Polio transition planning and polio post-certification Overview
The Executive Board at its 150th session noted an earlier version of this report.1 The present report provides an update on the implementation of the Strategic Action Plan on Polio Transition (2018–2023)2 at the start of 2022, within the context of the coronavirus disease (COVID-19) pandemic.
27 April 2022 Strengthening pandemic preparedness planning for respiratory pathogens: policy brief, 27 April 2022 Overview
This policy brief outlines core elements that Member States are encouraged to a) develop an integrated approach to respiratory pathogen pandemic preparedness planning and b) enhance national and sub-national functional capacities for preparedness. In addition, this policy brief highlights suggested actions for Member States as they initiate or update national and sub-national pandemic preparedness planning process.
Careful readers will note that the number and range of organizations now monitored in our Announcements section below has grown as the impacts of the pandemic have spread across global economies, supply chains and programmatic activity of multilateral agencies and INGOs.
Highlights include: a new Lab Notes podcast on why we don’t understand the brain, new research about how neurons connect, day-in-the-life features of our neuroscience labs and more.
The Bill & Melinda Gates Medical Research Institute is a non-profit biotech organization. Our mission is to develop products to fight malaria, tuberculosis, and diarrheal diseases—three major causes of mortality, poverty, and inequality in developing countries. The world has unprecedented scientific tools at its disposal; now is the time to use them to save the lives of the world’s poorest people
The European & Developing Countries Clinical Trials Partnership (EDCTP) aims to accelerate the development of new or improved drugs, vaccines, microbicides and diagnostics against HIV/AIDS, tuberculosis and malaria as well as other poverty-related and neglected infectious diseases in sub-Saharan Africa, with a focus on phase II and III clinical trials
Ahead of World Malaria Day, 25 April, the Global Fund calls for renewed commitment in the fight against malaria, a disease that now kills one child every minute. After years of steady declines, malaria cases and deaths are on the rise mainly due to s…
This is primarily because many are unable to bear the cost of travelling to a vaccine centre in the main city while others fear getting the vaccination owing to misinformation and lack of awareness.As a result, their families and communities remain v
Geneva (ICRC) – At its meeting on 27 April, the Assembly of the International Committee of the Red Cross (ICRC) appointed Ms Samia Hurst-Majno as its newest member.
Kuala Lumpur/Suva 28 April 2022 – The International Federation of Red Cross and Red Crescent Societies are increasingly concerned for more than 1 million people in Pacific nations as they struggle with their first major wave of COVID-19 fuelled by the Omicron variants.
Ramping up vaccinations is vital as the rapid surge in COVID infections is causing increasing death and illness in countries with low immunisation rates.
COVID-free for almost two years, Vanuatu, the Solomon Islands, Tonga, Kiribati, and Samoa have all experienced outbreaks in their capitals, and the virus is spreading to vulnerable outer island communities which lack basic treatment and vaccination facilities.
The virus is putting huge strains on fragile healthcare systems in population centres such as Honiara, Port Vila and Nuku’alofa. A rising number of healthcare workers are being struck down with COVID-19, further limiting health services and escalating the crisis…
ISC is a non-governmental organization with a unique global membership that brings together 40 international scientific Unions and Associations and over 140 national and regional scientific organizations including Academies and Research Councils.
On this International Day of Immunology, join ISC Member the International Union of Immunological Societies (IUIS) in celebrating the theme of vaccines with promotional and educational activities.
International Union of Immunological Societies (IUIS)
The National Academy of Medicine (NAM) Action Collaborative on Clinician Well-Being and Resilience is working urgently to develop a National Plan for health workforce well-being. The draft plan will be released in May 2022 for public input and builds on almost six years of collective work among 200 Clinician Well-Being Collaborative members and network organizations. […]
Despite progress made since the adoption of the 2030 Agenda for Sustainable Development and its 17 Goals (SDGs), OECD countries have met or are close to meeting only a quarter of the targets for which performance can be gauged, according to a new OECD report.
Starting in August 2020, the World Bank collaborated with the World Food Programme (WFP) and implemented nine (9) rounds of the Iraq High Frequency Phone Survey (IHFPS) as part of the WFP’s monthly mVAM…
WASHINGTON, April 28, 2022—The World Bank and government and foundation partners today launched a new program to scale up quality, affordable childcare in developing countries – a critical investment to…
We are meeting to discuss the issues of preparedness and response after more than two years of a global Pandemic. Although the situation has improved, we still need to be cautious given the case numbers…
Date: April 27, 2022 Type: Speeches and Transcripts
The Committee on Market Access held on 26 April the second experience-sharing session on COVID-19-related goods, with members reporting on how they have monitored and measured trade in essential goods to combat the pandemic. They also discussed ways to improve data collection at a time of crisis. In addition, members explored how to promote greater international cooperation to better track the trade flows of value chains for the manufacturing of essential COVID-19-related products.
Record food prices and a worsening food security context have given new urgency to the role of trade in addressing the challenges we face today, Director-General Okonjo-Iweala said at a seminar on food security organized by the WTO on 26 April. In her opening remarks, she said the event provided an opportunity to deepen understanding of the issues at stake and to help members take concrete steps forward so that trade can contribute to the attainment of food security around the world.
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ARM [Alliance for Regenerative Medicine] [to 30 Apr 2022]
Janet Lynch Lambert will step down as the CEO of the Alliance for Regenerative Medicine after guiding the leading international advocacy organization for cell, gene and tissue-engineered therapies through five years of extraordinary growth in membership, funding, and influence. In Lambert’s time as the CEO of ARM, the membership doubled to more than 425 diverse global members and the organization’s budget and full-time staff tripled…The ARM board has constituted an 8-person Search Committee to conduct the search for a CEO successor, and Lambert is a key member of that committee. Executive search firm Catalyst Advisors, led by Partner Gilbert Forest, has been retained to support the search….
USTR this week released its 2022 Special 301 Report. BIO, after reviewing the report, released the following statement:
“We welcome USTR’s efforts to address IP-related concerns for U.S.-based biotech enterprises in China, especially concerning China’s coercive technology transfer policies, patent prosecution, and patent enforcement obstacles. USTR’s emphasis on monitoring China’s progress in implementing its Phase One Agreement commitments to address these longstanding IP matters is encouraging…”
Journal Watch Vaccines and Global Health: The Week in Review continues its weekly scanning of key peer-reviewed journals to identify and cite articles, commentary and editorials, books reviews and other content supporting our focu-s on vaccine ethics and policy. Journal Watch is not intended to be exhaustive, but indicative of themes and issues the Center is actively tracking. We selectively provide full text of some editorial and comment articles that are specifically relevant to our work. Successful access to some of the links provided may require subscription or other access arrangement unique to the publisher.
If you would like to suggest other journal titles to include in this service, please contact David Curry at: david.r.curry@centerforvaccineethicsandpolicy.org
Health Equity in US Latinx Communities
Latinx communities in the US include over 60 million people with a plurality of political beliefs, cultural practices, and wealth. This diversity is also expressed in population health data: some health indicators suggest advantages of Latinx community membership while other data demonstrate inequitable disease burden and maldistribution of environmental and occupational risk. Legacies of colonial conquest of the Americas persist in discrimination and marginalization today and are embodied by members of our Latinx communities.
Integrated delivery of family planning and childhood immunisation services: a mixed methods assessment of service responsiveness Postpartum women represent a considerable share of the global unmet need for modern contraceptives. Evidence suggests that the integration of family planning (FP) with childhood immunisation services could hel…
Authors: Jessie K. Hamon, Misozi Kambanje, Shannon Pryor, Alice S. Kaponda, Erick Mwale, Helen E. D. Burchett, Susannah H. Mayhew and Jayne Webster
Citation: BMC Health Services Research 2022 22:572
Content type: Research Published on: 28 April 2022
Robustness analysis for quantitative assessment of vaccination effects and SARS-CoV-2 lineages in Italy In Italy, the beginning of 2021 was characterized by the emergence of new variants of SARS-CoV-2 and by the availability of effective vaccines that contributed to the mitigation of non-pharmaceutical intervent…
Authors: Chiara Antonini, Sara Calandrini and Fortunato Bianconi
Citation: BMC Infectious Diseases 2022 22:415
Content type: Research Published on: 29 April 2022
Circulating vaccine derived polio virus type 1 outbreak, Saadah governorate, Yemen, 2020 Yemen has faced one of the worst humanitarian crises in the world since the start of the war in 2015. In 2020; 30 Vaccine Derived Polio Virus type 1 (VDPV1) isolates were detected in Saadah governorate. The ai…
Authors: Mutahar Ahmed Al-Qassimi, Mohammed Al Amad, Labiba Anam, Khaled Almoayed, Ahmed Al-Dar and Faten Ezzadeen
Citation: BMC Infectious Diseases 2022 22:414
Content type: Research Published on: 29 April 2022
Exploration of attitudes regarding uptake of COVID-19 vaccines among vaccine hesitant adults in the UK: a qualitative analysis The aim of this work was to explore barriers and facilitators to uptake of COVID-19 vaccines and to explore views and reactions to efforts to improve vaccine uptake among vaccine hesitant individuals.
Authors: Sarah Denford, Fiona Mowbray, Lauren Towler, Helena Wehling, Gemma Lasseter, Richard Amlôt, Isabel Oliver, Lucy Yardley and Matthew Hickman
Citation: BMC Infectious Diseases 2022 22:407
Content type: Research Published on: 26 April 2022
Predictors of COVID-19 vaccine acceptability among health professions students in Vietnam The COVID-19 vaccine hesitancy or refusal has actually been a threat to global health. In the current situation, health professions students are at risk for SARS-CoV-2 infection during their internship at heal…
Authors: Cua Ngoc Le, Uyen Thi To Nguyen and Diem Thi Hoang Do
Citation: BMC Public Health 2022 22:854
Content type: Research Published on: 28 April 2022
What are the reasons for refusing a COVID-19 vaccine? A qualitative analysis of social media in Germany Vaccination against COVID-19 has been available in Germany since December 2020. However, about 30% of the population report not wanting to be vaccinated. In order to increase the willingness of the population …
Authors: Jana Fieselmann, Kübra Annac, Fabian Erdsiek, Yüce Yilmaz-Aslan and Patrick Brzoska
Citation: BMC Public Health 2022 22:846
Content type: Research Published on: 27 April 2022
A tool for early estimation of influenza vaccination coverage in Spanish general population and healthcare workers in the 2018–19 season: the Gripómetro Electronic vaccine registries are not yet widely established. There is a need to real-time monitor influenza vaccine coverage, which may raise awareness to risk groups and professionals, and eventually allow t…
Authors: Javier Díez-Domingo, Esther Redondo Margüello, Raúl Ortiz de Lejarazu Leonardo, Ángel Gil de Miguel, José María Guillén Ortega, Jesús Rincón Mora and Federico Martinón-Torres
Citation: BMC Public Health 2022 22:825
Content type: Research Published on: 25 April 2022
Factors related to parents’ adherence to childhood immunization Immunizations protect children from deadly infectious diseases. Yet, there is still insufficient understanding of the factors associated with parents’ non-adherence to immunizations in contexts outside of West…
Authors: Fatimah Hobani and Eman Alhalal
Citation: BMC Public Health 2022 22:819
Content type: Research Published on: 25 April 2022
Improving the reproducibility and integrity of research: what can different stakeholders contribute? Increasing awareness of problems with the reproducibility and integrity of research led the UK Parliament Science and Technology Committee to launch, in July 2021, an inquiry into reproducibility and research …
Authors: Malcolm Macleod
Citation: BMC Research Notes 2022 15:146
Content type: Commentary Published on: 25 April 2022
Therapeutic Innovations in Neuroscience
The theme of this issue of Clinical Pharmacology & Therapeutics (CPT) encompasses neuroscience in the broad sense to include neurology and psychiatry, nonclinical and clinical aspects, novel clinical trial methodologies, and modeling and simulation approaches applicable to central nervous system (CNS) drug development and therapy. While naturally the last two years have been dominated by coronavirus disease 2019 (COVID-19), it is important not to forget that drug development for other indications has not been stopped, albeit many trials were affected in terms of delays in recruitment and collection of clinical data.
COMMENTARIES Open Access End Malaria Faster: Taking Lifesaving Tools Beyond “Access” to “Reach” All People in Need
Courtney Emerson, Jed Meline, Anne Linn, Julie Wallace, Bryan K. Kapella, Meera Venkatesan and Richard Steketee
Global Health: Science and Practice April 2022, 10(2):e2200118; https://doi.org/10.9745/GHSP-D-22-00118
To “reach the unreached” with preventive and curative malaria services, we must know which individuals and communities remain unreached and then bring tailored services from the clinic to the community and home.
Community Health Workers in Pandemics: Evidence and Investment Implications
Madeleine Ballard, Ari Johnson, Iris Mwanza, Hope Ngwira, Jennifer Schechter, Margaret Odera, Dickson Nansima Mbewe, Roseline Moenga, Prossy Muyingo, Ramatulai Jalloh, John Wabwire, Angela Gichaga, Nandini Choudhury, Duncan Maru, Pauline Keronyai, Carey Westgate, Sabitri Sapkota, Helen Elizabeth Olsen, Kyle Muther, Stephanie Rapp, Mallika Raghavan, Kim Lipman-White, Matthew French, Harriet Napier and Lyudmila Nepomnyashchiy
Global Health: Science and Practice April 2022, 10(2):e2100648; https://doi.org/10.9745/GHSP-D-21-00648
Community health workers have long played a critical role in preventing, detecting, and responding to pandemics across the globe. To expand, improve, and institutionalize these services, changes in the approach to bi/multilateral aid and private philanthropic investments in low- and middle-income countries are required.
VIEWPOINTS Open Access Strategies to Promote Health System Strengthening and Global Health Security at the Subnational Level in a World Changed by COVID-19
Martin Alilio, Neetu Hariharan, Elizabeth Lugten, Kama Garrison, Rhea Bright, Wilberforce Owembabazi, Uwem Inyang, Saad El-Din Hassan and Kelly Saldana
Global Health: Science and Practice April 2022, 10(2):e2100478; https://doi.org/10.9745/GHSP-D-21-00478
Structural weaknesses in national health systems have led to huge variations in responses to COVID-19. This calls for a unified approach to health security and essential health services as public health threats and the expectation for health care systems to provide improved access and services at affordable cost increases.
ORIGINAL ARTICLES Open Access Cost of Delivering Tetanus Toxoid and Tetanus-Diphtheria Vaccination in Vietnam and the Budget Impact of Proposed Changes to the Schedule
Vu Quynh Mai, Laura Boonstoppel, Kelsey Vaughan, Carl Schutte, Annette Ozaltin, Duong Thi Hong, Nguyen Mai Khanh, Hoang Manh Thang, Tran Tuan Anh and Hoang Van Minh
Global Health: Science and Practice April 2022, 10(2):e2100482; https://doi.org/10.9745/GHSP-D-21-00482
This study shows that replacing tetanus toxoid vaccination in Vietnam for girls aged 15–16 years in high-risk areas with routine tetanus-diphtheria vaccination for children aged 7 years mainly through a school-based delivery strategy will likely result in immunization cost savings.
Review Article What makes global healthcare partnerships successful? A systematic review Regan Guilfoyle, Alexander D. Morzycki & Abdullah Saleh
Pages: 662-671
Published online: 09 Mar 2021 ABSTRACT
Academic communities are increasingly involved in efforts to address the overwhelming burden of disease in low-middle income countries. There is, however, little research dedicated to understanding the best approach to creating a successful and sustainable global healthcare project. Our objective was to review the shared characteristics of successful healthcare partnerships between high- and low-middle income countries. Two independent reviewers conducted a systematic review. Articles, describing collaborative, healthcare partnerships between a high- and low-middle income countries between 1910 and September 2018, were included. Twenty-six articles were included. The majority of collaborations were initiated by either the host institution or as a joint decision between institutions. The primary goal of these collaborations revolved around medical education/training and curriculum development. Two partnerships, after more than a decade of collaboration, had achieved a self-sustaining programme. Lack of funding was identified as a major barrier to sustainability. Successful global healthcare partnerships require true collaboration and equal participation of all partners. Funding should be secured prior to programme development in anticipation of a minimum 10-year project. A minimum list of guidelines has been proposed to improve the chances of both a successful and sustainable collaboration.
Research Letter Secondary Attack Rates for Omicron and Delta Variants of SARS-CoV-2 in Norwegian Households
Silje B. Jørgensen, MD, PhD; Karin Nygård, PhD; Oliver Kacelnik, MD, PhD; et al.
free access has active quiz
JAMA. 2022;327(16):1610-1611. doi:10.1001/jama.2022.3780
This nationwide registry data study from Norway assesses the secondary attack rate of SARS-CoV-2 variants Delta and Omicron in an effort to estimate the transmissibility of the Omicron variant.
Myocarditis Following a Third BNT162b2 Vaccination Dose in Military Recruits in Israel
Limor Friedensohn, MD; Dan Levin, MD; Maggie Fadlon-Derai, MHA; et al.
free access has active quiz
JAMA. 2022;327(16):1611-1612. doi:10.1001/jama.2022.4425
This study assessed whether a third vaccine dose was associated with the risk of myocarditis among military personnel in Israel.
Medical News & Perspectives Clinical Trials Disrupted During War in Ukraine
Rita Rubin, MA
free access has audio
JAMA. 2022;327(16):1535-1536. doi:10.1001/jama.2022.5571
This Medical News feature describes how the Russian invasion has disrupted clinical trials in Ukraine as well as Russia.
COVID-19 vaccines: awareness, attitude and acceptance among undergraduate University students The myths and conspiracy theories on the COVID-19 vaccine cause people to be hesitant and maleficent towards the vaccine.
Authors: Firew Asres and Belachew Umeta
Citation: Journal of Pharmaceutical Policy and Practice 2022 15:32
Content type: Research Published on: 26 April 2022
Article | 07 March 2022 | Open Access SARS-CoV-2 is associated with changes in brain structure in UK Biobank
Gwenaëlle Douaud, Soojin Lee, Stephen M. Smith
After infection with SARS-CoV-2, individuals show a greater reduction in grey matter thickness and tissue contrast in the orbitofrontal cortex and parahippocampal gyrus; greater changes in markers of tissue damage in regions that are functionally connected to the primary olfactory cortex; and a greater reduction in global brain size.
Article Climate change increases cross-species viral transmission risk Colin J. Carlson, et al. Published: 28 April 2022 Abstract
At least 10,000 virus species have the capacity to infect humans, but at present, the vast majority are circulating silently in wild mammals1,2. However, climate and land use change will produce novel opportunities for viral sharing among previously geographically-isolated species of wildlife3,4. In some cases, this will facilitate zoonotic spillover—a mechanistic link between global environmental change and disease emergence. Here, we simulate potential hotspots of future viral sharing, using a phylogeographic model of the mammal-virus network, and projections of geographic range shifts for 3,139 mammal species under climate change and land use scenarios for the year 2070. We predict that species will aggregate in new combinations at high elevations, in biodiversity hotspots, and in areas of high human population density in Asia and Africa, driving the novel cross-species transmission of their viruses an estimated 4,000 times. Because of their unique dispersal capacity, bats account for the majority of novel viral sharing, and are likely to share viruses along evolutionary pathways that will facilitate future emergence in humans. Surprisingly, we find that this ecological transition may already be underway, and holding warming under 2 °C within the century will not reduce future viral sharing. Our findings highlight an urgent need to pair viral surveillance and discovery efforts with biodiversity surveys tracking species’ range shifts, especially in tropical regions that harbor the most zoonoses and are experiencing rapid warming.
Editorials Covid-19 Boosters — Where from Here? P.A. Offit
n December 10, 2020, Pfizer presented results from a 36,000-person, two-dose, prospective, placebo-controlled trial of its Covid-19 messenger RNA (mRNA) vaccine, BNT162b2, to the Food and Drug Administration (FDA).1 The vaccine was 95% effective at preventing severe illness in all age groups, independent of coexisting conditions or racial or ethnic background. A remarkable result. Six months later, studies showed that protection against severe disease was holding up.2 The results of these epidemiologic studies were consistent with those of immunologic studies showing long-lived, high frequencies of Covid-19–specific memory B and T cells, which mediate protection against severe disease.3
In September 2021, 10 months after the BNT162b2 vaccine had become available, Israeli researchers found that protection against severe illness in people 60 years of age or older was enhanced by a third dose.4 In response, the Centers for Disease Control and Prevention (CDC) recommended that people 65 years of age or older should receive three doses of an mRNA vaccine.
In a study now reported in the Journal,5 Israeli researchers found that in a study population with a median age of 72 years, protection against severe disease was further enhanced by a fourth dose of mRNA vaccine during the wave of infections caused by the B.1.1.529 (omicron) variant of SARS-CoV-2. These findings were considered by the FDA and CDC in their decision-making process regarding the use of an additional booster dose of mRNA vaccine for people 50 years of age or older.
What about booster dosing for persons who are younger? One year after the BNT162b2 vaccine became available, studies in the United States showed that a third dose of vaccine also enhanced protection against severe disease for people as young as 18 years of age.6,7 Unfortunately, these studies did not stratify patients according to whether they had coexisting conditions. Therefore, it was unclear who among these younger age groups most benefited from an additional dose. Nonetheless, the CDC later recommended that everyone 12 years of age or older should receive three doses of BNT162b2, regardless of whether risk factors were present. This universal booster recommendation led some summer camps, high schools, universities, hospitals, and businesses to require three doses of mRNA vaccine. In February 2022, in a study that did not support the booster recommendation for children, CDC researchers found that two doses of BNT162b2 induced long-lived protection against serious illness in children 12 to 18 years of age.8
In addition to protection against severe disease, the initial phase 3 trial of BNT162b2 — which was performed over a period of several months — also showed 95% protection against mild illness.1 Unlike protection against severe illness, however, protection against mild illness, which is mediated by high titers of virus-specific neutralizing antibodies at the time of exposure, declined after 6 months, as would have been expected.2 In response, studies by Pfizer were published in which a booster dose was shown to restore protection against mild illness9; unfortunately, this protection did not persist for more than a few months.6 Short-lived protection against mild illness will limit the ability of booster dosing to lessen transmission.
People are now confused about what it means to be fully vaccinated. It is easy to understand how this could happen. Arguably, the most disappointing error surrounding the use of Covid-19 vaccines was the labeling of mild illnesses or asymptomatic infections after vaccination as “breakthroughs.” As is true for all mucosal vaccines, the goal is to protect against serious illness — to keep people out of the hospital, intensive care unit, and morgue. The term “breakthrough,” which implies failure, created unrealistic expectations and led to the adoption of a zero-tolerance strategy for this virus. If we are to move from pandemic to endemic, at some point we are going to have to accept that vaccination or natural infection or a combination of the two will not offer long-term protection against mild illness.
In addition, because boosters are not risk-free, we need to clarify which groups most benefit. For example, boys and men between 16 and 29 years of age are at increased risk for myocarditis caused by mRNA vaccines.10 And all age groups are at risk for the theoretical problem of an “original antigenic sin” — a decreased ability to respond to a new immunogen because the immune system has locked onto the original immunogen. An example of this phenomenon can be found in a study of nonhuman primates showing that boosting with an omicron-specific variant did not result in higher titers of omicron-specific neutralizing antibodies than did boosting with the ancestral strain.11 This potential problem could limit our ability to respond to a new variant.
It is now incumbent on the CDC to determine who most benefits from booster dosing and to educate the public about the limits of mucosal vaccines. Otherwise, a zero-tolerance strategy for mild or asymptomatic infection, which can be implemented only with frequent booster doses, will continue to mislead the public about what Covid-19 vaccines can and cannot do.
vaccines and global health :: ethics and policy 