Vaccine supply chains and Delta Plus
Plus, monoclonal antibody treatments and vitamin D in India
Hey Health Deskers! We’ve got new recommendations from the WHO on some monoclonal antibody treatments this week, as well as a look at guidance on heart muscle inflammation after COVID-19 vaccines. Our scientists are also unpacking Delta Plus and the impact that COVID-19 is having on childhood and other immunization supply chains.
First, a look ahead …
New Challenges with Missed Routine Childhood Vaccinations
When COVID-19 began to spread across low- and middle-income countries, the World Health Organization (WHO) and UNICEF warned the world that the administration of life-saving vaccines for preventable illnesses was declining greatly as a result of the novel coronavirus. Routine childhood immunizations for diseases like diptheria, tetanus and pertussis (DTP3) were missed while the expansion of the HPV vaccine to 106 countries slowed down dramatically. The WHO noted that because of this obstacle, children were in danger and decades of progress in fighting preventable diseases may be lost.
Before the COVID-19 pandemic began, immunization rates for measles and the DTP3 illnesses were 85% but today, the likelihood of a child being fully vaccinated with all the globally recommended vaccines by the age of 5 is less than 20%. Will these declines lead to a new pandemic for old diseases? We hope not but are following the data to keep you informed. See our explainer on this topic below for more details.
Two Monoclonal Antibody Drugs Recommended by WHO
The WHO recently recommended the use of two new monoclonal antibody medications to be used alongside corticosteroids to treat patients with severe COVID-19 infections. This recommendation came after a new study was published in the Journal of the American Medical Association which evaluated 27 trials in 23 countries with roughly 11,000 patients. It found that the two new medications helped reduce the risk of death and the need for mechanical ventilation.
The drugs were first created to treat the autoimmune disease rheumatoid arthritis. Against COVID-19, they were most useful when they were administered with corticosteroids. Doctors believe this is because the drugs help mediate the immune system's overreaction to severe COVID-19 infections, so this news may be most useful in countries without widespread access to vaccines.
Delta Variant and Vaccine Response
As the world grapples with the rapid spread of the delta variant, scientists are learning just how protective some vaccines can be against severe forms of the virus. The threats posed by these types of viral mutations are notable given the lack of vaccine access faced by dozens of countries, especially in low-income nations.
A French study revealed that the Delta variant was able to evade some of the neutralizing antibodies generated by either natural infection or vaccines, noting a single dose from a two-shot vaccine produced very little protection. However, when given two shots of the AstraZeneca or Pfizer vaccines, fully vaccinated people should be able to keep significant protection against the variant. How protective other vaccines are against the delta variant is being studied now, but given its infectiousness and ability to cause severe infections, it is clear that vaccinating as many people as possible with the most protective vaccines as possible is paramount to slowing down the infection.
And now, here are the latest topics our scientists are unpacking for you:
Did the Indian government provide vitamin D to control COVID-19?
Despite vastly improved rates of COVID-19, India did not distribute vitamin D among its residents in order to stop the virus from spreading. Though some vitamin D studies have suggested some positive results for preventing and treating COVID-19 (especially in people with vitamin D deficiencies), results are still mixed. At this time, there is not enough evidence to support the link between taking vitamin D supplements and preventing or treating the virus.
“There have been dozens of studies researching the impacts of vitamin D on COVID-19 infections. This is likely due to a 2017 study which found that vitamin D may be helpful in fighting off respiratory infections. The analyses involved 25 randomized controlled trials with 11,000 people who received vitamin D supplements. The largest impact occurred in people who began the study with serious vitamin D deficiencies. Many people have taken this study's findings to suggest that vitamin D can prevent any respiratory infections, which is not what the study actually notes. Additionally, COVID-19 is unlike other respiratory infections. It is a specific type of virus with unique characteristics that very few humans have developed any immune protection against. For that reason, it is difficult to apply the 2017's study's findings to such a specific and novel virus.”
What impact is COVID-19 vaccine production having on other immunizations?
Vaccine production for COVID-19 immunizations has interrupted, delayed, re-organized, or completely suspended other shots, especially routine childhood vaccines. As a result, many countries have been experiencing a decline in immunization coverage of vaccine-preventable childhood diseases.
“Carving out manufacturing capacity for COVID-19 vaccines in such a short period of time requires the global vaccine production process to divert existing manufacturing capacity to make COVID-19 vaccines. Diversion of capacity for COVID-19 has already threatened the production of other therapeutic drugs, such as monoclonal antibodies, which are widely used to treat cancers.”
What do we know about heart muscle inflammation after COVID-19 vaccination?
Heart muscle inflammation or "myocarditis" has appeared in a small group of people, mostly men under 30, who recently received a COVID-19 mRNA vaccine. The United States Centers for Disease Control and Prevention is monitoring the cases in young adults and said there is a "likely association" between the vaccines and reported cases of heart inflammation, but there is not a deep enough understanding of this issue to understand why vaccines may contribute to the condition. The group calls these events "important but uncommon" as they are highly rare.
'“Heart muscle inflammation, otherwise known myocarditis, is a condition caused most commonly by viral infections. It can also be caused by bacterial or fungal infections, autoimmune diseases, severe reactions to medicines, and exposure to certain environmental toxins. Common symptoms of myocarditis include chest pain, shortness of breath and heart palpitations. It most frequently occurs in young men, and those with pre-existing medical conditions. Myocarditis is a rare condition and is most commonly treated with medicines over a week to ten days. Very rarely, myocarditis can lead to hospitalization.”
What do we know about how the Delta Plus variant differs from the Delta variant?
The Delta Plus variant has mutations that are similar to the Delta variant. It has an additional mutation called K417, which is also found in the Beta variant that was linked to high hospitalization rates and the Gamma variant that was linked to high transmission rates.
“Some scientists question whether there is sufficient data at this time to indicate that the Delta Plus variant is more dangerous than the Delta variant. Typically, researchers study several hundreds of patients sick with a variant to find out whether they are at greater risk of disease. There were under 200 examples of Delta Plus on the global open sharing database GISAID at the time of India's announcement of the new Variant of Concern.”
That’s all for this time folks, have a good week and we’ll be back soon with more science to share!