Skip to content
For the nearly 100 million people around the world who’ve been infected with the coronavirus, new science offers some comfort: Reinfections appear to be rare, and you may be protected from Covid-19 for at least five months.
The study, the largest of its kind, followed more than 20,000 health workers in the UK, regularly testing them for infection and antibodies. Between June and November, the researchers — from Public Health England (PHE) — found 44 potential reinfections out of the 6,614 participants who had tested positive for antibodies or had a previous positive PCR or antibody test when they joined the study. Meanwhile, of the 14,000-plus people who had tested negative for the virus at the start of the study, there were 409 new infections.
Only two of the 44 potential reinfections were designated “probable” and the rest were considered “possible,” “based on the amount of confirmatory evidence available,” according to the health agency. Fifteen people — or 34 percent — had symptoms.
So if all 44 reinfections are real, that translates to an 83 percent lower risk of reinfection compared to health workers who never had the virus. If only two are confirmed, that rate of protection goes up to 99 percent. Either way, it suggests natural immunity might provide a similar level of protection as the approved Covid-19 vaccines.
But as with the vaccines, it’s not yet clear how long immunity after an infection lasts. Antibodies may fade after five months or last much longer, something the researchers behind the ongoing study, which will run for a total of 12 months, plan to investigate.
“This [new] study does provide some comfort that naturally acquired antibodies are pretty effective in preventing reinfections,” Akiko Iwasaki, an immunobiologist at Yale University, told Vox. The findings also square with another paper on health workers, published in the New England Journal of Medicine in December: Researchers found people who had Covid-19 antibodies were better protected from the virus for six months than people who did not.
Iwasaki added, “You can also interpret these data to mean that protection against reinfection is not complete — especially for people who had Covid during the first wave, say in March-April 2020.”
People who had the virus may still be able to pass it on if reinfected
The good news for individuals who have had Covid-19 also comes with a warning about the risk they can still pose to other people. While antibodies might protect against a second case of Covid-19 in most people, “early evidence from the next stage of the study suggests that some of these individuals carry high levels of virus and could continue to transmit the virus to others,” PHE warned in its press release.
“We now know that most of those who have had the virus, and developed antibodies, are protected from reinfection, but this is not total,” Susan Hopkins, a senior medical adviser at PHE and the study lead, said in a statement, “and we do not yet know how long protection lasts.”
In other words, even if you’ve had Covid-19, while you’re unlikely to get really sick again anytime soon, you should still consider yourself a potential risk of spreading it to others if you catch the virus again and are asymptomatic. That means continuing to take precautions — like mask-wearing and social distancing, Iwasaki added. And it’s one reason why immunologists have said people who’ve already been infected with the virus should still plan to get the vaccine when their turn comes.
So there’s still a lot more to learn about immunity after Covid-19: How will the new coronavirus variants affect it? Lab data from South Africa, where the 501Y.V2 variant has been spreading, suggests it might be able to escape antibodies produced by prior infections in some people.
Who is most likely to have a strong immune response? We do have some evidence that different individuals mount different antibody responses after Covid-19 infections, but the PHE researchers found no statistically significant difference in rates of protection between people who reported symptoms and those who did not. It’s also possible factors like gender and disease severity influence the strength of a person’s immune response.
For now, though, the research suggests that survivors of the virus might just help us get to herd immunity faster — if their immunity lasts long enough. But given the virus has only been known to humans for a little over a year, it may take a while to authoritatively answer the question.
Click Here:
THE GPA HAVE backed Antrim’s bid to have their Ulster SFC opener against Cavan played at Corrigan Park next month.
The Saffrons were drawn first out of the hat for the 23 April clash, handing them their first home championship game in nine years.
But an Ulster county board meeting last week saw delegates vote in favour of a Cavan motion to move the game out of the Belfast venue. Only Antrim, Tyrone and Derry voted against the motion.
The Breffni County requested a change of venue due to Corrigan Park’s capacity of around 3,700. It is being used as Antrim’s home pitch while Casement Park remains closed for a development which has stalled for years.
A switch to a neutral venue in Armagh or Omagh was mooted it the game was moved.
The GPA are standing by Antrim’s case to retain home advantage and insist the game should take place at the original venue.
Click Here:
“So long as the ground can host the game safely which appears to be the case, it is only fair and proper that the game should go ahead in Corrigan Park as per the draw last November,” a GPA spokesperson told The42.
A final decision has not been made on the matter yet. Antrim are set to state their case at an Ulster CCC meeting on Wednesday night.
Meanwhile, Wexford GAA have pulled out of a planned event on Friday due to the GPA’s dispute with the GAA over travel expenses.
Darragh Egan and a number of hurlers were due to give interviews.
“It has now been decided to postpone the media interview opportunity aspect of the event,” a statement said
“This is due to the current GPA request to players for non-engagement with the media.”
SEE SPORT
DIFFERENTLY
Get closer to the stories that matter with exclusive analysis, insight and debate in The42 Membership.
Become a Member
-Additional reporting by Sinéad Farrell
Ireland internationals Devin Toner and Lindsay Peat were our guests for The Front Row’s special live event, in partnership with Guinness, this week. The panel chats through Ireland’s championship chances ahead of the final round of Guinness Six Nations matches, and members of the Emerald Warriors – Ireland’s first LGBT+ inclusive rugby team – also join us to talk about breaking down barriers in rugby. Click here to subscribe or listen below:
Scientists are increasingly concerned about a rapidly spreading variant of the virus that causes Covid-19 that was first detected in South Africa. The variant may be more transmissible and could weaken protection from vaccines and prior infections.
There’s evidence from several small, and not-yet-peer-reviewed, studies that mutations in the South Africa variant — known as 501Y.V2 or B.1.351 and already present in at least 23 countries — may lead to reinfections in people who’ve been sick and still should have some immunity.
This 501Y.V2 variant is one of several seemingly more contagious variants of the new coronavirus currently in circulation. For instance, the B.1.1.7 variant that was first identified in the United Kingdom has already spread to several countries, and public health officials expect it will soon become dominant in the US.
But the variant first identified in South Africa is perhaps more alarming because of the prospect that the mutations it contains could limit the effectiveness of existing vaccines, one of the best tools we have for controlling the pandemic.
In their latest report, Moderna — the maker of one of two vaccines on the US market — found the British variant didn’t affect the levels of virus antibodies in the blood of people who had been vaccinated relative to prior variants, but the same wasn’t true for the South Africa strain. “These lower [antibody levels/titers] may suggest a potential risk of earlier waning of immunity to the new B.1.351 strains,” according to a January 25 press release.
The results of this and other recent studies are “a serious indication we have to look hard at how well vaccines might work,” Penny Moore, a virologist at the National Institute for Communicable Diseases in South Africa, told Vox. Taken together, they highlight the dangers of letting Covid-19 spread unchecked, and portend the challenges that lie ahead as the virus continues to evolve.
What the coronavirus variant discovered in South Africa might mean for Covid-19 vaccines
For the Moderna study, which is not yet peer-reviewed, researchers took the blood of eight people who had been vaccinated, as well as two monkeys, and tested it to see how the antibodies responded to the new variants compared with older versions of the virus. The UK variant did not seem to affect an individual’s antibody levels, but the South Africa variant did, reducing them by sixfold relative to older variants.
The company said that even the reduced antibody titers are high enough to still offer protection against the virus, meaning the vaccine will likely still prevent illness stemming from the 501Y.V2 variant. However, it points toward a path of mutations where the level of protection could erode faster than it would against older versions of the virus, increasing the risk of reinfection.
Moderna is now investigating how to reformulate its vaccine to better target the 501Y.V2 variant, while also studying whether an additional booster shot of its current vaccine could increase the levels of antibodies that can neutralize the variant.
The Moderna news comes after studies from other labs have arrived at similar conclusions. For a preprint paper (i.e., non-peer-reviewed) led by Rockefeller University scientists, researchers tested blood samples from 14 people who had received the Moderna vaccine and six who were immunized with the Pfizer/BioNTech vaccine. One particular mutation, named E484K, along with two others found in the South Africa variant, were associated with a “small but significant” drop in antibody activity, the researchers found.
Moore, of the National Institute for Communicable Diseases in South Africa, is the lead author of a new study on 501Y.V2, out as a preprint on BioRxiv. She and her team in South Africa took blood plasma samples from 44 people who had been infected with the coronavirus during the country’s first wave of infections last summer, and checked how their existing antibodies responded to 501Y.V2 as well as older variants.
The researchers sorted the plasma samples into categories — high and low antibody concentrations. In 21 cases — nearly half — the existing antibodies were powerless against the new variant when exposed in test tubes. This was especially true for plasma from people who had a mild previous infection, and lower levels of antibodies, to begin with.
These findings suggest immunity from previous versions of the virus might not help individuals fend off the new variant if they’re exposed, particularly if their prior case was mild or symptom-free.
For Fred Hutchinson Cancer Research Center scientist Trevor Bedford, who was not involved in the research, the study also came as a possible warning sign about the vaccines. As early as autumn this year, manufacturers may need to begin reformulating their shots to respond to the changes in the virus’s genetic code, he wrote on Twitter:
The specific mutation scientists are most worried about
The 501Y.V2 variant carries one mutation of particular concern, known as E484K. This change appears in the part of the virus, the spike protein, that fits into the receptor in human cells. The spike protein is also the major target for the currently available mRNA vaccines, from Pfizer/BioNTech and Moderna.
“This mutation sits right in the middle of a hotspot in the spike,” Moore said. And it’s become notorious among virologists for its ability to elude coronavirus antibodies.
Scientists have demonstrated how this might happen in other cell culture experiments. A new study, also in preprint form from South African researchers, took a similar approach to Moore’s — testing how antibodies from six convalescent plasma donors react to 501Y.V2. But this time they used live virus, considered “the gold standard for these experiments,” said study co-author Richard Lessells, a University of KwaZulu-Natal infectious disease specialist. And their findings pointed in the same direction: 501Y.V2 can — at least in the lab — escape the antibody response elicited from a prior infection, and the E484K mutation “has the clearest association with immune escape.”
In another recently published BioRxiv preprint, researchers in Washington state tracked how mutations altered the effectiveness of the antibody response in convalescent plasma of 11 people — and also found E484K had particularly potent antibody evasion capabilities.
Other variants of concern also carry the E484K mutation, including one first identified in Manaus, Brazil, known as P.1. And one case study suggests reinfection in some people might be possible when they’re exposed to the new variant.
In a preprint, researchers in Brazil documented the case of a 45-year-old Covid-19 patient with no comorbidities, who, months after her first bout with the illness, was reinfected with the new variant. The patient experienced more severe illness the second time around. While it’s limited evidence, it “might have major implications for public health policies, surveillance and immunization strategies,” the authors wrote.
The study’s broader context is also concerning: After up to three-quarters of the population in Manaus, Brazil, was estimated to be infected with the virus during a spring surge, cases are piling up again and hospitals are filling up. Researchers suspect reinfections with the new variant could be a driver.
“The news is not all grim”
But “the news is not all grim,” said University of Utah evolutionary virologist Stephen Goldstein. The Rockefeller University preprint found antibodies from the vaccine may be more potent than antibodies from a previous infection. And the antibodies induced by the vaccines “are so high to start with that the serum was still extremely potent against the mutant.”
To fully understand the threat the mutations pose to vaccines, we’ll need clinical trials involving vaccinated people, Moore said. “These studies flag a problem,” she added, “but how that translates to real life, we can’t tell.”
Click Here:
There’s also huge variation in immune responses among people, Goldstein said. In the Washington paper, the researchers found “extensive person-to-person variation” in how the mutations affected an individual’s antibody response.
“The bottom line there is some reason for concern about reduced efficacy, but efficacy will not fall off a cliff,” Goldstein said. “The vaccines are incredibly potent. … If [they go] from 95% [efficacy] to 85% or even a little lower, we are still in great shape.” That’s why researchers and public health officials are heavily advocating for everyone to be vaccinated as quickly as possible.
Even so, Moore cautioned: “From an immune escape point of view, the variants first detected in Brazil and South Africa are more of a concern, but this is just the beginning. It’s our first indication that this virus can and does change.”
It’s possible that as we learn more, even the E484K mutation won’t turn out to undermine the vaccines. But there may be other changes to the virus lurking out there or evolving that will escape even vaccine-induced antibodies. “So many people now are infected that this is an arms race — the virus is now given every opportunity to mutate,” Moore said, “so it can take those steps on the pathway to immune escape more easily.”
Since December, a handful of fortunate end-of-day shoppers have received coveted doses of the coronavirus vaccine by simply being in the right place at the right time. That place, during a pandemic, could be a Safeway or a Walgreens. Some of these recipients are young and healthy adults, and have likened their surprise immunization to winning the lottery.
As the country embarks on a decentralized Covid-19 vaccine rollout program, grocery stores and pharmacies are at the forefront of inoculating local residents and, in some cases, issuing leftover doses to whoever might be available. Some social media users have joked about hanging around pharmacies near closing time in the hope of receiving a leftover vaccine dose, instead of allowing it to go to waste.
Los Angeles County, for example, has no official standby line for the coronavirus vaccine, but hundreds of “vaccine chasers” — young people, entire families, and even seniors unable to secure an appointment — have flocked to sites countywide in the hopes of receiving an expiring shot. Getting a vaccine depends on who you know and access to local news: The Los Angeles Times reported that those waiting outside clinics “heard about the opportunity through word of mouth in their social and professional networks,” and some hailed from wealthier neighborhoods.
State and local jurisdictions are being recommended by the Centers for Disease Control and Prevention to issue their first vaccine doses to health care personnel, residents of long-term care facilities, and, more recently, adults over 65 and anyone with underlying medical conditions. These are only recommendations, though. Governors and individual vaccination sites are in charge of implementing their own vaccine prioritization plans. As coronavirus cases rise, state officials are amending their vaccine guidelines to include a larger population of people.
The US is lagging behind its projected vaccination goal of 20 million people by the end of 2020; only about 9 million people have received the vaccine’s first dose as of January 11. The two available vaccines, made by Moderna and Pfizer/BioNTech, have to be injected within hours after the doses are thawed from subzero storage temperatures, which complicates their distribution. Health and state officials have begun urging medical providers to consider vaccinating lower-priority groups to minimize vaccine wastage. As a result of these logistical hiccups, a small group of healthy, low-priority people has been administered the vaccine as a measure of last resort.
A number of these random immunizations (that have been publicly documented, at least) have occurred in Washington, DC, where local health officials have encouraged pharmacists to adopt a zero-waste policy. A DC-based law student posted a viral TikTok of his Moderna shot, which he was offered while grocery shopping at a Giant Food. A DC-based reporter was inoculated at Safeway after hearing an in-store announcement that its pharmacy had extra doses left. A DC couple was able to get on a Safeway pharmacy waitlist to receive end-of-day vaccines for when priority patients fail to show up for one.
There have been a few instances reported elsewhere as well: A Louisville couple made news for receiving a Christmas Eve vaccine at a local Walgreens. “[A friend] called us, and we ran right up. It was pure luck,” the recipient told the Courier Journal. The pharmacy later said it sought to prioritize its excess doses to first responders, Walgreens staff, and senior residents as the news garnered attention.
Sudden time-sensitive incidents such as a malfunctioning hospital freezer in Ukiah, California, have forced providers to make rapid distribution decisions with little forethought. But there are also instances of those looking to jump the line if providers are disorganized. The Los Angeles Times reported that at one South LA vaccination site in early January, about 100 people received vaccines without being asked to show proof that they worked in the health care industry.
These stories of circumstantial — even chaotic — vaccinations might provide a semblance of hope for those who fall further down the priority list. According to Business Insider, pharmacies and grocery stores in the DC metro area are already fielding “tons of calls” from interested recipients eager to get on a vaccine waitlist. These last-minute lists in DC, however, have quickly filled up via word of mouth. A pharmacy manager in Pennsylvania told the local Fox News station that it only takes names of those eligible under the state’s 1A categorization, which includes health care workers and residents of long-term care facilities, for its “do not waste” list. (The Food and Drug Administration and the federal government have yet to issue guidelines on who these extra doses should go to.)
These waitlists and random occurrences aren’t necessarily cause for optimism, though, especially as the vaccination timeline for most Americans remains unclear and varies from state to state.
“There has been outsized media and social media attention to the number of people this has happened to,” Josh Michaud, associate director for global health policy of the Kaiser Family Foundation, told Vox. “It’s a good approach to not waste vaccine doses at the end of the day … but in the grand scheme of things, it’s going to be a marginal contribution to vaccinations. The bulk of vaccinations being done at pharmacies are for those who fit into the prioritization groups and made appointments.”
It’s possible that vaccine providers might no longer need to resort to waitlists or last-minute immunizations, Michaud said, since the federal government has revised their vaccine recommendations: “We’re seeing more states moving in that direction, so the phenomenon of finding a random person might become less common, simply because there will be more people who fit into those higher-priority categories.”
The public desperation for a last-minute shot signifies a top-down failure of the federal government: Officials have largely ignored expert warnings of the potential for logistical hindrances, and there is no cohesive communication campaign to inform Americans when they’re available for a shot. Even as providers do their best to minimize vaccine waste, the disorganized rollout makes it harder for higher-risk Americans to receive the first vaccine dose. This approach “undercut[s] the needs-based approach to those who are savvy and to those who realize what’s going on,” Arthur Caplan of the Division of Medical Ethics at New York University told Business Insider.
The US population has a long way to go to reach herd immunity — which may require 70-85 percent of the population vaccinated — in order for normal life to resume. Officials have maintained that the more people who get vaccinated, the better, and so the general interest toward these random store vaccinations is a good thing. But most members of the public won’t be able to skip the wait, unlike the lucky few on social media, no matter how often they stop by their local pharmacy.
Click Here:
President Joe Biden on Thursday set a new goal for Covid-19 vaccines in the US: 200 million shots in his first 100 days in office. That’s up from Biden’s original goal of 100 million in 100 days. “I know it is ambitious — twice our original goal,” Biden said.
But the goal of 200 million shots in 100 days is really not that ambitious; it’s achievable if absolutely nothing changes with America’s current vaccine rollout.
That’s a testament to how much America’s vaccine campaign has improved since Biden took office. Before Inauguration Day, the country administered less than 1 million shots a day. Today, the US is at 2.5 million shots a day, on average.
At the current rate, the country could hit Biden’s goal of 200 million shots in 100 days — hitting the goal as soon as April 28, a couple days before Biden’s 100th day in office.
Things stand to improve beyond the current rate. As vaccine manufacturers ramp up production, they’ve already made deals with the federal government to deliver enough vaccines for every adult in the summer. At the very least, that should address questions about the supply of vaccines, though not about distribution or willingness to take them.
Biden previously pledged that the US will have enough vaccines for every adult in the US by the end of May. Getting all of those vaccines into arms will require a distribution boost: At the current rate of 2.5 million shots a day, only about 180 million adults, of roughly 255 million, will be fully vaccinated by the end of May. The US has to do more than 4 million shots a day, on average, by then to fully vaccinate every adult in the US before June.
That will be a challenge, with lots of potential factors involved: whether drug companies can ramping up manufacturing, whether the federal government can ship those vaccines out, whether local and state governments can turn those doses into shots in arms, and whether vaccine hesitancy is sufficiently addressed to get all adults to want the vaccine.
That’s a lot that could go wrong. Biden, for his part, has vowed to get ahead of these issues, dedicating more money to vaccine distribution and public education and awareness efforts, funded in part by the recently enacted Covid-19 relief package.
Now Americans waiting for a shot will have to wait and see if Biden can turn those promises into reality.
Click Here:
The rapid spread of new variants of the coronavirus, some of which seem to be more contagious than older versions, has experts in the US calling for stricter social distancing and better masking to avoid yet another big surge of new Covid-19 cases and deaths.
Health advocates and epidemiologists are particularly concerned about what will happen once the new variants find their way into prisons, jails, and immigration detention facilities.
Across the US, at least one in five incarcerated individuals has already been infected with Covid-19, and a disproportionate number of them have died. One study found that the 2.3 million Americans living behind bars have twice the risk of dying from Covid-19 as a similar person who is not.
Jaimie Meyer is an associate professor at Yale School of Medicine and a researcher and clinician who specializes in the spread of infectious diseases behind bars. The pandemic “has laid bare [and] exposed the issues around conditions in confinement,” she told Vox, including how difficult or impossible it is to truly safeguard those held behind bars. In its quest to survive, Covid-19 will find “all of the holes [in our public health strategy] … all of the weaknesses, and pressure test them” she added. “If facilities have not done something to keep people safe, a more highly transmissible strain will spread like wildfire.”
An epidemiological nightmare
Prisoners are at an increased risk of Covid-19 for a simple reason: how the virus spreads. Scientists now know that the illness is mostly passed from person to person through respiratory droplets and sometimes through the air, which is why being in sustained, close proximity to others is so risky — and why crowded prisons and jails are especially dangerous. Contagion also frequently happens even before someone has symptoms, making it impossible to know who to isolate without frequent, rapid, near-universal testing.
“Congregate settings in general, and prisons in particular, are places where physical distancing is impossible,” said Meyer. Moreover, she added, people in prisons are more likely to have certain medical conditions, including obesity and diabetes, that put them at greater risk of infectious diseases.
The epidemiological realities of Covid-19 have been exacerbated by the failures of elected officials and institutions whose job it is to protect those who are incarcerated. Chris Beyrer, a professor of public health and human rights at Johns Hopkins, has been a vocal critic of Maryland’s approach to managing the crisis. In December, cases of the virus in the state’s prisons more than doubled.
“The single most important thing you have to do to deal with Covid in prison is to [reduce] overcrowding,” he told Vox. “We failed at that.” Although prison and jail populations dropped at the outset of the pandemic — mostly because fewer people entered the system due to virus concerns, rather than early release pushes — these populations are now on the rise again.
The second most important thing is to implement policies that can stem the spread of the disease, including social distancing and giving prisoners and staff masks and other essential supplies. “That, too, has been slow, inadequate, and insufficient,” Beyrer said. The Maryland Department of Corrections, he told Vox, isn’t providing free, unlimited bars of soap to people locked up in the state, leaving prisoners unable to do something as fundamental as wash their hands.
And the concerns don’t stop there. In facilities across the country, incarcerated people have reported a range of serious safety issues during the pandemic: correctional officers who refuse, or are not required, to wear masks; insufficient or failed efforts to test staff and incarcerated people; and the creation of new outbreaks by transferring Covid-positive prisoners to new facilities.
Meanwhile, vaccination has not even begun in most of the country’s prisons and jails, while those in other congregate settings — including nursing homes and homeless shelters — have been among the first in line to receive the shot.
“We are living through the failure of the basics of Covid prevention,” said Beyrer.
With all of these systemic shortcomings, many are extremely worried prisons and jails will be even harder hit when more contagious strains breach their walls. Early research has indicated that people infected with the new strain may carry higher viral loads, meaning that engaging in the same conduct — spending extended periods of time indoors without distancing — poses an even greater risk of spreading the virus than it did previously. For prisoners, that means that the worst outbreaks may be yet to come.
“A more infectious virus is only going to infect more people,” Beyrer said. “If more people are going to get infected, more people are going to die.”
“Scared as hell”
With so few resources to protect themselves and, in most places, no vaccine in sight, many prisoners are worried about the future. Jabriel Lewis is incarcerated at Allenwood federal prison in Pennsylvania. “That new strain got everybody in here scared as hell,” he said. “[I]f it gets into the federal institutions it could possibly mean a death sentence.”
Click Here:
For Michelle Angelina, a woman locked up in New Jersey’s Edna Mann facility, the threat posed by the new variants isn’t limited to the virus. The steps the prison system has taken to protect prisoners — shutting down all visitation, ending academic and substance abuse programming, and canceling religious services — will only be extended even further. “It’s putting an immense strain on all of us.”
Her concerns were echoed by Shebri Dillon, a woman incarcerated at Fluvanna Correctional Center at Virginia, who described the difficulty of spending “hours upon hours in a concrete cage, without seeing or hugging our children and family.”
“This new variant means an extension of all that pains us,” Dillon told Vox. “It is not a matter of if it will get in, but when.”
A matter of equity and public health
There are basic ways, however, to protect this large, vulnerable segment of the population — and the rest of the public at the same time.
For epidemiologists, advocates, and incarcerated people, the answer is to implement the policies they’ve recommended all along. “The implications of a more rapidly spreading Covid-19 variant in jails are clear,” said Robert Cohen, a physician who previously worked on Rikers Island and now serves on the Board of Corrections that oversees New York City’s jails. In addition to providing better access to basic PPE, sanitizing supplies, and testing, as many people as possible need to be released from prisons, jails, and other detention facilities, stressed Cohen, and all remaining incarcerated people and staff must be inoculated against the virus sooner rather than later.
In a handful of states, including Massachusetts and California, the vaccinations of prisoners have already begun — but in many places, including New York, they aren’t being prioritized for the vaccine.
Advocates say this reality is just another example of the inequitable impact of the virus on poor people and people of color, given that Black and Latinx individuals are locked up at many times the rate of their white peers. “Despite calling for equity in vaccine distribution, [New York’s] Gov. Cuomo has neglected incarcerated people even while rolling out vaccines to other congregate settings,” including homeless shelters, said Katie Schaffer, director of advocacy and organizing at Center for Community Alternatives, which provides programming and policy work to reduce incarceration across New York state.
While many incarcerated individuals are eager to be inoculated, vaccine hesitancy does exist inside prisons and jails, in no small part due to the long history of medical experimentation inside these facilities. Some agencies are providing incentives to encourage prisoners to participate, including video visits with family members and slightly shortened sentences, while outside initiatives have sought to educate prisoners about the vaccine and its safety. Since the two coronavirus vaccines in the US currently only have emergency approval from the FDA, it’s likely unlawful for correctional authorities to mandate that prisoners or staff receive the shot.
Releasing more prisoners and accelerating the vaccination of those left inside is not only a matter of human rights, say public health officials — it’s also a necessary step to protect the public at large.
There are indications that widespread infection inside these sorts of facilities easily spreads to the community and beyond. One study found that the March outbreak in Chicago’s Cook County jail contributed to about one in seven of the state’s total cases in the following month. Prisons have also incubated especially deadly variants of other illnesses, including strains of multi-drug-resistant tuberculosis.
“This is part of our public health,” said Meyer. “We should all want people who are in any congregate setting to have the best chance of preventing exposure and infection” — for their own health and safety as well as that of everyone else in the country.
Aviva Stahl is an award-winning investigative reporter who writes about how health care policy and scientific debates play out in the prison context. She’s written for a variety of outlets including Vox, the Guardian, and the New York Times, and can be followed at @stahlidarity.
THE TWO SIDES beaten in the 2021 All-Ireland series by the eventual champions Tyrone, met in Tralee on Saturday night.
Kerry and Mayo both entered the game unbeaten in the league to date, and while the spoils went to the home team, both remain in the top two spots in Division 1.
Part of the current leading football group, what can either take from the mid-March meeting on a night of torrential rain?
*******
Kerry dig deep for victory
There were clear parallels that could be drawn between Kerry’s Round 5 tie on Saturday and their Round 1 game in late January in Newbridge. They were in front 1-10 to 0-9 in the 58th minute against Kildare and were ahead of Mayo 1-10 to 0-10 in the 55th minute in Tralee.
Kerry didn’t move the scoreboard thereafter against Kildare, hauled back for a draw as they leaked the last four points of the match. On Saturday something similar looked set to happen as three Mayo points on the spin drew them level but Kerry found the wherewithal to push ahead twice through David Clifford frees, the last proving the match-winner.
In a bruising battle on a sodden night, it was easy to understand why Jack O’Connor was so satisfied afterwards. He cannot influence how lopsided Munster football has become in his team’s favour, they are standout favourites to add another provincial title to their collection by late May.
That system will prompt concerns of them being undercooked by the time they reach the All-Ireland series. O’Connor’s awareness of that explains why he stressed after Saturday night’s game, that this was one they had explicitly targeted to collect a win.
Hitting the net and missing the target
A core strength of Mayo teams is their defensive prowess, specialist markers at the back allow them to push on further upfield. Padraig O’Hora and Oisin Mullin were principally detailed to protect the goalmouth on Saturday night, both taking up position next to David Clifford at different stages.
They were really only unlocked once, but it was a critical moment. Tony Brosnan skipped through in the 21st minute after a move he started himself, that availed of Lee Keegan slipping, with the swift passing of Clifford and Adrian Spillane also integral, before the Dr Crokes man slammed his shot to the net.
Kerry forward Tony Brosnan (file photo).
Source: Ben Brady/INPHO
Kerry were clinical when the first-half chance presented itself, Mayo in contrast were not. Aiden Orme’s connection was poor as he dragged a shot wide and Diarmuid O’Connor was denied by Shane Murphy’s intervention, both in the second quarter when raising a green flag would have boosted Mayo’s prospects.
SEE SPORT
DIFFERENTLY
Get closer to the stories that matter with exclusive analysis, insight and debate in The42 Membership.
Become a Member
If it seems a simplistic analysis, it’s worth thinking back to that aspect of last year’s All-Ireland final and how this can be a recurring issue for Mayo. Kerry have seven goals in this year’s league to date, joint highest in Division 1 with Armagh, and only bettered by Galway’s tally of nine across the top two tiers.
Absent attackers
Click Here:
Shortly before throw-in, there was a row of seats filled in the main stand at Austin Stack Park. David Moran, Dan O’Donoghue, Gavin White and Sean O’Shea amongst the group that filed in, a reminder of how Kerry’s depth had been tested. The absence of O’Shea, instrumental to Kerry’s progress this spring, was a reminder of how his playmaking talents at 11 will be central to Kingdom aspirations this year. Paul Geaney, a late withdrawal through illness, is another valuable option closer to goal.
Ryan O’Donoghue in action for Mayo against Kerry.
Source: Lorraine O’Sullivan/INPHO
Mayo lacked their own big-name forwards. Tommy Conroy’s season-ending knee problem will continue to be a source of regret for their camp. There has yet to be a sign of Cillian O’Connor in action since his Achilles tendon injury last June brought his year to a halt. Much of Mayo’s attacking strategy on Saturday night revolved around Ryan O’Donoghue as a focal point and if he didn’t score from play, he was a constant menace in winning frees, which he nervelessly converted. Fergal Boland weighed in with three impressive points but Mayo’s forward line lacked the necessary output to win this.
The42 is on Instagram! Tap the button below on your phone to follow us!
People who are pregnant are now eligible to get the coronavirus vaccine in more than 40 states — typically ahead of their lower-risk peers. And more than 60,000 of them have already rolled up their sleeves, according to the Centers for Disease Control and Prevention.
Although the Covid-19 vaccines authorized in the US were not studied in pregnancy, early data is now starting to emerge suggesting — as researchers expected — that the vaccines are likely safe during pregnancy and confer protection not only to the recipient but also, potentially, the baby.
“It’s all very positive,” says Stephanie Gaw, a maternal-fetal medicine specialist at the University of California San Francisco Medical Center, of the findings so far.
There have been many reasons to suspect the vaccines should be safe in pregnancy, including the lack of major adverse events reported so far, solid studies in animals, and a good understanding of how the vaccines work in the body (they don’t contain live virus, and they are quickly broken down). “The data that we’re collecting on it so far has no red flags,” Anthony Fauci, the top US infectious disease doctor, said in February.
Meanwhile, new research, published March 25 in the American Journal of Obstetrics and Gynecology, found that the vaccines offer strong immune protection for people who are pregnant, just like their non-pregnant peers.
Preliminary research also suggests vaccines might provide some protection to newborns, who are unlikely to have their own approved Covid-19 vaccine anytime soon (and are also vulnerable to more severe illness). The new AJOG paper joins other early findings that antibodies to Covid-19 generated by pregnant mothers after receiving their vaccines were passed through the placenta to the fetus.
But Covid-19 vaccine rollout to the pregnant population has been inconsistent around the globe.
For months, the US and many national medical groups — including the American College of Obstetrics and Gynecology, the Society for Maternal-Fetal Medicine, and the Academy of Breastfeeding Medicine — say the vaccine should be offered to this group, in large part because there’s strong evidence that pregnancy elevates the risk for severe Covid-19 and death. (Given this data, the American Society for Reproductive Medicine goes so far as to say the vaccine is “recommended” for those who are pregnant or considering pregnancy.)
“If a pregnant patient gets infected during pregnancy, her risk of intensive care admission is around 5 percent,” says David Baud, chief of obstetrics at Le Centre hospitalier universitaire vaudois in Switzerland, where he studies infections during pregnancy. “I do not know of any disease that put a 30-year-old woman at such high risk to be admitted to the ICU.” Furthermore, if the infection happens late in pregnancy, it increases the risk of preterm birth and the baby needing intensive care.
Israel went as far as adding pregnant women to its vaccine priority list in January. But other countries, such as the UK and Germany, and the World Health Organization are still saying most people who are pregnant should wait.
Why the disagreement? The clinical trials of the new Covid-19 vaccines explicitly excluded pregnant people, and we don’t yet have enough follow-up data from individuals who have opted to get the shots to say for sure they are safe for everyone during pregnancy.
Add to this muddled landscape the persistent misinformation swirling around the Covid-19 vaccines and pregnancy and fertility, and it is little wonder some people are still confused or worried. And most organizations still stop short of advising all pregnant people to definitely get the vaccine.
Thankfully, these information gaps are starting to fill in. Numerous studies are underway following the outcomes of pregnant and breastfeeding people and their offspring after immunization. And a handful of them are now starting to report early, reassuring results.
In the meantime, however, a growing number of people have had to come to their own decision, with the optional help of their care provider, with some uncertainty. And no one needs an extra thing to stress about during a pandemic pregnancy.
So more information about the coronavirus vaccines in pregnancy can’t come soon enough.
4 reasons the coronavirus vaccine should be okay to get while pregnant — but why not everyone is recommending it yet
One of the big reasons why, despite Covid-19’s known risks in pregnancy, not everyone has unequivocally recommended the vaccines that currently have emergency approval in the US for pregnant people is that the way they work is fairly new. But we do have some key pieces of information already:
1) These vaccines don’t contain live coronavirus. The only types of vaccines that are contraindicated in pregnancy contain live virus that has been weakened, such as the chickenpox vaccine. (Even fewer immunizations, such as the smallpox vaccine, are not recommended during lactation.) While these vaccines don’t pose a risk to most people, there is a small, theoretical chance they could cross the placenta and infect the fetus.
The Pfizer/BioNTech and Moderna vaccines, on the other hand, contain just a fragment of genetic material, called messenger RNA, that can tell human cells to build a tiny part of the virus’s outer shell, which the immune system learns to recognize and fight off. The Johnson & Johnson vaccine uses a different method, known as a viral vector (the same platform as the already-used Zika and Ebola vaccines), to get the body to build part of the virus’s shell.
In either case, there is no way the vaccine can cause a Covid-19 infection.
2) The main coronavirus vaccines are very fragile. Once the mRNA enters the body, it likely only reaches local arm muscle cells before the body breaks it down. This means it is unlikely to enter the bloodstream, and even less likely to make it as far as the placenta. Even if it does get that far, “one of the placenta’s main functions is to be an immune barrier to the fetus,” which adds another layer of protection, says Gaw. And although it contains genetic material, it doesn’t enter our cells’ nuclei, meaning that it can’t cause any mutations to our cells — or those of a developing fetus. This mRNA is so fragile, vaccine developers had to wrap it in nanolipids (which are also presumed to be safe for pregnancy) just to keep it intact long enough to reach muscle cells in the arm.
Experts also expect it is unlikely for the mRNA to make its way intact into breast milk. Preliminary research from Gaw and her team, which is in the process of being peer-reviewed, found no trace of the vaccine itself in breast milk samples from hours and days post-vaccination. And even if a small amount of it were to be transferred to a feeding baby, researchers say it (and any lipid nanoparticles) would get broken down by the baby’s stomach acids.
3) Animal studies look promising. Before any shots were given to pregnant humans, vaccine companies gathered safety data in other pregnant mammals. None of these developmental and reproductive toxicity (DART) studies from Pfizer/BioNTech, Moderna, or Johnson & Johnson suggest any safety concerns for use during pregnancy.
Rats, of course, are not humans, and DART study results do not always translate identically into humans. “Some results are similar to humans, and some are very different,“ Gaw says. Nevertheless, they are a good starting point — when combined with strong safety data in the clinical trials and public vaccinations so far.
4) We haven’t seen adverse events in pregnant people who have gotten it so far. For the Covid-19 vaccine trials, those of “childbearing potential” were screened for pregnancy before each shot, and those with positive tests were removed from the studies. However, a handful of people (12 who got the vaccine in Pfizer/BioNTech’s study and six who got the vaccine in Moderna’s study) ended up having been pregnant at the time of vaccination — and companies haven’t reported any negative outcomes from these individuals.
A newer and much larger data set is emerging from the Centers for Disease Control and Prevention, which is following pregnant people who sign up for its tracking platform V-safe after being vaccinated — and allowing them to sign up for a more targeted pregnancy-specific vaccine registry.
At the beginning of March, the CDC reported data from more than 1,800 pregnant people in the registry who had received Covid-19 vaccines. Among these individuals, there was not a statistically significant increase in adverse pregnancy or birth outcomes. Nor have they found any significant differences in side effects from the vaccine (such as fatigue or fever).
“From a scientific perspective, there’s no specific reason to think that pregnant individuals would have more adverse reactions to the vaccine or that there would be a risk to the fetus with the vaccine, while we know that there is risk with the Covid infection,” says Alisa Kachikis, an assistant professor of obstetrics and gynecology at the University of Washington.
A January study published in JAMA Internal Medicine, for example, analyzed the outcomes of more than 406,000 people who gave birth in hospitals between April and November 2020 and found that a significantly higher rate of those with Covid-19 had major complications. “The higher rates of preterm birth, preeclampsia, thrombotic [blood clotting] events, and death in women giving birth with Covid-19 highlight the need for strategies to minimize risk,” noted the authors.
So why are some, such as the WHO and the UK, still saying most pregnant people should not get the coronavirus vaccine yet? They are waiting for more data.
There are also, of course, other types of coronavirus vaccines in the works, such as protein-based vaccines (which is the basis for Novavax’s shots). This model of shot has been used for years — including for pertussis and hepatitis B — “and we are very comfortable with [their] safety profile,” Gaw says. Viral vector vaccines (which is how the Johnson & Johnson and AstraZeneca/Oxford shots work) have also been used safely in pregnancy, such as for the Ebola and Zika vaccines, although there is less historical data on these.
So, says Kachikis, if what’s hanging people up about getting a Covid-19 vaccine in pregnancy is mostly the novelty of the mRNA vaccines, having other types to choose from — as long as they’re just as effective — could be a good option.
What studies are happening, and what will they help us learn about the Covid-19 vaccine in pregnancy?
The CDC continues to monitor for any adverse outcomes and side effects through its V-safe program — and related pregnancy registry (which will check in with participants in each trimester, after delivery, and when the baby is 3 months old).
Pfizer/BioNTech started giving vaccine doses in their pregnancy-focused, placebo-controlled clinical trial this February. They are first running a smaller safety study of just 350 healthy pregnant participants before scaling up to give the vaccine to a total of about 4,000 people who are at between 24 and 34 weeks gestation. (This study design, however, will still leave some questions about the safety and efficacy of the vaccine, especially earlier in pregnancy.)
Moderna has created a registry that people can sign up for after receiving their vaccine while pregnant. For its part, Johnson & Johnson plans to conduct trials of its vaccine in pregnant participants later (likely after it studies the vaccine in children).
In the meantime, other researchers are racing to collect and study data from the natural experiment that started in December, when many pregnant people began electing to get vaccines as they became eligible because of their high-risk work in hospitals or long-term care centers.
At the University of Washington, Kachikis is leading a study to also follow vaccination in people who are pregnant. Thousands of people from around the US and the world who have received the vaccine while pregnant have already signed up for the registry, she says. (People who are pregnant or lactating but have not yet gotten vaccinated can also sign up, as can people who are considering becoming pregnant within the next two years.) This research will help them track any adverse outcomes, as well as gather additional data, such as whether any vaccinated individuals (or their newborns) later get Covid-19.
An additional large-scale clinical trial, which has not started enrolling participants, aims to track 5,000 women and their offspring over the course of 21 months. Other smaller studies are in the works as well, such as one at Duke University.
At UCSF, Gaw and her team are in the midst of separate observational studies. They will more closely follow a smaller group of participants — 100 or so of whom are pregnant and roughly 50 of whom are lactating — “to determine whether the Covid vaccines are equally effective in pregnant and lactating women, how long antibody responses last, and whether immunity is transferred to the baby,” Gaw explains.
Other vaccines are routinely given in pregnancy, such as pertussis, in large part to provide protective antibodies to the fetus and protect the newborn until they are old enough to get the vaccine themselves.
Covid-19 antibodies have been shown to transfer across the placenta in women who were positive for the virus at delivery. The new AJOG study found that even higher levels of antibodies were present in the umbilical cord after Covid-19 vaccination than after natural infection. “The research shows really promising results,” Kachikis says.
If these antibodies prove to be protective, it could be especially helpful, as newborns and infants will likely be among the last to have an authorized vaccine — and have the highest rates for complications and death from the virus among children. “There is still a lot of data that needs to be assessed, but for individuals who are thinking of ways that the vaccine may benefit their newborn, this is really encouraging,” Kachikis says.
More nuanced research might also eventually help advise on optimal timing for the Covid-19 vaccine during pregnancy. For example, Gaw notes, “there needs to be sufficient time for the mom to develop a robust antibody response, and then pass [this] to the baby.” After extensive research, the Tdap vaccine is recommended around 27 weeks of gestation so as to provide the best protection for the infant after birth. Without such information for the Covid-19 vaccine, many experts are recommending that those who decide to get the shot treat it like the flu shot — getting it as soon as it’s available to them, regardless of where they are in their pregnancy.
People who are lactating were also excluded from the vaccine trials. So researchers at a number of institutions are now working to study how the vaccine might impact breast milk contents and a nursing child. A study from October 2020 showed that most people who had recovered from Covid-19, as well as those suspected of being infected, passed on antibodies to the virus in their breast milk.
The recently released AJOG paper found a high level of antibodies in breast milk from women who had received the Covid-19 vaccine. Gaw’s team also has new findings, which are currently in peer review, that show a solid dose of Covid-19 antibodies in breast milk samples after vaccination. This, they hope, will provide some protection from the virus for babies.
“It’s all reassuring,” Gaw says. But “all the studies have been small…[so] we can’t 100 percent determine safety until a lot more people have been vaccinated and it’s been reported on.”
Wait, why weren’t pregnant people included in the early research to begin with?
Pregnancy has, for decades, been considered a “vulnerable” condition when it comes to researching new medical treatments and preventions, meaning people who are pregnant have been excluded from general trials in much the same way as have those who are unable to give informed consent, like children and those with severe mental disabilities.
Part of the reason for this might be due to the damaging legacy of thalidomide. This drug was given to pregnant women around the world starting in the 1950s as a way to ease nausea (although it was never approved specifically for use in pregnancy in the US). Soon, thousands of these babies were being born with devastating birth defects. This hammered home for scientists and the public that, when it comes to pregnant women and their fetuses, much more care ought to be taken in giving medications or vaccines.
But this conclusion, many are now saying, has it backward, as the oft-repeated phrase indicates: Protect pregnant people “through research, not from research.” If thalidomide had been carefully and systematically studied for pregnancy, it likely never would have been approved for use (or used unofficially) in this population, preventing the majority of these tragic outcomes.
“It can’t be emphasized enough that pregnant women should be included in vaccine trials from the get-go,” Kachikis says.
Gaw agrees: “We actually cause harm by not including [pregnant people] in early research, as they have to wait longer for good data to be published.”
So when will we have more data about the coronavirus vaccine in pregnancy and lactation?
One big challenge with researching anything to do with pregnancy is that it takes a long time: nine months, plus follow-up time to monitor infant outcomes. And subsequent study during lactation while you’re at it, and maybe preconception research, too.
Consider that it took vaccine makers just 10 months to develop the Covid-19 vaccines and ensure they were safe and effective in adults. But with formal studies in pregnant people just getting underway (and with many having not yet started, and others, like Pfizer’s, currently limited to late pregnancy), it could be late 2021 or beyond until we have comprehensive, robust safety data for all stages of pregnancy. And even later to assess long-term outcomes for babies.
Click Here:
Follow-up to the early work Gaw and colleagues are doing at UCSF will take “at least six to nine months, as we have to wait for a sufficient number of babies to deliver,” Gaw says.
Kachikis and her team at the University of Washington plan to follow the outcomes of people who sign up for their list for about a year, with hopes to continue more long-term follow-up. For example, they plan to test babies months after birth to see how long antibodies from vaccines given during gestation persist — and if these antibodies are equally as effective at fighting off the coronavirus as those found in the vaccinated adults.
But they aren’t waiting that long to start sharing what they learn. “The focus is on getting any data out,” Kachikis says. And “if multiple groups can get some data out, that will be better than having absolutely nothing,” which has been the situation, she notes.
For now, much of the official guidance in the US stresses the need for people to conduct their own analysis of the known increased risks of Covid-19 in pregnancy with the remaining unknowns of the vaccine. And this calculus is not the same for everyone.
“As more evidence is coming out, it’s tilting to more benefit of getting the vaccine,” Gaw says. “But every individual has a different level of risk they’re willing to take” — as well as the amount of risk they might have of contracting the virus or getting extremely sick from it. The bottom line, based on the latest Covid-19 vaccine research in pregnancy, she says, is that “it’s looking more and more like it does work, it does pass antibodies to the baby (although we don’t know yet how protective they are), and there doesn’t look like there’s any harm at this moment.”
Additionally, even those who are reluctant to advocate the vaccine for all pregnant people just yet, such as the WHO, do suggest it should be available to those at high risk of exposure to the virus or underlying health conditions that increase their risk of severe Covid-19.
And some might elect to wait until there is more solid data. So to help move along the plodding process, people who are pregnant and have gotten the vaccine — or are considering it — can contribute to getting more and better guidance sooner by opting in to registries and studies.
Katherine Harmon Courage is a freelance science journalist and author of Cultured and and Octopus! Find her on Twitter at @KHCourage.
July 4 this year could also be America’s Independence Day from Covid-19.
At current rates, America is administering nearly 2.8 million Covid-19 vaccine doses a day — roughly enough to vaccinate every adult (18 and older) in the country by July 4.
That would mean 80 percent of the population would be able to get a vaccine. We don’t know for certain if that’s enough for herd immunity, when enough of the population is immune to the disease, through vaccines or natural infection, that the virus can no longer sustain its spread. But it’s in the range that experts typically mention.
Since a vaccine isn’t yet approved for children younger than 16, this is also close to the highest level of vaccination we can expect for the time being. (The estimates in this story don’t include 16- and 17-year-olds who are eligible for vaccines.)
As of Tuesday, March 30, about 96 million adults in the US have received at least one shot. More than 53 million, around 21 percent of adults, have been fully vaccinated, according to the Centers for Disease Control and Prevention.
At current rates, then, America could fully vaccinate up to 255 million people by July 4 — covering the entire adult population. (This is assuming about one-third of doses are the Johnson & Johnson vaccine, which, unlike the Moderna and Pfizer vaccines, requires one shot instead of two.)
The rollout is likely to speed up even more. In the coming weeks, drug companies are expected to deliver as many as 4 million doses a day to the federal government. If the companies deliver and states can turn those doses into shots in arms, it’d be enough to meet President Joe Biden’s goal to have enough vaccine supply for all adults by the end of May and, potentially, vaccinate all adults by June.
That would leave the rest of the summer to, hopefully, live life closer to the pre-pandemic normal, without worrying about the coronavirus.
None of this seemed very likely before Biden took office, when the US was administering fewer than 1 million shots a day. But local, state, and federal governments, along with the health care system, have worked around the clock since then to improve the rollout. We’re now seeing the results, with the rate of vaccinations improving steadily from day to day.
A lot can still go wrong. Maybe the drug companies won’t be able to deliver on the supply they’ve promised. Maybe cities, states, and the feds won’t clear all the logistical hurdles to get shots in arms. Maybe something else will break in a fairly complicated supply chain.
And as supply increases, it’s likely vaccine hesitancy will become a bigger issue as more adults simply refuse a vaccine. Overcoming that — to continue increasing the nationwide rate of vaccinations — will require creative education and awareness campaigns, focused on local pockets of resistance. That will pose its own logistical challenges.
The country is also seeing a recent increase in Covid-19 cases. If that marks the beginning of a fourth surge, it could lead to another wave of illness, hospitalizations, and deaths. It could also give the virus the room it needs, through millions more replications as it jumps from host to host, to mutate into another variant. So far, the current vaccines seem to work well against the variants, but that could change if the virus is allowed to mutate once again — and upend the US’s vaccination efforts.
At the very least, though, the country can see a likely finish line just a few months away. After more than a year of dealing with the coronavirus, America is so close to potentially breaking free.
Click Here: