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booster shot

These 6 covid jabs safe as booster doses: UK Study

by Medically Speaking Team December 4, 2021

A UK-based research found that six COVID-19 vaccines are safe, effective, and elicit a significant immune response when administered as booster doses after two initial doses of either the Oxford-AstraZeneca or Pfizer-BioNTech vaccine.

Phase 2 trial was conducted on seven vaccines to check their safety and efficacy as booster doses, the study published in The Lancet medical journal on Thursday said.

The UK Vaccine Taskforce and National Institute for Health Research funded the study.

The vaccines studied were those produced by Oxford-AstraZeneca, Pfizer-BioNTech, Moderna, Novavax, Johnson & Johnson, Valneva and Curevac. None of these vaccines posed safety concerns, revealed the study which was conducted on 2,878 adults over the age of 30.

Common side effects, mostly reported in younger people, were fatigue, headaches, and pain at the injection site. On being administered after 10 to 12 weeks of the two doses of the Oxford-AstraZeneca vaccine, all seven vaccines boosted spike protein immunogenicity.

However, for those participants who received the Pfizer-BioNTech vaccine, all vaccines except Valneva’s boosted immunity.

According to Business Line, the AstraZeneca vaccine has been administered in over 180 countries, while 145 countries received the Pfizer vaccine. The impact of the boosters on long-term protection and immunological memory can only be revealed once more data is available after three months and one year of receiving the booster shot, the study said.

According to the study’s authors, research had not been done on how well the different booster combinations worked in preventing transmission, hospitalisation and death from COVID-19.

India uses AstraZeneca’s Covishield vaccine, which is manufactured by the Serum Institute in Pune. The Serum institute also has the mandate to produce the Novavax vaccine.

Although J&J and Moderna vaccines, which were part of the study, have permissions to be used in India, they are not in the market yet. Two other vaccines used in India — Covaxin and the Russian vaccine Sputnik V – were not part of the UK study.

“When we set up the trial, we only had access to the vaccines that the UK Vaccine Taskforce had negotiated for the UK – timelines, unfortunately, did not allow the VTF to consider other vaccines for the trial,” Saul Faust, director of the NIHR Clinical Research Facility at University Hospital Southampton and head of the trial, told BusinessLine.

December 4, 2021 0 comment

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Policies on booster shots and additional Covid shots to be released in two weeks, says NTAGI chief

by Medically Speaking Team November 29, 2021

written by Medically Speaking Team

COVID-19 task force chairman Dr N K Arora said that a detailed strategy on the booster and additional doses of COVID-19 vaccination will be released in two weeks due to the emergency of the new COVID-19 variation ‘Omicron.’

“National Technical Advisory Group on Immunisation (NTAGI) is coming up with a comprehensive policy on the booster and additional doses in the next two weeks. The policy will deal with who will require the vaccine, when and how. This needs to be seen in the context that a new variant is coming and with time only we will get to know more information about it. Therefore relevance and effectiveness of the current vaccines will also become apparent with time only,” said Arora.

“There is a difference between booster dose and additional dose. A booster dose is given in a predefined period after two primary doses. Whereas, an additional dose is only given to those people who have problems with their immune function even after the primary doses. If a person’s immune function is not appropriately built you give them an additional dose. So these are two different things,” he added.

On the issue of vaccination of Children, Arora said, “As I have repeatedly been saying that children are our most important asset and we have developed a comprehensive plan for immunising our 44 crore children below the age of 18 years. A prioritisation process is also being built so that children with co-morbidities will be given priority and healthy children will be vaccinated. This plan will be made public very soon. ZyCoV-D , Covaxin, Corbevax and then mRNA vaccine are available for children and I will say it again that vaccines will be available in sufficient quantity for children also.”

The Omicron variant (B.1.1.529), a new variant of the coronavirus, was first reported in Botswana on November 11, 2021, and appeared on November 14 in South Africa. It has been declared a variant of concern by the World Health Organisation (WHO).

November 29, 2021 0 comment

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ICMR Chief Balram Bhargava on need for booster shots: No scientific evidence

by Medically Speaking November 25, 2021

written by Medically Speaking

Dr Balram Bhargava, the head of the Indian Council of Medical Research (ICMR), has said that there is no scientific evidence to yet to support the necessity for a booster vaccination dosage to provide further protection against the coronavirus illness (Covid-19). “Administering the second dose of Covid-19 vaccine to all adult population, and ensuring that not only India, but the entire world gets vaccinated, is the priority of the government for now,” the ICMR director general (DG) said.

“More so, there is no scientific evidence so far to support the need for a booster vaccine dose against Covid-19,” Bhargava told news agency PTI on Sunday.

The senior scientist’s remarks come in the backdrop of recent reports that the National Technical Advisory Group on Immunization (NTAGI), the Centre’s top expert panel on immunisation, is likely to meet in the last week of November to discuss key issues such as booster shots, as well as opening up the vaccination for children.

In recent days, several people, including Rajasthan chief minister Ashok Gehlot, have urged the Union government to permit the boosters.

“The Centre cannot take a direct decision in such a matter. When the ICMR says that a booster shots should be given, we will consider it then. At present, the aim is to complete full vaccination of the target population. Once that is done, a decision on boosters will be taken. We have enough stocks available,” Union health minister Mansukh Mandaviya said recently.

According to official data, out of 940 million eligible adults, around 82 per cent have taken their first dose of a Covid-19 jab, while nearly 43 per cent have taken both doses, or, in other words, are fully inoculated.

The nationwide vaccination drive against this viral illness began on January 16 this year. Till now, nearly 1.17 billion doses have been administered.

November 25, 2021 0 comment

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People who may face recurrent infection may need booster dose: Dr Padma, Chief, Neurocenter, AIIMS

by Medically Speaking Team November 23, 2021

written by Medically Speaking Team

“I think a booster dose would be required for the people who when face a recurrent infection will go to a severe illness,” claimed Dr Padma Srivastava, Chief of Neurocenter of AIIMS, in an interview with Medically Speaking.

Read more to find out:

What is your view on booster shots for the immuno-compromised?

Dr. Padma

Let me answer this in few verticals. First is to understand the immune response after the vaccine. So, once there is a vaccine shot, you have two types of immune protection that is generated in a human body, what is called as a b cell or T cell , the other cellular immune response. So, both of them give you some kind of protection and that’s what we need. There are ways trying to record or measure this kind of a response. You might have heard of anti-bodies. So people do the serum anti-body test after the immunization and say anti-body is very good or anti-bodies are not there, so that gives you some measure of what is the immune response and what is the kind of protection you may have. Although that is not protection, but that is one measurement. Now what we have gained in our knowledge ever the last year of vaccination programs in most of the world and probably more than a year across several other counties across the world. And in our country nearly now 11 months there are some things which have come forward and some things which have been published. Number 1 is that, when someone is immunized, there is a group of people who are immune-compromised like what you have said. People, say are very elderly or someone who is immuno-compromised because of a comorbid situation like a bad controlled diabetes, or someone who has cancer or who are on medication with a very commonly used drug called a steroid, which is a chronic steroid used and there are several other immune suppressants. So, I must say, earlier publication from US and other countries which have said that even after two shots of vaccine, this group of cancer patients, or say who were on chemotherapy did not receive the immune response as measured by anti-bodies. So, they say if the immune response is not good, can we give them a booster dose, in order to augment the protection level. And then came this entire thing of how long does the protection last after the two doses of vaccines. So, this was seen in two ways, 1. They have generally looked at the anti-body responses even for those who are infected, say with the corona virus infection and looked at the anti-body responses for several months, how it veined or did it persist. The second one was after the vaccination, in that then they had come to this, that on an average maybe 6 months, hence the anti-body response was not so robust. So, this was across several countries and people also started another vertical of, testing of the booster dose. And also you know we have an Indian trial, where the booster dose was given to the people who were immunized with two shots. So, with Pfizer, Moderna at the end of six months they gave these boosters and those results also have come and all of them have said that yes that booster dose did not lead to any significant adverse actions but it did increase the immune-response, therefore it was good to give. So, altogether what it seems is, that booster dose may be required in the group of individuals where the anti-body response is not going to be robust, for example, immune-compromised. 2^nd , booster dose maybe given to those individuals in which now we know after 6 months, although we don’t know for sure, maybe some be gone for 12 months, or even longer but overall it seems 6 months. It is kind of a zone where you might need a booster. So, therefore those individuals, if they get an infection, will get more severe infection who are more prone to getting exposed and therefore maybe infected Or other group of individuals, say journalists going down to the mass and get exposed or other individuals who, if they get an infection they might get a severe illness, so maybe they need a booster. Said that, there is another vertical that has come in, which is the ethical vertical because in those situations where in we have a significant population where in even the first dose has not been given or Did not receive the full doses. So, is it ethical to go with a booster dose for those who have already been vaccinated while there are people waiting for the first dose itself. So, that’s and ethical vertical that has come. Hence, we have the recommendations from the CDC , recommendations. And also the recommendations from the World Health Organization. So, I think we should look at all of them and take in the best course of action which is suitable for our country.

Would you say that once everyone gets their first and the second dose, should the government look at the booster shot for the remaining population?

Dr. Padma

I think there definitely are groups, especially the task force which is looking into the vaccination program at the central level. And, I did see one of the press releases that they are strongly looking at a way forward on this and they will take the best action for the same. Yes, if you ask me, my personal opinion is that yes, I think a booster dose would be required for the people who when face a recurrent infection will go to a severe illness, so yes we need to take care of that and in a lot of countries it is thus targeted but then what has happened in other countries is because there was a long list of medical conditions, they said look it is difficult to go through each and every condition so let’s go with everybody after the age of 18 years. That I don’t think will come to our country right now, we have to vaccinate the maximum number of people in our country before we get to that. But, having said that, in that small group, I must say the percentage of the population varied. If they are exposed and get into severe illness, they must be considered for a booster dose having significantly vaccinated, a significant proportion of our country. But I will not say the booster dose should be given to everybody before everyone gets there two shots of vaccines.

Would you say or recommend, perhaps a booster shot for all adults is something which the government should look at?

Dr. Padma

So, by then I think we will be having an advantageous position because it would have been rolled out in other parts of the world. We have that advantage to see how safe it is and by then we would know that giving these shots to everyone over the age of 18 years as a booster dose is that what is the priority vs vaccinating children. So, you see there are a lot of things we need to weigh and then decide, but till such time, we come to that important line or I should say, lets cross the bridge when it comes to it. Before that I think we should train our guns towards vaccinating everybody and in the meanwhile, also try and protect the vulnerable population who have been received two doses and who are six months hence, so that they would get their booster dose to protect themselves.

Who all do u think should be included in those who should get the first priority to get booster doses?

Dr. Padma

I would say, the ones who get a severe infection once they are exposed again, so in that group I would put the normal ones, immune suppressed and immune-compromised and that doesn’t have an age bar. Even if it is an 18-year-old who has a bad cancer and Is on chemotherapy should get it. That, plus the elderly population and severe comorbid situations. Next come the healthcare worker and other workers like you, me and others who have a greater chance of getting exposed to an infection. Population who has a chance of getting severe illness, that would be my number one, next is the groups who are exposed to the likelihood of getting exposure. These two will be in my priority zones.

The scientific data does not back for any booster shot in India, perhaps just stay indoors, just follow the covid protocols and you will not need the booster shots. What will be your response to that argument?

Dr. Padma

I don’t really think that the scientific community is saying so because, we have publication to this regard, as I even said the task force is also looking at the concern and I do believe that there is some data even from Indian make vaccines, they said after 6 months maybe you would require 1 booster dose to pep up and keep up the immunity. But, fortunately we still speak that we have not really had a bad 3^rd wave which is a great thing and a great boost in the arm and hope that it never happens. Said that though, in preparation to prevent bad infections from happening to even this small group of people where there is definite immune-compromised situation. No we have a lot of literature that has come in saying that they would need a booster shot and I think that part nobody would negate. But again coming back to generalizable kind of per statement we can not give, that everybody should get a booster shot before we vaccinate everybody. That I don’t think is tenable for our country yet.

What would you like to tell the people who are watching the show and are very eagerly waiting for the booster shot because that’s a large number of a population?

Dr. Padma

So it seems that there still exists vaccine hesitancy, I still come across of patients who say that they have not been vaccinated for whatever reason and then we tell them please don’t do that and get vaccinated. So as we still look at vaccine hesitancy which is now still cutting short our prerogative that everyone must get vaccinated. On the hand, the people who got vaccinated are waiting for the booster dose, so I would still say that I do believe that the booster dose for us has situation. Those individuals should get the booster dose and we should not get into this race. And yes the data is rolling in for the mix and match that you can mix vaccines and that also has inseminated from the availability of these vaccines. You shouldn’t keep waiting for another vaccine to come in. whatever is available, you take it at that point which is required to be taken.

November 23, 2021 0 comment

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United States: Booster shots authorized for all adults

by Medically Speaking Team November 20, 2021

written by Medically Speaking Team

According to Pfizer and Moderna, the United States today extended the authorisation of Covid-19 vaccine boosters to all persons aged 18 and older, six months after the completion of their original immunisation series.

“This emergency use authorization comes at a critical time as we enter the winter months and face increasing Covid-19 case counts and hospitalizations across the country,” said Moderna CEO Stephane Bancel.

Pfizer and Moderna announced the FDA decision after at least ten states had already begun giving boosters to all adults.

The current measure clarifies who is eligible, which had previously been a confusing list, by enabling anybody 18 or older to pick either company’s booster six months after their last dosage – regardless of whose vaccination they received initially.

But there’s one more step: The Centers for Disease Control and Prevention must agree to expand Pfizer and Moderna boosters to even healthy young adults. Its scientific advisers were set to debate later Friday.

If the CDC agrees, tens of millions more Americans could have three doses of protection ahead of the new year. Anyone who got the one-dose Johnson & Johnson vaccine can already get a booster.

All three COVID-19 vaccines used in the US still offer strong protection against severe illness including hospitalisation and death, but protection against infection can wane with time.

Previously, the government had cleared boosters of Pfizer and BioNTech’s vaccine, as well as the similar Moderna vaccine, only for vulnerable groups including older Americans and people with chronic health problems.

The decision to broaden comes as the number of new COVID-19 cases has progressively increased over the previous two weeks, particularly in places where colder weather has kept people home.
As a result of these concerning patterns, several states did not wait for federal officials to take action. Utah and Massachusetts are the most recent states to announce that booster shots would be available to all adults in the coming weeks.
The Biden administration’s first intention was to provide boosts to everyone. However, a panel of FDA experts largely voted against that notion in September, citing the vaccinations’ ongoing efficacy in most age groups. Instead, they advocated for an additional Pfizer dosage just for the most vulnerable.

Since then, administration officials, including Dr. Anthony Fauci, have continued making the case for using boosters more widely, noting that even milder infections in younger people can cause “long COVID” and other complications.

“I don’t know of any other vaccine where we only worry about keeping people out of the hospital,” said Fauci at a briefing Wednesday.

Last week, Pfizer and its German partner BioNTech filed new data to make the case that broader boosters could help tamp down infections at a critical period.

“We have absolutely no chance in the current situation to control the pandemic without providing boosters to everyone,” BioNTech CEO Ugur Sahin told reporters during a visit to Washington last week.

The companies studied 10,000 adults of all ages and found that a booster restored protection against symptomatic infections to about 95 per cent even while the extra-contagious delta variant was surging. It’s too soon to know if that high level of protection will last longer after a third shot than after the second, something Sahin said the companies will carefully track.

Backing up that evidence, Britain released real-world data this week showing the same jump in protection once it began offering boosters to middle-aged and older adults. Israel has credited widespread boosters for helping to beat back another wave of the virus in that country.

More than 195 million Americans are fully vaccinated, defined as having received two doses of the Pfizer or Moderna vaccines or the single-dose Johnson & Johnson vaccine. More than 30 million already have received a booster.

Before the expansion, people who received the Pfizer or Moderna vaccinations were eligible for a third dose if they’re elderly or at high risk of COVID-19 because of health problems or their jobs or living conditions.

Because a single J&J shot hasn’t proven as effective as its two-dose competitors, any J&J recipient can get a booster at least two months later.

But people who don’t meet the criteria often score an extra shot because many vaccine sites don’t check qualifications.

The FDA previously ruled that people getting a booster can receive a different brand from the vaccine they received initially.

Some experts worry that all the attention to boosters may harm efforts to reach the 60 million Americans who are eligible for vaccinations but haven’t gotten the shots. There’s also growing concern that rich countries are offering widespread boosters when poor countries haven’t been able to vaccinate more than a small fraction of their populations.

“In terms of the No. 1 priority for reducing transmission in this country and throughout the world, this remains getting people their first vaccine series,” said Dr. David Dowdy of Johns Hopkins Bloomberg School of Public Health.

November 20, 2021 0 comment

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‘Severely’ immunocompromised people should get a third COVID-19 vaccine shot: ATAGI

by Medically Speaking Team October 8, 2021

written by Medically Speaking Team

For those who are “severely” immunocompromised, Australia’s vaccine expert council has advised a third dosage of the COVID-19 vaccine.

The extra shots will be available to eligible folks starting next week.

According to the Australian Technical Advisory Group on Immunisation (ATAGI), persons with specific illnesses or who are receiving immunosuppressive treatments like chemotherapy may not be adequately protected by the standard two vaccination doses.

A third dosage should be given two to six months following the second treatment, according to ATAGI.

“The third dose is intended to maximise the level of immune response to as close as possible to the general population,” ATAGI said in a statement.

“Protection from three primary doses in severely immunocompromised individuals may still be lower than the general population.

“People should continue risk mitigation strategies such as mask wearing and social distancing even after receipt of a third dose.”

Under ATAGI’s recommendation, around 500,000 patients would be eligible for a third dosage, according to Health Minister Greg Hunt.

Persons with malignant tumours, organ transplants, stem cell transplants, people on immune-suppressing treatments or taking specific steroids, and people born with immunodeficiencies are all included.

However, Mr Hunt pointed out that those who were only moderately immunocompromised were not yet receiving further injections.

Pfizer and Moderna are the favoured vaccinations for booster injections, according to ATAGI.

AstraZeneca, on the other hand, can be utilised for individuals who have previously received the first two doses.

No recommendations on third doses have been made for the general population at this stage.

Mr Hunt said that decision would be made later this month.

October 8, 2021 0 comment

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Must wait for everyone to get both doses before discussing booster, says Dr Anil Arora

by Medically Speaking Team October 4, 2021

written by Medically Speaking Team

“If we keep on giving boosters to those who have a controversial role in prevention of disease, we are trying to put the cart ahead of the horse. Those who are at high risk of infection like transplant recipients, can lay their hands on the vaccination, it is a good alternative, but not across the board. Let everybody be vaccinated with the second shot before talking about the boosters,” stated Dr Anil Arora, Senior Consultant from Institute of Liver Gastroenterology of Sir Gangaram Hospital, in an exclusive interview with Medically Speaking on administration of booster shots for Covid-19.

Here are a few snippets from the interview:

Tell us really about the tumour, which had been removed by you during the 100^th live webcast surgery through an endoscopic invasion. Tell us a little more about the same layman’s terms.

Dr. Anil Arora: This was a patient who had been going around with the tumour in the summer for almost a year. He had earlier been reluctant to get operated because of the ongoing covid-19. He went to a surgeon who thought the tumour was superficial and maybe it was may be amenable to endoscopy. So, we spent about six hours and fortunately, we were able to remove the whole tumour without any surgery from within the stomach. This is a new technique, called endoscopic submucosal dissection. That is not new in terms of Indian scenario, but to have an early malignancy in the stomach is uncommon in Indian scenario. Most of our patients come late in the course of the illness and they are not fit for endoscopic surgeries. So, this is one of the uncommon varieties of early stomach cancer, which has been very well handled by endoscopic removal without having been subjected to surgery at all.

Many people are delaying their much required surgeries due to this endemic fear of Covid. Even though the top experts and scientists have said that the third we may actually not come the number at an all-time low, why is this fear still remaining?

Dr. Anil Arora: If you look at the devastating effects of the Covid-19 second wave, it has still not been off of our conscience. People have been affected mentally, physically, socially and economically. People are still recuperating. This is once in a century pandemic. I think most of us will never be able to see it again. And we have experiences and then we are the lucky ones we have survived. We’re still trying to come out of the ripple effects of the second wave.

Do you think that a booster shot is needed perhaps at a later stage at least for the comorbid?

Dr Anil Arora: Anybody who is immunocompromised, or has not had the exposure to protective jabs certainly needs a vaccination. And those who have not got the antibodies made, they are the subgroup of the patients who will certainly need boosters. But having said that, the disease tends to spread among those people who have not been vaccinated. If you look at the Indian data, only one fourth of the population has got the second jab, they still do not have adequate protection.

If on top of that due to lack of availability of the vaccines, if we keep on giving boosters to those who have a controversial role in prevention of disease, we are trying to put the cart ahead of the horse. Those who are at high risk of infection like transplant recipients, can lay their hands on the vaccination, it is a good alternative, but not across the board. Let everybody be vaccinated with the second shot before talking about the boosters.

Talking about the gallbladder gangrene, a rare case you saw, how could it develop? How is it post-Covid symptom?

Dr Anil Arora: See we recently reported a large number of complications occurring in the peri-Covid era, primarily after recovery from Covid. We reported white fungus, black fungus, cytomegalovirus induced colitis and finally we were baffled by influx of the 5 patients with severe inflammation of the gallbladder, leading to the gangrene, four out of which, developed perforation of the gall bladder requiring emergency surgery. We believe that the antigens, which may be persisting in the body or antibodies which have been formed against the virus, may have an affinity for the wild of the epithelium. Now Ace 2 receptors which are conducive to the entry of the virus into the alveolar cells of the lung, which is the most important site of involvement of the covid-19 infection or equally prevalent, in abundance in the bile duct epithelium. So, we believe the combination of effect of Ace 2 receptors will dysregulated immune mechanism would have resulted in severe inflammation involving the bile duct epithelium, as well as compromising the vascular supply causing vasculitis. Combination of the two-event resulting in the double whammy resulted in acalculous cholecystitis, which means these patients had inflammation of the gallbladder, even in the absence of the stones. Acalculous cholecystitis to a stage where it almost lead to gangrene requiring surgery is almost unheard of in covid. We reviewed the literature, there have been five to seven more cases reported in the world literature and we thought we will make everybody conscious of it.

What really is the reason for a condition like this developing? Isn’t it quite fatal as well as whatever little I understand of it?

Dr. Anil Arora: Of all the cases of cholecystitis is 10% likely to occur in the absence of the gospels and the typical and classical setting for acalculous cholecystitis is a sick patient who is in ICU on prolonged ventilation. Surprisingly these were the patients who had recover from covid, they were at home and presented with fever and symptoms of cholecystitis. So it was not the traditional causes of acalculous cholecystitis in gallbladder gangrene. So, the lesson is, if you have symptoms of inflammation of the gallbladder after recovering from the covid, even in the absence of the gall stones, do not ignore it. Maybe a timely intervention with IV fluids and antibiotics may herald the progress of disease to gangrene requiring surgery.

October 4, 2021 0 comment

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