Category: COVID19

The possible side-effects of Moderna’s COVID-19 vaccine in some people.

Moderna’s vaccine is effective in preventing severe COVID-19 and has been highly praised since the clinical trials have shown a 94.1 percent protection rate.

However, the public needs to be aware of the possible adverse effects, even if there are no serious safety concerns.

The Moderna vaccine phase 3 clinical trial results show that, in general, reactions to the vaccine like pain, redness, and swelling at the site of injection were mild.

Nevertheless, 50 percent of recipients after the second dose experienced moderate-to-severe side-effects such as headache, muscle aches, joint pain, and fatigue.

The side-effects were temporary, occurring 15 hours after the injection and disappearing in most cases by day 2 with no consequences.

Expected adverse reactions after vaccination

Dr Luke Hutchison a computational biologist, who participated in Moderna’s coronavirus vaccine trial talks about his experience in an article published in the journal Science.

He said his arm swelled up to the size of a goose egg after the second dose and within a few hours he had a 38.9°C fever and muscle aches:

“I started shaking.

I had cold and hot rushes.

I was sitting by the phone all night long thinking: ‘Should I call 911?’”

The symptoms were resolved after 12 hours, but as he points out nobody had prepared him for the severity of the reaction.

He added that people should be told about the possible adverse reactions as some people, soon after vaccination, might experience these symptoms.

According to Professor Florian Krammer, a vaccinologist who participated in Pfizer’s trial, those short-term side effects (reactogenicity) should not stop people from getting vaccinated because the coronavirus kills 1 in every 200 people that it infects.

He said:

“Sore arms, fevers, and fatigue are “unpleasant but not dangerous.”

Data analysis of Moderna’s vaccine trial by an independent board suggests several severe side-effects as follows:

• fatigue in 9.7 percent,
• muscle pain in 8.9 percent,
• joint pain in 5.2 percent,
• headache in 4.5 percent,
• and fevers of 39°C to 40°C in 2 percent of participants.

Most people will have no or mild side-effects after receiving a Pfizer or Moderna vaccine, but if only 2 percent of 500 million people across the world who get either the Pfizer or Moderna vaccine develop severe fevers, that would be 10 million people.

Professor Arnold Monto, an epidemiologist at the University of Michigan School of Public Health, said:

“This is higher reactogenicity than is ordinarily seen with most flu vaccines, even the high-dose ones.”

Side-effects are sign of normal response

Many experts believe that the side-effects are normal signs, showing an effective immune response to the vaccine.

Professor Drew Weissman, an immunologist at the University of Pennsylvania whose work was important for the COVID-19 vaccines, said:

“Both Moderna’s and Pfizer/BioNTech’s vaccines require two doses separated by several weeks.

Reactogenicity is typically higher after a second dose.

The side effects “mean the vaccine is working well. …

[It] means you had such a good immune response to the first dose and now you are seeing the effects of that.

We suspect the lipid nanoparticle causes the reactogenicity, because lipid nanoparticles without mRNA in them do the same thing in animals.

We see production, in the muscle, of inflammatory mediators that cause pain, [redness], swelling, fever, flulike symptoms, etc.”

→ Read on: The Common Side-Effects Of The Pfizer Vaccine

The study was published in The New England Journal of Medicine (Baden et al., 2021); The article published in Science (Wadman, 2020).

Artificial intelligence can foresee if you will die from COVID-19, even before infection.

A computer model used by researchers in Denmark can predict whether a person will die before they even get infected with the coronavirus.

Being older and overweight are the main predictors, along with being a man and having high blood pressure.

The model determines the progression of the disease and death showing who should be the first to receive the SARS-CoV-2 vaccine in Denmark.

The model’s prediction of whether a person with no evidence of COVID-19 infection would die or survive was 90 percent accurate.

The model’s prediction of whether a person will be admitted to hospital and Intensive Care Unit (ICU) or require a respirator was 80 percent accurate.

Professor Mads Nielsen, study co-author, said:

“We began working on the models to assist hospitals, as during the first wave, they feared that they did not have enough respirators for intensive care patients.

Our new findings could also be used to carefully identify who needs a vaccine.”

Since the COVID-19 outbreak, scientists have been working on machine learning (ML) models to predict the severity of the disease before people become ill by using their health records.

The computer program was designed to look for patterns in people’s history of illness and how they fought against COVID-19.

Professor Nielsen said:

“Our results demonstrate, unsurprisingly, that age and BMI are the most decisive parameters for how severely a person will be affected by COVID-19.

But the likelihood of dying or ending up on a respirator is also heightened if you are male, have high blood pressure or a neurological disease.”

According to the study, health risk factors and chronic diseases are the keys to find out whether a COVID-19 patient will need a breathing machine or respirator.

BMI, age, high blood pressure, being male, neurological diseases, Chronic obstructive pulmonary disease (COPD), asthma, diabetes and heart disease were the key parameters in predicting the risk of hospital and ICU admission, use of mechanical ventilation, and death.

Professor Nielsen said:

“For those affected by one or more of these parameters, we have found that it may make sense to move them up in the vaccine queue, to avoid any risk of them becoming inflected and eventually ending up on a respirator.”

The research team are hoping to develop a program to help hospitals foresee whether they need respirators several days in advance.

Professor Nielsen said:

“We are working towards a goal that we should be able to predict the need for respirators five days ahead by giving the computer access to health data on all COVID positives in the region.

The computer will never be able to replace a doctor’s assessment, but it can help doctors and hospitals see many COVID-19 infected patients at once and set ongoing priorities.”

The study was published in the journal Scientific Reports (Jimenez-Solem et al., 2021).

These active ingredients found in mouthwash can inactivate over 99.9% of the coronavirus.

Some over‐the‐counter mouthwashes, gargles, and nasal rinses can make human coronaviruses inactive, a study found.

These products seem to lower the amount of virus (viral load) in an infected person’s mouth and so reduce the transmission of SARS-CoV-2, which is responsible for COVID-19.

Oral and nasal cavities are the major entry points and spreaders of human coronaviruses.

Professor Craig Meyers and his team tested several nasal rinses and mouthwash gargling products for their level of protection against human coronaviruses.

The mouthwashes included were Peroxide Sore Mouth Cleanser, Hydrogen peroxide diluted to 1.5 percent in PBS solution, Listerine and Orajel Antiseptic Rinse.

The nasal rinses were Neti Pot solution (made based on manufacturer’s instructions), Johnson’s Baby Shampoo diluted to 1 percent in PBS solution.

Some of these products were able to neutralize the human coronavirus, suggesting their potential ability to reduce virus spread by COVID-19 patients.

Professor Meyers said:

“While we wait for a vaccine, methods to reduce transmission are needed.

The products we tested are readily available and often already part of people’s daily routines.”

They tested those products on a human coronavirus genetically similar to SARS-CoV-2 in a laboratory, the contact time with the virus was 30 seconds, one minute, and two minutes.

The 1 percent baby shampoo solution during the two-minute contact time was able to inactivate more than 99.9 percent of the virus whereas the over‐the‐counter saline nasal rinse and Neti Pot had no effect on the virus.

Also several over‐the‐counter antiseptic mouth washes with alcohol‐based eucalyptol, menthol, methyl salicylate, and thymol formulations were able to inactivate 99.9 percent of infectious virus.

Another study has suggested that chemicals such as ethanol, cetylpyridinium, and povidone-iodine commonly found in dental mouthwashes can destroy the outer shell of fat of many enveloped viruses.

These experimental findings show that certain types of oral rinses such as Listerine antiseptic have the inactivating properties which can be highly effective on reducing the viral load of SARS-CoV-2 even outside the lab.

Professor Meyers said:

“People who test positive for COVID-19 and return home to quarantine may possibly transmit the virus to those they live with.

Certain professions including dentists and other health care workers are at a constant risk of exposure.

Clinical trials are needed to determine if these products can reduce the amount of virus COVID-positive patients or those with high-risk occupations may spread while talking, coughing or sneezing.

Even if the use of these solutions could reduce transmission by 50%, it would have a major impact.”

The study was published in the Journal of Medical Virology  (Meyers et al., 2020).

A cocktail of drugs can prevent 100 percent of symptomatic COVID-19 infections by “passive immunization”.

A combination of drugs can prevent 100 percent of COVID-19 infections, researchers at the University of Virginia Health System have found.

The antibody cocktail is called REGN-COV and is aimed at people who live or come into contact with a COVID-19 patient.

Although it provides a short-term benefit, the drug can block symptomatic infections for those who share a household with a COVID-19 patient.

Moreover, those with no symptoms (asymptomatic) have a lower amount of the virus in their body (viral load) and so the infections resolve in seven days.

Dr William Petri, the leader of this clinical trial, said:

“This is the first treatment shown to prevent COVID-19 after a known exposure, and offers protection for unvaccinated individuals caring for a family member with COVID-19.

We expect that Regeneron will file for emergency use authorization from the FDA so that this drug can be used outside of the context of a clinical trial.”

This is “passive immunization” using antibodies to prevent people from developing disease, despite being exposed to the virus.

For this study, 400 people participated, with 186 receiving the antibody cocktail treatment and the rest getting a placebo.

The results showed that the coronavirus infection rates, both asymptomatic and symptomatic, were 50 percent less in the antibody group compared to the placebo group.

The viral load in placebo recipients who developed infections was 100 times bigger than infected people from the antibody group.

Those in the antibody group who got COVID-19 recovered from the disease within a week, whereas the recovery period was three to four weeks for those patients in the placebo group.

The antibody cocktail is able to reduce the duration of viral shedding, the time when the virus replicates in the body.

Since the viral particles that are being shed can be infectious then reducing the period will lower the risk of spreading the disease.

Dr Petri said:

“Antibody treatments like this are in a way a stop-gap and so, until we can have everyone vaccinated, antibody treatment is in a way beneficial to people that are at risk of the most severe complications of the infection.”

It is likely that the antibody cocktail will also be effective against new coronavirus variants.

Dr Petri said:

“These combinations of antibodies are probably going to be more effective at treating and preventing infections from the new variants because it’s much harder for the virus to mutate around two different antibodies than a single one.”

The antibody cocktail is different with a vaccine and it cannot give long-term protection from COVID-19.

→ The study has not been published in a scientific journal yet.

How effective is the Pfizer vaccine and do people need a second shot for immunity?

A single shot of the Pfizer-BioNTech COVID-19 vaccine gives people 90 percent protection 3 weeks after injection.

A study reveals that people in Israel who received the first jab of the Pfizer vaccine were highly protected against the SARS-CoV-2 virus.

However, it can take up to 21 days after the initial injection for a single dose to achieve 90 percent immunity from the disease.

If the protection is that high then having a second dose seems to be unnecessary and wasteful when most countries are struggling to secure a vaccine.

The recommended time frame for a second dose is after 21 days but in the UK the current decision has been to delay this up to 12 weeks after the first injection.

The present study supports the UK’s plan but the authors highlight that the risk of infection is doubled during the first eight days after injection due to people became careless after having their vaccine.

Professor f Paul Hunter, the study’s first author, said:

“A second dose of the Pfizer vaccine would normally be given 21 days or more after the first to top up and lengthen the effect of the first dose.

But here in the UK, the decision was made to delay the timing of the second injection until 12 weeks after the first.

The logic behind this is to protect more people sooner and so reduce the total number of severe infections, hospitalisations, and deaths.

But this decision caused criticism from some quarters due in part to a belief that a single injection may not give adequate immunity.

A recent non peer-reviewed pre-print paper based on Israel’s experience looked at data from 500,000 people who had been given the Pfizer vaccine.

It reported that a single dose may not provide adequate protection.

But we saw a number of flaws in how they looked at the data including the fact that they did not attempt to estimate the effectiveness of the vaccine from day 18 onwards.

This would have given a better indication of how effective a single dose of the vaccine could be if the second dose was delayed by up to 12 weeks.”

The team wanted to find out how effective a single dose of the Pfizer COVID-19 vaccine is by using real-world data.

The outcome suggests that the number of coronavirus cases will increase for eight days after the first dose but then will decline to their lowest by day 21.

Professor Hunter said:

“Surprisingly, the daily incidence of cases increased strongly after vaccination till about day eight—approximately doubling.

We don’t know why there was this initial surge in infection risk but it may be related to people being less cautious about maintaining protective behaviours as soon as they have the injection.

We found that the vaccine effectiveness was still pretty much zero until about 14 days after people were vaccinated.

But then after day 14 immunity rose gradually day by day to about 90 percent at day 21 and then didn’t improve any further.

All the observed improvement was before any second injection.

This shows that a single dose of vaccine is highly protective, although it can take up to 21 days to achieve this.

And it supports the UK policy of extending the gap between doses by showing that a single dose can give a high level of protection.

Whilst we do not know how long this immunity will last beyond 21 days without a second booster, we are unlikely to see any major decline during the following nine weeks.

The study was published in medRxiv (Hunter & Brainard, 2021).

A model of SARS-CoV-2 infection suggests the virus will become as mild as a common cold across the years.

The COVID-19 pandemic is having a devastating impact on people’s physical and mental health, the economy, children’s education, and much more across the world, but would be there an ‘endgame’ for the virus.

According to a model developed by scientists from Emory and Penn State, the virus will become endemic as seen in other known human coronaviruses and so it will become a very low-level threat, like a common cold.

The model uses SARS-CoV-1 and the four coronaviruses responsible for more than a quarter of all common colds.

SARS-CoV-2 is very similar to the SARS-CoV-1 virus but it has ten times the binding affinity to human cell receptors compared to SARS-CoV-1.

Dr Jennie Lavine, the study’s first author, noted that the phrase ‘herd immunity’ for those viruses is partial and somewhat misleading.

The four common cold coronaviruses have long been known since most people are infected during their childhood.

Infection in general makes children develop natural immunity which protect them against severe illnesses in later life but it doesn’t mean that it can stop the recurrence of reinfection.

Dr Lavine said:

“Reinfection is possible within one year, but even if it occurs, symptoms are mild and the virus is cleared from the body more quickly.

It highlights the need to tease apart the components of immunity to SARS-CoV-2.

How long does immunity that prevents pathology last, and how long does immunity that prevents transmission last?

Those durations may be very different.”

Recent papers on lasting immunity and antibodies against COVID-19 in recovered patients are continuously providing reliable data, however, the part regarding protection or blocking of transmission remains a puzzle.

Dr Lavine said:

“Overall, we’re asking: how does SARS-CoV-2 compare to other viruses such as seasonal influenza or respiratory syncytial virus.

This model assumes immunity to SARS-CoV-2 works similar to other human coronaviruses.

We don’t really know what it would be like if someone got one of the other coronaviruses for the first time as an adult, rather than as a child.”

Once COVID-19 becomes endemic, the model foresees the infection fatality ratio (percentage of deaths amongst infected patients) could drop below seasonal influenza (a rate of 0.1%).

Professor Ottar Bjornstad, study co-author, said:

“We are in uncharted territory, but a key take-home message from the study is that immunological indicators suggest that fatality rates and the critical need for broad-scale vaccination may wane in the near term, so maximum effort should be on weathering this virgin pandemic en route to endemicity.”

The authors hint that a COVID-19 vaccination can save hundreds of thousands people during the first or second year of vaccine rollout.

However, ongoing mass vaccination may be unnecessary when SARS-CoV-2 becomes endemic, except for those who are in vulnerable groups.

They add that SARS-CoV-2 infection rates in infants and young children appear to be mild with low mortality.

If children experience severe SARS-CoV-2 infection, like MERS-CoV (Middle East respiratory syndrome-related coronavirus), then routine vaccinations will become critical.

The study was published in Science (Lavine et al., 2020).

COVID-19 patients who have higher levels of this nutrient in their blood are more likely to recover from the disease.

Scientists have published the first direct evidence that suggests higher omega-3 fatty acid levels can lower the risk of dying from the coronavirus infection.

Previous studies have found that omega-3 fatty acids have anti-inflammatory properties that could lower the severity and mortality in COVID-19 patients but up to now there wasn’t enough supporting evidence.

The present study examined 100 hospitalized patients with Covid-19 at Cedars-Sinai Medical Center in Los Angeles.

They analysed those patients blood samples for their omega-3 index (O3I), which is a measure of EPA and DHA levels in red blood cells.

They found that the chance of surviving was nearly four times greater for those with the highest omega-3 index compared with those with the lowest.

The patients were divided into four quartiles based on their omega-3 index, ensuring each quartile contained 25 percent of participants.

The top quartile group consisted of patients with an O3I greater than 5.7 percent and these subjects had a 75 percent reduced risk of death from coronavirus disease compared with those in the 3 lower quartiles.

Dr Arash Asher, the study’s first author, said:

“While not meeting standard statistical significance thresholds, this pilot study—along with multiple lines of evidence regarding the anti-inflammatory effects of EPA and DHA—strongly suggests that these nutritionally available marine fatty acids may help reduce risk for adverse outcomes in COVID-19 patients.

Larger studies are clearly needed to confirm these preliminary findings.”

Professor Clemens von Schacky, co-developer of the Omega-3 Index, said:

“Asher et al have demonstrated that a low Omega-3 Index might be a powerful predictor for death from COVID-19.

Although encouraging, their findings clearly need to be replicated.”

Clinical studies show that 3 grams a day of EPA and DHA supplementation for 10 weeks can lower levels of circulating inflammatory cytokines.

Cytokines are messengers in the immune system that regulate the activity of white blood cells.

Dr James H O’Keefe, commenting on the study, said:

“An excessive inflammatory response, referred to as a ‘cytokine storm,’ is a fundamental mediator of severe COVID-19 illness.

Omega-3 fatty acids (DHA and EPA) have potent anti-inflammatory activities, and this pilot study provides suggestive evidence that these fatty acids may dampen COVID-19’s cytokine storm.”

A diet high in oily fish containing EPA and DHA such as mackerel, salmon, herring, trout, albacore tuna, and sardines can be the best way to obtain omega-3.

The study was published in the journal Prostaglandins, Leukotrienes and Essential Fatty Acids (Asher et al., 2020).

COVID-19 patients who have this syndrome are more likely to experience severe infection.

An unhealthy gut can reduce the chance of surviving a COVID infection.

Factors like a “Western diet”, long-term illness, and aging can cause microbial imbalance in the gut, resulting in a leaky gut.

Leaky gut syndrome enables the COVID-19 virus to get through the surface of internal organs and the digestive tract, making the infection worse, a study has found.

The severity of infection is due to the ACE2 protein which is the entry point for SARS-CoV-2.

The protein is largely located on the surface of organs such as intestines, heart, and lungs.

SARS-CoV-2 infection can cause severe symptoms such as respiratory complications and high fevers.

Furthermore, autopsies show that the infection can damage the heart, liver, gastrointestinal (GI) tract, spleen, and kidneys.

Some hospitalized patients not only have breathing difficulty but also experience nausea, vomiting, and diarrhoea.

This suggests that if the virus reaches the GI tract, it can cause more damage to patients.

We now know that older people and those with health conditions such as diabetes, obesity or even high blood pressure are at increased risk of severe coronavirus disease.

It appears that aging and underlying health conditions can disturb gut microbiota, causing gut barrier dysfunction in which the wall of the intestine becomes permeable.

In this situation, toxins and pathogens including any virus or bacteria can easily enter the lining of the intestine.

Dr Heenam Stanley Kim, the study’s author, said:

“There seems to be a clear connection between the altered gut microbiome and severe COVID-19.”

Some studies have argued that unhealthy gut microbiomes could be the hidden cause of severe infections in some people, Dr Kim noted.

For instance, a study in Singapore found that 50 percent of symptomatic patients with COVID-19 carried a noticeable amount of the coronavirus in stool samples, while only half of them had gastrointestinal symptoms, suggesting the possibility of no harm by the virus despite reaching the GI tract.

Dr Kim, however, hinted that whether the symptoms progress is dependent on people’s gut health when infected.

Several studies have found that COVID-19 patients have a lower level of bacterial diversity and beneficial bacteria but higher amounts of pathogenic organisms.

The microbial imbalance (gut dysbiosis) have also been found in influenza patients.

The coronavirus appears to reduce a type of bacteria that produces a short-chain fatty acid called butyrate.

This fatty acid is important for gut health since it enhances intestinal barrier function.

Zuo and colleagues suggest the use of a probiotic formula addressing gut dysbiosis in order to enhance immune defence against viral infections such as COVID-19.

The other issue is that the Western diet causes changes in gut microbiome composition.

Dr Kim noted that Western Europe and the United States are well known to be wealthy with a well-functioning health care system, but they are one of the worst hit by the coronavirus pandemic.

These countries have one thing in common; the Western diet, which is poor in fibre.

Dr Kim said:

“A fiber-deficient diet is one of the main causes of altered gut microbiomes.

And such gut microbiome dysbiosis leads to chronic diseases.”

Eating fibre rich foods can lower the severity of illness but patients with severe Covid-19 might need fecal microbiota transplantation to treat the infection.

Dr Kim said:

“The whole world is suffering from this COVID-19 pandemic, but what people do not realize is that the pandemic of damaged gut microbiomes is far more serious now.”

The study was published in the journal mBio (Kim, 2021).