COVID-19 Roundup: Boosters Likely for Immunosuppressed; The Vaccinated vs. Delta; and More

COVID-19 Booster Shots Likely for Those with Compromised Immune Systems

COVID-19 booster shots for people with compromised immune systems who are at higher risk of “breakthrough” infections are likely to be finalized, possibly before year’s end, according to various media reports, public health officials and infectious disease experts.

Breakthrough infections among the fully vaccinated are still rare but on the increase because of the dominance of the more contagious delta variant. COVID-19 vaccines protect the vast majority of people from serious illness and hospitalizations, experts agree.

Nonetheless, momentum is growing internationally for booster shots for those at higher risk. Officials in Germany and Israel said this week that they would start offering boosters to some. France, Russia and Hungary are also about to do so. In response, the World Health Organization (WHO) this week called for a moratorium on coronavirus booster vaccinations at least until the end of September. The WHO said these nations should focus, for now, on helping supply under-vaccinated countries with vaccine shipments.

Meanwhile, an advisory group to the U.S. Centers for Disease Control and Prevention (CDC) is considering whether fully vaccinated Americans with weakened immune systems need a booster dose of one of the three COVID-19 vaccines available here. These individuals are less likely to have sufficient antibodies to fight the virus because of age, underlying health issues or otherwise compromised immune systems from treatments to fight cancer or other diseases. The makers of the COVID-19 are currently conducting clinical trials to test booster shots.

“So, now we’re dealing with potentially a waning immunity of our bodies with (the delta variant) that has a much higher viral count,” explains Sergio Segarra, M.D., chief medical officer at Baptist Hospital. “So, that’s why we need to bring in our other strategies. That’s why we also need to bring back mask wearing and social distancing to protect us from the virus. I am behaving as if I was unvaccinated. So, when I go into a store, I wear my mask. When I go inside to a room where I don’t know a lot of people, I wear my mask.”

Scott Gottlieb, M.D., who led the U.S. Food and Drug Administration (FDA) from 2017 to 2019 said in a televised interview this week that he believes COVID-19 vaccine booster shots will start to be given in the U.S. as early as next month to older adults and those with compromised immune systems, or “immunosuppressed.” He added that the boosters would represent a third dose of the currently available vaccines in the U.S., barring any further variants to the virus that would render the vaccines ineffective.

Infections at Public Events in Provincetown, Mass. Spurred the CDC’s New Mask-Wearing Guidance

Several events and public gatherings last month, July 3-17, in Provincetown, Massachusetts attracted thousands of tourists from across the U.S. — and also drew the attention of researchers with the U.S. Centers for Disease Control and Prevention (CDC).

It was the findings of a study of COVID-19 infections from this time period in Provincetown that primarily fueled the CDC’s re-evaluation of its mask-wearing guidance for vaccinated people.

Researchers examined the COVID-19 outbreak in Provincetown involving 469 cases, and found that three-quarters of cases occurred in fully vaccinated people. At the time, Massachusetts had a high rate of vaccination, about 69 percent among eligible adults.

Moreover, testing identified the delta variant in 90 percent of specimens from 133 patients, the CDC said. Health experts caution that the more transmissible delta variant, already the dominant strain of the coronavirus in the U.S., can carry much greater viral loads when infecting an individual, compared to the original strain of the virus.

And most strikingly, researchers also found no significant difference in the viral load present in the “breakthrough infections” in fully vaccinated people and the other cases, indicating the viral load of vaccinated and unvaccinated persons infected with COVID-19 is similar.

That finding was preceded by the CDC’s announcement last week that fully vaccinated people begin wearing masks indoors again in places with high transmission rates. The CDC is referring to areas where there are either more than 50 COVID-19 cases per 100,000 people over a seven-day period, or that the COVID-19 test positivity rate is higher than 5 percent. Nonetheless, vaccinated Americans still have a far lower chance of becoming infected with COVID-19, and are responsible for far less spread of the disease, compared to the unvaccinated.  Even in breakthrough cases, the vaccines remain powerfully effective against severe illness and death from COVID-19. 

In addition to urging the vaccinated to start wearing masks again in many settings, the CDC also urged the review of protective measures by event organizers across the nation — as a result of the Provincetown study.

“Event organizers and local health jurisdictions should continually assess the need for additional measures, including limiting capacity at gatherings or event postponement, based on current rates of COVID-19 transmission, population vaccination coverage, and other factors,” the CDC concluded.

Common Cholesterol-Lowering Meds May Lower Risk of COVID death by 40%, Researchers Find

The most prescribed cholesterol-lowering medications, known as statins, may improve the chances of survival for hospitalized COVID-19 patients and reduce their risks of more severe disease, a new study indicates.

In an analysis of more than 10,000 hospitalized COVID-19 patients across the U.S., the use of statins prior to hospital admission was associated with a more than 40 percent reduction in in-hospital death, and a greater than 25 percent reduction in the risk of developing a severe outcome, according to a news release from the American Heart Association (AHA). Researchers compared similar patients who did and did not use statins or anti-hypertensive medication to treat high blood pressure — among those both with and without underlying health conditions.

For about 30 years, cholesterol-lowering medications, known as statins, have been available to reduce the risk of heart attacks in individuals who had suffered previous heart attacks and who have high levels of LDL cholesterol. Nearly one of every three U.S. adults have high levels of “low-density lipoprotein cholesterol” (LDL-C), considered the “bad” cholesterol, because it contributes to fatty plaque buildups and narrowing of the arteries.

“Early during the pandemic, there were questions as to whether certain cardiovascular medications might worsen COVID-19 infections,” said Lori Daniels, M.D., lead author of the study, who is director of the Cardiovascular Intensive Care Unit at UC San Diego Health. “We found that not only are statins and anti-hypertensive medications safe – they may very well be protective in patients hospitalized for COVID, especially among those with a history of hypertension or cardiovascular disease.”

What are the reasons behind the lower risks among statin users and those on anti-hypertensive medications? Statins and anti-hypertension medications stabilize the underlying diseases for which they are prescribed, making patients more likely to recover from COVID-19. Additionally, these drugs can reduce inflammation, which can cause severe illness in COVID-19 patients with serious symptoms.

Findings of the study were published in the journal PLOS ONE.

The goal of researchers was to better understand the links between prior medication use, existing health conditions and COVID-19 outcomes. They relied on data from the American Heart Association’s COVID-19 Cardiovascular Disease Registry. The registry contains “de-identified health data on patients treated for COVID-19 at over 140 participating hospitals across the country,” the AHA states. As of July 2021, data from more than 49,000 patient records had been added to the registry.

People prescribed cholesterol and/or blood pressure medicine are encouraged to continue taking these medications during the age of COVID-19.   

Healthcare that Cares

With internationally renowned centers of excellence, 12 hospitals, more than 27,000 employees, 4,000 physicians and 200 outpatient centers, urgent care facilities and physician practices spanning across Miami-Dade, Monroe, Broward and Palm Beach counties, Baptist Health is an anchor institution of the South Florida communities we serve.

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