Biden administration purchases extra Pfizer doses to prepare for possibility of children vaccine needs and booster shots

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CNN 23 July, 2021 - 09:38am 38 views

Updated 10:38 AM ET, Fri July 23, 2021

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Covid vaccine: Eight-week gap seen as sweet spot for Pfizer jab antibodies

BBC News 23 July, 2021 - 12:11pm

Experts say the findings support the UK's decision on extending dosing intervals from the initial recommendation of three weeks.

An eight-week gap seems to be the sweet spot for tackling the Delta variant.

The UK initially extended the dosing gap to 12 weeks at the end of 2020.

But as the vaccination programme has been rolled out through the age groups - everyone over 18 has now been offered at least their first jab - people have been encouraged to bring their second jab forward and get it after eight weeks.

The government-funded work is published in a pre-print paper not yet peer reviewed.

For the study, the researchers compared the immune responses of 503 NHS staff who received their two shots at different intervals in late 2020 and early 2021, when the Alpha Covid variant, first identified in Kent, was rapidly spreading.

Antibody levels in their blood were measured a month after the second vaccine dose.

Prof Susanna Dunachie, the joint chief investigator in the Pitch study, at Oxford University, said two doses were better than one but the timing of the second was somewhat flexible depending on the circumstances.

For the UK's current situation, she said: "Eight weeks is about the sweet spot for me, because people do want to get the two vaccine [doses] and there is a lot of Delta out there right now.

"Unfortunately, I can't see this virus disappearing, so you want to balance that against getting the best protection that you can."

Dr Rebecca Payne, one of the study authors, from Newcastle University, said: "Our study provides reassuring evidence that both dosing schedules generate robust immune responses against Sars-CoV-2 after two doses.

"We now need to carry out more follow-up studies to understand the full clinical significance of our findings."

Real-world data from Public Health England shows the Pfizer vaccine is effective at reducing levels of serious disease, hospital admissions and death, even after one dose.

Vaccines Minister Nadhim Zahawi said: "The findings from this latest Pitch study are hugely significant not just for the UK but for the world, helping us better understand the mechanics behind our immune response to Covid-19 and the importance of getting both doses of the vaccine.

"As we raced to offer a vaccine to all adults, we took the [Joint Committee on Vaccination and Immunisation] JCVI's advice to shorten the dosing interval from 12 to eight weeks, to help protect more people against the Delta variant.

"This latest study provides further evidence that this interval results in a strong immune response and supports our decision.

"I urge every adult to get both doses of the vaccine, protect yourself and those around you, and we are looking to offer millions of the most vulnerable a booster jab from September to ensure this protection is maintained."

The Pfizer jab is one of three currently being used in the UK, along with vaccines made by Oxford-AstraZeneca and Moderna.

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  The study might help inform vaccination strategies against the Delta variant, which reduces the effectiveness of a first dose of COVID-19 vaccine even though two doses are still protective. 

  "For the longer dosing interval ... neutralising antibody levels against the Delta variant were poorly induced after a single dose, and not maintained during the interval before the second dose," the authors of the study, which is being led by the University of Oxford, said. 

  "Following two vaccine doses, neutralising antibody levels were twice as high after the longer dosing interval compared with the shorter dosing interval." 

  Neutralising antibodies are thought play an important role in immunity against the coronavirus, but not the whole picture, with T cells also playing a part. 

  The study found overall T cell levels were 1.6 times lower with a long gap compared with the short dosing schedule of 3-4 weeks, but that a higher proportion were "helper" T cells with the long gap, which support long-term immune memory. 

  The authors emphasised that either dosing schedule produced a strong antibody and T cell response in the study of 503 healthcare workers. 

  The findings, issued as a pre-print, support the view that while a second dose is needed to provide full protection against Delta, delaying that dose might provide more durable immunity, even if that's at the cost of protection in the short-term. 

  Last December, Britain extended the interval between vaccine doses to 12 weeks, although Pfizer warned there was no evidence to support a move away from a three-week gap. 

  Britain now recommends an 8-week gap between vaccine doses to give more people high protection against Delta more quickly, while still maximising immune responses in the longer term. 

  "I think the 8 week is about the sweet spot," Susanna Dunachie, joint chief investigator on the study, told reporters. (Reporting by Alistair Smout; Editing by Giles Elgood) 

LONDON (Reuters) -A longer gap between doses of Pfizer's COVID-19 vaccine leads to higher overall antibody levels than a shorter gap, a British study found on Friday, but antibody levels are not sustained for long after the first dose. The study might help inform vaccination strategies against the Delta variant, which reduces the effectiveness of a first dose of the vaccine even though two doses are still protective, and one author said that Britain's eight-week gap was a "sweet spot" against Delta. "For the longer dosing interval ... neutralising antibody levels against the Delta variant were poorly induced after a single dose, and not maintained during the interval before the second dose," the authors of the study, which is being led by the University of Oxford, said.

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Morrison's ill-judged remarks risk trashing the reputation of a key expert body

ABC News 22 July, 2021 - 02:09pm

On Wednesday Morrison told a news conference he (or the government) made a "constant appeal" to the Australian Technical Advisory Group on Immunisation (ATAGI) to review its advice on AstraZeneca according to the balance of risk.

On Thursday he said on radio: "I've just simply said balance of risk is changing, guys, so how is that impacting on your advice, and it's time to think about that."

The "guys" (and girls) on ATAGI are obviously as aware as anyone of the changing risk profile as cases increase.

Indeed ATAGI has already altered its advice on AstraZeneca in light of the Sydney outbreak.

On July 13 it said where there was an outbreak and the Pfizer supply was constrained, people under 60 without immediate access to Pfizer should "reassess the benefits to them and their contacts from being vaccinated with COVID-19 vaccine AstraZeneca, versus the rare risk of a serious side effect".

ATAGI, whose members have qualifications in immunisation and infectious diseases, is charged with advising the health minister on immunisation issues.

There's no doubt its advice on AstraZeneca has been very cautious.

It threw a spanner in the vaccination works when it said that Pfizer (of which Australia doesn't yet have enough) was preferred for those under 50, and then raised the age to under 60.

This was based on the very small risk of blood clots, which are more likely to occur in younger people. Two more recent deaths associating AZ and clots were announced by the Therapeutic Goods Administration on Thursday — the people were in their 40s.

But it is not the only expert source in Australia taking this position.

A paper by the Kirby Institute's Raina MacIntyre and other authors published in this month's issue of the international journal Vaccine reported their "risk-benefit analysis for Australians aged 18–59", comparing the risk of AZ vaccination with the risk of COVID infection.

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The article also said: "The latest policy decision to avoid use of this vaccine in adults < 60 years in Australia is entirely consistent with past vaccine risk–benefit policy decisions when rare but serious adverse events were identified."

The authors say their analysis, done after the death of a 48-year-old woman, was "shared with senior health officials in Australia on April 8, 2021".

That was the same day ATAGI advised against AZ for under 50s, with the government announcing this at a hastily called night news conference.

It's up to the government whether it accepts whatever ATAGI says — as ATAGI's remit indicates, it only "advises".

Certainly we know ATAGI's advice (and the debate it prompted) contributed to vaccine hesitancy including among those for whom AZ is most appropriate — older people — and this is very unfortunate.

It would be legitimate — if difficult and some would say irresponsible — for Morrison at any point to say he thought ATAGI wrong, that other advisers were telling him something else, and so the government rejected ATAGI's advice.

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The PM's aim seemed obvious. If ATAGI was pliable, he could say, "this is the new health advice — everyone should follow it". He would have the best of all worlds.

Or perhaps not. If and when ATAGI changes its advice from now on — even if the PM's view has nothing to do with that change — will it have the same credibility? Won't many people, already suspicious and cynical, think 'that's just ATAGI giving into political pressure'?

If the perception of ATAGI's independence is going to be undermined, the usefulness of the body — whatever it says — becomes questionable.

At his Thursday news conference, Morrison tried to re-spin his pressure on ATAGI.

He completely respected its advice, he said.

"That's why we've followed the advice of ATAGI. It's my job as Prime Minister not just to simply accept advice uncritically. Whether it's sitting in cabinet meetings or in other forums, of course I challenge the advice that I receive. I ask questions. I drill into it. You would expect me to do that. I think Australians would not expect me to just take this advice simply on the face of it."

Actually, on numerous occasions, the government has made a virtue of just accepting health advice without question.

In the Australian Financial Review two economists, Ashley Craig and Matthew Lilley, have criticised ATAGI for not building into its recommendations social benefits versus risks.

They write: "Ask yourself whether ATAGI made the right call by refusing to properly account for social benefits in its advice, which encouraged millions of Australians to delay vaccination."

"It is not too late to change this message. With millions stuck in lockdowns, ATAGI could instead be emphasising how accelerating vaccinations will make society better off."

This, however, seems wrong-headed. ATAGI is a narrow, specialist vaccination advisory body. You wouldn't ask Treasury to assess the effectiveness of Pfizer against AstraZeneca. ATAGI's advice is part of a wider picture, which government has the job of bringing together into one frame.

The ATAGI episode is just the latest chapter in the evolving story of the role of health experts in this pandemic.

Early on, their status was substantially unquestioned. Morrison and other leaders constantly referred and deferred to them.

But then health officials, especially at state level, became controversial figures, accused of being political.

Although the federal bureaucrats have not been targets in the same way as state officials, there has been a growing perception their advice is influenced by the political needs of their masters.

This makes it all the more important that independent advisory groups like ATAGI are not perceived as having a political tinge.

He had been under pressure for earlier refusing to say "sorry" for the rollout problems — he'd resisted the word, preferring to say he took responsibility.

But at Thursday's news conference he said: "I'm certainly sorry that we haven't been able to achieve the marks that we had hoped for at the beginning of this year. Of course I am."

He had decided, or been persuaded, that the "sorry" question wouldn't go away without being dealt with. It might be harder to put the ATAGI questions to rest.

AEST = Australian Eastern Standard Time which is 10 hours ahead of GMT (Greenwich Mean Time)

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