Peer Reviewed

Viral infections

COVID-19 Roundup: Additional Vaccine Dose, Breakthrough Cases, Death Toll

Third Vaccine Dose Approved1

The US Food and Drug Administration (FDA) has authorized an additional dose for both the Pfizer-BioNTech and Moderna COVID-19 vaccines in certain immunocompromised groups.

Included in this emergency use authorization are individuals who have received a solid organ transplant, or who have been diagnosed with a condition with an equivalent level of immunocompromise.

This additional dose is now recommended by the Centers for Disease Control and Prevention’s Advisory Committee on Immunization Practices2 and is supported by the Infectious Diseases Society of America.3

“Today’s action allows doctors to boost immunity in certain immunocompromised individuals who need extra protection from COVID-19,” concluded Janet Woodcock, MD, who is the Acting FDA Commissioner. “As we’ve previously stated, other individuals who are fully vaccinated are adequately protected and do not need an additional dose of COVID-19 vaccine at this time. The FDA is actively engaged in a science-based, rigorous process with our federal partners to consider whether an additional dose may be needed in the future.”

 

Breakthrough Cases With mRNA Vaccination4

The Moderna COVID-19 vaccine may be more effective at preventing breakthrough infections due to variants than the Pfizer-BioNTech COVID-19 vaccine, according to the results of a recent preprint study.

To compare the two mRNA vaccines, the researchers examined 25,589 individuals from Minnesota who visited the Mayo Clinic Health System from January 2021 to July 2021. The Alpha and Delta variants were widespread in the United States during this study period.

The preliminary results indicated that the effectiveness of the Moderna vaccine (mRNA-1273) dropped to 76% in July, while the Pfizer-BioNTech (BNT162b2) dropped to 42%. During the same time, the prevalence of the Delta variant increased to above 70% from 0.7% and the Alpha variant decreased to 13% from 85% in Minnesota. 

When compared with matched individuals in several states including Minnesota, Wisconsin, Arizona, Florida, and Iowa, the Moderna vaccine was associated with a 2-fold risk reduction in breakthrough cases than the Pfizer-BioNTech vaccine.

 

College Alcohol Use During the Pandemic5

Alcohol use and binge drinking among first-year college students declined during the COVID-19 pandemic, according to the results of a recent study.

The researchers examined the relationship between alcohol use, COVID-19 stressors such as work reductions and distanced learning difficulties, and social engagement such as social isolation and distancing. Included were 439 students aged between 18 to 20 years who were in their first year at a large public university in North Carolina. All participants were to be enrolled both before October 2019 to February 2020 and after June to July 2020.

The results indicated that the prevalence of alcohol use decreased from 54.2% to 46.0% in the previous 30 days. Similarly, binge drinking decreased from 35.5% to 24.6%. These results were associated with reductions in social engagement.

Further, challenges in distance learning was the only stress-related factor associated with an increase in alcohol use among those who were drinking prior to the pandemic. Alcohol use also increased among individuals who reported using substances to cope. Alcohol use was not associated with resilient coping.

“Unless new drinking habits are formed during the pandemic, decreases in alcohol use among college students are unlikely to be sustained as social distancing measures are removed,” the researchers concluded. “Colleges may want to target interventions to students who have responded to stress with increased alcohol use, partly by addressing difficulties with distance learning.”

 

Under-Reported Death Toll of COVID-196

The death toll of COVID-19 within the United States may be underreported, according to the results of a recent excess-mortality Poisson regression model.

In effort to better estimate the number of deaths due to COVID-19 within the United States from March 2020 to April 2021, the researchers examined deaths both directly and indirectly caused by SARS-CoV-2.

The results indicated that an estimated 24% (n = 184,477) of deaths due to COVID-19 are not included in the official death count as reported to the National Notifiable Disease Surveillance System and the National Vital Statistics System. Of these unrecognized deaths, 82% were in individuals aged 65 years or older.

Factors such as strain on the health care system, insufficient testing, concerns about health care costs, and misattribution of COVID-19 mortality to other causes were all included in this regression model.

“Estimating COVID-19-attributable unrecognized deaths provides a better understanding of the COVID-19 mortality burden and may better quantify the severity of the COVID-19 pandemic,” the researchers concluded. 

 

—Leigh Precopio

 

References:

  1. Coronavirus (COVID-19) update: FDA authorizes additional vaccine dose for certain immunocompromised individuals. News release. US Food and Drug Administration; August 12, 2021. Accessed August 16, 2021. https://www.fda.gov/news-events/press-announcements/coronavirus-covid-19-update-fda-authorizes-additional-vaccine-dose-certain-immunocompromised
  2. Media statement from CDC director Rochelle P Walensky, MD, MPH, on signing the Advisory Committee on Immunization Practices’ Recommendation for an additional dose of an mRNA COVID-19 vaccine in moderately to severely immunocompromised people. News release. Centers for Disease Control and Prevention; August 13, 2021. Accessed August 16, 2021. https://www.cdc.gov/media/releases/2021/s0813-additional-mRNA-mrna-dose.html
  3. Statement on FDA authorization of supplemental vaccine dose for immunocompromised patients. News release. Infectious Diseases Society of America; August 13, 2021. Accessed August 16, 2021. https://www.idsociety.org/news--publications-new/articles/2021/statement-on-fda-authorization-of-supplemental-vaccine-dose-for-immunocompromised-patients/
  4. Puranik A, Lenehan PJ, Silvert E, et al. Comparison of two highly-effective mRNA vaccines for COVID-19 during periods of Alpha and Delta variant prevalence. medRxiv. Published online August 9, 2021. https://www.medrxiv.org/content/10.1101/2021.08.06.21261707v2.article-info
  5. Fruehwirth JC, Gorman BL, Perreira KM. The effect of social and stress-related factors on alcohol use among college students during the COVID-19 pandemic. J Adolesc Health. Published online August 2, 2021. https://www.sciencedirect.com/science/article/pii/S1054139X2100327X?dgcid=author
  6. Iuliano AD, Chang HH, Patel NN, et al. Estimating under-recognized COVID-19 deaths, United States, March 2020-May 2021 using an excess mortality modelling approach. Lancet Regional Health – Americas. Published online July 13, 2021. doi: https://www.sciencedirect.com/science/article/pii/S2667193X21000119