Covid-19 vaccines and vaccinations

AstraZeneca vaccine linked with ‘spike’ in cases of rare disease that can paralyse victims
Scientists have drawn a link between the Oxford-AstraZeneca vaccine and a “spike” in cases of a rare disease that can leave its victims paralysed.

Three separate studies reported an increase in Guillain-Barré syndrome (GBS) shortly after the roll out of the AstraZeneca vaccine.

GBS is a potentially deadly condition in which a person’s immune system attacks their nerves and gradually paralyses victims from the feet upwards. While most patients recover, it can be life-threatening or permanently debilitating.

Two of the studies looked at rates of GBS in England and said there was an increase in cases “attributable to” the AstraZeneca vaccine, or that there was a probable “causal link”.

The Telegraph has spoken to several people who developed GBS after receiving the AstraZeneca vaccine, and have become severely disabled as a result.

Two of the individuals have been awarded payments through the Government’s Vaccine Damage Payment Scheme but the third has been refused compensation on the basis that he is not “60 percent disabled” – the threshold for a pay-out.

On Friday, one of the victims spoke of his “anger” that he had the AstraZeneca jab without knowing that it posed such a risk.
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AstraZeneca vaccine linked with ‘spike’ in cases of rare disease that can paralyse victims (msn.com)
 
Moved posts

Vaccination Dramatically Lowers Long Covid Risk

Several new studies reveal that getting multiple COVID vaccine doses provides strong protection against lingering symptoms

https://www.scientificamerican.com/article/vaccination-dramatically-lowers-long-covid-risk/
Scientific American said:
At least 200 million people worldwide have struggled with long COVID: a slew of symptoms that can persist for months or even years after an infection with SARS-CoV-2, the virus that causes COVID. But research suggests that that number would likely be much higher if not for vaccines.

A growing consensus is emerging that receiving multiple doses of the COVID vaccine before an initial infection can dramatically reduce the risk of long-term symptoms. Although the studies disagree on the exact amount of protection, they show a clear trend: the more shots in your arm before your first bout with COVID, the less likely you are to get long COVID.

One meta-analysis of 24 studies published in October, for example, found that people who’d had three doses of the COVID vaccine were 68.7 percent less likely to develop long COVID compared with those who were unvaccinated. “This is really impressive,” says Alexandre Marra, a medical researcher at the Albert Einstein Israelite Hospital in Brazil and the lead author of the study. “Booster doses make a difference in long COVID.”
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Surely it doesn't say what the headlines states at all.

The headline would only appear to be true if you have the vaccine shots before catching covid.

Surely this would dramatically reduce your chances of catching covid in the first place, making long covid less likely in that manner, possibly only in that manner.

Possibly irrelevant to a pwME whose had 5 out of 6 covid shots available in the UK. Apparently I didn't qualify for the other. Possibly due to not being an 85 year old. Been classified as serious risk for all but serious risk wasn't high enough to qualify for that one.
 
Effect of a 2-week interruption in methotrexate treatment on COVID-19 vaccine response in people with immune-mediated inflammatory diseases VROOM study: a randomised, open label, superiority trial (2023)
Abhishek et al

Background
Methotrexate is the first-line treatment for immune-mediated inflammatory diseases and reduces vaccine-induced immunity. We evaluated if a 2-week interruption of methotrexate treatment immediately after COVID-19 booster vaccination improved antibody response against the S1 receptor binding domain (S1-RBD) of the SARS-CoV-2 spike protein and live SARS-CoV-2 neutralisation compared with uninterrupted treatment in patients with immune-mediated inflammatory diseases.

Method
We did a multicentre, open-label, parallel-group, randomised, superiority trial in secondary-care rheumatology and dermatology clinics in 26 hospitals in the UK. Adults (aged ≥18 years) with immune-mediated inflammatory diseases taking methotrexate (≤25 mg per week) for at least 3 months, who had received two primary vaccine doses from the UK COVID-19 vaccination programme were eligible. Participants were randomly assigned (1:1) using a centralised validated computer program, to temporarily suspend methotrexate treatment for 2 weeks immediately after COVID-19 booster vaccination or continue treatment as usual. The primary outcome was S1-RBD antibody titres 4 weeks after COVID-19 booster vaccination and was assessed masked to group assignment. All randomly assigned patients were included in primary and safety analyses. This trial is registered with ISRCTN, ISRCTN11442263; following a pre-planned interim analysis, recruitment was stopped early.

Finding
Between Sept 30, 2021, and March 7, 2022, we screened 685 individuals, of whom 383 were randomly assigned: to either suspend methotrexate (n=191; mean age 58·8 years [SD 12·5], 118 [62%] women and 73 [38%] men) or to continue methotrexate (n=192; mean age 59·3 years [11·9], 117 [61%] women and 75 [39%] men). At 4 weeks, the geometric mean S1-RBD antibody titre was 25 413 U/mL (95% CI 22 227–29 056) in the suspend methotrexate group and 12 326 U/mL (10 538–14 418) in the continue methotrexate group with a geometric mean ratio (GMR) of 2·08 (95% CI 1·59–2·70; p<0·0001). No intervention-related serious adverse events occurred.

Interpretation
2-week interruption of methotrexate treatment in people with immune-mediated inflammatory diseases enhanced antibody responses after COVID-19 booster vaccination that were sustained at 12 weeks and 26 weeks. There was a temporary increase in inflammatory disease flares, mostly self-managed. The choice to suspend methotrexate should be individualised based on disease status and vulnerability to severe outcomes from COVID-19.

Link | PDF (The Lancet Rheumatology)
 
Hilda Bastian blog post:

A Major First Next Generation Covid Vaccine: Could There Be More in 2024? (Update 13)

https://absolutelymaybe.plos.org/20...accine-could-there-be-more-in-2024-update-13/
Hilda Bastian said:
A next generation vaccine has been authorized by a major drug regulator for the first time. It’s based on a next generation mRNA, called self-amplifying messenger RNA (SAM, or samRNA).

SAM doesn’t just leave a message and disappear, the way current mRNA vaccines do. It makes copies of itself inside our cells – similar to the way a virus works. Theoretically, leaving a blueprint behind enables longer-lasting immunity than mRNA can offer. There’s a small amount of evidence showing immune effects of this new vaccine from Arcturus Therapeutics are durable to at least 12 months. Called LUNAR-COV19, it was authorized in Japan late last year.

In this update, I’m starting with vaccine rollout – where else this new vaccine might be authorized this year, and which vaccine might be next. After that, I have recent results broken down into 3 categories of next-generation Covid vaccines (definitions below). The trials for LUNAR-19 are in the “durable” category below, including a recent small head-to-head trial between the LUNAR-COV19 and Pfizer vaccines.
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I didn't read the whole post, just skimmed it, since so much of it is over my head.
 
ahimsa said:
Hilda Bastian blog post:

A Major First Next Generation Covid Vaccine: Could There Be More in 2024? (Update 13)

https://absolutelymaybe.plos.org/20...accine-could-there-be-more-in-2024-update-13/


I didn't read the whole post, just skimmed it, since so much of it is over my head.
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Just picking out a few bits I wanted to know (in case others do too):
Mucosal Covid vaccine overview:

  • Mucosal vaccines are currently authorized for use in 6 countries.
  • 27 have reached clinical trial, with at least one of those has been discontinued. These are tracked in a table below.
  • 6 mucosal vaccines have reached phase 3 trials, including the 5 authorized vaccines.
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  • On the lunar-cov19 series (efficacy, adverse effects):

  • The trial in Vietnam is this vaccine’s efficacy trial. It was placebo-controlled, running during Delta and Omicron waves in Vietnam. Of the over 16,000 participants, 17% were aged 60 or over, and 35% of the participants under 60 had co-morbidities.

    There were 2 injections, 28 days apart. Efficacy:

    • Any confirmed Covid: 56.6% (95% CI: 48.7–63.3).
    • Severe Covid: 95.3% (80.5–98.9), with 2 in the vaccine group and 41 in the placebo group.
    • Death from Covid: 86.5% (-7.4–98.3), with 1 death in the vaccine group and 9 in the placebo group.
    The rate of systemic adverse events was close to 50% for the first dose in phase 3, and close to 75% in the earlier phases – and lower for the second dose. That was roughly similar to the BNT/Pfizer and Moderna trials, but the rate of severe events was less than 1%. For context, the most common severe event for BNT/Pfizer was 4% for fatigue; for Moderna, it was 10% for fatigue.
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I can't read the whole paper, but perhaps someone who can could explain why missing four doses appears to reduce the risk a bit? (Although not as much as getting the full recommended dose)
 
@Subtropical Island
The trial in Vietnam is this vaccine’s efficacy trial. It was placebo-controlled, running during Delta and Omicron waves in Vietnam. Of the over 16,000 participants, 17% were aged 60 or over, and 35% of the participants under 60 had co-morbidities.
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It would be interesting to see the comorbidities broken down a bit more i.e. which comorbidities were involved, and how many were autoimmune diseases. It is good to see this part of the study being included. It might help identify if there are groups in the population who are more at risk of an adverse reaction.
 
There is an article in the Times today "Missed Covid vaccines 'to blame for 7,000 deaths and hospitalisations'" in the summer of 2022. Study is published in the Lancet and was based on anonymised health records covering the entire national population. More that one third of population had not had recommended number of covid jabs by June 2022.

Online article https://www.google.com/url?sa=t&rct=j&q=&esrc=s&source=web&cd=&ved=2ahUKEwj95P-Pk-KDAxXqVUEAHVpHCH8QFnoECB8QAQ&url=https://www.thetimes.co.uk/article/missed-vaccines-caused-7000-covid-hospitalisations-and-deaths-tknkngkxt&usg=AOvVaw1WK7DF9b72265gxuzY0bc4&opi=89978449

Work was led by Health Data Research UK and the University of Edinburgh who say this 'ushers in a new era' for scientific research.

edit: if we had accurate data on the adverse effects of vaccination (difficult to collect I know), might it be possible to come to a more balanced calculation of the overall numerical benefits of vaccination?
 
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Some surprising news! (well, I was surprised, you might not be ;))

Switching arms between vaccine doses could dramatically improve immune response, OHSU study shows

https://www.opb.org/article/2024/02...lly-improve-immune-response-ohsu-study-shows/
OPB said:
Until recently, doctors didn’t think it made a difference which arm patients got their COVID-19 vaccine in. But a new study from Oregon Health & Science University shows that switching arms between doses could lead to as much as a fourfold increase in immune response.

Though further studies are necessary, researchers suspect the improvement has to do with how the body learns to protect itself against viruses, meaning the results could be replicated in other multidose vaccine regimens.
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This is an audio story from the Think Out Loud podcast. I have not been able to find a transcript.

But here's a link to the study:

https://www.jci.org/articles/view/176411
 
Merged
A 62-year-old man from Germany has, against medical advice, been vaccinated 217 times against Covid, doctors report.

The bizarre case is documented in The Lancet Infectious Diseases journal.

The shots were bought and given privately within the space of 29 months.

The man appears to have suffered no ill effects, researchers from the University of Erlangen-Nuremberg say.

https://www.bbc.co.uk/news/health-68477735

The Anti-Vaxxers won't be happy to hear that.
 
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Given the risk of a serious adverse response to an individual vaccine event is fairly low, perhaps 217 does not represent a high cumulative risk if simply adding the potential risks of each individual event.

However can we say yet if the risks of subsequent vaccine events remain the same or are increased or decreased as a result previous injections?
 
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Adaptive immune responses are larger and functionally preserved in a hypervaccinated individual, Kocher

217 Covid vaccines!


https://www.thelancet.com/journals/laninf/article/PIIS1473-3099(24)00134-8/fulltext


Prime-boost vaccinations can enhance immune responses,
1
whereas chronic antigen exposure can cause immune tolerance.
2
In humans, the benefits, limitations, and risks of repetitive vaccination remain poorly understood.
Here, we report on a 62-year-old male hypervaccinated individual from Magdeburg, Germany (HIM), who deliberately and for private reasons received 217 vaccinations against SARS-CoV-2 within a period of 29 months (figure A; appendix 1 tab 1). HIM's hypervaccination occurred outside of a clinical study context and against national vaccination recommendations. Evidence for 130 vaccinations in a 9 month period was collected by the public prosecutor of Magdeburg, Germany, who opened an investigation of this case with the allegation of fraud, but criminal charges were not filed. 108 vaccinations are individually recorded and partly overlap with the total of 130 prosecutor-confirmed vaccinations (appendix 2 p 12). To investigate the immunological consequences of hypervaccination in this unique situation, we submitted an analysis proposal to HIM via the public prosecutor. HIM then actively and voluntarily consented to provide medical information and donate blood and saliva. This procedure was approved by the local Ethics Committee of the University Hospital of Erlangen, Germany. Throughout the entire hypervaccination schedule HIM did not report any vaccination-related side effects. From November 2019, to October 2023, 62 routine clinical chemistry parameters showed no abnormalities attributable to hypervaccination (appendix 1 tab 2). Furthermore, HIM had no signs of a past SARS-CoV-2 infection, as indicated by repeatedly negative SARS-CoV-2 antigen tests, PCRs and nucleocapsid serology (figure A; appendix 1 tab 1).
 
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