The Chicago Journal

A Promising Breakthrough in Meningitis Prevention

Nicholas Alexander Nicholas Alexander on November 27, 2023

In a world where medical science continually advances, the story of Patti Wukovits and her daughter, Kimberly Coffey, serves as a poignant reminder of the urgency for improved protection against deadly diseases. Kimberly’s tragic battle with meningitis B, despite adhering to the CDC’s recommendations for vaccination, sheds light on a new turning point in the fight against this debilitating ailment. This article explores the significance of Pfizer’s pentavalent meningococcal vaccine, Penbraya, and how it has the potential to transform the landscape of meningitis vaccinations.

Kimberly’s Tragic Tale

Kimberly’s journey into the world of meningitis began with a high fever and body aches. She described it as feeling like her ankles were bleeding, a sensation that led to her mother, Patti Wukovits, rushing her to the emergency room. Tragically, Kimberly was diagnosed with meningitis B, a strain not covered by the existing MenACWY vaccine recommended by the CDC. Despite her mother’s best efforts, Kimberly lost her life to the disease, leaving her family forever changed.

The Inadequacy of Existing Vaccines

The MenACWY vaccine, which adolescents are advised to receive when they turn 11 or 12, offers protection against four groups of meningococcal bacteria. However, it falls short when it comes to the group that includes meningitis B. In Kimberly’s case, this inadequacy proved fatal. At the time, there was no vaccine to safeguard against meningitis B. The inadequacies of the existing vaccines called for a new, more comprehensive solution.

A Beacon of Hope: Penbraya

On a promising note, Pfizer’s Penbraya vaccine has emerged as a potential game-changer in the fight against meningococcal disease. Unlike its predecessors, Penbraya safeguards against not one, but five kinds of bacteria, making it a beacon of hope for individuals seeking broader protection with fewer shots.

Understanding Meningococcal Disease

Meningococcal disease, inclusive of meningitis, is a rare yet devastating illness caused by the bacteria neisseria meningitidis. It can lead to severe consequences such as infections in the lining of the brain and spinal cord, memory and concentration issues, seizures, balance problems, hearing loss, and even blindness. In some cases, it can escalate into a life-threatening blood infection known as septicemia or blood poisoning. Alarmingly, statistics reveal that approximately one in ten cases of bacterial meningitis results in fatality.

The Challenges of Early Diagnosis

Early diagnosis is critical in fighting meningococcal disease, but it’s often delayed due to symptoms that can mimic other infections like Covid-19 or the flu. Symptoms include fever, headache, nausea or vomiting, trouble waking, stiff neck, a distinctive skin rash, sensitivity to light, and brain fog. Swift action is essential, as the infection can spread rapidly, as seen in Kimberly’s case.

Transmission and Outbreaks

The disease is highly contagious and can be transmitted through coughing, sneezing, or sharing drinks with an infected person. While outbreaks are rare, they can be devastating, particularly in settings where people operate in close quarters, such as schools or dormitories.

Current Vaccine Recommendations

Presently, the CDC recommends two types of meningococcal vaccines in the United States. The MenACWY vaccine, which protects against A, C, W, and Y variations, is administered to preteens and teens. There is also the MenB vaccine, designed to combat the strain that claimed Kimberly’s life. The existing vaccination schedule requires multiple shots, which can be burdensome.

The Promise of a Simpler Vaccination Schedule

Recognizing the complexity of the current vaccination schedule, the CDC’s independent vaccine advisors have recommended Pfizer’s Penbraya vaccine, a pentavalent solution that protects against the majority of meningococcal disease in young people. It offers the prospect of increased vaccine coverage by streamlining the vaccination process with just two doses, administered six months apart.

The Road Ahead

While the committee’s vote on Penbraya is a significant step, it awaits final approval from the CDC. As we celebrate this turning point in the fight against meningitis, it’s crucial to ensure easy access to Pfizer’s groundbreaking vaccine to save lives and provide comprehensive protection.

Takeaway

Pfizer’s Penbraya vaccine signifies a new hope in the battle against meningococcal disease, especially for young adults and adolescents. Kimberly Coffey’s tragic story underscores the urgency for comprehensive protection, and Penbraya’s potential to simplify the vaccination process is a significant step forward. As we await the CDC’s final decision, this new vaccine offers a brighter future in safeguarding our youth against this deadly disease.

WHO Excludes Influenza B/Yamagata from 2024 Flu Vaccines

Claire Peterson Claire Peterson on November 27, 2023

WHO’s Decision Based on Extinction and Theoretical Risk

In its recent recommendations for the 2024 Southern Hemisphere flu season, the World Health Organization (WHO) made a significant and noteworthy decision to exclude a particular family of flu viruses from the upcoming vaccines. This family, known as influenza B/Yamagata, has remained elusive since the early days of the Covid-19 pandemic. In this comprehensive article, we will delve into the reasoning behind this decision, its potential implications for public health, and how it aligns with the principles of data-driven decision-making that professionals like you value.

The Disappearance of Influenza B/Yamagata

As the Covid-19 pandemic swept across the globe in 2020, people worldwide adopted protective measures such as mask-wearing, frequent handwashing, and social distancing. An unexpected consequence of these measures was a dramatic drop in flu infections. While the flu has made a comeback since then, one family of flu viruses, specifically influenza B/Yamagata, did not resurface. This absence has led experts to speculate that it may have been driven to extinction. This intriguing phenomenon raises questions about the interplay between pandemic responses, human behavior, and the epidemiology of infectious diseases.

WHO’s Recommendations for 2024 Flu Vaccines

Looking ahead to the 2024 Southern Hemisphere flu season, WHO’s expert advisors have recommended trivalent vaccines, a decision that carries significant weight given the evolving landscape of infectious diseases. These trivalent vaccines target three types of flu, including two influenza A strains (H1N1 and H3N2) and an influenza B/Victoria strain. Notably, quadrivalent vaccines, which target four types of flu, can still include a component targeting the B/Yamagata lineage. However, WHO advisers have stated that since no B/Yamagata infections have been identified in years, there is no longer a benefit to including it in vaccines. This strategic move not only reflects a commitment to precision but also highlights the adaptability required in the field of public health and vaccine development.

Weighing Theoretical Risks

In their comprehensive report, WHO’s advisers meticulously considered the “theoretical risk of reintroduction into the population” associated with using B/Yamagata viruses to manufacture vaccines. To mitigate this theoretical risk, they recommended excluding B/Yamagata from the vaccines. This decision showcases the careful balance between the absence of the Yamagata lineage virus in circulation and the potential risk associated with its inclusion. It’s a testament to the proactive approach that professionals in your field appreciate—a holistic consideration of both short-term and long-term implications.

Impact on Current Flu Vaccines

Currently, flu vaccines administered in the United States for the ongoing flu season are quadrivalent vaccines, including two influenza A viruses (H1N1 and H3N2) and two influenza B viruses, one of which belongs to the Yamagata lineage. Evidence from the earlier Southern Hemisphere season suggests that these vaccines will effectively match the viruses circulating during the fall and winter. This decision underscores the importance of flexibility in adapting vaccination strategies based on real-world data and epidemiological trends.

The Safety and Effectiveness of Flu Vaccines

WHO advisers want to emphasize that flu vaccines, whether trivalent or quadrivalent, are safe and effective. This reassurance aligns with your commitment to data-driven decisions and underscores the importance of clear, concise communication to instill confidence in vaccination programs. Moreover, it highlights the need for continuous monitoring and evaluation to ensure the ongoing efficacy of vaccination strategies.

Upcoming FDA Meeting

The FDA’s vaccine advisory committee is scheduled to convene on October 5 to discuss recommendations for flu vaccines to be offered in the Southern Hemisphere in 2024. This forthcoming meeting provides an opportunity for regulators to align their decisions with WHO’s recommendations and consider the implications of this strategic shift. It also underscores the collaborative nature of global health initiatives, where information and insights are shared and refined to benefit populations worldwide.

Covid-19 surges among senior citizens or ‘senior waves’

Edward Anderson Edward Anderson on January 30, 2023

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Covid-19: Despite a spike in hospitalizations throughout the majority of states in the winter of 2022, Covid-19 has only slightly increased.

When compared to other surges, the overall rate is still a very small portion of what it once was.

Cases involving senior individuals have so far been the only prominent exception.

Senior hospitalization

The age difference is at its widest degree ever as senior hospitalizations approach the height of the Delta spike.

In Covid-19, the hospitalization rate for seniors has been four times higher than the national average since October.

There was never a gap between nursing facilities greater than threefold, even during the winter spike in 2020.

Seniors who tested positive for Covid-19 during the pandemic have repeatedly been a source of concern.

Only 13% of all cases reported in the US were adults 65 years of age or older, according to the US Centers for Disease Control and Prevention.

However, that age group has been responsible for 50% of all hospitalizations and 75% of all deaths.

According to larger trends, the hospitalization rate for seniors in Covid-19 has changed.

Before seeing a steep drop in the summer, it hit a record high during the Omicron spike last winter.

However, senior hospitalization rates have often been greater than those of other age groups.

Age Gap

Professor of molecular medicine at Scripps Research, Dr. Eric Topol, has termed the latest increase the “senior wave.”

“Right now, we have an immunity wall built up against the Omicron family – between shots and prior infections and combinations thereof – that seems to be keeping younger folks in pretty good stead,” said Topol.

“But the immune systems of people of advanced age are not as strong.”

Topol says that the most recent wave is likely having disproportionately severe effects on young people who have immunocompromised systems.

To assess the trends in that age range, however, not enough data is available.

According to Dr. Eric Topol, a factor in the growth in senior hospitalization rates may have been the underuse of medications like Paxlovid and new, immune-evasive variants.

He emphasized booster deficiency as the main culprit, notwithstanding the appallingly low rates.

“It all points to waning immunity,” said Topol.

“If more seniors had their booster, the effect would be minimal.”

Read also: Skincare Essential Recommended by a Dermatologist

Vaccines & boosters

Only a third of those 65 and older had an updated booster shot, according to CDC data, which worries experts.

Infectious diseases and geriatric medicine specialist Dr. Preeti Malani from University of Michigan Health said: “It’s very, very concerning.”

“There’s a sizable number of people who actually got previous boosters who have not gotten this one and I worry that there’s confusion, there’s misinformation,” Malani added.

“So to seniors – and to everyone – I say: if you have not been boosted, get boosted.”

According to a Kaiser Family Foundation survey, 60% of seniors were concerned about an increase in Covid-19 cases and hospital admissions this winter.

More over 40% of respondents said they were concerned about becoming sick, but almost as many said they had no immediate plans to get the new booster.

Additionally, 25% of seniors claim they don’t have any plans to get a booster and will only do so if it’s required.

Communities

Vaccinations and booster doses continue to be effective at preventing serious illnesses.

Seniors still utilize boosters more frequently than other age groups, despite their low uptake.

Less than 10% of adults under 50 and less than 5% of children got their most recent booster, according to CDC data.

Despite this, experts insist that the difference in hospitalization rates cannot be explained by the expanding gap in vaccination rates alone.

“The truth is that, really, anyone can get this,” said Dr. Preeti Malani.

“But the older you are, the more likely you are to have severe symptoms, the more likely you are to be hospitalized, and the more likely you are to die.”

According to experts, viral diseases like COVID-19 spread equally among older and younger people.

Seniors are often introduced to Covid-19 by family, friends, and the greater community since they are more likely to suffer more serious consequences.

“Seniors are the most at risk, but we bring it to them,” said Malani.

“A thing unique to older adults is that many of them are grandparents and many of them provide childcare for their grandchildren.”

“So they sometimes get infected from their grandkids, who may also be going to school or daycare.”

Malani also emphasized the particular risks that senior citizens who live in communal settings, like nursing homes, present.

Read also: Mental health becomes concern following studies

Nursing homes

Despite how vulnerable they may appear, seniors do not constitute the majority of population growth.

A government watchdog report from earlier this month discovered a strong connection between breakouts in nursing homes and community spread.

This winter, nursing homes are at risk once more.

With the exception of the initial winter wave and the Omicron wave, weekly cases among residents have already surpassed previous highs.

They continue to rise.

However, according to information from the US Centers for Medicare and Medicaid Services, only 22% of the staff and 47% of the residents had received all of their vaccines.

The Council of State and Territorial Epidemiologists’ executive director, Janet Hamilton, said:

“We all would have hoped that we would have a vaccine that prevents transmission. We don’t have a vaccine that does that, but it does reduce transmission and it does reduce severe outcomes.”

Hamilton underscored the importance of vaccination for elders who interact with other seniors in order to avoid detrimental consequences.

“But really, any individuals that come in contact with high-risk groups need to be the primary focus for getting vaccinated.”

Reference:

A Covid-19 ‘senior wave’ is diving up hospitalizations

Pfizer cleared of stroke risks, CDC and experts claim

Edward Anderson Edward Anderson on January 16, 2023

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Pfizer: Despite the necessity of Covid-19 booster doses and vaccinations in general, some people still opt not to get the shots due to fear of getting sick.

Seniors, in particular, are anxious about the injections’ potential side effects since many have developed a phobia of strokes.

However, the Centers for Disease Control and Prevention has conducted studies to dispel such concerns.

Surveillance

The discovery prompted the implementation of a CDC surveillance system that Pfizer’s omicron Covid variant booster dose was linked to an increased risk of stroke in adults 65 and older.

In collaboration with networks across the US, the CDC’s Immunization Safety offices, and a comprehensive healthcare organization, the Vaccine Safety Datalink (VSD) system was developed.

It monitors and evaluates the safety of vaccinations using electronic health data from affiliate facilities.

It includes information on the type administered, the vaccination date, and any other vaccines received on the same day.

The VSD also utilizes information on health problems identified during doctor visits, ER visits, urgent care visits, and hospital stays.

Statement

The CDC issued a press release on its website on Friday.

“Following the availability and use of the updated (bivalent) COVID-19 vaccines, CDC’s Vaccine Safety Datalink (VSD), a near real-time surveillance system, met the statistical criteria to prompt additional investigation into whether there was a safety concern for ischemic stroke in people ages 65 and older who received the Pfizer-BioNTech COVID-19 Vaccine, Bivalent.“

“Rapid-response investigation of the signal in the VSD raised a question of whether people 65 and older who have received the Pfizer-BioNTech COVID-19 Vaccine, Vivalent were more likely to have an ischemic stroke in the 21 days following vaccination compared with days 22-42 following the vaccination.“

A review of the Centers for Medicare and Medicaid Services database found that there was no increased risk of stroke as a result of the modified vaccines.

Additionally, Pfizer-BioNTech’s global safety database has not discovered any signs of stroke in connection with the updated injections.

Read also: Covid-19 surges among senior citizens or ‘senior waves’

Detection

A CDC spokesperson said the problem was first brought up in late November.

The CDC began looking into the possibility of seniors suffering a stroke 21 days after receiving the Pfizer injection when it was discovered in the middle of December, and worries persisted.

For Moderna boosters, the initial signal and results were the same.

The representative stated that 130 patients 65 and older who had the Pfizer omicron booster injection suffered strokes within 21 days.

More than 550,000 seniors who had their booster injection reported the data.

According to the CDC, no other monitoring system has so far detected any issues with the Pfizer booster.

Data

No extra stroke risk was noted when researchers examined the data from the following sources:

  • Center for Medicare and Medicaid Services
  • The Department of Veterans Affairs
  • The Vaccine Adverse Reporting System
  • Pfizer’s global safety database

“Although the totality of the data currently suggests that it is very unlikely that the signal in VSD represents a true clinical risk, we believe it is important to share this information with the public, as we have in the past, when one of our safety monitoring systems detects a signal,” the CDC wrote.

The CDC asserts that the monitoring system picks up signals from sources unrelated to immunization.

The agency spokesperson noted that the investigations should provide a clearer view and additional facts in the upcoming weeks.

Investigation

The Food and Drug Administration will convene a panel discussion with independent immunization authorities on January 26 to tackle the issue.

Furthermore, Pfizer said in a statement made on Friday that there is no proof between the Covid vaccination and ischemic strokes.

Pfizer, BioNTech, the CDC, and the FDA have not discovered any connections between the different monitoring systems in the United States, claims company spokesperson Kit Longley.

“Compared to published incidence rates of ischemic stroke in this older population, the companies to date have observed a lower number of reported ischemic strokes following the vaccination with the omicron BA.4/BA.5-adapted bivalent vaccine,” said Longley.

The omicron injection from Pfizer is still prescribed by the CDC.

Those who have finished the primary vaccine series and are five years of age or older are eligible for the booster.

Ages six months to four years old are the youngest children that can receive an omicron injection.

Reference:

CDC says it’s ‘very unlikely’ Pfizer booster carries stroke risk for seniors after launching review

CDC & FDA identify preliminary COVID-19 vaccine safety signal for persons aged 65 years and older

A new strategy implemented tilts the monkeypox vaccine to varying results

Claire Peterson Claire Peterson on September 19, 2022

With the increase in monkeypox cases in the United States, there has been a demand for vaccines, and strategies are being implemented with varying results.

Vaccine supply

Vaccination strategies have changed to accommodate the low-dose intradermal approach of Biden administration.

As a result, the change expanded vaccine stocks and met a growing demand for the Jynneos monkeypox vaccine.

Meanwhile, others have reported that the method should allow for five small doses of vaccines; instead, they could only extract four.

The shift

According to Bob Fenton, the White House’s national coordinator for response to monkeypox, more than three-quarters of the jurisdiction moved to the United States to implement the intradermal method of administering the monkeypox vaccine.

“As of today, 75% of jurisdictions are already applying intradermal administration of vaccine, and another 20% are working to move in that direction,” said Fenton.

Claire Hanna, executive director of the Association of Immunization Managers, shared similar results from a recent survey of immunization managers.

Emergency use

In early August, the U.S. Food and Drug Administration issued an emergency use permit that allows health care workers to administer the Jynneos monkeypox vaccine intradermally rather than subcutaneously.

Intradermal administration of the vaccine requires one fifth of the dose for subcutaneous injection, allowing healthcare professionals to receive up to five doses from the standard single-dose vial.

“It’s a little too early to tell how it’s going to help with the supply meeting demand, but I think logically, you use less vaccine for one person,” said Dr. Emily Volk, the president of the College of American Pathologists.

“This is a dose-sparing approach, so it’s going to allow for the doses that we do have to be usable for many more people. So, to me that is very positive and I am actually heartened that the public health community is thinking outside the box.”

“It also buys time to make more vaccine,” she added.

Availability and eligibility of vaccines

The city and county of San Francisco, New York, Fairfax County of Virginia, Cook County of Illinois, and Dallas County of Texas are among the places where a large number of monkeypox cases have been admitting the intradermal administration of the vaccine.

The San Francisco Department of Public Health noted that the U.S. Centers for Disease Control and Prevention and the California Department of Health have provided guidance on switching to the intradermal technique.

After New York adopted its new intradermal vaccination strategy last week, the city announced it would open more than 12,000 new appointments to the public.

Appointments are for people who are eligible for the vaccination and who have not yet received the first dose.

In most places, the vaccine is available to people who are believed to be at risk of exposure to the virus.

Meanwhile, in Virginia last week, vaccine eligibility was expanded to include people of any sexual orientation or gender who have had anonymous or multiple sexual partners in the past two weeks.

In Dallas, vaccination coverage has been extended to adults diagnosed with HIV, chlamydia, gonorrhea, or early syphilis in the past 12 months.

Doses

Dr. Sharon Welbel, an infectious disease physician and director of hospital epidemiology and infection control systems at Cook County Health in Illinois, has attended meetings with public health officials in other cities.

Public health officials said they could not get five doses from the vial.

However, Dr. Welbel said that each of their vaccines managed to get five doses per vial.

But in some areas, such as Fairfox County in Virginia, vaccine administrators have not been able to extract all five doses.

Opportunities

According to Dr. Welbel, Chicago had the opportunity to vaccinate more people with the smaller vaccination, leading the city to switch to the intradermal method.

Some healthcare providers practiced with similar weapons, while those who didn’t weren’t allowed to bother vaccinating people until they got used to the new technique.

The new strategy has been successful so far, and Dr. Welbel said Chicago has expanded the population of people eligible for the vaccine, similar to other cities.

Reference:

Monkeypox strategy shift yields more supply for some, hurdles for others