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CDC Calls for Extra COVID Dose for Seniors and At-Risk Groups
United States: In October, the CDC issued guidance for high-risk Americans that they should get a second booster shot of a covid vaccine to enhance immunity.
The agency now suggests that elderly individuals aged 65 and older and those with decreased immune response should receive a booster shot of the 2024-25 vaccine, six months after the first shot, as reported by NBC.
Unprecedented Frequency of Boosters
It is not the first time the agency has advised or permitted an additional probe for high-risk groups several months after the initial one. The Government, in early spring 2022, approved a second booster dose after the initial distribution in the fall of the same year. The same applies to the spring of 2023 and the spring of 2024, as mentioned in the analytical overview above.
This extreme frequency of injections is unprecedented for any other vaccine, yet the experts don’t doubt its effectiveness, especially the currently popular mRNA vaccines from Pfizer and Moderna.
Pfizer and Moderna vaccines are based on mRNA technology, which paved immunity against a virus for the first time; this was very helpful in the initial months of the pandemic because mRNA vaccines can be developed over short periods.
However, there is no proof that the mRNA vaccines are not performing as anticipated even with an added dose, according to Akiko Iwasaki, a professor in immunology at Yale School of Medicine.
Hybrid Immunity and Its Effectiveness
Emory University researchers conducted a study and concluded that in order to fight the coronavirus, so-called hybrid immunity — when a person is both vaccinated and infected — does not work effectively and, for the most part, did not create certain long-term cells that release antibodies. It was not true for people who received a shot of the flu and the tetanus vaccine, indicating, as Iwasaki opined, that there was a difference with the virus.
“You would think that kind of hybrid immunity is going to be the most rigorous, and yet they did not see increases in these long-lived plasma cell numbers,” she said.
Virus Mutations and Vaccine Durability
Dr. Ashish Jha, dean of the Brown University School of Public Health and a former COVID-19 response coordinator for the White House, added that there is some unknown about the lifespan of the novel mRNA vaccines as compared to the more traditional vaccines.
“Maybe it is a little less durable,” Jha said. “I would say we don’t know.”
According to Jha, the virus’s year-round persistence and rate of mutation are the main problems.
“The problem here, in my mind, is not so much with the vaccine but much more with the virus,” he said, adding that he supports the updated guidance.
“It’s what I’ve actually been recommending to my own parents, and it’s what I have said publicly,” he said.
The guidelines have been issued following concerns about vaccine-induced immunity decline, especially in the elderly, which may cause more serious disease and hospitalization.
The Importance of Regular Boosters
“Getting booster doses of your vaccine-induced immunity every six to 12 months is not a bad idea,” according to the University of Pennsylvania’s immunologist E. John Wherry. The vaccine increases the antibody titers that are the body’s direct protective mechanisms against the virus, Professor Saleh noted.
“That makes it easier for the rest of your immune system to clean up and prevent that little bit of infection-causing disease,” Wherry said.
A rapidly changing virus
We look at our flu vaccine strains every year and try to match them up as best we can,” said Dr. Anna Durbin, an infectious disease physician and associate professor at the Johns Hopkins University School of Medicine. “It’s changing even faster with Covid — it’s constantly mutating to get the advantage.”
A virus-like measles doesn’t have periodic boosters because it doesn’t evolve as quickly as the coronavirus.
“A measles virus that you encounter today is very similar to a measles virus that you might have encountered five years ago or 10 years ago,” Jha said.
Ideally, it should be possible to produce new vaccines in a much shorter time to reflect the circulating strains.
“By the time we pick which strain of Covid we’re going to switch the vaccine to, and by the time that vaccine is ready and rolled out, the virus has already mutated some,” Durkin said. “So the thought really is, can we boost immunity that may not be a perfect match to the strain circulating?”
If that immunity is given another lift through a booster shot of the vaccine, then it will mean even better protection for those high-risk individuals, she pointed out.
Jha does not think that the twice-yearly vaccine will be recommended for each age group, at least, simply because the immune system of a 30 year old man or woman is very different from the immune system of an 80 year old man or woman, as reported by NBC.
“Unless the virus gets more virulent,” he said. “Which I don’t really think is going to happen.”
News
Nicotine Cap Could Expose Cigarettes’ True Danger
United States: The Biden administration is expected to officially put forward a limit to nicotine in cigarettes in the last days of its term. It would be an eleventh hour act to speak against the tobacco industry after Biden has still not solidify plans to enact a prior campaign promise of eradicating menthol cigarettes, as reported by NBC News.
A Last-Minute Push Against Tobacco Addiction
The plan, which may be unveiled as soon as this Monday, is not likely to include methods such as tobacco alternatives or vaping and nicotine gum, patches, and lozenges.
“This is a Hail Mary from the Biden administration to move forward with a meaningful proposal, or at least to jump-start one in the waning days of the administration,” said Erika Sward, assistant vice president of national advocacy for the American Lung Association.
The Hook Behind Smoking Addiction
The chemical compounds that lead to chronic diseases and death for smokers are those found in combustible tobacco, whereas nicotine is the addictive substance that initially engages the smoker and sustains the habit.
The specific measures regarding the proposed limits of nicotine have not been unveiled. Various researchers have it, however, that it may have to be reduced to as low as 5% for the product to be considered minimally or non-addictive.
“This would be a historic action by the FDA that has the potential to have an enormous impact on public health,” said Dr. Rose Marie Robertson, science and medical officer of the American Heart Association.
America’s Leading Preventable Health Threat
A vast majority of smokers have taken their first cigarette in their teenhood. The move to a lesser addictive cigarette, Sward said, would save millions of lives.
An academic analysis conducted by the Food and Drug Administration in 2018 showed that the cap on nicotine levels would lead to 16 million people not becoming smokers, to begin with, by 2060. According to that study, it would rise to 33.1 million by the year 2100 at the earliest level.
That means even if the Biden administration releases the proposed rule next week, it will probably be years before it becomes final.
Game-Changing Public Health Impact
Yolanda C. Richardson, president and CEO of the Campaign for Tobacco-Free Kids, told NBC News that limiting the amount of nicotine in cigarettes would be “game-changing.” Few initiatives would make a greater impact on combating chronic illnesses like cancer and heart disease, which significantly impair American health and that the next government has stated should be a top focus.
Before the FDA announced it was thinking about capping nicotine levels, which it has the right to do, it was during President-elect Donald Trump’s first term in office.
Challenges Ahead for the Proposed Rule
By announcing a “comprehensive plan” in 2017, then-FDA Commissioner Dr. Scott Gottlieb started the process by proposing to “regulate nicotine in combustible cigarettes and render them minimally or non-addictive.”
It was also designed, in part, to refocus adult smokers onto non-combustible products like e-cigarettes. The 2017 plan also envisaged regulation of e-cigarette flavors and a total ban on the use of menthol products. In 2020, the federal government approved a restriction on all popular flavors, although menthol is still available.
Adding to this, in an interview this week, Gottlieb stated that smoking prevalence would have to be “on the list of top priorities of any public health agenda geared towards reducing chronic diseases.”
“There could be perhaps no more impactful thing we can do than to dramatically reduce smoking rates in this country,” he said.
News
Is a Foreign Weapon Behind Havana Syndrome?
United States: The CIA and the Treasury Department do not believe a foreign power has caused the still-unexplained ailments that affected some U.S. diplomats and other officials while posted in Cuba, but two agencies now concede it is possible that an adversary might have developed or even used a weapon to produce the mysterious injuries, as reported by HealthDay.
The conclusion, which resembles the findings of the earlier probes, stems from a survey of seven intelligence bodies that analyzed the incidences of head impacts and other symptoms expressed by other American diplomats and various other military and governmental personnel who raised the concerns about involvement of a foreign competitor.
Intelligence Findings
The new assessment of the situation was unveiled by the U.S. intelligence on Friday. When assessing the data, five intelligence agencies stated that the external enemy’s participation is highly improbable, a U.S. intelligence official told reporters upon the briefing on condition of anonymity since it was the requirement of the Office of the Director of National Intelligence.
Two of the agencies, however, concluded that it could be that a foreign power might have developed, or perhaps used, a weapon that might have caused the injuries reported by the US diplomats and the government officials.
The Ongoing Mystery
Headaches, balance problems, and problems with thinking and sleeping were first reported in Cuba in 2016 and in hundreds of American personnel in several countries later in the year. American diplomats stationed in Havana were the first to complain, which prompted the sequence of maladies to be nicknamed Havana syndrome.
The two agencies, which officials did not name, failed to trace any of these events to a particular foreign technology but came to their conclusions through some understanding of foreign weapons systems development and capabilities. Finally, one of the agencies discovered that the probability was roughly even that a foreign government utilized such a weapon or prototype device in a small, unknown number of cases involving U.S. personnel.
The other agency concluded that although it might have been developed by another nation, it is still doubtful that it has ever been used.
The Biden Administration’s Response
The Biden administration has been under pressure to probe the incidents after the American staff complained of brain injuries and other symptoms after keeping getting attacked in what some call an attempt to attack and harm US personnel operating in a foreign land. However, till now, officials have not been able to pinpoint any one reason for such events.
Friday revelations issued are a variant of a ‘change in key judgments by some intelligence components’ and require further research, National Security Council spokesperson Sean Savett said in an email communiqué to journalists.
“Our focus on these priorities remains unwavering and must continue,” Savett said. “It is vital that the U.S. government continue critical research, investigate credible incidents, and strengthen efforts to provide timely care and long-term clinical follow-up.”
No Direct Evidence
The intelligence official who briefed reporters on Friday dismissed the shift, stating that the two agencies that left open the possibility that a foreign government was developing or deploying a weapon that caused the injuries had reported low confidence in their assessment, as reported by HealthDay.
The official admitted that other NSAs were more sure that foreign governments were not involved and that certain intelligence leads discovered by some of the U.S. intelligence raised doubts about foreign involvement.
“There’s no intelligence linking a foreign actor to any specific event,” the official told reporters.
News
Could Nicotine Caps End Smoking Addiction?
United States: More specifically, in the last days of its term, the current Biden government is speculated to formally offer a threshold on nicotine levels in cigarettes. It would probably be taken at the eleventh hour to counter the tobacco industry after President Joe Biden did not seal a long-standing promise to ban cigarettes containing menthol, as reported by NBC News.
A Last-Minute Push for Nicotine Regulation
The change will likely happen until next Monday and will not affect items such as tobacco products such as e-cigarettes or nicotine replacement patches and lozenges.
“This is a Hail Mary from the Biden administration to move forward with a meaningful proposal, or at least to jump-start one in the waning days of the administration,” said Erika Sward, assistant vice president of national advocacy for the American Lung Association.
Though people die and get sick from the poisonous chemicals produced by combustible tobacco, it is the nicotine that initially hooks smokers and sustains their addiction.
Details of the proposal for reducing the levels of nicotine have not been disclosed comprehensively. It was not the end of the year, though, when numerous studies have pointed out that, to achieve the compounds minimally or non-addictively, dosage may have to be reduced by almost 95 percent.
The Impact of Nicotine Reduction
“This would be a historic action by the FDA that has the potential to have an enormous impact on public health,” said Dr. Rose Marie Robertson, science and medical officer of the American Heart Association.
Tobacco use itself is the number one cause of preventable disease and death in the United States, based on the CDC, resulting in more than 480,000 deaths per year.
Data indicated that the majority of smokers began the habit when they were teenagers. Sward said that any process that could make cigarettes less appealing, less enjoyable, or less satisfying would save millions of lives.
An FDA study carried out in 2018 found that a nicotine cap would reduce smoking addiction cases to 16 million people in the year 2060. It would rise to 33.1 million in 2100, based on the study’s estimate.
Even if the Biden administration issues the proposed rule early next week, it may take several years to become final.
Yolonda C. Richardson, president and CEO of the Campaign for Tobacco-Free Kids, told NBC News that limiting the amount of nicotine in cigarettes would be “game-changing.” Few initiatives would make a greater impact on combating chronic illnesses like cancer and heart disease, which significantly impair American health and that the next government has stated should be a top focus.
The first time the FDA weighed in on limits on nicotine was during President-elect Donald Trump’s first term in office.
A Decade in the Making
In 2017,then-FDA Commissioner Dr.Scott Gottlieb kick-started the process with a “comprehensive plan,” of which one proposal was to “regulate nicotine in combustible cigarettes and make it minimally or nonaddictive.”
It was meant, in part, to move adult smokers to less hazardous products like vapor cigarettes or e-cigarettes. The 2017 plan also contained the prospect of integrating the regulation of e-cigarette flavors and a complete prohibition on the use of menthol products. A federal rule to eliminate most flavored e-cigarettes in 2020, but they now come in menthol flavor, as reported by NBC News.
This week, in an interview with Gottlieb, he was of the opinion that smoking incidence would necessarily have to be on the list of activities, which needed focus to enhance the health standards of people with chronic diseases.
“There could be perhaps no more impactful thing we can do than to dramatically reduce smoking rates in this country,” he said.
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