Government releases new booster ads as experts fear ‘tripledemic’

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THE CORONAVIRUS FILES

By Amber Dance

New vaccine ads target underserved populations

New advertisements for COVID boosters target Black, Latino, Asian American, Native Hawaiian and Pacific Islander populations, as well as residents of rural areas, reports Jacqueline Howard at CNN.

“The new television ads airing today send an urgent message to communities at high risk of severe illness from COVID that the updated vaccine is the best tool we have against hospitalization and death,” said Sarah Lovenheim, HHS assistant secretary for public affairs. “These ads also reflect our commitment to equality in our COVID response.”

As of last week, 22.8 million people in the United States had received an updated booster shot.

Weary officials told Dan Diamond at The Washington Post that there’s little they can do to reach vaccine holdouts at this point, and they are making efforts to protect vulnerable seniors and people with weak immune systems.

The latest government efforts also include a “#VaxUp America Family Vaccine Tour,” with events at places like the upcoming NASCAR Cup in Arizona, and emails and phone calls to seniors to share information about the new vaccines, report Ben Gittleson and Morgan Winsor at ABC News.

“Almost everyone who will die from COVID this year will not be up to date on their shots, or they will not have taken Paxlovid when they got sick,” said President Joe Biden when he publicly received his own updated booster. “This year, nearly every death is preventable.”

Cold weather brings worries about three respiratory viruses

A brewing viral stew could hit the United States with a triple whammy this winter as a new COVID surge meets comebacks of not only the flu, but also the respiratory virus RSV, creating a potential “tripledemic,” writes Apoorva Mandavilli at The New York Times.

The surge in RSV and flu is likely due to lockdowns and other anti-COVID measures that kept these viruses at bay for two years, leading to an “immunity gap” that makes people extra vulnerable now, writes Jen Christensen at CNN.

The nation’s flu season has started earlier than normal this year, and already more than 10% of tests are coming back positive for influenza in some Southeastern states.

High schools in Virginia and California have suffered serious outbreaks of flu-like illness this fall, with about 1,000 students out sick at each school, reports Scott Gleeson at USA Today.

Influenza, normally mild in children, seems to be more serious for young people this year, reports Erika Edwards at NBC News. One-third of flu hospitalizations are of children, the CDC told NBC.

Young children, as well as older adults, are also vulnerable to the respiratory syncytial virus RSV. It infects the airway and lungs to cause cold-like symptoms.

RSV is typically seasonal, with cases beginning to tick up in the late autumn, but it started to appear in the spring this year, writes Christensen. Current case counts are already well over the peak numbers from 2021, according to CNN’s analysis.

The high rates of RSV and other viruses are overwhelming pediatric hospitals, report Fenrit Nirappil and Ariana Eunjung Cha at The Washington Post. In some regions, more than 90% of beds are occupied; some children have been forced to wait for a bed in the ICU to open.

RSV used to mainly infect infants and toddlers, but it is now showing up in kids older than 3, said Andrew Pavia, an infectious disease expert at the University of Utah. That’s likely because pandemic precautions prevented earlier exposure, so kids who were babies during lockdown are being exposed for the first time now.

As these viruses stage their comeback, COVID is still infecting about 37,000 people per day in the United States — with many more cases likely going unrecorded. The next variants to watch are BQ.1 and BQ.1.1, descendants of omicron BA.5, which have risen quickly to make up more than 27% of cases as of the week ending in October 29. “BQ.1.1 evades immune system on a greater scale than other variants and subvariants,” writes the Editorial Board of The Washington Post.

The latest COVID boosters should provide some protection against the BQ strains, and flu shots will protect against influenza. There is not yet an RSV vaccine, though scientists are making progress.

“It’s becoming a petri dish out there,” writes Katelyn Jetelina in her newsletter, Your Local Epidemiologist. “We don’t have a triple threat yet, but I don’t think we want to see one.”

New boosters don’t enhance short-term omicron response

The new, reformulated bivalent boosters that the FDA insisted upon for this fall seem to generate an immediate immune response on par with the old, monovalent shots, but no better efficacy against omicron, according to two small, short-term studies now in preprint, reports Brenda Goodman at CNN Health.

There is no indication the new shots are in any way bad or less effective; they just aren’t a big improvement. “Getting boosted this fall is still an important way to renew protection,” writes Goodman.

Research teams at Columbia and Harvard universities evaluated the antibody responses of people within weeks of a booster of the new or old shots and found “essentially no difference,” said Dr. David Ho at Columbia.

With either version of the booster, the bulk of new antibodies targeted the original coronavirus, not the omicron version included in the bivalent shot. Neither shot increased T cells by much, according to the Harvard study.

“We would not expect [the slight differences in antibody levels] to be clinically significant,” said Dr. Dan Barouch of Harvard.

These data are preliminary, and based on the short-term immune response on a total of 73 people between both studies. It’s possible the immune responses of people who got different boosters will diverge with time, Ho said. Immune cells can take a couple of months to update their antibodies.

“We have to be careful not to draw too many conclusions from it,” said Dr. Peter Hotez, co-director of vaccine development at Texas Children’s Hospital, told Spencer Kimball at CNBC. He also suggested the new boosters might perform better against newer omicron variants such as BQ.1 or XBB, neither of which were included in the studies.

Both Moderna and Pfizer have larger studies underway.

The updated boosters probably failed to amplify anti-omicron responses because of “immune imprinting,” said Michael Worobey of the University of Arizona. People’s immune cells were already well-trained against the original strain, and its inclusion in the new shots mainly amplified those responses. It’s possible a monovalent booster targeting only omicron would have worked better, Worobey suggested.

New vaccine research also suggests that people who experience side effects after mRNA vaccines have a greater antibody response, writes Jacqueline Howard at CNN— but even those who don’t suffer after their shots have good immunity.

Regular exercise may also boost vaccine efficacy, reports Gretchen Reynolds at The Washington Post.

An ongoing problem with the vaccines is how quickly immunity wanes — within months. While this fall’s boosters were presented as the first round of what will be annual COVID shots going forward, that may not be the case after all, reports Helen Branswell at STAT. The FDA’s Dr. Peter Marks told her that another booster may be necessary before next autumn, at least for vulnerable people, such as seniors.

“We need to look at other types of vaccines,” said Marks. “There are those out there that might provide more durable immunity.”

For example, inhaled vaccines are under development, and China recently deployed a booster that is inhaled through the mouth.

COVID symptoms settle into familiar pattern

The latest research indicates that current COVID infections cause symptoms much like those for colds and flu, reports Melissa Healy at the Los Angeles Times.

The Zoe Health Study has released data from the past several weeks in the United Kingdom, and it found today’s primary symptoms are runny nose, cough, sore throat and headache, with loss of smell, shortness of breath and fever much less common than before.

Vaccination also influences symptoms, with those who’ve had at least two shots more likely to experience a stuffy nose, people with one shot tending towards sneezing, and unvaccinated folks more likely to have a fever.

The Zoe Health Study attributed the changes to more cases in vaccinated and younger individuals, who naturally experience less severe symptoms.

“I don’t think it’s really possible, from patients’ initial symptoms, to distinguish COVID from what we long called ‘influenza-like illnesses,’” said Dr. John O’Horo of the Mayo Clinic.

That makes testing especially important to distinguish COVID from other infections.

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