By Amber Dance

COVID shots to become once-a-year affair

The U.S. is ready to transition to annual COVID shots, officials said at an upbeat White House press conference last week.

Of course, that plan could change if some new variant emerges.

Officials extolled the U.S. vaccine effort that has, for the first time, caught up to the most dominant omicron BA.4 and BA.5 variants.

BA.5 has been holding steady as the main player in the U.S. for more than two months, with BA.4 now responsible for most of the rest of infections. But it remains to be seen how protective the updated vaccines are against these variants.

So long as the virus continues to evolve from BA.5, vaccines should provide excellent protection, said White House Coronavirus Response Coordinator Dr. Ashish Jha.

“For the moment, experts are optimistic that another Greek letter isn’t yet on the horizons,” writes Cecelia Smith-Schoenwalder at U.S. News & World Report.

Experts are also “guardedly optimistic” that the upcoming fall and winter season will be less severe than in the past two years, write Joel Achenbach and Lena H. Sun at The Washington Post.

Projections do indicate a late-fall surge is possible, though.

At the press conference, CDC Director Dr. Rochelle Walensky cited work suggesting that if Americans get the new COVID boosters at about the same rate they usually get annual flu shots — about half the population — then the nation could avoid up to 9,000 deaths and 100,000 hospitalizations in the coming months.

Achieving that level of uptake could pose a challenge, though. Thus far, just over one-third of people eligible for their first COVID booster have received one.

Some experts said it’s too soon to move to annual vaccination, particularly before next-generation vaccines such as nasal sprays or pan-coronavirus vaccines are available.

“I don’t see any evidence for how an annual COVID shot will provide durable protection,” tweeted Dr. Eric Topol of Scripps Research.

Epidemiologist Katelyn Jetelina, on her blog, said “the stars would need to align” for the annual-shot plan to be effective. Influenza vaccines are annual because the virus is seasonal and because decades of experience make it feasible to predict the virus’ evolution. COVID has not yet achieved that status.

Pandemic-era migration law limits Central Americans’ entry

A Trump-era migration order has made U.S. entry harder for people from Mexico, Guatemala, Honduras and El Salvador, writes Nina Lakhani at The Guardian.

The order, known as Title 42 and originally implemented by the CDC in March of 2020, authorized border officials to expel migrants to stop the spread of COVID-19 in border facilities and protect U.S. agents. The Biden administration has been trying to lift the order since spring of 2022, but been blocked by Republican-controlled states and federal courts.

Many migrants are deported to Mexico, but that nation only formally accepts people whose country of origin is Mexico, Guatemala, Honduras or El Salvador. People of other nationalities often get to stay because the U.S. is unwilling to pay for their flights back to their countries of origin, Lakhani reports.

Many migrants fly into Mexico from elsewhere before entering the U.S. Separating people by nationality has become routine at some entry points, but enforcement of Title 42 varies widely.

The effect has been to force Central Americans to enter through more isolated and dangerous territory in the hopes of evading detention and expulsion, Lakhani writes.

But officials don’t fully understand the migration patterns.

“The smuggling organizations control the flow,” said John Modlin, chief of Customs and Border Patrol in Tucson.

Study finds stress, depression linked to long COVID

Psychological factors such as anxiety and loneliness are among the best predictors that a person will experience long COVID, according to a new study in JAMA Psychiatry.

People who experienced worry and other psychological distress prior to COVID infection were up to 50% more likely to report symptoms more than four weeks after recovery, report the authors from Harvard’s School of Public Health.

The study emphasizes the importance of treating mental health concerns, senior author Andrea Roberts told STAT’s Brittany Trang. The authors were careful to note that the results do not mean long COVID symptoms are not real.

The study surveyed nearly 55,000 people, mainly current or former health care workers and mostly women, between April 2020 and November 2021. Nearly 3,200 tested positive for COVID over the study period, and of those just over 1,400 reported symptoms lasting four weeks or more.

Psychological stress had a stronger link to long COVID than physical factors such as asthma, obesity and high blood pressure.

It’s not clear how stress or anxiety might predispose someone to long COVID, or even if the psychological factors directly cause the increased risk. The study’s design can’t establish causation, only correlation.

It’s possible that stress reduction could help people recover from long COVID, but this hasn’t been proven, Roberts told told Aria Bendiz at NBC News.

People with the ongoing condition are more likely to start taking antidepressants than those whose COVID infection was short-lived, report Julie Steenhuysen and Jennifer Rigby at Reuters.

Epidemiologists are also investigating a link between long COVID and suicide risk, but the relationship remains unclear, the pair write.

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Pregnant, low-income New Yorkers living in neighborhoods with higher levels of air pollution were 60 percent more likely to test positive for COVID-19, according to a new study led by scientists at Columbia University Mailman School of Public Health. Study results appear in the American Journal of Epidemiology.

The researchers examined the relationship between 3,318 pregnant individuals’ COVID-19 test results and their long-term exposure to fine particulate matter (PM2.5). COVID testing was done for everyone at the time of delivery at Columbia University Irving Medical Center, March–December 2020. Exposure estimates were based on location-specific air pollution data between 2018 and 2019 at participant residences. Results were adjusted to account for individual- and neighborhood-level socioeconomic status.

They found no association between PM2.5 and ever testing positive for COVID-19 for everyone in the study group. However, odds of testing positive were 60 percent higher for each 1 μg/m3 increase in long-term PM2.5 among those using Medicaid health coverage for low-income Americans. While only 22 percent of those testing positive reported symptoms, 69 percent of symptomatic individuals used Medicaid.

Pregnant persons with COVID-19 are more likely to experience significant respiratory morbidity and more likely to die than non-pregnant persons with COVID-19. Pregnant persons with COVID-19 are also more likely to experience adverse pregnancy outcomes, including preterm delivery, preeclampsia, and possibly stillbirth. Exposure to PM2.5 during pregnancy has been shown to increase risk of preterm birth, as well as delivery of a low-birth-weight neonate.

Large-scale epidemiologic studies reveal consistent associations between higher long-term PM2.5 concentrations and increased risk of acute respiratory infection in the general population.

“COVID-19 has exposed and exacerbated existing health disparities. Low-income pregnant people may have been more likely to test positive for the virus and be symptomatic due to more exposure on the job or inability to isolate, as well as heightened exposure to a range of environmental pollutants,” says first author Joan Casey, PhD, assistant professor of environmental health sciences at Columbia Mailman School of Public Health.

Study co-authors include Marianthi-Anna Kioumourtzoglou, Jeffrey Shaman, Sasikiran Kandula of Columbia Mailman; Andreas Neophytou of Colorado State University; Elizabeth L. Ogburn, Kristin C. Darwin, and Jeanne S. Sheffield of Johns Hopkins University; and Cynthia Gyamfi-Bannerman, University of California San Diego School of Medicine.

The research was supported by the National Institute of Environmental Health Sciences (grants ES027023 and ES009089).

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