CDC panel backs Pfizer boosters for 12- to 17-year-olds

[BumRushDaShow]

Source: Yahoo!News

The Centers for Disease Control and Prevention's vaccine advisory committee voted 13-1 on Wednesday to endorse booster doses of Pfizer-BioNTech's COVID-19 vaccine for 12- to 17-year olds.

Why it matters: CDC director Rochelle Walensky is expected to sign off on the recommendation, which will expand the number of children eligible for boosters as a surge of COVID-19 cases driven by the Omicron variant spreads nationwide.

Read more: https://news.yahoo.com/cdc-panel-backs-pfizer-boosters-221115160.html

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They just voted and concluded the meeting.

Voting question -



Updated vaccine recommendations (including boosters) which once it receives final sign off, will have the 1st row adjusted to 12+ (Pfizer only) -



And here is where Omicron stands among variants (as of 1/1/22) -

[CottonBear]

1. I'm going to find a clinic or pharmacy to get my child boosted this week.

I am thinking about keeping them out of school until they’re boosted.

[OneCrazyDiamond]

2. The WHO would like us to hold off.

They say blanket COVID boosters risk prolonging pandemic, by limiting the vaccine supply for poorer nations.

[BumRushDaShow]

4. The U.S. has shipped over 1/3rd of a billion doses overseas

(including as part of COVAX)

https://www.state.gov/covid-19-recovery/vaccine-deliveries/

That is more than any other country in the world. This has a good breakdown of where they were shipped - https://www.kff.org/coronavirus-covid-19/issue-brief/u-s-international-covid-19-vaccine-donations-tracker/

It's not "limiting supply". You have an issue - particularly in many of the most rural and destitute areas - where there are infrastructure issues, including cold storage and getting the vaccine distributed. You also many countries with unstable governments (including ours apparently, as of a year ago) that make it difficult coordinating the shipments. All one has to do is see what continually happens with "the poorest nation in the western hemisphere" (Haiti) when disaster strikes and ships with supplies get to port, where they sit, unloaded, because there are no good roads for trucks to get to the docks and then no usable warehouses nearby to offload the stuff.

[OneCrazyDiamond]

7. I don't know if they factored our donations

In the request to not blanket boost. I think they are more thinking about global containment of the pandemic.

I just hope the world gets places like Haiti vaccinated soon. I'll admit, I am concerned about a super variant from the unvaxxed taking out those I care about.

[BumRushDaShow]

9. I think much of it is to "shame" Europe (particularly Germany, where BioNTech is headquartered)

(yes the partner with Pfizer)

I.e., that brand mRNA vaccine - COMIRNATY - is technically attributed as "Pfizer-BioNTech" and Germany played a big part in the development and needs to step it up with respect to the donations.

I think everyone is concerned but it's not as simple as loading up a plane and flying it in. There needs to be some serious logistics work done ahead of time - mainly because at least for the mRNA vaccines (which are the only ones being made here at the moment) they have some strict chilling requirements including ultra-low freezers). Fortunately after stability studies were done, the doses were found to actually be stable, once diluted, under normal freezer conditions, but that is still only for I think about 30 days.

And sadly, you have many around the world who are just as vaccine-hesitant as many people here are, so it becomes a project just to get the populace educated (like here) about the benefits of the vaccines.

[OneCrazyDiamond]

10. Yeah.

The vaccines should be freely available. No strings.

[BumRushDaShow]

11. I know I have posted this before

but many in big pharma have always considered vaccines and other biologics as "loss leaders" and health agencies around the world have often had to beg them to even manufacture them because they feel they make little or no profit from them compared to their pharmaceuticals (notably their solid dosage forms).

I.e., you will now start witnessing the ramping up of the anti-virals and other therapeutics to make up for being cajoled into manufacturing a step-child product (out of habit). Meanwhile the smaller companies and start-ups (like a Moderna) have burst onto the scene to fill the void of innovative biotech that have traditionally been eschewed by the multinationals. In fact, those big corporations have generally gobbled up the little biotech guys so they have something "different" in their portfolios, but then they usually throw them on the back burner.

The pandemic has actually been a literal "freak occurrence" and financial boon, in an otherwise sleepy vaccine world.

[Ouroborosnek]

3. Been pressing refresh on the CVS page

waiting for it to update with this, maybe by tomorrow?

[BumRushDaShow]

5. Walensky has to sign off on it

which she'll probably do by (or) tomorrow. Then the pharmacies will probably start updating their pages.

[BumRushDaShow]

12. And start the refreshing - Walensky signed off on the recommendation

https://www.democraticunderground.com/10142849234

(don't know how long it will take the chain pharmacies to update their websites though)

[YP_Yooper]

6. Curious if you ran across this

If the boosters are approved, and considering how fast SARS2 is spreading among that demographic, have you seen what is recommended for kids who are vacc'd, then get and recover from COVID? Any legitimate guidance?

I ask because UPMC in PA said now my family has recovered, a) we are not eligible for a shot for 90 days, b) no longer require to quarantine if exposed, c) kids don't need to quarantine if exposed at school either. Medical guidance is that once recovered, even in the remote chance you contract it again, you're not going to transmit it. For reference, here in Pitt, they report reinfections are only like 10% with omicron even if your first infection was 2 yrs ago. In S Africa, it was only 1.8% reinfection rate with Omicron.

I understand if kids have not yet been infected, but for those who have? Should they get boosted? The list is growing very rapidly now they're all back in school.

[BumRushDaShow]

8. Some of that discussion came up during the ACIP meeting

particularly since there are a number of pediatricians on the committee. I think the recommendation was that if they are either unvaxxed, partially vaxxed, or fully vaxxed, to wait to get any next dose if infected.

However one thing about Omicron they noted was that the infection rate (including vaxxed) has gone up significantly (in relative terms) among children, and many are ending up hospitalized (the unvaxxed and partial vaxxed ones).

One of the slides showed this for the 12 - 17 group -



One of my sisters had just texted me a couple hours ago to say that 2 of her neighbors texted her to let her know that the adults and their kids (all fully vaxxed) all tested positive (2 young brothers in one family and a young girl in another who all play together on their street).

[YP_Yooper]

13. Appreciate the guidance (as always, BRDS)

I was planning to wait too. They were tested positive (we all were), but they had no symptoms.

About those CDC numbers, though, at 1-2 per hundred thousand and not accounting for comorbidity, there is basically no risk. It's hard to have any real stats with such low rates. I see this as good news - at least for this low risk demographic.

[BumRushDaShow]

14. One thing I literally just read in a "The Atlantic" article this morning

was the description of a very simple concept to consider -

Up for Debate
Omicron and the Return to Normalcy

Are precautions still needed as endemicity seems to come into view?

By Conor Friedersdorf
January 5, 2022, 3:11 PM ET


(snip)

The sociologist Zeynep Tufekci added,

NYC at ~50,000 known cases per day … and who knows how many untested. Yes hospitalization rate is very low but a small % of a huge number is big … There is a point at which exponential math takes over policy preferences. I don’t understand how this isn’t obvious two years into this pandemic.

(snip)

https://www.theatlantic.com/ideas/archive/2022/01/omicron-precautions-normalcy/621166/

The above excerpt linked to this tweet -

Link to tweet

zeynep tufekci
@zeynep
NYC at ~50,000 known cases per day. I’d guess as many from untracked rapid tests—and who knows how many untested.
~25% test positivity.
Yes hospitalization rate is very low but a small % of a huge number is big.
Decision is what gets disrupted in an orderly vs. disorderly manner.
Mark D. Levine
@MarkLevineNYC
Hospitalizations in NYC are rising faster than at any point since March, 2020.

With a healthcare workforce which is now exhausted and depleted.

We can't just accept this. We have to do more to slow this wave.
Image
9:32 PM · Jan 2, 2022

So "low rates" as a standalone concept is meaningless.

From CDC here - https://www.cdc.gov/coronavirus/2019-ncov/cases-updates/burden.html over the course of the pandemic, approx. 5% of those infected were hospitalized (and obviously that skews to early on and pre-vaccine).

So you may have a location with "10,000 positive cases" over a 7-day period (or about 1428/day) and "5% might be hospitalized" (no matter their vax status), and that then means you have 500 people hospitalized that week.

But if you have "140,000 positive cases" over that same 7-days, now you are talking ~20,000 per day (like what is currently happening right here in PA), and that comes out to 7,000 hospitalized in a week's time statewide (using the same potential 5% hospitalization rate). And since some of the hospitalized are not suddenly "well and discharged", your hospitals might start filling up week after week with new hospitalizations while others are either getting sicker or are slowly recovering.

So that simple concept being (when using the same example) - if "only a small % of those infected with COVID-19 are hospitalized", then that in and of itself is a "small number" ("rare" ). HOWEVER - and this is the big caveat of "math" - a "small percent" of a "SMALL number" is "small" (manageable). BUT a "small percent" of a "LARGE number" can be overwhelming, and that is where we are at the moment.

The "low percent" ("rarity" ) becomes almost meaningless in a practical sense due to the large overall numbers, particularly when it comes to the hospital systems that must handle them.

Just last month, post-Thanksgiving, PA had been reported as hospitalizing 3900 per day and that is when the daily cases were starting to skyrocket and ramping up higher and higher from about 8000/day (or around 56,000/wk).

[YP_Yooper]

15. Agreed with you there population-wide

I was just speaking to the pediatric rates. even at 2/100k kids, here in Pitt that would amount to a very low number and risk (not accounting for the spread to others outside that demographic).

On another topic (since you like research), I read this today and helped explain why omicron is spreading fast even among the vaccinated:

Vaccines provide systemic antibodies, but this is a respiratory virus, so infects your sinuses and the mucosal immunity (think a runny nose when you get sick) doesn't have those antibodies. So it takes time for your body to kill it, and in the meantime, easily spreads to others. Your innards are protected by the vaccine. This research is to provide a nasal vaccine to boost that immune system.

While the currently approved vaccines induce systemic immune responses, they probably do not evoke mucosal immunity in form of mucosal, secretory immunoglobulin A (IgA) or tissue-resident memory T cells (TRM). Secretory, polymeric IgA can neutralize incoming viral particles at the mucosal surface before infection of epithelial cells takes place, which is important for an optimal protection against respiratory virus infections

[link:https://www.nature.com/articles/s41467-021-27063-4|

[BumRushDaShow]

16. But it's the same principle

"Low rate with low overall totals equals low number of impacted and thus a lower risk". But we aren't having a "low overall number" so the same "fixed number" of chances end up resulting in children's hospitals like those here in Philly seeing an "unprecedented" number of hospitalizations (although the "per capita" rate may be the same).

A record-high number of kids are getting hospitalized with Covid-19 as overall Covid-19 hospitalizations soar past the Delta peak

By Holly Yan and Travis Caldwell, CNN

Updated 3:02 AM ET, Wed January 5, 2022
Largest pediatric hospital sees 4x increase in hospitalizations


(CNN) More children are getting hospitalized with Covid-19 than ever before as the Omicron variant's dominance intensifies. An average of 672 children were admitted to hospitals every day with Covid-19 during the week ending Sunday, the highest such number of the pandemic, according to data from the Centers for Disease Control and Prevention.

It follows a record-high number of new cases among children, according to the American Academy of Pediatrics (AAP).

The US had more than 325,000 new cases among children during the week ending December 30, according to data published this week by the AAP, marking a 64% increase in new childhood cases compared to the previous week, the AAP said. About 1,045 children under 18 have died from Covid-19, the CDC said. And across all age groups, Covid-19 hospitalizations reached a new milestone.

https://www.cnn.com/2022/01/04/health/us-coronavirus-tuesday/index.html

A CDC MMR published this past June summarized the adolescent hospitalizations (from data gathered from 14 states) here - https://www.cdc.gov/mmwr/volumes/70/wr/mm7023e1.htm

At the time, this is what the conclusion was (this was before vaccines were approved for that age group) -

What is added by this report?

COVID-19 adolescent hospitalization rates from COVID-NET peaked at 2.1 per 100,000 in early January 2021, declined to 0.6 in mid-March, and rose to 1.3 in April. Among hospitalized adolescents, nearly one third required intensive care unit admission, and 5% required invasive mechanical ventilation; no associated deaths occurred.

So the per capita has now doubled since that time (for unvaccinated adolescents) and based on that plot earlier in this thread, you can see the effectiveness of the vaccines keeping the per capita hospitalizations down, although again, just based on sheer total numbers who have been infected, that will proportionately increase the numbers hospitalized regardless.

The odds of me being struck by lightning is noted as 1 in 500,000 or 0.2 per capita (100,000). But if I put myself in a position that changes those odds (standing under a tree during a severe thunderstorm), and "everyone" did the same, then the per capita rate will go up. And if there is a lot of severe weather going on, you will have more people being struck (and the per capita may even creep up).

So depending on the circumstances, the per capita CAN change (by variant).

And yup I did see that article. There are a number researchers are looking at doing a nasal vaccine (similar to those used for some flu vaccines), which would also be beneficial for those who are needle-phobic. I also believe that similar concepts of taking an approach to aid the immune system triggers is being done through therapeutics, similar to Pfizer's and Merck's anti-virals (that target other parts of the virus itself outside of the spike proteins) that were recently approved for EUAs.