(NEW YORK) — Vaccine makers say they are in the midst of testing their shots’ effectiveness against the newly discovered omicron coronavirus variant, and they remain optimistic that a new variant-specific vaccine could be produced and rolled out quickly if needed.
When asked about the new omicron variant that was first detected in southern Africa, Paul Burton, Moderna’s chief medical officer, told ABC News’ “Good Morning America” on Monday that vaccine manufacturers around the world, including Moderna, “are testing samples from people who have received our vaccines against the strains.”
Burton said that while the company thinks “vaccine effectiveness may come down, based on the mutation seen in this in this virus,” he added that with booster shots of the existing version of the vaccine, “We should be able to get antibody levels up, so that’s a very important initial line of defense.”
Burton said that researchers will know just how effective the vaccines are against this variant “in the next couple of weeks.” If manufacturers need to make an omicron variant-specific vaccine, it should take approximately “two to three months” to test and manufacture it, he said.
Fellow coronavirus vaccine maker Pfizer similarly expressed confidence that it could produce a new vaccine quickly if needed. Pfizer’s CEO Albert Bourla told CNBC’s “Squawk Box” on Monday that he is very optimistic the company will be able to speedily switch production to a new vaccine, if the research merits, without losing any volume.
Johnson & Johnson also said in a statement Monday that it is evaluating its current COVID-19 vaccine against the omicron variant.
“In addition, the company is pursuing an omicron-specific variant vaccine and will progress it as needed,” it said.
Scientists suspect the omicron variant could partially chip away protection from current vaccines due to its mutations, but they are still waiting on testing to learn if, and to what extent, that could be the case.
Vaccine experts have told ABC News that the current COVID-19 vaccines, which rely on genetic technology, could easily be updated to better combat emerging variants. This has not been necessary so far, as the original vaccines have been effective against the dominant variants that have spread in the past, but companies are preparing to tweak vaccines to respond to the omicron variant just in case.
The good news is that these novel vaccines employing genetic technology mean updates can be made to the vaccines easily — unlike vaccines based on older technology, which used a piece of the virus or a killed virus to mimic infection.
The new vaccines, which use the genetic technology, introduces an instruction manual of sorts into your body. This introduction manual tells your cells to start churning out a protein normally found on the outside of the virus, and your body activates an immune response when your body senses that viral protein.
In remarks on Monday, President Joe Biden assured Americans that the omicron variant “is a cause for concern, not a cause for panic.”
“We have the best vaccine in the world. The best medicines, the best scientists, and we’re learning more every single day,” the president said. “And we’ll fight this variant with scientific and knowledgeable actions and speed. Not chaos and confusion.”
(NEW YORK) — While the new omicron variant of the COVID-19 virus has not yet been detected in the United States, it will “inevitably” arrive, Dr. Anthony Fauci said Sunday.
“We all know when you have a virus that has already gone to multiple countries, inevitably it will be here,” Fauci told ABC’s This Week anchor George Stephanopoulos. “The question is, will we be prepared for it?”
The omicron variant, named after the 15th letter of the Greek alphabet, was first detected last week in Botswana, officials said. Since then, cases of the new variant have been found in South Africa, Germany, Belgium and Hong Kong.
Pressed by Stephanopoulos on whether the omicron variant is as or more transmissible than the delta variant and other mutations that have swept the globe, Fauci, director of the National Institute of Allergy and Infectious Diseases and the White House chief medical adviser, said, “It appears to be.”
“It has a bunch of mutations,” Fauci said, including “a disturbingly large number of mutations in the spike protein, which is the business end of the virus.”
“Inevitably, it will be here. The question is will we be prepared for it?”
Fauci’s comments came one day before the United States plans to impose a travel ban on most travelers from eight southern African countries.
When asked by Stephanopoulos whether the travel ban will make a difference, Fauci said, “It will slow things down.”
“Travel bans, when you have a highly transmissible virus, never completely … prevent it from coming into the country. No way that’s going to happen,” Fauci said. “But what you can do is you can delay it enough to get us better prepared. And that’s the thing that people need to understand.”
He cautioned that traveling during the pandemic is “always risky,” but if Americans have to travel, he recommended they be vaccinated and to wear a mask on flights and in airports, which he described as “one of the most congregate settings you can imagine.”
The chief medical adviser said early signs “strongly suggest” that the variant may be more transmissible and might evade protections from monoclonal antibodies and “perhaps even antibodies that are induced by vaccine.”
Dr. Anthony Fauci tells @GStephanopoulos that the omicron variant of COVID-19 “appears” to be more transmissible than other variants, “might evade some of the protection of monoclonal antibodies and…perhaps even antibodies that are induced by vaccine.” https://t.co/ETIov84eDopic.twitter.com/gzkaQEHZj6
In South Africa, cases of new COVID-19 infections have been heavily weighted toward the omicron variant, Fauci said, so, “you have to presume that it has a good degree of transmissibility advantage.”
However, Fauci noted that a relatively small proportion of the population of South Africa is vaccinated. According to Johns Hopkins University, just over 24% of people in South Africa is fully vaccinated, compared to 60% of the U.S. population.
“So, you’ve got to take that into the equation when you’re trying to figure out where this virus is really going and what its impact is going to be,” Fauci said.
Asked by Stephanopoulos if omicron causes more severe disease, Fauci said that currently remains a mystery.
He said U.S. scientists spoke to their counterparts in South Africa on Friday and plan to meet with them again later Sunday “to try and find out if the cases they have identified that clearly are caused by this variant, what is the level of severity in that.”
“Hopefully, it will be light,” Fauci said.
Pressed by @GStephanopoulos on whether vaccines can fight omicron variant, Dr. Fauci says “I don’t think there’s any possibility that this could completely evade any protection by vaccine. It may diminish it a bit, but that’s the reason why you boost.” https://t.co/RB4JDN9jsrpic.twitter.com/rE9IxqwtL3
Stephanopoulos also pressed Fauci on how susceptible vaccinated people are to the new variant, asking what is known about how resistant omicron is to the currently available vaccines.
Fauci said studies and experiments are already underway to figure out how strong the vaccines are against omicron and estimated it will take about two weeks before scientists get the answers.
“The way you find that out is you get the virus and you put it either as a whole virus or as what we call a pseudovirus, and you take antibodies or serum from people who have been vaccinated, and you determine if those antibodies can neutralize the virus,” Fauci said.
The chief medical adviser said the best way for Americans to prepare for the omicron variant is to be vaccinated, to get a booster shot as soon as they are eligible, and to keep adhering to other protective recommendations such as wearing masks and practicing social distancing.
“We are on the lookout for this. The CDC has a good surveillance system,” Fauci said. “So, if and when — and it is going to be when — it comes here, hopefully, we will be ready for it by enhancing our capabilities via the vaccine, masking, all the things that we do and should be doing.”
Asked for guidance about traveling outside of the country right now, Dr. Anthony Fauci tells @GStephanopoulos that travelers should get vaccinated and “be prudent” about wearing masks in indoor settings like airports. https://t.co/Z7XtvfKbzNpic.twitter.com/QY6dTqclTC
When Stephanopoulos broached the possibility of returning to the lockdowns due to the new variant, Fauci said it’s “really too early to say.”
“We just really need to, as I’ve said so often, prepare for the worst,” Fauci said. “It may not be that we’re going to have to go the route that people are saying. We don’t know a lot about this virus. So, we want to prepare as best we can, but it may turn out that this preparation, although important, may not necessarily push us to the next level.”
He added, “Let’s see what the information that we’re getting in real-time tells us, and we’ll make decisions based on the science and the evidence, the way we always do.”
(NEW YORK) — Global health authorities said they’re monitoring a new COVID-19 variant first identified in Botswana, with the World Health Organization saying Friday the new strain, dubbed omicron, is a variant of concern.
Previously referred to as B.1.1.529, the WHO urged countries to step up monitoring and surveillance, citing the high number of mutations and early indications that the virus was spreading in South Africa. The global health agency said it’s still not clear whether the variant is more transmissible or causes more serious illness, or if it affects vaccines. And that such studies will take time.
Scientists have now confirmed 87 cases of the new variant — 77 in South Africa, six in Botswana, two in Hong Kong, and one each in Israel and Belgium, though hundreds more diagnoses are expected.
“We don’t know very much about this yet,” said WHO COVID-19 Technical Lead Dr. Maria Van Kerkhove, speaking at an “Ask WHO” briefing Thursday. But concern about this variant stems from its “large number of mutations,” Kerkhove said, which could “have an impact on how the virus behaves.”
Dr. Anthony Fauci told CNN on Friday that scientists from the United States and South Africa will discuss the new variant on Friday, as early indications suggest it could be spreading in South Africa.
“Literally,” Fauci added, “it’s something that, in real time, we’re learning more and more about.”
Concerns about this variant already have prompted the U.K., EU and India to propose travel restrictions from South Africa. The World Health Organization, meanwhile, is urging calm, saying it’s premature to close borders.
There are thousands of COVID-19 variants, with new ones emerging all the time. Usually new variants disappear quickly because they’re overrun by a more dominant strain.
The now-dominant delta variant is so highly transmissible that most of the new variants that have cropped up in recent months have been unable to gain a foothold. In the United States, the delta variant comprises an estimated 99.9% of all cases.
“There’s obviously this tension between crying wolf and exacerbating concerns about the variants, but also being caught flat-footed and not responding swiftly enough,” said Dr. John Brownstein, chief innovation office at Boston Children’s Hospital and an ABC News Contributor. “This is where we have to cautiously respond without inciting panic, because this could easily turn out to be a variant similar to others that have never really panned out to be global concerns.”
Scientists across the globe constantly monitor all newly emerged variants to see if they’re spreading in a meaningful way, and global health authorities have said they’re monitoring this new variant closely.
Pfizer and partner BioNTech said they will conduct experiments to see if the new variant can chip away at vaccine efficacy. Vaccine experts said current COVID-19 vaccines, which rely on genetic technology, could be easily updated to better combat emerging variants — though so far, that hasn’t been necessary.
Eight variants are currently being monitored by the WHO, which designates particularly worrisome strains as variants of “interest” or “concern.” When they no longer pose a significant public health threat, the variants are reclassified — so far during the pandemic, 13 have been removed from the WHO’s list.
But public health experts said the emergence of variants underscores the urgent need to vaccinate everyone on the planet.
“It gives us a lens into why as epidemiologists we’ve been so concerned about global vaccine equity,” Brownstein added. “It’s a recognition that with not enough people around the globe immunized, it creates more opportunities for variants to emerge, and this is a very good example of that.”
(NEW YORK) — Waning immunity has become a focal point in the pandemic.
COVID-19 cases among those fully vaccinated against the virus have been cited by several state public health officials as partly responsible for recent surges in cases. They were also behind the push for boosters for all adults ahead of federal authorization — and the reason for boosting in the first place.
“There’s no doubt that immunity wanes. It wanes in everyone. It’s more dangerous in the elderly, but it’s across all age groups,” Dr. Anthony Fauci, the White House chief medical adviser, said earlier this month, citing data from Israel and the U.K., where more people were vaccinated sooner and both began to first document waning immunity.
Experts stress that the vaccines remain highly effective against severe COVID-19 illness, and vaccinated people continue to share a lower burden of hospitalizations and deaths among COVID-19 patients as cases and hospitalizations are on the rise again in the U.S.
The data is limited and hard to track, though knowing more about breakthrough infections is an important tool in responding to the pandemic, experts say.
Vaccinated COVID-19 cases always expected
Data from the Centers for Disease Control and Prevention tracking COVID-19 case rates by vaccination status since April shows a relatively flat line for vaccinated people that started to slope up in July — though not nearly as steeply as case rates among unvaccinated people.
Breakthrough cases were always expected — and expected to go up over time, Dr. David Dowdy, an epidemiologist at the Johns Hopkins Bloomberg School of Public Health, told ABC News.
“The reason is, first of all, more people are vaccinated,” he said. “The more people who are vaccinated relative to being unvaccinated, the more likely it is that a person who gets sick is going to be vaccinated, just by pure numbers.”
As the number of unvaccinated people who get COVID-19 also continues to increase, it may look like more cases are breakthrough when comparing cases by vaccination status, he said.
COVID-19 Case Rates by Vaccination Status
Another reason for increasing cases is due to waning immunity, Dowdy said.
“There is this waning immunity to getting sick — not getting really sick, but getting infected, getting that initial illness,” he said. “And so over time, people have a little bit less protection against that.”
No vaccine provides 100% protection, though they are intended to help prevent you from getting very sick if infected. The initial immune system response is ramped up for several months after vaccination, though those antibodies “die out over time,” leaving behind a “memory response” to help protect against severe infection, Dowdy said.
When that happens varies from person to person depending on factors like age and health. In general, Pfizer’s data on its COVID-19 vaccine shows a decrease from an initial 96% efficacy to 83.7% efficacy after four months. A study by Kaiser Permanente Southern California found that efficacy against infections declined from 88% during the first month after full vaccination to 47% after five months.
A booster dose brings the immune response back up to a “robust” level seen one month after two doses, Pfizer found.
Booster doses are now eligible for all adults as COVID-19 transmission remains high in many parts of the country, “creating additional challenges and exposures for those who are vaccinated,” said Dr. John Brownstein, an epidemiologist at Boston Children’s Hospital and an ABC News contributor.
“Just based on probability, with enough exposures to the virus, you will have breakthrough infections,” he said. “But those breakthrough infections doesn’t mean the vaccines aren’t working — it just means over time, the probability of getting infected through an exposure to the virus, that probability increases.”
“Despite that, we know that the vast majority of those breakthrough infections are mild, especially much milder than they would be if someone wasn’t previously vaccinated, and they don’t lead to anywhere near the same levels of severe illness and death,” he said.
In September, unvaccinated individuals had a 5.8 times greater risk of testing positive for COVID-19, and a 14 times greater risk of dying from it, as compared to vaccinated individuals, according to CDC data.
COVID-19 Death Rates by Vaccination Status
Waning immunity a ‘real phenomenon’
Although the vast majority of COVID-19 infections and severe hospitalizations are among the unvaccinated, cases in vaccinated people do appear to be on the rise due to waning immunity, according to health officials.
In New Mexico, health officials have cited waning immunity as one of the reasons behind a recent surge in COVID-19 cases. The most recent state data shows that nearly 29% of cases and 21% of hospitalizations from Oct. 18 to Nov. 15 were among vaccinated people.
Similarly, health officials in Vermont, the most vaccinated state by population, have pointed to waning immunity as partly behind its worst COVID-19 surge yet.
“Waning of vaccine immunity is a real phenomenon,” Dr. Mark Levine, commissioner of the Vermont Department of Health, said during a press briefing in mid-November.
Vermont also leads the nation in administering booster doses to people ages 65 and up. This week, Levine told reporters that the health department’s data reaffirms that “booster shots are working.” Case rates among those ages 65 and up in the state make up only 10-12% of COVID-19 cases, he said. The most recent state data also shows case rates among that population have decreased 14% week-over-week while increasing for every other age group.
“The need for a booster does not mean the COVID-19 vaccines have failed to do their job,” he said. “They are highly protective against the worst effects of COVID. But the protection we get from a vaccine can start to wear off over time.”
“For COVID-19, booster shots are especially important for those at higher risk who got vaccinated early on, like the majority of Vermonters who fall into this category and were vaccinated very early in this year. And at a time when COVID-19 transmission is high, when we’re indoors more and getting together over the holidays, boosters really do benefit us all,” he added.
Challenges in tracking breakthrough infections
Tracking breakthrough cases can be challenging, and most efforts likely represent an undercount due to a lack of testing of asymptomatic cases and reporting of at-home test results, according to The Pandemic Tracking Collective, a group of former members of The Covid Tracking Project that offers data solutions for tracking the pandemic. Breakthrough data is also not standardized across states, and not all report breakthrough cases, hospitalizations and deaths, the group said in a recent report.
In this patchwork of breakthrough infection-related collection, 36 U.S. jurisdictions report cases, 34 report hospitalizations and 37 report deaths, according to The Pandemic Tracking Collective report. At the time of its report, the CDC tracked cases for 16 jurisdictions and deaths for 15 jurisdictions by vaccination status, updated monthly. That has since increased to 24 and 20 jurisdictions, respectively, in the tracker’s latest update this week. The CDC also reports on hospitalizations by vaccination status in 14 states.
“Now we have data on COVID-19 case counts and hospitalizations at our fingertips. What we lack is nuanced and detailed information on vaccine breakthroughs, which will be key to ending this pandemic,” Jessica Malaty Rivera, science communication lead at The Pandemic Tracking Collective, said in a statement.
Breakthrough infections can help scientists better understand declining vaccine efficacy and detect new variants, the group said. Having better data can also help enact effective policies, Brownstein said.
“It’s very hard to make policy decisions with imperfect data,” he said. “Being able to understand the extent to which we’re seeing breakthrough infections and their severity is important to make decisions around things like boosters, decisions around requirements for those who’ve been exposed or infected.”
“When you have that kind of data, it can tell you very clearly what the burden of disease is in vaccinated people,” he continued. “But without that, we have very limited information. So I think that is one of the real deficiencies in public health surveillance, is a lack of clarity on the impact of this virus among vaccinated and unvaccinated.”
For Dowdy, data on breakthrough cases can provide “valuable information as we think about how we can best fight this pandemic,” including the duration and level of protection that the vaccines are providing. Though he warned against reading the data as “trying to split the population in two.”
“At the end of the day, we’re all in this together, vaccinated or unvaccinated,” he said.
(NEW YORK) — A healthy athlete all his life, Jared Butler entered his college basketball physical exam as the last step before he could step on the court. But an unexpected diagnosis of a potentially lethal heart condition put him on the sidelines while he anxiously wondered if his basketball career was over.
“After a month of testing, we found out that I had hypertrophic cardiomyopathy,” Butler told ABC News. “I had never heard the term before. I was worried what this would mean for my playing career — and ultimately my life.”
That was three years ago. Today, Butler is coming off a starring role in an NCAA championship run at Baylor University and playing as a rookie in the NBA for the Utah Jazz. He has been able to continue his career thanks to routine cardiac evaluation and support by his family, doctors and team.
Hypertrophic cardiomyopathy is this most common genetically inherited heart disease, estimated to affect between 1 in 200 and 1 in 500 people worldwide, according to a 2015 study published in the Journal of the American College of Cardiology. The condition causes the heart muscle to become too thick, which could lead to life-altering conditions such as arrhythmias, heart failure, stroke or death.
Dr. Steve Ommen, cardiologist and medical director of the Mayo Hypertrophic Cardiomyopathy Clinic in Rochester, Minnesota, said the disease is not gender-selective and has no ethnic or geographic hotspots.
“The disease can manifest at any time and at any age among family members carrying the mutation,” said Dr. Seema Mital, pediatric cardiologist and head of cardiovascular research at The Hospital for Sick Children in Toronto. “Some may even go without any evidence of the disease throughout their lifetime.”
Once someone, like Butler, is found to have the disease, immediate family members are tested for the genetic mutation. In Butler’s case, his mother, Juanea, also tested positive for genetic markers of the disease. She will also be monitored regularly by a cardiologist.
“I found out that I am the culprit. I am the one who carries the gene” said Juanea. “I was really confused and in a state of shock. I grew up active as well and never had symptoms or noted to have heart problems.”
Mother and son were symptom-free their whole lives. But Dr. Michael Ackerman, genetic cardiologist at the Mayo Clinic and Jared Butler’s physician, said people and physicians should be aware of the most-concerning symptoms, including chest pain, fainting and shortness of breath.
The disease can be especially risky for professional athletes because it increases the risk of sudden cardiac death. But thanks to the medical field having a better understanding of this disease, not every athlete needs to give up their career.
“Every athlete [with hypertrophic cardiomyopathy] doesn’t need to give up what they’re doing,” said Mital. “Having the disease means you are going to be followed medically to make sure we can prevent heart failure and death. In fact, we now know that patients with hypertrophic cardiomyopathy can live a long, healthy life without any complications.”
Ackerman has treated over 700 athletes with genetic cardiac conditions, a majority of whom do not require extensive medical procedures.
“For Jared, we made a plan with him, his family and his team and reassess that plan frequently and alter it as needed,” said Ackerman. “This is not the new and improved way, this is just the approved and best way.”
Ommen added that “shared decision-making” between a doctor and patient is meant to educate patients about the potential risks and make a group decision that is best for them.
He’s more concerned about the 85% of the patients — assuming 1 in 500 Americans have the condition — who are living undiagnosed. To raise awareness, Butler and his mom decided to launch a campaign, “Could it be HCM?” in conjunction with Bristol Myers Squibb.
Ackerman added the second aspect of the campaign is knowing your family history. Having that knowledge about the sudden death of a family member could be life saving information
“Young patients come to the doctor complaining of shortness of breath, or chest pressure, and they are mistakenly diagnosed with exercise-induced asthma,” said Ommen. “Campaigns like ‘Could it be HCM?’ are trying to raise awareness that if a young person does come in with symptoms, think about hypertrophic cardiomyopathy as one of the potential causes.”
There is no cure, but Mital said that there are medications and surgical techniques to help alleviate symptoms and a lot of research invested in finding treatments to slow progression of the disease is in the future.
“Finding out you have the condition is just the beginning. It has been a long journey, and it has changed my life,” said Butler. “But I find myself lucky that I do not have symptoms and I can continue playing basketball.”
Lily Nedda Dastmalchi, D.O., M.A., is a physician and cardiology fellow at Temple University Hospital and a contributor to the ABC News Medical Unit.
(NEW YORK) — With coronavirus infection rates back on the rise, many Americans are wondering why the U.S. is, once again, experiencing surge in cases and hospitalizations, despite widespread vaccinations.
The U.S. is now reporting more than 94,000 new COVID-19 cases each day — up by 47% since late October. And 35 states — nearly all of them in the north or mountain region — have seen an uptick in daily cases of 10% or more in the last two weeks.
Just under 53,000 COVID-19 positive patients are currently receiving care in hospitals across the country — up by more than 7,000 patients from earlier this month.
Several states — including Michigan, Maine and New Hampshire — are experiencing record-breaking surges.
Experts say a confluence of factors is likely driving the country’s recent increases in infections, including the more than 100 million Americans who remain completely unvaccinated, cold weather and relaxed restrictions, the highly transmissible delta variant, and waning vaccine immunity.
Unvaccinated Americans continue to drive COVID-19 transmission
According to health officials, the vast majority of infections and severe hospitalizations continue to be among the unvaccinated.
This September, federal data showed that unvaccinated individuals have a 5.8 times greater risk of testing positive for COVID-19, and a 14 times greater risk of dying from it, as compared to those fully vaccinated.
“The thing we are concerned about is the people who are not vaccinated, because what they’re doing is they’re the major source of the dynamics of the infection in the community,” Dr. Anthony Fauci, the White House’s chief medical adviser, said during an appearance on ABC’s “This Week” on Sunday. “The higher the level of dynamics of infection, the more everyone is at risk.”
Across the country, more than 101 million Americans remain completely unvaccinated — 81 million of whom are currently over the age of 5, and thus are eligible to be vaccinated.
The significant number of unvaccinated individuals — about 30.5% of the total population — leaves millions at-risk and completely unprotected against the virus.
Relaxed restrictions, increased travel, and colder weather pushing people indoors
With winter arriving, and the holiday season on the horizon, many Americans are spending more time indoors, as the weather gets colder. COVID-19, as well as other respiratory illnesses, has been shown to spread more in indoor settings, and when people are forced to be in close proximity to one another.
Millions of Americans are also once again traveling, taking to the air, the railways and the highways. A total of 53.4 million people are expected to travel for Thanksgiving, up 13% from 2020, according to estimates from AAA.
Although masking is required in all forms of public transportation, across the country, COVID-19 restrictions are sparse, with few jurisdictions now requiring face coverings or social distancing.
“We’re seeing cases trickle up, this is probably likely due to waning immunity, but also because of the colder temperatures people are gathering indoors and adhering less to social distancing and masking,” John Brownstein, an epidemiologist at Boston Children’s Hospital and an ABC News contributor, told “World News Tonight.” “Unfortunately, that is a recipe for an increase in transmission this holiday season.”
Masking has been shown to reduce the risk of COVID-19 transmission, and is still recommended by the Centers for Disease Control and Prevention in crowded outdoor settings and for activities with close contact with others who are not fully vaccinated.
Delta variant remains highly transmissible
In the U.S., federal data shows that the delta variant accounts for 99.9% of new coronavirus cases. According to the CDC, delta is far more transmissible than prior variants.
Many of the country’s northern states were not as hard hit by the delta surge over the summer. Those states are just now feeling the impacts of the delta variant. Comparatively, states like Florida, which bore the brunt of the summer delta surge, are reporting very low COVID-19 infection numbers.
“We’re seeing is pockets of surges across this country, the Midwest being one but also in the Northeast,” Brownstein said
The delta variant spreads more easily among vaccinated people than prior versions of the virus, though vaccinated people are still far less likely to spread the virus compared to unvaccinated people.
Vaccine immunity is waning
Although the vast majority of infections and severe hospitalizations are among the unvaccinated, breakthrough positive COVID-19 cases among the vaccinated do appear to be on the rise, due to waning immunity, according to health officials.
“There’s no doubt that immunity wanes. It wanes in everyone. It’s more dangerous in the elderly, but it’s across all age groups,” Fauci said earlier this month, citing data from Israel and the U.K., where more people were vaccinated sooner and began to first document waning immunity.
Experts stress that the vaccines remain highly effective against severe COVID-19 illness.
Boosters are now recommended for everyone 18 and older, at least six months after an initial Pfizer or Moderna vaccination, or two months after a Johnson & Johnson shot.
(NEW YORK) — Every year, thousands of Americans undergo routine screening to catch cancer in its early stages, while it’s still treatable. But these routine tests can be painful and invasive, and doctors only regularly screen for five of some of the most common types of cancer.
So for decades, scientists have been working on ways to screen for cancers using a simple blood draw rather than a painful biopsy or invasive test. These so-called “blood biopsy” tests are closer than ever to dramatically improving the way doctors screen for cancer.
Galleri, a new blood test by health care company GRAIL, is one of the most advanced blood biopsy tests. It works by looking for fragments of DNA in a person’s blood that indicate the presence of more than 50 types of cancer.
According to Dr. Pashtoon Kasi, director of colon cancer research and precision medicine at Weill Cornell Medicine, the underlying technology was actually first used to serve a different purpose.
“The same technology has been around for more than 20 years,” he said. “It started with prenatal diagnostics.”
But now, similar technology has been harnessed to detect early signatures of cancer.
Dr. Michael Seiden, the former president of the US Oncology Network, sees blood biopsy tests as part of the future wave of so-called “precision medicine” — the idea that each person’s medical care can be tailored to fit their specific genetics, medical needs and unique characteristics.
Precision medicine tries “to learn as much [as possible] about a person’s health through sort of sophisticated diagnostic tests,” Seiden said.
According to Kasi, less than two thirds of Americans get screened for colon cancer, which often involves an invasive procedure called a colonoscopy. A simple blood biopsy such as Galleri may improve current cancer screening due to ease of use, he said.
But despite the recent advancements, many doctors say there’s a long way to go — and some say there are reasons to wait for more research to be done.
The Galleri test, though promising, is not yet FDA approved. It still needs to undergo more testing to show it can produce reliable results every time.
“What you want to see is evidence it detects cancers early and in a reasonably good-sized population and that there aren’t harms done,” Dr. Ann Partridge, a breast oncologist at the Dana-Farber Cancer Institute, said.
But there’s another, more complex challenge, some experts say. In routine medical care, more testing isn’t always better.
“To do a screening test for any kind of disease or disorder, you have to consider what’s the benefit of doing it,” Partridge said. “If you live for 15 minutes longer, it might not be worth it. But if you live for 10 months longer, it might be worth it.”
A common refrain in cancer treatment is “earlier is better”: that the earlier a cancer can be found, the treatment is often more successful. However, sometimes it can be difficult to tell the difference between an early cancer and a non-cancerous growth.
A final diagnosis often involves an invasive procedure, such as a needle biopsy or surgery in order to remove tissue. These procedures are not without risk, and any screening tool, such as the Galleri test, should reduce the number of unnecessary procedures by not flagging non-cancers as cancers.
That’s why some in the medical community have hesitation about the utility of a blood biopsy capable of detecting only a few cancer cells, as it may accidentally detect a non-cancer as a cancer.
But at the very least, Galleri could provide an early warning system, so doctors could monitor patients and treat them if it becomes necessary.
“This provides an additional screening test that might detect an early-stage cancer that’s not detectable by other available tests,” Seiden said. But, “It does not prove you don’t have cancer, and it does not replace currently recommended screening. It’s a supplement.”
Partridge added that she’s hopeful that someday she’ll be able to order tests like these, but right now, “I think the big picture is very optimistic, but really not ready for our patients routinely, outside a clinical trial. I look forward to seeing this important research evolve.”
Although Galleri is still not FDA approved, the test can be prescribed by any physician in the United States. Because it’s not covered by insurance, it costs $949 out of pocket.
Jacob S. Warner, an internal medicine resident at Dartmouth-Hitchcock Medical Center, is a contributor to the ABC News Medical Unit.
(NEW YORK) — A holiday like Thanksgiving that is centered on food, family and more food can be a precarious time for people struggling with eating disorders or disordered eating.
Alex Mutti, 27, of New York City, said she always loved Thanksgiving until her early teens, when she began to suffer from an eating disorder and the holiday became “really terrifying.”
She said making it through Thanksgiving became even more difficult even as she went through recovery.
“In my experience, a lot of eating disorder recovery was around eating mindfully and creating routine around my eating,” Mutti told Good Morning America. “And Thanksgiving throws all that out the window. Not many people are eating mindfully on Thanksgiving.”
“Losing that kind of routine that became safe for me was always really anxiety-provoking,” she said. “And being around the extended family and friends was difficult, even if they didn’t say anything.”
Lauren Larkin, now a mental health counselor in private practice in New York City, said she recalls many Thanksgivings she “white-knuckled” her way through the worst stages of her eating disorder, prior to recovery.
“Thanksgiving is really the holiday where you talk about food and talk about regretting the food you ate,” she said. “I would push myself to show up and act like everyone else and be like everyone else, even when maybe I couldn’t, and then I would have really intense anxiety afterwards.”
This holiday is approaching as the United States has seen a mental health crisis during the coronavirus pandemic, of which eating disorders are a major part.
The number of people who were hospitalized for eating disorders doubled in the U.S. during the pandemic, according to research published recently in JAMA Network.
And even for people who may more casually struggle with disordered eating, this Thanksgiving holiday may be more fraught with discussions on weight and looks as family members see each other for the first time in months due to the pandemic.
“I think about the stereotypical great-aunt who is stuck in the diet culture and who is going to make comments about your weight,” said Larkin. “Thanksgiving is probably the most triggering holiday for anyone who has struggled.”
As Thanksgiving Day nears, here are five tips from experts to help cope with diet and negative food talk.
1. Set boundaries.
If you are at a holiday meal with supportive family members or friends, Christy Harrison, a registered dietitian and author of the book “Anti-Diet” recommends setting boundaries ahead of time, like asking loved ones to not comment on your body or what you’re eating, and to do the same for others too.
If difficult conversation does emerge at the dinner table, Harrison suggests appealing to people on an emotional level.
“They probably care about you, they’re people you’re spending the holidays with, so talk on a human level about why diet talk hurts you or what you have found to be helpful in your own relationship with food,” she said. “And keep it focused on yourself, like, ‘for me,’ and, ‘in my experience.'”
“And if you’re not quite as close, you can say something a little less personal, like, ‘I’ve found that talking about this kind of stuff just makes the meal less fun for me,” she said.
2. Remember it is one meal, one day.
“Remember that it’s just one day, it’s just another day of eating and you can have those foods anytime you want,” said Larkin. “Try to minimize the importance and the exact rules around food and remember, you can have it anytime. You can have more. “You can have less. It’s just one day out of 365 days of the year.”
Speaking of her own recovery, she added, “Those are the kinds of conversations I had to have with myself and with my individual therapist leading up those these events until it became true for me.”
Larkin and other experts also recommend staying in a routine with meals both before and after a Thanksgiving lunch or dinner, again reinforcing that it is just one meal among many.
3. Start new traditions.
Larkin said that during certain parts of her eating disorder and her recovery, she chose to travel over the Thanksgiving holiday instead of joining family.
“I had to put my needs in front of my family’s need of wanting to see me and had to say, ‘Even though you want to see me, this holiday is too triggering and I’m not going to participate in the way that I normally would,'” she said. “That’s okay.”
In other cases, a healthy new tradition may be going to a Thanksgiving dinner hosted by friends instead of family, or organizing activities before and after a Thanksgiving meal that don’t involve sitting and talking about food, according to Larkin.
4. Have an ally by your side.
Chelsea M. Kronengold, a spokesperson for the National Eating Disorders Association, said it is important to have a support system on hand around a stressful holiday like Thanksgiving.
“If you have a therapist or a nutritionist, talk to them about your concerns prior to the holiday so you can work together on helpful coping strategies,” she said. “And in addition to professional support, if you have a friend or a family member who’s either in the room with you or available for you to text if the meal is challenging or the family dynamics are challenging, that can be extremely helpful.”
5. Practice self-compassion.
“It’s okay to acknowledge that Thanksgiving and other food and family-focused holidays won’t be easy,” said Kronengold. “If you end up restricting or bingeing, remember that tomorrow is a new day.”
“When you perpetuate that cycle of shame and guilt, it’s only going to be counterproductive to your mental health and your recovery journey,” she said.
If you or a loved one is struggling with food and body image concerns this Thanksgiving, the National Eating Disorder Association (NEDA) Helpline is available via click-to-chat on Thanksgiving Day from 12 pm – 8 pm ET. For 24/7 crisis support, text “NEDA” to 741-741.
(NEW YORK) — The rush to vaccinate children against COVID-19 is accelerating amid a steady increase in coronavirus infections and hospitalizations nationwide.
Last week, nearly 142,000 child coronavirus cases were recorded, with weekly infections among children up by more than 40% since late October, according to a new report from the American Academy of Pediatrics (AAP) and the Children’s Hospital Association (CHA).
Nationally, new coronavirus cases among all age groups have been increasing for the last three weeks, with the average now topping 92,000 new cases a day. Thirty-one states, as well as Washington, D.C., have seen an uptick in daily cases of 10% or more in the past two weeks.
Last week, children accounted for about a quarter of reported weekly COVID-19 cases, despite individuals under age 18 only making up 22.2% of the U.S. population. Regionally, the Midwest continues to see the highest number of pediatric cases, as the area experiences a notable viral resurgence with winter arriving across the region.
The nation has also seen an uptick in pediatric hospital admissions, alongside other age groups. Although hospitalization totals are still significantly lower than during the nation’s most recent summer surge, across the country, just under 1,250 children are hospitalized with a confirmed or suspected COVID-19 infection. Ohio currently leads the country with 168 children receiving care, followed by Texas with 120 children.
Amid this viral resurgence, health experts are urging parents to get their eligible children vaccinated.
COVID-19 “is one of the top 10 leading causes of death in children,” Dr. Leana Wen, emergency physician and professor of health policy and management at the George Washington University Milken Institute School of Public Health, said during a briefing Wednesday with the National Press Foundation. Vaccines are a “safe and simple intervention,” she said, and significantly lower the risk of severe illness.
Earlier this month, Centers for Disease Control and Prevention Director Rochelle Walensky reported the agency had seen a surge of interest in pediatric COVID-19 vaccinations, following emergency use authorization of the Pfizer/BioNTech vaccine.
“We’re seeing strong demand for COVID vaccinations among children ages 5 to 11 across the country with hundreds of thousands of appointments booked for the next few weeks,” Walensky said at the time.
Approximately one-third of children ages 5-17 have received at least one COVID-19 vaccine dose, according to recently updated federal data. In the last two weeks alone, 2 million children ages 5-11 years-old have received their first dose.
If parents get their children vaccinated now, they will be able to be fully vaccinated by the later winter holidays, Dr. Anthony Fauci, the White House’s chief medical adviser, said during an appearance on ABC’s “This Week” on Sunday.
“We now have vaccines that are highly effective and clearly very safe, particularly now with the recent data showing that we can vaccinate children from 5 through 11,” Fauci said. “There are 28 million children within that age category. If we started vaccinating them now, they’ll be fully protected by Christmas.”
Although severe illness due to COVID-19 remains “uncommon” among children, the two organizations wrote, there is an “urgent” need to collect more data on the long-term consequences of the pandemic on children, “including ways the virus may harm the long-term physical health of infected children, as well as its emotional and mental health effects.”
(NEW YORK) — COVID-19 booster shots are now authorized for anyone over the age of 18. For anyone hoping to get a COVID-19 booster dose before the Thanksgiving holiday, experts say it’s important to understand that protection doesn’t kick in right away.
Although the body starts to increase antibodies within a few days after the shot, it takes two weeks for peak protection to return.
“There is a meaningful increase in antibody titers by one week and peak responses at 2 weeks following mRNA boosting,” said Dr. Dan Barouch, director of the Center for Virology and Vaccine Research at Beth Israel Deaconess Medical Center in Boston.
More than 32 million people in the U.S. have already received a COVID-19 booster dose. The FDA and CDC say it’s safe to mix and match boosters.
COVID-19 booster shots are composed of the same formulation as the current COVID-19 vaccines. But the Moderna vaccine booster is given at half the dose of the primary Moderna series.
Studies show the immunity gained from the primary vaccine series may decline over time — particularly protection against mild breakthrough infections. Therefore, experts recommend booster vaccination to increase immunity.
“The booster shot will have a similar response as the second dose of the primary series. The highest antibody level will be around 10-14 days and then things will level off. The antibody levels will decline as it would with all vaccines, however the boosters help to stabilize the antibody levels,” said Dr. Simone Wildes, an infectious disease specialist at South Shore Health in Massachusetts.
Public health experts say booster shots could also help slow the spread of COVID-19 within communities. However, to truly curb the pandemic, it’s far more important for the unvaccinated to get their initial doses.
The expanded authorization of the Moderna and Pfizer boosters comes right in time for the holidays to allow many more Americans to get their booster shots before the holidays for safer travels and gatherings. The expanded authorization to now everyone over the age of 18 also helps eliminate any confusion on who may receive booster shots and ensures boosters are available to everyone who needs one.
Esra Demirel, MD is an OB-GYN resident physician at Northwell Health-North Shore University Hospital & LIJ Medical Center and is a contributor to the ABC News Medical Unit.
