The latest on the Covid-19 pandemic and vaccines

By Meg Wagner, Melissa Macaya, Melissa Mahtani, Fernando Alfonso III and Veronica Rocha, CNN

Updated 9:48 PM ET, Wed September 22, 2021
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2:29 p.m. ET, September 22, 2021

Vaccine protection against Covid-19 wanes over time, especially for older people, CDC says

From CNN’s Maggie Fox

Michael Ciaglo/Getty Images
Michael Ciaglo/Getty Images

The protection provided by Covid-19 vaccines appears to wane over time, especially for people 65 and older, a US Centers for Disease Control and Prevention expert said Wednesday.

Ruth Link-Gelles, who helps lead the CDC’s Vaccine Effectiveness Team, reviewed a series of studies looking at the overall effectiveness of vaccines in various groups between February and August and found similar patterns for Pfizer’s and Moderna’s vaccines, both made using mRNA. Effectiveness started to wane a few months after people were fully vaccinated – defined as two weeks after their second dose of either vaccine.

“For individuals 65 plus, we saw significant declines in VE (vaccine effectiveness) against infection during Delta for the mRNA products,” Link-Gelles told the a meeting of CDC vaccine advisers.

“We also saw declines, particularly for Pfizer, for 65 up, that we're not seeing in younger populations. Finally there's evidence of waning VE against hospitalization in the Delta period,” she said.

The CDC’s Advisory Committee on Immunization Practices is meeting to discuss the potential need for booster doses of vaccines, and is discussing vaccine effectiveness and safety in general. Pfizer has asked the US Food and Drug Administration to approve a booster dose of its vaccine for people 65 and older. FDA’s own vaccine advisers have recommended a booster only for people 65 and older, those with underlying conditions putting them at high risk of severe disease, and for people whose jobs put them at high risk of exposure.

Link-Gelles said that, overall, Moderna’s vaccine effectiveness is higher than the vaccine made by Pfizer/BioNTech. For the Johnson & Johnson vaccine, vaccine effectiveness actually increases with time, even after the Delta variant has dominated.

One study called SUPERNOVA looked at veterans between February and August of this year. In that study, the Pfizer vaccine provided 92% protection against hospitalization for those ages 18 to 64, and 77% for those over 65, Link-Gelles said. The Moderna vaccine provided 97% protection against hospitalization for those 18- to 64, and 87% for those 65 and older. Effectiveness did not seem to be affected by the arrival of the Delta variant, the study found. 

A study called IVY looked at hospitalized adults in 18 states between March and August. Efficacy of Pfizer’s vaccine waned from 91% 14 to 120 days after full vaccination, to 77% three months or more after full vaccination. Moderna’s vaccine effectiveness did not really wane, staying at 92% or 93% in that study.

In a study of 4,000 health care personnel, first responders, and other frontline workers in eight places who were tested every week regardless of symptoms, vaccine protection against any infection declined from 91% pre-Delta to 66% during Delta.

2:30 p.m. ET, September 22, 2021

Pfizer will continue to study how long vaccine protection lasts after third doses, company official says

From CNN's Jamie Gumbrecht

Patrick T. Fallon/AFP/Getty Images
Patrick T. Fallon/AFP/Getty Images

Pfizer hopes and expects that antibody protection from a third dose of its Covid-19 vaccine will last longer than after the initial two doses, but more research will be needed to determine whether more doses would be needed later on, a company official said Wednesday.

The conversation for now is focused on a third dose – a booster – of the company’s two-dose Covid-19 vaccine dose, a Pfizer official told the US Centers for Disease Control and Prevention’s Advisory Committee on Immunization Practices.

Experience with past vaccines suggests a third dose may provide longer, stronger protection, Pfizer Senior Vice President Dr. William Gruber told the committee. In that case, the primary series of the vaccine may works better as three doses, Gruber noted. But, he acknowledged, some experts believe protection is likely to drop again after a third booster dose.

“I think this is going to be driven largely by what we find in retrospect as we gather more information about protection, and we just need to stay tuned,” Gruber said.

Gruber said the company will continue to explore whether a longer interval between vaccine doses would work better; currently, the recommendation is 21 days between a first and second dose. He noted researchers in Europe and elsewhere have studied longer intervals, but the company’s focus has been maximizing protection as quickly as possible during the pandemic.

“We'll continue to explore whether or not it makes some sense to look at a longer interval,” Gruber said.

Pfizer is not studying the Pfizer vaccine as a booster for the Moderna or Johnson & Johnson vaccines, Gruber said, but it welcomes studies by others.

12:25 p.m. ET, September 22, 2021

Biden pledges US will become "arsenal of vaccines" in virtual Covid-19 summit

From CNN's Adrienne Vogt

President Joe Biden speaks during a virtual summit on Covid-19 at the White House on September 22.
President Joe Biden speaks during a virtual summit on Covid-19 at the White House on September 22. (Alex Wong/Getty Images)

President Biden opened up a virtual summit on Covid-19 at the White House, saying the meeting's goal is "supercharging our efforts" to combat the virus.

Biden said he is keeping his promise to have America be the "arsenal of vaccines."

"We also know that to beat the pandemic here, we need to beat it everywhere. And I made — and I'm keeping — the promise that America will become the arsenal of vaccines as we were the arsenal of democracy during World War II," Biden said at the summit.

The US is purchasing an additional 500 million Pfizer Covid-19 vaccines to donate to low- and lower-middle-income countries around the world, he announced. The doses will be shipped by this time next year, he said. This comes on top of 500 million doses already announced.

"We're not going to solve this crisis with half measures or middle-of-the-road ambitions. We need to go big, and we need to do our part — governments, the private sector, civil society, leaders, philanthropists. This is an all-hands-on-deck crisis," Biden said at the White House.

Biden touted the number of vaccinations administered in the US since the beginning of the year.

"I'm proud that we've gone from two million Americans being fully vaccinated when I took office on Jan. 20 to 182 million and counting today in America. But we also know that to beat the pandemic here, we need to beat it everywhere," he said.

The President also announced the launch of a vaccine partnership between the United States and European Union to expand global vaccinations.

He pledged $370 million from the US "to support administering these shots and delivery globally."

He also said the US is providing nearly $1.4 billion to "reduce Covid-19 deaths and mitigate transmission through bulk oxygen support, expanded testing and strengthening health care systems and more."

Biden proposed a second summit in the first quarter of 2022.

CNN's Betsy Klein and Kate Sullivan contributed reporting to this post. 

11:32 a.m. ET, September 22, 2021

Study shows remdesivir significantly reduces risk of hospitalization among high-risk Covid-19 patients

From CNN's Jen Christensen

A vial of remdesivir
A vial of remdesivir (Dirk Waem/Belga/AFP/Getty Images)

Gilead Sciences said Wednesday that its late-stage trial of a three-day intravenous course of the antiviral remdesivir significantly reduced the risk of non-hospitalized Covid-19 patients becoming sicker and dying.

In this trial, remdesivir, also known by its brand name, Veklury, was tested on 562 people considered high-risk for severe Covid-19 based on their health conditions and age. Half received the drug and the other half received a placebo.

The group that got the drug saw an 87% reduction in risk of hospitalization by day 28, and an 81% reduced risk of dying compared with the group that got a placebo.

The company had stopped enrolling people in the trial in April, it said, “reflecting the evolution of the Covid-19 landscape and changing patient needs.” At that time, the National Institute of Allergy and Infectious Diseases had decided to start giving remdesivir to patients who had been receiving standard care, since NIAID found that the drug had showed a small effect against Covid-19. The company said it continued to collect data on the patients in its trial so that it was able to produce the results of this latest trial. 

The data has not yet been peer-reviewed or published, and Gilead said it will be presented at the IDWeek 2021 virtual conference.

“Antiviral medications provide maximal benefit when used early in the disease course. Last summer, data from clinical trials demonstrated the benefit of remdesivir in patients hospitalized with COVID-19, even when not yet requiring oxygen. These latest data show remdesivir’s potential to help high-risk patients recover before they get sicker and stay out of the hospital altogether,” Dr. Robert L. Gottlieb, a cardiologist and principal Investigator at Baylor University Medical Center and Baylor Scott & White Research Institute, said in a company news release. “We are seeing very high numbers of hospitalized patients as new COVID-19 infections surge, placing increased demands on already over-burdened healthcare systems. Remdesivir, also known as Veklury, is an effective antiviral for the treatment of hospitalized patients with COVID-19 and an essential tool to help reduce disease progression.”

What's next: Gilead said it plans to continue to study how safe the drug is and how well it works in patients who are hospitalized. In November, the World Health Organization had updated its ongoing guidance on medication to advise against using the antiviral drug to treat hospitalized patients. However, it is approved for temporary use in 50 countries and has been provided to 127 middle and low income countries.

In October, the antiviral was the first drug to be approved by the US Food and Drug Administration to treat Covid-19; it’s approved for treatment of hospitalized adult and pediatric patients age 12 and older, and has emergency use authorization for treatment of younger children. It is approved for use only in a hospital or health care setting and needs to be administered by IV over 30 to 120 minutes.

11:22 a.m. ET, September 22, 2021

Regular Covid-19 testing in schools caught cases that symptom-based testing may miss, research suggests 

From CNN's Lauren Mascarenhas

Regular Covid-19 testing of all students and staff in schools catches cases that symptom-based testing may miss, according to research published Wednesday in the journal JAMA Network Open. 

As many as 9 in 10 cases among students and 7 in 10 cases among staff may be missed by conventional reporting mechanisms, the researchers said.

For the study, students and staff in three schools in Omaha, Nebraska, participated in a weekly PCR-testing program between November 9 and December 11, 2020. Over the study period, 2,885 self-collected saliva samples from 458 staff and 315 students with no symptoms were tested. Among those, 22 students and 24 students tested positive.

That’s around twice as many cases identified through symptom-based testing strategies, the researchers noted. The case rate was 7% among students and 5.3% among staff in the weekly testing program, compared to 1.2% among students and 2.1% among staff using conventional reporting mechanisms. Cases detected even exceeded the infection rates reported at the county level.

Covid-19 was also detected in wastewater samples from all three schools and air samples from two choir rooms. Researchers said this could be a cost-effective strategy to identify hot spots and guide where to direct individual screening, which is more resource-intensive.

Students in choir were 2.8 times as likely to test positive for the coronavirus than other students, when adjusting for school attended, but researchers note the impact of choir was not statistically significant.

The category of staffer was not significantly associated with coronavirus testing results, the authors said, but business teachers were 28.5% as likely to test positive than other staff members. “Our initial findings regarding business teachers suggest a higher risk for infection among teachers associated with computer laboratories,” the authors wrote.

The researchers said that the differences in community case rates and those among students and staff in the weekly testing program suggest that the strategy may help mitigate school-based transmission risk.

 

11:12 a.m. ET, September 22, 2021

CDC forecast predicts US Covid-19 hospitalizations will decrease over next 4 weeks 

From CNN’s Naomi Thomas

Paramedics prepare to transport a Covid-19 patient to a hospital in Houston, Texas, on September 15.
Paramedics prepare to transport a Covid-19 patient to a hospital in Houston, Texas, on September 15. (John Moore/Getty Images)

For the second consecutive week, an ensemble forecast from the US Centers for Disease Control and Prevention predicts that new daily Covid-19 hospitalizations will likely decrease over the next four weeks.  

Last week’s forecast, published Sept. 15, predicted hospitalizations would decrease for the first time since the June 23 forecast. 

This week’s forecast predicts that there will be 4,600 to 11,800 new confirmed Covid-19 hospital admissions likely reported on Oct. 18.

According to data from the US Department of Health and Human Services, there were 89,266 people hospitalized with Covid-19 as of Sept. 21. 

The new deaths forecast predicts that deaths will have a stable or uncertain trend over the next four weeks, with a total of 709,000 to 736,000 Covid-19 deaths reported by Oct. 16.

The previous weeks forecast predicted up to 719,000 deaths by Oct. 9

According to data from Johns Hopkins University, there have been 678,522 Covid-19 deaths in the United States. 

The cases forecast predicts 360,000 to 1,290,000 new cases likely reported in the week ending October 16. 

The agency did not forecast whether cases would increase in the next four weeks, something which has not been included since July 28. 

“Case forecasts were not assessed for likely increases or decreases because more reported cases than expected have fallen outside the forecast prediction intervals,” the forecast said.

10:26 a.m. ET, September 22, 2021

CDC's vaccine advisers are meeting now on Covid-19 boosters

From CNN's Jamie Gumbrecht

The CDC headquarters in Atlanta, Georgia.
The CDC headquarters in Atlanta, Georgia. (Elijah Nouvelage/Bloomberg/Getty Images)

The US Centers for Disease Control and Prevention’s Advisory Committee on Immunization Practices (ACIP) is meeting now, and the committee will hear presentations on Covid-19 vaccine booster doses from CDC experts and Pfizer, as well as presentation on vaccine effectiveness and vaccine safety during pregnancy.

They are scheduled to meet today until 4:30 p.m. ET and tomorrow from noon to 3:30 p.m. ET.

No vote is currently on the agenda today or tomorrow.

The US Food and Drug Administration is still considering a booster dose of the Pfizer/BioNTech Covid-19 vaccine after a lengthy discussion among its advisers on Friday.

If the FDA authorizes booster doses of Pfizer’s vaccine ahead of tomorrow’s ACIP meeting, the CDC committee could vote on whether to recommend the doses for use.

9:08 a.m. ET, September 22, 2021

White House announces US will send additional 500 million doses of vaccines to other nations in 2022

From CNN's Jason Hoffman 

The United States is set to significantly increase the amount of Covid-19 vaccines it will ship to foreign nations beginning in 2022 in an effort to end the pandemic worldwide, the White House announced Wednesday.

As part of today's virtual Covid-19 summit on the margins of the UN General AssemblyPresident Biden will announce that the US is purchasing an additional 500 million Pfizer Covid-19 vaccines to donate to low- and lower-middle-income countries around the world, a senior administration official said, previewing the summit. The newly announced 500 million doses are on top of the 500 million the US had already committed to sharing with other nations.

Those vaccines will begin shipping out in January, and from January through September of next year, the US will ship out 800 million vaccines to the world, the official said. These vaccines bring the United States total to over 1.1 billion vaccines donated to other countries.

"The President's strategy from day one has been to take care of Americans and to help vaccinate the world, and that's why even as we mounted an unprecedented domestic vaccination program here, we purchased 500 million vaccine doses for the sole purpose of giving them to others," the official said, adding that the US will now double that commitment even as the country continues to vaccinate Americans and prepare for potential booster shots.

The official said that the additional 500 million vaccines will be purchased at a not-for-profit price and will be distributed through Covid-19 Vaccines Global Access, the global vaccination program known as COVAX.

"We're proving that you can take care of your own, while helping others as well. We can and we must do both," the official said.

Read more about today's Covid-19 summit here.

10:03 a.m. ET, September 22, 2021

How global vaccine inequality was highlighted at the UN General Assembly

From CNN's Eliza Mackintosh

President Joe Biden addresses the United Nations General Assembly on September 21.
President Joe Biden addresses the United Nations General Assembly on September 21. (Eduardo Munoz/Pool/Getty Images)

US President Biden called for a new era of international cooperation to fight the pandemic in his debut address to the United Nations General Assembly, but, one year after world leaders pledged to bring Covid-19 vaccines and treatments to “all people, everywhere,” the message of unity rang empty. 

Speaking to a much smaller crowd than usual due to the ongoing coronavirus crisis, Biden on Tuesday urged heads of state to take swift action to rein in a pandemic that has killed millions and continues to resurge. 

“We need a collective act of science and political will,” he said to a hybrid audience of virtual and in-person UN delegations. “We need to act now to get shots in arms as fast as possible, and expand access to oxygen, tests, treatments, to save lives around the world.” 

On Wednesday, the White House said it was set to send an additional 500 million doses of Covid-19 vaccines to foreign nations in 2022.  

But the ongoing debate over how best to address the wide gap in vaccine access is boiling over at the UN, with national leaders condemning vaccine abundance in rich nations like the US and the drip-feed of shots afforded to the rest of the world. 

President Rodrigo Duterte of the Philippines on Tuesday accused rich countries of hoarding Covid vaccines while the poor “wait for trickles” and developing countries consider half-doses to cover more of their populations. The Philippines has one of the lowest Covid vaccination rates in Asia, with just 17% fully vaccinated. 

The divide, Duterte said in a prerecorded speech, “is shocking beyond belief – it must be condemned for what it is, a selfish act that can neither be justified rationally nor morally.” 

Speaking to CNN on Sunday, UN Secretary-General Antonio Guterres highlighted Biden’s Covid-19 summit on the UNGA sidelines and an International Monetary Fund proposal to create a $50 billion vaccine program for poor countries, saying these were “positive signs” that rich nations were starting to work together to tackle vaccine inequity. 

"But let's be clear: All this is too little, too late," he added. 

Out of six billion doses administered worldwide, only 2% have been in low-income countries. Discussions around how many traveling diplomats might still be unvaccinated illustrated just “how dramatic” the disparity in distribution remains, Guterres told Reuters. In a new take on vaccine diplomacy, a free Covid-19 testing and vaccination van welcomed world leaders and delegates at the UN, with the aim of avoiding a super-spreader event. 

A so-called “honor system” calling for foreign delegations to be vaccinated before entering the assembly hall was broken on the very first day of the General Assembly.