The latest on the coronavirus pandemic and vaccines

Vaccine advisers to the Centers for Disease Control and Prevention have scheduled a meeting for April 23 to take up the question of whether Johnson & Johnson’s Janssen coronavirus vaccine causes blood clots and, if so, what to do about it.

The CDC’s Advisory Committee on Immunization Practices met Wednesday without voting on taking any action on news about six cases of a rare type of blood clotting event in people who got the J&J vaccine. They said they needed more information.

The CDC and US Food and Drug Administration say they are seeking information on whether there are more cases, and whether other blood clot types might be associated with vaccination.

The CDC and FDA on Tuesday recommended a pause in giving out J&J vaccines while they gather information and inform clinicians about how to recognize and treat the condition.

Pharmacy student Jason Rodriguez prepares Pfizer vaccines at the Christine E. Lynn Rehabilitation Center in Miami on April 15.

Even young and relatively healthy people who have had Covid-19 before should still get a vaccine to prevent re-infection and to slow down the spread of the disease, new research suggests.

The study, published Thursday in the journal the Lancet Respiratory Medicine, found that about 10% of those who had previous infections in the study became reinfected, compared to the 50% of new infections among those who had not had Covid-19 before.

The study was conducted among more than 3,000 otherwise healthy US Marines between May and November of 2020. Most of the people in the study were men between the age of 18 and 20. 

For the study, the Marines had an unsupervised two-week quarantine at home before going into a Marine facility that had a supervised quarantine for another two weeks. 

The Marines underwent antibody tests at the start of camp to determine if they had prior infection. Nearly 200 had indicators that they had a prior Covid-19 infection, more than 2,200 had no signs of prior infection. 

The Marines were given a biweekly PCR test throughout their time in basic training that lasted about six weeks. Across both groups there were more 1,098 new infections during the study, 19 of which had a prior infection. 

“Immunity is not guaranteed by past infection, and vaccinations that provide additional protection are still needed for those who have had COVID-19,” said study co-author Dr. Stuart Sealfon, a professor of neurology and pharmacological sciences at the Icahn School of Medicine at Mount Sinai.

There are limits to the study. Researchers were unable to determine the severity of infection among those who had Covid-19 before. Some infections may also have been missed in the period between the bi-weekly PCR testing during the program. Researchers also believe the risk of reinfection would be about the same for other demographics, although the exact rates may vary. Earlier studies among populations that don’t live in such crowded conditions found lower reinfection rates.

A commentary that accompanied the research said that the study showed some “interesting insights” about reinfection. 

“These data confirm that seropositive individuals have a significant albeit limited protection for new infections,” the commentary written by Maria Velasco, a researcher at Hospital Universitario Fundación Alcorcón, Spain, said. “Second, the rate of new SARS-CoV-2 PCR detection among seropositive Marines cases is not negligible (1·1 cases per person-year), even in the young and healthy population. Globally, these results indicate that COVID-19 does not provide an almost universal and long-lasting protective immunity such as measles.” 

An arena worker removes the net from the ice after the Vancouver Canucks and Calgary Flames NHL hockey game was postponed due to a positive COVID-19 test result, in Vancouver, British Columbia, on March 31.

Following a Covid-19 outbreak within the Vancouver Canucks team, the National Hockey League has abruptly delayed the team’s scheduled return to the ice.

The league had scheduled the Canucks to play the Edmonton Oilers on Friday, the team’s first game since March 24, but has now delayed the return just over 24 hours before the puck was to be dropped.

Some context: This delay comes a day after Canucks forward J.T. Miller told reporters that he thought it was “dangerous” to be rushed back onto the ice after the team dealt with a Covid-19 outbreak in which at least 21 players tested positive for the virus. 

“We try to talk about the number one priority being the player’s health and their families’ safety, and it’s almost impossible to do what they’ve asked us to do here on our return,” Miller said on Wednesday. 

A date for a return to play has not announced yet, but the league expects it to be released on Friday.

The US Centers for Disease Control and Prevention put off making any decision about the Johnson & Johnson coronavirus vaccine, saying they need more information about a rare type of blood clot.

The CDC and US Food and Drug Administration earlier this week recommend the US pause the vaccine after six reported blood clot cases among more than 6.8 million doses of J&J administered in the US.

CNN’s chief medical correspondent Dr. Sanjay Gupta answered your questions about the the J&J vaccine.

Watch:

The National Institutes of Health is awarding up to $33 million to fund Covid-19 testing initiatives for students, teachers, and staff so they can return to in-person school.

Funding comes from the $1.9 trillion Covid-19 economic relief package signed into law by President Biden on March 11 and will be distributed over a two-year period to projects at 10 institutions across eight states.

The awards are meant to go to increase at-home and at-school Covid-19 testing access for vulnerable and underserved populations as part of the NIH Rapid Acceleration of Diagnostics Underserved Populations (RADx-UP) program.

Participating schools range from public, chartered, special education, and pediatric complex care that serve students in urban, rural and tribal communities.

Georgia Tech employee Adam Jackson receives a Pfizer COVID-19 vaccination at a vaccination site on the campus of Georgia Tech on April 8 in Atlanta.

More than 5 million doses of Covid-19 vaccine have been administered in Georgia, according to a news release from Gov. Brian Kemp today.

There have been 1 million vaccinations reported in the state in the last 12 days, the release said. 

More than 3.2 million Georgians have received at least one dose, according to the release.

Dr. David Kessler, chief science officer for the Biden administration’s Covid response, testifies at a House Select Subcommittee on the Coronavirus Crisis hearing on April 15 on Capitol Hill in Washington, DC.

The US is making plans just in case Covid-19 vaccines need booster doses later, officials told a congressional hearing Thursday.

Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, said that there were a few different approaches that could boost the potency of a Covid-19 vaccine.

One is to create a booster that would strengthen the original vaccine and would be strong enough to protect against variants. The other is to make a booster that would work against particular variants. While the variant first found in South Africa, known as B.1.351, is not dominant in the US, it theoretically could be a bigger problem for the existing vaccines, and vaccine makers could target that particular variant.

“The problem with that, is, that if you get more and more variants, that’s almost like playing Whack-a -mole,” Fauci said.

“You hit this one, then you go to the other one, you go to the other one, and that’s the reason why, what we’re putting a lot of effort in, is to try and get a more universal vaccine that would cover all different types of variants. That’s the ultimate end game,” Fauci said.

He added that research is already underway. Until then, scientists are trying to figure out what the most dangerous variant is and to make a special boost against that.

A health care worker administers a dose of the Pfizer COVID-19 vaccine at CIELO, an Indigenous rights organization, on April 10 in Los Angeles.

About 198 million doses of Covid-19 vaccine have been administered in the United States, according to data published Thursday by the US Centers for Disease Control and Prevention.  

The CDC reported that 198,317,040 total doses have been administered, about 78% of the 255,400,665 doses delivered. 

That’s about 3.5 million more doses reported administered since yesterday, for a seven-day average of about 3.3 million doses per day. 

More than 30% of adults in the US are fully vaccinated, and about 48% of adults have received at least one dose of vaccine. Among seniors, about 64% are fully vaccinated and 80% have received at least one dose.

Overall, about 78.5 million people in the US are fully vaccinated and nearly 126 million people have received at least one dose, according to CDC data. 

Data published by the CDC may be delayed, and doses may not have been given on the day reported. 

Albert Bourla, chief executive officer of Pfizer pharmaceutical company, is seen at the New York Stock Exchange on January 17, 2019, in New York City.

People are likely to need a booster dose of vaccine six to 12 months after their first round, Albert Bourla, CEO of Pfizer, said.

Real-world data shows the Pfizer vaccine is effective against a worrying variant of coronavirus first seen in South Africa, called B.1.351, Bourla said during a CVS Health Live event posted to Facebook Thursday. “Protection goes down by time but still in six months it’s still extremely, extremely high,” he said.

Bourla said it remains to be seen how often this would have to happen, but “a likely scenario is that there will be likely a need for a third dose somewhere between six and 12 months and then from there, there will be an annual re-vaccination. But all this needs to be confirmed.”

“In pandemics, you are as protected as your neighbor,” Bourla said. He said that’s why it’s important that all countries get their citizens vaccinated.

Airport employees push a cart carrying a shipment of AstraZeneca/Oxford Covid-19 vaccines at the Pristina International Airport on March 28.

A new campaign to raise $2 billion for the global fight against Covid-19 was launched today at an event hosted by the United States and Gavi, the Vaccine Alliance.

Gavi have set a deadline of June for this additional round of funding, which would enable them to finance a total of 1.8 billion doses of COVAX Covid-19 vaccines for 92 lower-income countries by the end of the year.

COVAX is a program is co-led by Gavi, the Coalition for Epidemic Preparedness Innovations (CEPI) and the World Health Organization. Its aim is to accelerate the development and manufacture of coronavirus vaccines, and to guarantee fair and equitable access for every country in the world.

At the event, governments and private sector partners made early pledges worth nearly $400 million and committed to donate millions of Covid-19 vaccine doses to COVAX to benefit the most vulnerable, according to the news release.

It includes commitments by Sweden, Denmark, Portugal, the Netherlands, the Bill & Melinda Gates Foundation and the Visa Foundation among others. Google also announced a commitment to donate $2.5 million to COVAX and $15 million in Ad credits to Gavi. New Zealand said it would donate 1.6 million vaccine doses to COVAX, with a focus on the Pacific region.

Speaking at the event, Gavi CEO Seth Berkley warned that the global supply of Covid-19 vaccines is “ incredibly tight right now.” He said it is unlikely COVAX will be able to secure “more supply in 2021 beyond the doses that we have reserved,” calling on countries with excess supply to share spare vaccine doses with COVAX.

At the same event, AstraZeneca CEO Pascal Soriot admitted the company has had bumps in the road. “It’s been not only an R&D challenge but also a manufacturing challenge,” he said adding that “manufacturing is ramping up very quickly now.”

Dr. Anthony Fauci said Thursday he hopes there will be a quick decision about when, and if, the country should proceed with the Johnson & Johnson Covid-19 vaccine.

“Hopefully, we’ll get a decision quite soon as to whether or not we can get back on track with this very effective vaccine,” Fauci, who is director of the National Institute of Allergy and Infectious Diseases, told a Congressional hearing.

Fauci said the US Centers for Disease Control and Prevention and the US Food and Drug Administration recommended the pause in the administration of the vaccine after what he called a “really quite devastating complication” in a “relatively small number” of people.

There have been six reported US cases of a rare and severe type of blood clot among more than 6.8 million Americans who got the shot. A day later, advisers to the CDC put off making any decision about recommendations for the vaccine, with members of the group saying they need more information.

The pause in the J&J vaccine, he said, gives public health officials a chance to make sure there are no other unreported cases and it will alert doctors to be on the lookout for these cases.

The first US Centers for Disease Control and Prevention accounting of breakthrough coronavirus infections among fully vaccinated people shows such infections are very rare, Dr. Kawsar Talaat, an infectious disease physician and assistant professor at Johns Hopkins Bloomberg School of Public Health, told CNN on Thursday. She said it actually underscores the urgency to vaccinate more people against Covid-19.

The likelihood of these “very rare” infections depends on how much virus is circulating within a community, Talaat said. As more people become fully vaccinated, there will be less virus circulating, and less opportunity for anyone to be exposed.

About 77 million people in the United States have been fully vaccinated. In data released to CNN on Wednesday, the CDC said 5,800 breakthrough cases have been reported so far, although there is a delay in reporting. Among the reported cases, 396 were hospitalized, 74 died. The CDC also said 29% were asymptomatic. 

The CDC said it’s monitoring reported cases “for clustering by patient demographics, geographic location, time since vaccination, vaccine type or lot number, and SARS-CoV-2 lineage,” and so far, no unexpected patterns have been identified.

Talaat said that, overall, the breakthrough infections tend to be much milder than the cases seen among unvaccinated people.

“It’s important to realize how many lives have already been saved by the number of people that we vaccinated so far,” she said. “The more people we vaccinate the more lives that we can save.”

Hypothetically, “you have a population where there’s 20,000 people. Half are vaccinated and half are unvaccinated. In the unvaccinated group, if 1% of those people have Covid – that’s 100 people in the unvaccinated group of 10,000 – then you would have maybe 10 in the vaccinated group,” Talaat said. “But then if at any given time the percent of people infected is .1% in the population, then those numbers go down to 10 and one.”

Some breakthrough infections are expected with these and other vaccines. No vaccine is 100% effective. 

In clinical trials of the vaccines, there were a few breakthrough infections among vaccinated people, Dr. Carlos del Rio, executive associate dean at Emory University School of Medicine, wrote in an email on Thursday. Del Rio is an investigator on clinical trials for Moderna and Novovax Covid-19 vaccines.

Del Rio added that in the meantime, the public needs to continue masking and social distancing to also help drive the numbers down.

France marked a grim milestone Thursday as its Covid-19 death toll exceeded 100,000, according to the French health ministry’s Geodes website.

France has registered 100,077 total deaths, and currently has the eighth highest global death toll, according to data from Johns Hopkins University.

There remains some confusion around new research from the University of Oxford in the United Kingdom that compares the risk of a rare type of blood clot among people who have had Covid-19 with people who received the AstraZeneca, Moderna and Pfizer vaccines, Dr. Anthony Fauci said.

Fauci who is director of the National Institute of Allergy and Infectious Diseases made the comments during a hearing with the House Select Subcommittee on the Coronavirus Crisis Thursday.

However, Fauci added that when the researchers calculated what the incidence of these thromboses may be following Covid-19 vaccination to compare incidents following different types of vaccines, some concerns in the methodology emerged. 

“It is impossible, the way this study was designed and conducted to make that determination. So, I believe when this paper, which is in a pre-print server, gets submitted to the classical scientific journals and undergoes peer review that that confusion will be straightened out,” Fauci said. 

“It will be clear that you cannot make any statement, the way this is designed, about the adverse events following the vaccination with the mRNA comparing to anything else,” Fauci said.

“There were many, many, I would say, procedural gaps in here regarding the way the study was done. It was a well-meaning attempt to show that Covid-19 disease is followed by this complication, but they led to some suggestions that I think are not called for in the paper.”

Norway is postponing the introduction of the Johnson & Johnson Covid-19 vaccine pending “ongoing investigations,” the Norwegian Institute of Public Health announced on Thursday.

“Use of [Johnson & Johnson’s Covid-19] Janssen vaccine in Norway is postponed until more information is available from the ongoing investigations,” Geir Bukholm, director of infection control at the Institute of Public Health, said on Thursday.

Some background: The US Food and Drug Administration and the Centers for Disease Control and Prevention said Tuesday that they were recommending a pause in the use of the Johnson & Johnson Covid-19 vaccine. The agencies cited the cases of six women between the ages of 18 and 48 who had developed a rare and severe condition called cerebral venous sinus thrombosis (CVST), a brain blood clot, combined with thrombocytopenia, or low platelet counts, after their Johnson & Johnson vaccination.

On Tuesday, Johnson & Johnson unilaterally announced that it was pausing deliveries of its single-dose vaccines to the European Union that had started on Monday. A delivery of 200 million doses to the EU has been scheduled for the second quarter of this year

In a news release on Wednesday, the European Medicines Agency said it “remains of the view that the benefits of the [Johnson & Johnson] vaccine in preventing COVID-19 outweigh the risks of side effects.”

The agency in charge of verifying the safety of vaccines for the EU also said they are still assessing the “very rare cases of unusual blood clots with low platelets” with that vaccine and the “EMA is expediting this evaluation and currently expects to issue a recommendation next week.”

Dr. Rochelle Walensky, director of the Centers for Disease Control and Prevention, testifies in Washington, DC, on April 15.

As the pause of administering Johnson & Johnson Covid-19 vaccines in the United States continues, the Centers for Disease Control and Prevention and the Food and Drug Administration will keep the public informed about new developments, CDC Director Dr. Rochelle Walensky said Thursday.

She made the comments to the House Select Subcommittee on the Coronavirus Crisis during a hearing.

“We take all reports of adverse events following Covid-19 vaccinations seriously. As announced earlier this week, CDC and FDA recommended a pause in administering the Johnson & Johnson vaccine while we review data and assess significance around adverse events reported in six people,” Walensky said.

A National Health Service staff member prepares to administer the Oxford/AstraZeneca Covid-19 vaccine in London on March 21.

Researchers at Oxford University have found the risk of a rare type of blood clot is low overall, but higher for people who have been infected with Covid-19 than among people who’ve had the three vaccines authorized in the UK – those made by AstraZeneca, Moderna and Pfizer.

The study, made available in pre-print on Thursday on the Oxford website ahead of publication in a scientific journal, says the risk of cerebral venous thrombosis or CVT – also known as cerebral venous sinus thrombosis or CVST – following Covid-19 infection is around “100 times greater than normal and several times higher than it is post vaccination or following influenza,” across all age groups.  

Oxford University, which developed the AstraZeneca vaccine, said the research is from a separate part of the university and is not connected to the vaccine team. The data used was obtained from external sources, specifically the European Medicines Agency.

When compared to the risk of clots from the three vaccines, the risk from infection is “between 8-10 times higher, and compared to the baseline, approximately 100 times higher for infection,” Oxford said in a news release. According to the research, when compared with the mRNA vaccines – Pfizer and Moderna – the risk of CVT from Covid-19 infection is about 10 times greater. When compared with AstraZeneca, the risk of a CVT from Covid-19 is about eight times greater. The Johnson & Johnson Covid-19 vaccine was not included in the analysis.

Using an electronic health records network of over 500,000 Covid-19 positive cases, 489,871 vaccinated cases and 172,724 cases of influenza, the study found 30% of CVT cases occurred in the under-30 age group, the most at-risk for blood clots.

“Considering the balances between risks and COVID-19 risk is higher than see with the current vaccines, even for those under 30; something that should be taken into account when considering the balances between risks and benefits for vaccination,” Harrison added. 

Dr. Maxime Taquet from Oxford’s Translational Neurobiology Group and a co-author of the study cautioned that data is still accruing. Researchers also are still to determine if Covid-19 and vaccines lead to CVT in the same way, she said. 

Experts noted that CVT is so rare, there is limited data even from before the pandemic, and the data and data sources around the Covid-19 vaccines are inconsistent and limited.

Some background: European and British medicines regulators last week announced a “possible link” between the AstraZeneca vaccine and rare cases of blood clots, with the UK announcing it would offer people under 30 an alternative vaccine. Other countries have followed suit and are either only offering to people above a certain age or are like Denmark and Norway, scrapping the vaccine entirely. While advising the public to look out for the signs of clots, the regulators said the benefits of the shot were still worth the risk. The AstraZeneca vaccine has not been authorized for use in the United States.

Six reports of similar clotting events following vaccination with the single-dose Johnson & Johnson vaccine prompted the US Centers for Disease Control and Prevention and the US Food and Drug Administration to recommend a pause on administering the vaccine to allow for further investigation.  

Six women between the ages of 18 and 48 had developed a cerebral venous sinus thrombosis, a clot in the area of the brain that collects and drains oxygen-depleted blood. Blood thinners, the typical treatment for clots, should not be used in such cases.  The six reported cases were among more than 6.8 million doses of the Johnson & Johnson vaccine administered in the United States. 

The EU, which is heavily relying on the J&J vaccine to bolster its lagging vaccination rollout, has also paused use of the shot. The European Medicines Agency is expected to announce a decision on administering the Johnson & Johnson vaccine next week.

The WHO on Thursday said “for now the risk of suffering blood clots, is much higher for someone with COVID-19 than for someone who has taken the AstraZeneca vaccine.” WHO Regional Director for Europe Hans Kluge reiterated its recommendation of the AstraZeneca vaccine for all eligible adults, calling it “effective in reducing COVID-19 hospitalization and preventing deaths.”

Norway will stop using the Oxford-AstraZeneca Covid-19 vaccine as part of its vaccination program because of the risk of side effects in the younger population, the Norwegian Institute of Public Health announced on Thursday.

The institute said there is now a “greater risk associated with the AstraZeneca vaccine than with the Covid-19 disease in Norway,” in a statement on its website.

The Institute explains that Norway “has come a long way” in vaccinating its elderly population and the continued use of the vaccine would now be mostly relevant for those age 65 and younger.

“There is now significantly more knowledge about the connection between the AstraZeneca vaccine and the rare and serious incidents of low platelets, blood clots and bleeding, than when Norway chose to put further use of the AstraZeneca vaccine on pause in March,” Bukholm also said. “Based on this knowledge, we have arrived at a recommendation that the AstraZeneca vaccine be removed from the coronavirus vaccination program in Norway.”

In the statement, Bukholm went on to point out that this “has not been an easy recommendation” with a direct impact on the vaccination rollout and infection control measures. 

Remember: The European Medicines Agency (EMA) said on April 7 that a particular combination of unusual blood clots with low blood platelet counts should be listed as a side effect of the Oxford-AstraZeneca vaccine, but stopped short of recommending its use be limited. The benefits of the shot outweigh the risks and Covid-19 is a “very serious disease,” it added.

Employees of the Vila Formosa cemetery carry a coffin to bury a person who died of Covid-19 in São Paulo, Brazil, on April 2.

Médecins Sans Frontières (MSF) called on Brazilian authorities to urgently acknowledge the severity of the Covid-19 pandemic and put in place a central Covid-19 response and coordination system. 

“More than 12 months into Brazil’s Covid-19 emergency, there is still no effective, centralized and coordinated public health response to the outbreak,” the agency said in a news release Thursday.

Brazilians accounted for 11% of global infections and 26.2% of global deaths last week, according to the release, adding on April 8, more than 4,000 deaths and more than 86,000 new cases were reported in a 24 hour period. MSF say that these “staggering figures” are evidence of failure of authorities to manage the crisis and protect Brazilians. 

“More than a year into this Covid pandemic, the failed response in Brazil has caused a humanitarian catastrophe,” said Dr. Christos Christou, international president of MSF during a news briefing, also on Thursday. 

Christou said that even with new record of deaths and infections each week and overflowing hospitals, there is still no coordinated, centralized response.

Health workers are exhausted, he said, and have been left alone to pick up the pieces of a failed government response and improvise solutions. He added that medical facilities are running low on essential medical supplies, and material needed to save lives. 

He also said that science and evidence based medicine have been undermined, which is not just a problem of fake news and disinformation, but also a seeming lack of political will to control the pandemic. 

Relatives of a person who died of Covid-19 are at a crematorium in New Delhi on April 14.

India is currently experiencing its second wave of the pandemic as the number of Covid-19 cases in the country surpassed 14 million on Thursday. More than 200,000 new cases of coronavirus were reported — the highest single-day rise in cases since the start of the pandemic, according to a CNN tally of figures from the Indian Ministry of Health.

The health ministry also reported 1,038 new deaths from the virus, bring the death toll to 173,123.

India’s previous peak was in September when cases rose by more than 97,000.

Several regions have imposed strict curfews. India’s capital, Delhi, imposed a weekend curfew along with a night curfew that will remain in place until April 30.

This comes despite the world’s second most populous country — with nearly 1.4 billion people — rolling out a massive vaccination campaign. More than 114 million doses have been administered. The health ministry also announced it will fast-track emergency use authorization for vaccines approved in other countries to expand the vaccine availability.