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Study: Latest XBB COVID-19 vaccine offers protection against hospitalization


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JAMA Internal Medicine published a study calculating the protection offered by the latest Pfizer COVID-19 XBB vaccine compared to older vaccines against COVID-associated hospitalization and emergency department (ED) or urgent care (UC) visits. 

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The authors compared outcomes among those who had received an updated XBB vaccine and those who had not received an XBB vaccine of any kind, regardless of prior COVID-19 vaccination or infection history. 

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62% protection against hospitalization

Compared to those who had not received an updated XBB vaccine, recipients had 62% protection against COVID-19 hospitalization (95% confidence interval [CI], 32% to 79%). Protection was 58% against ED/UC visits (95% CI, 48% to 67%).

 

A history of vaccination with pre-XBB vaccines did not significantly reduce the risk of COVID-19 outcomes, including hospital admission, and outcomes were similar to those of unvaccinated patients. 

 

(more)

 

https://www.cidrap.umn.edu/covid-19/latest-xbb-covid-19-vaccine-offers-protection-against-hospitalization-deaths

 

 

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Findings  In this case-control study among 2854 cases and 15 345 controls, the BNT162b2 XBB vaccine provided statistically significant additional protection against a range of COVID-19 outcomes during the early part of the 2023 to 2024 viral respiratory season. Older versions of COVID-19 vaccines offered little, if any, additional protection compared with being unvaccinated, including against COVID-19 hospital admissions, regardless of the number or type of prior doses received.

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Results  Among 2854 cases and 15 345 controls (median [IQR] age, 56 [37-72] years; 10 658 [58.6%] female), adjusted estimation of effectiveness of the BNT162b2 XBB vaccine received a median of 34 days prior vs not having received an XBB vaccine of any kind was 62% (95% CI, 32%-79%) against COVID-19 hospitalization and 58% (95% CI, 48%-67%) for ED/UC visits. Compared with being unvaccinated, those who had received only older versions of COVID-19 vaccines did not show statistically significant reduced risk of COVID-19 outcomes, including hospital admission.

 

(more)

 

https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2820268

 

 

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A couple of additional things to note about the above study:

 

1. It was funded, as clearly disclosed in the study, by Pfizer and done in conjunction with the Kaiser Permanente Southern California health system. The authors included researchers both from Kaiser and Pfizer.

 

2. But more pertinent to readers here, various forum members are often commenting that they had their original COVID vaccines several years ago in Thailand, and don't feel that they need any more.

 

One of the findings that was particularly interesting on that point is this study found that the original version or 2nd generation bivalent COVID vaccines people received in past years, at this point in the pandemic, provided no statistically significant protection against COVID hospitalization vs. those who had never received any COVID vaccine.

 

Specifically, the authors wrote:

 

"Finally, compared with unvaccinated individuals, those who had not received an XBB vaccine of any kind but had received older versions of COVID-19 vaccines (ie, ≥1 BA.4/5 bivalent dose or ≥3 or ≥2 original wild-type doses and no variant-adapted vaccines of any kind) did not show a statistically significant reduced risk of COVID-19 outcomes, including hospital admission, during the study period.

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Thus, analogous to influenza, although older versions of COVID-19 vaccines once provided high levels of protection, the combination of waning vaccine-induced immunity and continuous SARS-CoV-2 strain evolution eventually renders prior versions of vaccines ineffective. This, in turn, warrants routine updates to COVID-19 vaccines—also like influenza—so long as SARS-CoV-2 continues to circulate and cause disease."

 

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3 minutes ago, Robert Paulson said:

I wonder why nobody is taking it. The mysteries of the universe 

 

Here, because the Thai government for now has abandoned all government-provided COVID vaccination efforts, probably because they don't want to spend the money amid their national government budget problems.

 

And thus are leaving their senior citizen and other high-risk COVID groups, in particular, at serious health risk.

 

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This topic is outdated fast.  Looking at the chart on the below link, XBB isn't even around anymore!

 

https://www.idsociety.org/covid-19-real-time-learning-network/diagnostics/covid-19-variant-update/#/+/0/publishedDate_na_dt/desc/

 

The JN.1 variant is antigenically distinct from the XBB.1.5 variant, which is the current target of monovalent COVID-19 vaccines. Recent research shows that JN.1 is very efficient at immune evasion (even more so than other Omicron variants), resulting in an increased reproductive number. Evidence from a small serological study has suggested that serological protection against SARS-CoV-2 is reduced against JN.1 variants compared to other BA.2.86 viruses among young adults who had received at least a complete primary series of SARS-CoV-2 vaccines.

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That's why we have the following:

As Covid cases rise, CDC recommends new version of vaccine

The updated Covid vaccines should become available for people ages 6 months and older in August and September.

 

June 28, 2024

 

On Thursday, the Centers for Disease Control and Prevention recommended new shots for all Americans this fall.

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A vaccine by Novavax will target JN.1, the variant that prevailed for months in the winter and spring. The shots to be made by Pfizer and Moderna are aimed at KP.2, which until recently seemed poised to be the dominant variant.

 

But KP.2 appears to be giving way to two related variants, KP.3 and LB.1, which now account for more than half of new cases. All three variants, descendants of JN.1, are together nicknamed FLiRT, after two mutations in the virus’s genes that contain those letters.

 

(more)

 

https://www.nbcnews.com/health/health-news/covid-cases-rise-cdc-panel-recommends-updated-vaccine-fall-rcna159349

 

Just like there are new, updated versions of the flu vaccine done and needed every year to keep up with new variants, there are going to be new versions of the COVID vaccine needed -- at least as long as the virus continues to circulate and remain a health risk.

 

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Posted (edited)

There's also been recent research that shows the current XBB variant vaccines -- until the new versions become available this fall -- are still helpful against the newer circulating COVID strains, albeit at reduced levels of effectiveness.  See the following:

 

COVID Shots Could Use Another Update, Study Suggests

 

Latest vaccines mostly kept up with circulating strains, but dipped against JN.1

 

May 29, 2024

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for those vaccinated between Oct. 26, 2023 and Feb. 10, 2024 -- when the JN.1 variant was dominant -- vaccine effectiveness against infection was 44.3% after week 4 and decreased to 17.4% after week 10.

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Among those vaccinated after the JN.1 variant became dominant, effectiveness against hospitalization was 60.1% after week 4 and effectiveness against death was 59.8% after week 4, and both steadily decreased over time.

 

"It would be worthwhile to develop and deploy new vaccines targeting JN.1 or future strains," the authors wrote.

 

MedPage Today

https://archive.ph/G7c1d

 

Edited by TallGuyJohninBKK
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Posted (edited)

There also was recent research out of Singapore indicating that the current XBB COVID vaccines continue to provide decent protection against the more recent JN.1 COVID variant, although the older bivalent and earlier COVID vaccines did not:

XBB booster offers protection against JN.1 infections, hospital cases, new data show

June 29, 2024
 
"A new study in Clinical Infectious Diseases looks at outcomes among more than 3 million adult Singaporeans who received the XBB booster amid JN.1 virus circulation and finds protection against both infection and serious outcomes. 
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Lower risk of all negative outcomes

An XBB booster [8-120 days prior] was associated with a 41% reduced risk of JN.1 infection (adjusted hazard ratio [aHR], 0.59). COVID-19–associated ED visits were reduced 50% among those with XBB boosters (aHR, 0.50), while hospitalizations were 42% lower (aHR, 0.58). 

 

There was no statistically significant reduction of risk for JN.1 infections, ED visits, or hospitalizations in people vaccinated with a bivalent booster within 8 to 365 days after the shot."

 

(more)

 

https://www.cidrap.umn.edu/covid-19/xbb-booster-offers-protection-against-jn1-infections-hospital-cases-new-data-show

 

 

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"Compared with individuals last boosted ≥1 year prior with ancestral monovalent vaccines, receipt of an updated XBB.1.5 booster 8-120 days prior was associated with lower risk of JN.1 infection (adjusted-hazard-ratio, aHR = 0.59 [0.52-0.66]), COVID-19 associated ED-visits (aHR = 0.50[0.34-0.73]) and hospitalizations (aHR = 0.58 [0.37-0.91]), while receipt of a bivalent booster 121-365 days prior was associated with lower risk of JN.1 infection (aHR = 0.92[0.88-0.95]) and ED-visits (aHR = 0.80[0.70-0.90]). Lower risk of COVID-19 hospitalization during the JN.1 outbreak (aHR = 0.57[0.33-0.97]) was still observed following receipt of an updated XBB.1.5 booster 8-120 days prior, even when analysis was restricted to previously infected individuals.

 

Conclusion

Recent receipt of updated boosters conferred protection against SARS-CoV-2 infection and ED-visits/hospitalization during a JN.1 variant wave, in both previously infected and uninfected individuals. Annual booster doses confer protection during COVID-19 endemicity."

 

https://academic.oup.com/cid/advance-article-abstract/doi/10.1093/cid/ciae339/7699692

 

Note: when studies like this cite figures for "aHR" meaning adjusted hazard ratio, that means the level of reduced risk is the inverse number. For example, an aHR of 0.59 translates into a 41% reduction in risk.

 

"For example, a scientific paper might use an HR to state something such as: "Adequate COVID-19 vaccination status was associated with significantly decreased risk for the composite of severe COVID-19 or mortality with a[n] HR of 0.20 (95% CI, 0.17–0.22)."[1] In essence, the hazard for the composite outcome was 80% lower among the vaccinated relative to those who were unvaccinated in the same study. So, for a hazardous outcome (e.g., severe disease or death), an HR below 1 indicates that the treatment (e.g., vaccination) is protective against the outcome of interest."

 

https://en.wikipedia.org/wiki/Hazard_ratio

 

Edited by TallGuyJohninBKK
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On 7/6/2024 at 8:47 PM, Robert Paulson said:

I wonder why nobody is taking it. The mysteries of the universe 

If you open your eyes and look around Thailand, your mystification issue will soon disappear.  Perhaps an appointment at an optometrist will help.

Edited by gamb00ler
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