Moderna Vs. Pfizer: COVID-19 Vaccine Effectiveness

Findings of a recent study, Comparison of two highly-effective mRNA vaccines for COVID-19 during periods of Alpha and Delta variant prevalence, show that Moderna’s COVID-19 vaccine appears to have a higher effectiveness rate compared with the Pfizer vaccine. This observational study was conducted from a Minnesota patient cohort in July 2021. Both vaccines appeared to be highly protective (Moderna 86%, Pfizer 76%) from January to July 2021, which was the period of time when the Delta variant first became predominant. However, the researchers observed the rates of protection for both vaccines dropped during the month of July 2021, and that the Moderna vaccine maintained higher protection than Pfizer (Moderna 76%, Pfizer 42%). 

Investigators of this observational study conclude that further evaluation of the mechanisms of the two vaccines are warranted to understand the difference in protectiveness.

Read the Medpage news article here

Read more LDA articles on COVID here

Read the full text MedRxiv observational study article here

Note: This article is a preprint and has not been peer-reviewed [what does this mean?]. It reports new medical research that has yet to be evaluated and so should not be used to guide clinical practice.


T-Cell Exhaustion: Penn Med Investigation

In a recent press release, researchers in the Perelman School of Medicine at the University of Pennsylvania have discovered that T-cells, which are important fighters in the immune system, not only become “exhausted” from fighting cancer or viral infections, but they remain “exhausted” many weeks after these exposures. According to the press release, “exhaustion” leaves durable “epigenetic scars” in T cells that restrict their ability to support immune responses. T-cell function is critical to the immune system, especially in prolonged battles against cancers and viral infections. The findings of Penn researchers study lead to a need to discover how to reverse the “epigenetic scarring” that occurs in order to rejuvenate T-cell function after exposure to cancer and viral infections.

The findings of this study are published in Nature Immunology

Read the full press release here

Read more LDA articles on Immune Function here

COVID in White-tailed Deer?

In a recent study conducted by the U.S. Department of Agriculture’s (USDA) Animal and Plant Health Inspection Service (APHIS) serum samples were analyzed from free-ranging white-tailed deer for SARS-CoV-2 antibodies.
Researchers found that a cohort of white-tailed deer populations from Illinois, Michigan, New York, and Pennsylvania were exposed to SARS-CoV-2. The USDA-APHIS has published an informational brief that addresses both questions and answers regarding these findings. USDA-APHIS also expresses the need for more research on the significance of the finding of SARS-CoV-2 antibodies in free-ranging white-tailed deer,  as well as what, if any, potential impacts this may have on overall deer populations, other wildlife species, and humans.

Read the full publication here

Read more LDA Articles on COVID here

COVID Anchoring Bias & Tick-Borne Disease Diagnosis

This illustration, created at the Centers for Disease Control and Prevention (CDC), reveals ultrastructural morphology exhibited by coronaviruses.
(Photo Credit: Alissa Eckert, MS; Dan Higgins, MAMS)

Harold W. Horowitz, et al., published the research letter, “COVID-19 and the Consequences of Anchoring Bias” in the CDC’s August publication of the monthly journal, Emerging Infectious Diseases. The authors disclose how suspected coronavirus disease in febrile patients can influence healthcare providers’ decisions and may result in misdiagnosing other serious infections with epidemiologic risk.

The paper provides two patient cases illustrating how this biased mindset can have potentially severe consequences. This was demonstrated by human granulocytic anaplasmosis, and Lyme disease detected in a pregnant woman, and human granulocytic anaplasmosis in another person.

The article’s contributors acknowledge the devastating effects caused by a missed COVID-19 diagnosis, including the epidemiologic impacts. However, they emphasize that failing to diagnose tick-borne illnesses, as well as other infections, can also have harmful patient outcomes. They urge healthcare providers to keep an open mind despite pressure to evaluate for COVID-19 and to also consider other diagnoses when evaluating febrile patients.

Read the research letter.

More on COVID-19 and tick-borne illness.

FLCCC Announces Treatment Protocol for Long Haul COVID-19

A new protocol for patients suffering from Long Haul COVID-19 Syndrome (LHCS) has been developed in a collaboration led by Dr. Mobeen Syed (“Dr. Been”), Dr. Ram Yogendra, Dr. Bruce Patterson, Dr. Tina Peers, and the Front Line COVID-19 Critical Care Alliance (FLCCC). The protocol, I-RECOVER, is based on the group’s experiences using certain therapies with a focus on the drug ivermectin. The group observed “consistent, sustained, and often profound” clinical responses with the I-RECOVER protocol. The protocol has also been used to treat post-vaccine inflammatory syndromes with similar success.

LHCS consists of often debilitating symptoms such as malaise, headaches, generalized fatigue, sleep difficulties, smell disorder, decreased appetite, painful joints, dyspnea, chest pain and cognitive dysfunction. LHCS does not only occur after severe COVID-19 cases – it often affects mild-to-moderate cases and younger adults. LHCS symptoms after COVID-19 infection or vaccination can occur from 10% up to 80% of the time. (LHCS from vaccination is likely due to monocyte activation by the spike protein from the vaccine).

Studies of treatment options for LHCS are few, and there are no pharmacologic treatments offered. Due to the large numbers of patients suffering with LHCS around the world, the I-RECOVER protocol was developed.

LHCS is very similar to the chronic inflammatory response syndrome (CIRS)/myalgic encephalomyelitis/chronic fatigue syndrome and mast cell activation syndrome. Delayed treatment with ivermectin when early symptoms occur, will most likely cause a high viral load, which would increase the risk and severity of LHCS.

As with all FLCCC Alliance protocols, the I-RECOVER may change as scientific and clinical data evolves.

Click here for FLCCC article and I-RECOVER protocol

Emergency Meeting Planned After Rise in Myocarditis Following Covid Vaccine

Increased cases of myocarditis and pericarditis have been reported in the United States after mRNA COVID-19 vaccination (Pfizer-BioNTech and Moderna) since April 2021, particularly in adolescents and young adults. These rates for ages 16-24 following a second dose are above what is expected. Myocarditis or pericarditis has now been verified in 226 people ages 30 and younger who have received an mRNA COVID-19 vaccine and Federal Health Officials are investigating reports of approximately 250 more cases. 

Due to this increase, the Advisory Committee on Immunization Practices (ACIP) is scheduled to hold an emergency meeting on June 18, 2021 to discuss myocarditis cases and the American Academy of Pediatrics (AAP) plans to closely monitor meeting.  However, at this time, there is no recommended change to vaccination of adolescents 12 and older.

Cases have been reported predominantly in young males 16 years of age and older, with onset of symptoms typically manifesting within several days after mRNA COVID-19 vaccination. Symptoms have more often occurred after the second dose of vaccine than the first dose. 

It is recommended by the CDC that clinicians consider myocarditis and pericarditis in patients who develop acute chest pain, shortness of breath or heart palpitations within a week after vaccination, and to report cases of myocarditis and/or pericarditis after COVID-19 vaccination to the Vaccine Adverse Event Reporting System. (VAERS).

Read full American Academy of Pediatrics article here.

Read more LDA Articles on COVID vaccine here.

Judge Orders Hospital to Give Ivermectin to COVID Patient

Judge James Orel of DuPage County in Illinois ordered Edward-Elmhurst Hospital to give the drug, ivermectin, to a 68-year-old COVID-19 patient who had failed other treatments.

The patient, in intensive care for over a month, in a coma, and on a ventilator was not improving. Her daughter read the news story about a Buffalo, New York woman who recovered from COVID-19 after receiving ivermectin. Ivermectin is not endorsed by federal health agencies for treatment of COVID-19, but her daughter felt there was nothing to lose by trying it. However, the hospital and doctors refused to administer the drug, so she sued the hospital to force them, with the help of a New York law firm that has taken on other ivermectin cases.

The hospital finally agreed to let an outside doctor administer the drug.

The physician-led group called the Front Line COVID-19 Critical Care Alliance (FLCCC) has a review of ivermectin and its efficacy in the prophylaxis and treatment of COVID-19. FLCCC believes that ivermectin has anti-viral and anti-inflammatory properties.

See Medpagetoday.com (May 5, 2021) – “Judge Orders Hospital to Give COVID Patient Ivermectin”

COCA/CDC Lyme Disease Conference Call – May 20th, 2020

The Clinician Outreach and Communication Activity (COCA)/Center for Disease Control is offering a conference call on May 20th, 2020: Lyme Disease Updates and New Educational Tools for Clinicians from 2:00–3:00 P.M. ET.  See right side of page for instructions on how to join the call via zoom or phone. Advanced registration is not required.

During this COCA Call, presenters will review updates in Lyme disease epidemiology, diagnosis, treatment, and prevention and share new educational tools for both healthcare providers and their patients.

Presenters include Grace Marx, MD, MPH –LCDR, U.S. Public Health Service
Medical Epidemiologist, Bacterial Diseases Branch, Division of Vector-Borne Diseases, CDC

Free Continuing Education (CE) credits can be earned for this call, even if you cannot participate live. Click here for info on CE for COCA calls/webinars

Click here for information on the call: Lyme Disease Updates and New Educational Tools for Clinicians

Click here to view prior COCA calls/webinars

Click here for Post-Webinar Analysis by LDA

COCA provides clinicians with the most up to date information and guidance from the Center for Disease Control (CDC) regarding emergency preparedness and response and emerging public health threats.

Assessing the Safety Profile of mRNA-Based Vaccines in Patients with Autoimmune Inflammatory Rheumatic Diseases

A case series assessing the safety profile of mRNA-based vaccines in patients with autoimmune inflammatory rheumatic diseases (AIIRD) has been published in the journal Rheumatology. The study’s authors aim to raise awareness of reactivation of herpes zoster (HZ) following the BNT162b2 mRNA vaccination in patients with AIIRD.

The researchers found the occurrence of HZ was 1.2% (n = 6) in patients with AIIRD compared with none in the control group. The 6 patients who developed HZ were females aged 49 ± 11 years with stable AIIRD: rheumatoid arthritis (n = 4), Sjogren’s syndrome (n = 1), and undifferentiated connective disease (n = 1). Five of the patients developed a first-in-a-lifetime occurrence of HZ within a short period after the first vaccine dose and in one case, HZ occurred after the second dose. Five of the patients completed the second vaccine dose with no other undesirable effects. In most of the cases, HZ infection was mild.

Additional epidemiologic studies on the safety of the mRNA-based COVID-19 vaccines in patients with AIIRD are needed to determine the association between the BNT162b2 mRNA vaccination and HZ reactivation.

Read the full study in Rheumatology.

Read more on LDA’s COVID & Lyme Disease page.

LDA’s List of News & Journal Articles on Covid-19 & Lyme

This illustration, created at the Centers for Disease Control and Prevention (CDC), reveals ultrastructural morphology exhibited by coronaviruses.
(Photo Credit: Alissa Eckert, MS; Dan Higgins, MAMS)

The LDA is compiling a list of articles in the news & journals of possible interest regarding Covid-19 & Lyme disease.

Autonomic dysfunction in ‘long COVID’: rationale, physiology and management strategies (Clinical Medicine – London) Melanie Dani, et al.

Lyme Disease in the Era of COVID-19: A Delayed Diagnosis and Risk for Complications (Case Reports in Infectious Diseases, 2021) Novak, C. B., Scheeler, V. M., & Aucott, J. N. 

The Safe Way to Get Your COVID-19 Vaccine: #ScreenB4Vaccine (noorchashm.medium.com 1/28/2021) Hooman Noorchashm, MD, PhD

Reaction of Human Monoclonal Antibodies to SARS-CoV-2 Proteins With Tissue Antigens: Implications for Autoimmune Diseases
(Frontiers in Immunology 1/19/21) Aristo Vojdani, Elroy Vojdani and Datis Kharrazian

Ivermectin Could Turn COVID-19 Around. We Need To Find Out If It Works (trialsitenews.com 10/1/2020) by Mary Beth Pfeiffer

Is There a Connection Between COVID-19 and Popular Hypertension Medication (pcornet.org  8/12/2020) National Patient-Centered Clinical Research Network

What happens when coronavirus and Lyme disease intersect? (USAtoday.com 6/22/2020) by Isabel Rose and Dana Parish

Why the Coronavirus Has Been So Successful (The Atlantic 3/20/2020) by Ed Yong

Lessons From Lyme Disease: Six Reasons The CDC’s COVID-19 Failure Was Predictable (Forbes 3/13/2020) by Mary Beth Pfeiffer