And remdesivir can now be considered for use in double-vaccinated adults at high risk of severe covid.
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21 February
- The RACGP raises concerns about vaccine misinformation as rollout slows in children.
- Remdesivir now also an option in double-vaccinated adults at high risk.
- No myocarditis and only one possible pericarditis in children from Pfizer vaccine.
- BA.2 Omicron subvariant outpacing its parent variant in the UK.
- Pfizer vaccine reduces risk of covid hospitalisation and death in adolescents by more than 94%.
- Yet another nail in the ivermectin coffin.
- Risk of hospitalisation and death much lower with Omicron compared to Delta.
As the pace of the vaccine rollout in children slows, the RACGP has expressed concern about the rise in vaccine hesitance among parents and called for improved vaccine education.
Nine newspapers reported yesterday that the rate of vaccination among children aged 5-11 years has dropped by around 89% since the first two weeks of the vaccine rollout in that age group.
In response, the RACGP has issued a statement condemning the risk in vaccine misinformation and said there is a need for culturally and linguistically targeted vaccination education campaigns for parents and those who are pregnant.
It comes as Australian researchers find that vaccine refusal is higher among parents for their children than it is among adults generally.
Remdesivir should be considered for use even in adults who have received two vaccine doses but who are considered at high risk for severe disease because of immunodeficiency, age or other risk factors.
The National Covid-19 Clinical Evidence Taskforce has updated the living guidelines to expand the recommendation for use of the antiviral beyond just at-risk unvaccinated adults.
While the clinical trials for remdesivir haven’t been done in vaccinated individuals, the guidelines committee exercised its clinical judgement and suggested there was a chance that the drug could still benefit those who have had two doses of vaccine – not three doses – but were at high risk.
There has only been one case of pericarditis and no cases of myocarditis reported from around 1.1 million doses of the Pfizer vaccine given to 5-11-year-olds since the vaccination program launched in this group on 10 January.
The Therapeutic Goods Administration says while there were 10 reports of suspected pericarditis/myocarditis, only one case “possibly” met the international criteria for mild pericarditis in a 10-year-old boy.
Meanwhile, the reduced use of the AstraZeneca vaccine has meant so far the TGA hasn’t received any reports of thrombosis with thrombocytopenia this year, and the total number of TTS cases since the start of the vaccination campaign still stands at 172.
The BA.2 subvariant of Omicron appears to be spreading even faster across the UK than the original BA.1 Omicron variant but doesn’t seem to have a greater ability to get around vaccines.
The latest report from the UK’s Health Security Agency on Omicron shows that the BA.2 subvariant, which was first documented in Denmark, increased in frequency from 5.1% of cases on 31 January to 18.7% of cases on 6 February.
There are so far no confirmed cases of someone getting infected with BA.2 after a previous infection with the original BA.1, and the report’s authors said it is still too early to know if the subvariant is more or less severe than its parent variant.
The Pfizer vaccine is highly protective against hospitalisation, intensive care admission and death from covid in adolescents aged 12-18, a study has found.
A paper published in the New England Journal of Medicine presented data from a case-control study looking at the vaccination status of 445 adolescents admitted to hospital for covid between July-October 2021, compared to that of 777 controls who either had covid-like symptoms but tested negative or had no symptoms and were also covid-free.
Only 4% of those admitted to hospital with covid were fully vaccinated, compared to 36% of those without covid, and only 2 of the 180 patients admitted to the ICU were fully vaccinated. All seven who died during the study were unvaccinated.
Researchers calculated that two doses of vaccine were 94% protective against hospitalisation, 98% protective against intensive care admission and 98% protective against requiring life support.
There are now so many scientific nails in the coffin of ivermectin as a covid treatment that it’s more nail than coffin.
The latest is an open-label controlled trial involving 490 adults aged over 50 with PCR-confirmed mild or moderate covid and at least one comorbidity, who were randomised to either five days of ivermectin treatment plus standard of care or standard of care alone.
The study, published in JAMA Internal Medicine, found no significant difference between the two groups in the risk of progressing to severe disease, and no differences in other outcomes including the risk of ventilation, risk of intensive care admission or length of hospital stay.
A similar number of patients in each group achieved symptom resolution with five days. The authors also commented that the rate of adverse events was much higher in the ivermectin group, saying it “raises concerns about the use of this drug outside of trial settings and without medical supervision.”
The risk of hospitalisation or death from Omicron infection is 59% lower than with Delta, according to a Canadian study comparing outcomes from the two variants.
The study, published in JAMA, matched just over 9000 cases of Omicron (BA.1, not BA.2) with the same number of Delta cases based on factors including sex, age, vaccination status and time since the last vaccine dose.
Over a median of 24 days of follow-up, 0.6% of those with Omicron were hospitalised and 0.03% died, compared to 1.4% and 0.3% among those with Delta. The overall hazard for intensive care admission or death was 81% lower with Omicron and the hazard for death was 88% lower.
“While severity may be reduced among Omicron cases, the absolute number of hospitalisations and the effects on health care systems are likely to be significant due to the elevated incidence of Omicron,” the authors wrote.
