Covering COVID-19 is a daily Poynter briefing of story ideas about the coronavirus and other timely topics for journalists, written by senior faculty Al Tompkins. Sign up here to have it delivered to your inbox every weekday morning.
When Pfizer sought approval for its COVID-19 booster shot in late September, the Food and Drug Administration said the company’s data did not prove a need for a booster for everyone. The FDA is now saying the same about Moderna’s request for approval for a third shot.
In Pfizer’s case, the Vaccines and Related Biological Products Advisory Committee, which makes key recommendations for vaccines, recommended — and the FDA approved — booster shots for seniors and people who are immunocompromised. Then the Centers for Disease Control and Prevention expanded that to say all people who are vulnerable to getting infected should get a booster.
The committee will meet Thursday and Friday to discuss Moderna’s request. The same rulings could happen this time, too. Or not.
The FDA, once again, has scant booster data to work with. Moderna sent its results from a clinical trial involving only 170 adults. Pfizer’s booster trials involved 318 people, and the FDA said then it was not enough
Moderna is asking for the booster shot to be half the dosage of the first two vaccinations.
J&J makes a stronger case for its booster
Johnson & Johnson’s one-shot vaccine performed less robustly than the two-shot vaccines from Moderna and Pfizer. But the one-shot regimen made it easier for some people to get a vaccine and avoid side effects that might cost them workdays or force them to travel to a vaccination site.
Now, Johnson & Johnson says its testing shows a booster significantly increases antibody protection:
Based on recent data, administration of a booster dose resulted in increased protection against symptomatic COVID-19, increased strength and breadth of immune responses against variants and increase protection against severe/critical COVID-19.
The Johnson & Johnson study involved more than 9,000 patients.
Based on the recent data, it can be assumed that the administration of the booster dose will result in increased protection against symptomatic infection, increased strength and breadth of immune responses against current variants and increase of the magnitude of protection against severe disease across populations. The booster dose can also increase the probability of protection against future variants of concern. A booster dose is recommended at 6 months or later, based on the strength of the immune responses, although a booster dose may be administered as early as 2 months. The need for a booster dose and/or its timing will depend on the local/epidemiological situation and the needs of individuals/specific populations.
CDC to hear evidence on mixing vaccines this week
Also this week, ACIP, the committee that advises the CDC on vaccines, will hear the newest evidence about whether it helps or hurts patients to mix vaccines. In other words, can someone safely and effectively take one dose of Pfizer’s vaccine and one dose of Moderna’s vaccine? Or two doses of Pfizer’s vaccine and then the Moderna booster?
Another big question, maybe an even more important question, is whether it affects immunity to take a mixture of the mRNA vaccines and a Johnson & Johnson booster. They are two different technologies, so might their immunity response be more potent together?
First, learn these two terms:
- Homologous boosters refer to booster shots that are the same technology and brand as the original vaccination.
- Heterologous boosters mean the booster is a different brand and/or technology from the original vaccination.
Keep in mind that with vaccines, the first dose matters a lot. Experts call it “priming.” The United States would ideally have advised longer between first and second doses of COVID-19 vaccines to give the first dose time to finish priming immune systems before hitting them with a second. But we were in a hurry to get as much protection in place as possible. Priming also matters when considering whether to mix doses. Stat explains:
Is it possible that any combination of vaccine types or brands will work as well — or better — than if the shots were all of a single brand? That’s not yet clear, but it’s possible — even likely — that the combinations and the order in which the vaccines are given will matter.
“A followed by B may not be the same as B followed by A,” explained Bruce Gellin, chief of global public health strategy for the Rockefeller Foundation’s pandemic prevention institute.
“The priming event is really important,” said Barney Graham, who was deputy director of the National Institutes of Health’s Vaccine Research Center until the end of August and who played a critical role in the design of the Moderna and other vaccine prototypes.
Graham explained that the kind of immune response one gets from Covid vaccines is determined by the first dose. “And so it kind of locks you into a repertoire and a pattern of antibody, T-cell balances that carry on through subsequent boosters,” he said.
Much remains to be learned about how to effectively mix Covid vaccines — and it will take time to answer these questions, Graham said. “Those are the kind of things that happen over a 12-year development program. We didn’t do that this time.”
Journalists, this is the sort of understanding that the public will badly need if the CDC acts on this matter. It is complicated enough to help people understand a) to get vaccinated and b) who should get boosters and. Mixing in how to effectively mix boosters and priming vaccines adds a whole other layer.
To make things a little more complex, it is not at all clear who would tell the public to mix and match. The FDA approves drugs as effective and safe. But no drug company is asking to be approved to be used in combination with another company’s drug. The CDC’s ACIP group could issue something called a “preferential recommendation,” which does not direct anybody to administer a drug but says, if you do, this is what experts recommend.
Why the vaccine mixing question is critical for US-Canada travelers
The United States does not currently consider people who received two different brands of vaccines fully vaccinated, even if the person’s home country does. Canada vaccinated 4 million people with heterologous vaccines. The question is whether that means those Canadians would be allowed into the U.S. CTV reports:
More than 3.9 million Canadians have two different doses of Health Canada approved COVID-19 vaccines, not including Quebec, which does not categorize data by vaccine product.
Of those, approximately 1.6 million had a dose of the AstraZeneca formula followed by an mRNA vaccine, data from the Public Health Agency of Canada shows. It’s not yet clear whether those who have received a mixed-dose regimen will meet the criteria.
The COVID-19 vaccines approved under the WHO’s emergency use listing have only been assessed as single product regimens, meaning people receive the same vaccine for both shots.
But the agency’s Strategic Advisory Group of Experts on Immunization recommends mRNA vaccines — Pfizer-BioNTech or Moderna — can be used as a second dose following a first one with AstraZeneca if a second shot of the same is not available.
In one state, a vaccine mandate vs. a big-time college football coach
Government-ordered COVID-19 vaccines are getting something of a stress test these days. Southwest Airlines pilots are suing to stop the federal mandate, the governor of Texas ordered (mandated) no mandated vaccines for anybody in his state. And in Washington state, football coach Nick Rolovich is risking his job by refusing a vaccination required by the state. Rolovich is claiming a religious exemption and has until Oct. 18 to get the exemption, take the shot or punt his job.
All we know about Rolovich’s religious background is that he comes from a Catholic family and went to a Catholic High School. But the state rules for granting a religious exemption require “requestors to explain specifically what tenets of their religious practice prevent them from being vaccinated or from receiving other types of medical care.”
Although the deadline has passed to receive a shot in order to be fully vaccinated by the October 18 deadline, it’s believed there’s a little wiggle room for compliance. The state doesn’t want to fire employees; what it wants is for people to be vaccinated. If Rolovich were to reverse course and receive the Johnson & Johnson vaccine (which is one shot), it seems likely he’d simply be on administrative leave starting on October 19 and until he met “fully vaccinated” status sometime after that.
Rolling Stone vs. Eric Clapton vs. COVID-19 vaccines
Rolling Stone says rocker Eric Clapton is “bankrolling” nonsense about the COVID-19 vaccines, and it is true that Clapton is an outspoken anti-vaxxer who spews a good bit of nonsense about vaccines. But “bankrolling,” in this case, may be a bit of an overstatement of what Rolling Stone can prove. Unless a $1,300 GoFundMe donation to anti-vax British band Jam For Freedom and a loan to the band to buy a van counts as “bankrolling” in your book.
Clapton blames the vaccine for causing nerve damage that he said he had before the pandemic. He said he would not perform at any venue that required vaccines but then did a concert at a venue that required vaccines.
Weddings restart, diamond sales sparkle
Signet Jewelers — the company that owns Zales, Kay Jewelers and Jared — says it is buying Diamonds Direct and that diamond sales are great. One reason is that so many people delayed their weddings during the pandemic that there is an unusually high demand to get hitched right now. Signet’s stock tripled this year.
Why police departments are “getting less Black”
Some of America’s largest police forces are suddenly — and quickly — getting less diverse, as two trends converge: A wave of Black officers is reaching retirement age, and recruitment efforts to replace them are sputtering.
- The NYPD has seen a 14 percent drop in Black officers since 2008, from a high of 4,162 to 3,598 this September.
- Black employment in the Philadelphia Police Department has fallen 19 percent since 2017.
- The number of Black officers in the Chicago Police Department has dropped by 12 percent since May 2019.
- Even Washington, D.C., long a leader in minority-police recruitment, has had a 25 percent decrease since 1998, when two-thirds of officers were Black, to 50 percent today, though the city also got whiter over that time period.
- The LAPD has seen a 24 percent drop in Black officers, from 1,175 in 2010 to 885 today, though the department’s ranks have also shrunk.
Gathering a complete national view of demographic changes is effectively impossible. The United States has more than 18,000 police departments, many of them tiny and all with their own practices for collecting and releasing data. But the data from the big departments all point in the same direction and match anecdotal reports: America’s police forces are getting less Black, and some are getting whiter.
The Police Executive Research Forum finds that there has been a significant exodus of some of the most experienced officers during the pandemic. Some of this is just a coming of age, but there may be other factors that are leaving police short-staffed. PERF writes:
- Increases in resignations were more significant. Agencies reported an overall 18% increase in the resignation rate in 2020-21, compared to 2019-20. The smallest increase in resignation rates was found in small agencies with fewer than 50 officers.
- Increases in retirements were even larger. Among all responding police departments, there was a 45% increase in the retirement rate. (In small departments, a small number of retirements may result in a high percentage increase in the retirement rate. But even in the largest agencies, with 500 or more officers, the retirement rate increased by 27%.) Agencies with fewer than 250 sworn personnel saw the biggest increases in officer retirement rates.
- Agencies with 250 or more sworn personnel saw the biggest decreases in the rate of officers hired between the two time periods.
- In Seattle, a record 180 officers left the police department in 2020, and 66 more officers have left so far this year. “I have about 1,080 deployable officers. This is the lowest I’ve seen our department,” Police Chief Adrian Diaz said recently.
- In Minneapolis, Chief Medaria Arradondo told a City Council panel that reduced staffing is making his department “one-dimensional,” with officers mostly responding to 911 calls and not having time to do proactive policing.
4.3 million workers told employers to shove it in one month
Sometimes we get so focused on employment numbers that we do not pay attention to another important figure: how many people quit their jobs each month. The figures are buried in the government’s “Job Openings and Labor Turnover Survey” from the U.S. Department of Labor.
In August, a stunning 4.3 million people quit their jobs, which is similar to the figures we saw in December when workers said, “I quit.”
Retail and food workers were the biggest quitters in August. The Department of Labor found:
Quits increased in:
- Accommodation and food services (+157,000)
- Wholesale trade (+26,000)
- State and local government education (+25,000)
- Quits increased in the South and Midwest regions.
Quits decreased in:
- Real estate and rental and leasing (-23,000)
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