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Pfizer-BioNTech’s vaccine will get barely weaker over time, firm knowledge exhibits, however stays robust in stopping extreme illness.

The Pfizer-BioNTech vaccine’s effectiveness wanes slightly over time, according to newly released data from the companies, but remains strong in preventing severe disease. With coronavirus cases surging again in many states, the findings may influence the Biden administration’s deliberations about delivering a booster shot.

The vaccine had a sky-high efficacy rate of about 96 percent against symptomatic Covid-19 for the first two months, the study showed, but then declined about 6 percent every two months after that, falling to 83.7 percent after six months. Against severe disease, its efficacy held steady at about 97 percent. The data was posted online on Wednesday and has not been published in a scientific journal.

Despite the decline, the data confirm that the vaccine gives potent protection against Covid-19. Still, the study raises questions about how much protection two doses will provide in the months to come. Adding to these concerns is the rise of the Delta variant, which makes vaccines somewhat less effective against infection. The variant became dominant only after the study ended. But recent studies have also shown that vaccines remain strongly protective against the worst outcomes of Covid-19 caused by the Delta variant.

The findings come from 42,000 volunteers in six countries who participated in a clinical trial that Pfizer and BioNTech began last July. Half of the volunteers got the vaccine while the other half got a placebo. Both groups received two shots spaced three weeks apart. The researchers compared the number of people in each group who developed symptoms of Covid-19, which was then confirmed by a P.C.R. virus test.

When the companies announced their first batch of results, the vaccine showed an efficacy against symptomatic Covid-19 of 95 percent. In other words, the risk of getting sick was reduced by 95 percent in the group that got the vaccine compared to the group that got the placebo.

That result — the first for any Covid-19 vaccine — brought an exhilarating dose of hope to the world in December when it was riding what had been the biggest wave of the pandemic. Since then, the Pfizer-BioNTech vaccine has made up the majority of shots that Americans have received, with more than 191 million doses given so far, according to the Centers for Disease Control.

After the first analysis, the Pfizer and BioNTech researchers continued to follow the volunteers. The research became more challenging as time passed, because volunteers who got the placebo could ask to get the vaccine once it was authorized in their country.

Understand the State of Vaccine Mandates in the U.S.

For the new study, the researchers followed the volunteers for six months after vaccination, up to a cutoff date of March 13. Looking over that entire period, the researchers estimated the vaccine’s efficacy at 91.5 percent against symptomatic Covid-19. (The study did not measure the rate of asymptomatic virus infections.)

But within that period, the efficacy did gradually drop. Between one week and two months after the second dose, the efficacy was 96.2 percent. In the period between two and four months, the efficacy fell to 90.1 percent. And between four months and six months, the efficacy hit 83.7 percent.

Each estimate came with a margin of uncertainty. But over the six months of the trial, there was a clear decline in efficacy.

The new study comes on the heels of data from Israel suggesting that the Pfizer-BioNTech’s protection may be waning there. But experts have pushed back against a rush to approving a booster there. The data have too many sources of uncertainty, they say, to make a precise estimate of how much effectiveness has waned. For example, the Delta-driven outbreak hit parts of the country with high vaccination rates first and has been hitting other regions later. “Such an analysis is still highly uncertain,” said Doron Gazit, a physicist at Hebrew University who analyzes Covid-19 trends for the Israeli government.

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Infectious illness knowledgeable says Covid vaccine misinformation is ‘killing individuals’

Dr. Nahid Bhadelia, founding director of the Center for Emerging Infectious Diseases at Boston University, expressed concern about the spread of misinformation about Covid vaccines on social media.

“I think social media plays a huge role in amplifying misinformation that is leading people not to take the vaccine, which is killing them,” Bhadelia told CNBC on Friday. “It’s the honest truth. Covid is a vaccine-preventable disease at the moment.”

President Joe Biden said Friday that platforms like Facebook are killing people by allowing misinformation about Covid-19 vaccines through their services. He went back those comments on Monday, mainly accusing the platform’s users of sharing misinformation.

Bhadelia cited results from the Kaiser Family Fund poll, which found that 54% of Americans either believe or cannot tell whether a common Covid vaccine myth is fact or fiction.

The US is struggling with a drop in vaccination rates and an increase in infections. All 50 states have reported an increase in Covid cases over the past week, according to Johns Hopkins University. The US has an average of more than 26,000 new cases a day, and that’s the highest number in two months, according to Johns Hopkins.

Bhadelia told CNBC The News with Shepard Smith that she believes social media companies can do a lot more to stop the spread of disinformation.

“You have to invest a lot more resources and improve your balance to clear that information faster, invest more resources in changing your matrix, because right now what is on top of your page is not right, but what it is is popular, “said Bhadelia, a medical worker for NBC News.

She also suggested that social media companies should partner with public health officials more to get the right information out to the people.

Facebook spoke out against the White House claims.

“We will not be distracted by allegations that are not supported by the facts,” said a spokesman. “The fact is, more than 2 billion people have viewed authoritative information about COVID-19 and vaccines on Facebook, more than any other place on the internet. More than 3.3 million Americans have also used our vaccine finder tool to find out where and how to get a vaccine. The facts show that Facebook helps save lives. Point.”

Correction: This article has been updated to include Dr. Nahid Bhadelia’s view that “social media plays a huge role in amplifying misinformation” about Covid vaccines. An earlier version misinterpreted your quote.

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Health

How CRISPR gene enhancing will deal with illness: Intellia founder Doudna

The gene editing technology CRISPR reached an important milestone last weekend and completed its first systemic drug delivery to the human body.

CRISPR, or clustered, regularly spaced short palindromic repeats, cuts genomes and cuts DNA effectively to treat genetic diseases.

The latest breakthrough, the result of a study between biotech company Regeneron and Boston startup Intellia Therapeutics, treats a rare disease after it has been given as an IV infusion. Previously, other uses of CRISPR technology have been limited to ex vivo therapy, or where cells are removed from the body for genetic manipulation in a laboratory and then returned to the body.

Jennifer Doudna, who was awarded the Nobel Prize in Chemistry in 2020 for her work on CRISPR gene editing and is the co-founder of Intellia, recently told CNBC about the development of the technology from the publication of her early work to clinical studies showing its effectiveness at treating disease in less than 10 years means “one of the fastest rollouts in my opinion of technology from basic, initial science to actual application.”

“This is mainly because the technology comes at a time when there is a huge demand for genome editing and a lot of knowledge about genomes,” said Doudna at the recent CNBC Global Evolve Summit in mid-June.

As for next, Doudna highlighted several challenges and opportunities that CRISPR has on the horizon.

Deploying CRISPR remains a major challenge

As technology continues to advance, the task of getting the processed molecules in the body to the cells in the areas where they are needed remains a challenge.

“This is a particular issue in clinical medicine where the ability to manipulate brain cells, heart cells or muscle cells has incredible potential, but right now we don’t really have the tools to introduce the editors to those cells,” said Doudna. “We have the editors; we just don’t know how to get them where they need to go.”

Sickle cell anemia was an early focus

Much of the success of CRISPR’s previous applications has been in ex vivo therapy, in which extracted cells are manipulated in a laboratory and then returned to a patient.

Sickle cell anemia, which is genetically inherited and affects approximately 100,000 Americans, according to the CDC, was a particularly good target for the technology because blood stem cells “can be harvested, processed, and then returned to patients,” Doudna said.

Genetic eye diseases were also a focus for CRISPR applications, as Doudna said, “It is certainly easier to get into the eye than other parts of the body.”

The delivery of the processed cells to the liver has also proven to be easier so far. “A liver is an organ that naturally accepts molecules in the body,” she said.

Any advance in eradicating the 100+ liver diseases could have a huge impact on the lives of Americans. According to the American Liver Foundation, at least 30 million people, or one in ten Americans, have liver disease.

Next, let’s focus on the brain, heart, muscles

The next step for innovation around CRISPR will be to move these cells to other parts of the body like the brain, heart and muscles, Doudna said.

“There are already some technologies that make some of this possible, for example with different types of viruses or virus-like particles, and I look forward to the innovations that will come in this regard over the next few years,” she said.

Treatment costs are a problem

But as technology improves and scientists become able to fight disease throughout the body, Doudna said that CRISPR technology needs to be cheaper in order for it to have “widespread effects.”

Treating sickle cell anemia with CRISPR therapy costs about $ 2 million per patient, according to Doudna.

“That is clearly not a price point that makes this available to most of the people who can benefit from it,” she said.

While addressing delivery challenges can also help reduce costs, the medical community needs to figure out how “to scale molecule production so that we can cut costs,” said Doudna.

Applying CRISPR to Agriculture

The advancement of CRISPR technology may have an impact on other industries as well, with agriculture being one of the first to benefit.

Rather than addressing genetic problems through breeding, which can take months to years, or through current methods of genetically modifying crops that have seen a boom over the past few decades but that incorporate biological material from other species, CRISPR technology can address the Genes from plants “without touch” manipulate everything else, “said Doudna.

“This opens the door to a lot of things that can be done now to both address the challenges of climate change, manage drought, and introduce properties into the plants that will protect them from pests,” she said.

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Health

New York Turns to Good Thermometers for Illness Detection in Faculties

And then of course there are the inevitable privacy concerns. Kinsa emphasizes that all data made available to the city is aggregated and anonymized. “None of the individual data goes to anyone other than that person,” said Mr Singh. “You have the data, and we’re really persistent with it.”

While digital privacy experts say these are important safeguards, they also point out that information about children and health is particularly sensitive. “It’s really important to weigh the benefits and needs of public health against the social or societal risks,” said Rachele Hendricks-Sturrup, health policy advisor at the Future of Privacy Forum, a think tank focused on privacy.

For example, even anonymized data can sometimes be re-identified. “Even if it turns out to be ‘A fourth grader at this school in this neighborhood,’ that might narrow it down,” said Hayley Tsukayama, a legislative activist at the Electronic Frontier Foundation, a digital privacy group. “It doesn’t take a lot of data points to identify something new.”

The data, aggregated by zip code, will also feed into disease signals that Kinsa makes available on its public HealthWeather map. The company sometimes shares this information at the postal code level with pharmacies, vaccine distributors, and other companies. For example, Clorox used Kinsa’s data to determine where to target its ads. (Lysol won’t have special access to the data, says Kinsa.)

Both Kinsa and the city need to be transparent to families about how the data is used, stored and shared, and how long it is retained, experts said. City officials “are essentially putting their stamp on,” said Amelia Vance, director of youth and education privacy at the Future of Privacy Forum. “They need to make sure they are living up to parents’ trust that this program has been fully reviewed and is safe for their children and families.”

City officials will be closely monitoring how well the program is performing over the coming months, said Dr. Varma. How do families feel about the program? Is there enough intake to produce useful data? Can they actually spot outbreaks earlier – and slow the spread of disease?

“Our goal is to see if it really has the effect we hope in the real world,” said Dr. Varma. “It is also possible that the system does not detect anything conspicuous or unusual, but still proves successful because it provides people with useful information and increases their confidence that they have their children in school.”

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Health

The Illness Detective – The New York Occasions

Meningitis itself is not a disease, just a description that means that the tissues around the brain and spinal cord have become inflamed. In the United States, bacterial infections can cause meningitis, as can enteroviruses, mumps, and herpes simplex. But a high percentage of cases, as doctors say, have no known etiology: Nobody knows why the patient’s brain and spinal cord swell.

This was the case with the Dhaka eruption. CHRF is one of the leading microbiology laboratories in Southeast Asia and is responsible for tracking meningitis in the country for the World Health Organization. “Every case of meningitis that comes in, we cultivate,” Saha told me. “We do antigen tests for pneumococci, Neisseria meningitidis, Haemophilus influenzae and GBS” or group B streptococci – the four infections most likely to cause meningitis. “Then we do a much more sensitive and specific test for Streptococcus pneumoniae bacteria as this causes the highest percentage of cases. And then we also do real-time PCR to look for DNA fragments from one of these pathogens. ”

When the outbreak began, the cause was thought to be bacterial again, but none of the tests could locate a pathogen. Over the next year, Saha worked to solve the puzzle, sometimes in collaboration with other laboratories. A partnership with an organization in China broke up when the group was unwilling to share their techniques. Another group of researchers in Canada did their own tests on the meningitis samples, but couldn’t figure out the cause either. Not long after, Saha was attending a conference at the British Museum where she gave a presentation entitled “The Dark Side of Meningitis”. “It was a negative conversation,” recalls Saha. “How: Why does everyone only talk about the successful cases? We have to talk about thousands of cases each year where we have no idea what is causing the disease. ”

Before meeting DeRisi, Saha was skeptical about further collaboration. But the two hit it off right away. Although DeRisi could be impatient, Saha liked that he was direct and appreciated that his “ethics are very strong. In his head he says: That’s right; that is wrong; I’ll do that. ”Still, she proceeded cautiously. “Because IDseq was new and I’m very meticulous, I built in a lot of controls,” she told me. Of the 97 cerebrospinal fluid samples, only 25 were from actual mystery meningitis cases. The remainder were either from cases for which Saha’s lab had already identified the cause or were not meningitis at all. Several were just water. “The idea was that all of this would be tested and the process dazzled,” says Saha. “Because I had to see whether the platform worked or not.”

However, when Saha and her team performed the mysterious meningitis testing through IDseq, the result was surprising. Rather than uncovering a bacterial cause as expected, a third of the samples showed signs of the Chikungunya virus – particularly a neuroinvasive strain that was thought to be extremely rare. “At first we thought: That can’t be true!” Saha remembers. “But when Joe and I realized it was Chikungunya, I went back and looked at the other 200 samples we had collected around the same time. And we also found the virus in some of these samples. ”

Until recently, chikungunya was a comparatively rare disease that occurs mainly in parts of central and east Africa. “Then it just exploded across the Caribbean and Africa and across Southeast Asia to India and Bangladesh,” DeRisi told me. No cases of chikungunya were reported in Latin America in 2011. In 2014 there were a million.

Common chikungunya can cause permanent neurological damage and lifelong joint pain. DeRisi called the disease “enormously devastating” and stated that chikungunya means “to be distorted” in the Kimakonde language spoken in Tanzania. But one neuroinvasive version that caused brain damage, particularly affecting children and infants, was particularly alarming.

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Health

On-the-Job Train Could Assist Shield In opposition to Coronary heart Illness and Most cancers

For the new study, published in The Lancet Public Health in April, researchers from the Norwegian School of Sports Science in Oslo and other institutions decided to dig as deep as possible into lifestyle, work in the workplace, and lifespan.

They started with data already collected by Norwegian health authorities, which have been conducting studies to measure the health of hundreds of thousands of Norwegians for decades. These data included detailed information about their work and movement history, education, income, and other aspects of their life.

The researchers now compiled data sets for 437,378 of the participants in these studies and categorized them by occupation type. Some, like clerks or inspectors, would walk and lift at work; others did heavy manual labor; and the others sat more or less at their desks all day. The researchers then compared people’s records to decades-long databases tracking diseases and deaths in Norway.

On an initial run, their results reinforced the idea that active jobs shorten life. Over the course of approximately 30 years, sedentary men outlived those who frequently walked or otherwise exerted themselves at work. (There was still no significant correlation between women’s occupations and their longevity.)

But when scientists scrupulously checked everyone’s education, income, smoking, exercise habits, and weight, the associations turned around. In this more in-depth analysis, men who were professionally active were less likely to develop heart disease and cancer than men who were confined to desks. Regardless of whether they walked a fair bit to get to work or did other, more strenuous work, active men lived on average about a year longer.

In essence, the study shows that “every movement counts, regardless of whether you are active at work or in your free time,” says Ulf Ekelund, professor at the Norwegian School of Sports Science, who oversaw the new study. Conversely, the results also remind us that sitting, even at comfortable desks or on comfortable sofas, is unhealthy.

What this study does not tell us is what aspects of our lives apart from work could most affect our health and longevity, or why women’s lifespans in general seem unaffected by the exertion of work hours. Dr. Ekelund and colleagues hope to examine some of these questions in future research. But for the time being, he says, assume “that any physical activity is beneficial, whether it’s in your free time, at work, at home or during transport.”

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Crohn’s Illness Is on the Rise

Rapid diagnosis and appropriate therapy to suppress inflammation in the digestive tract are extremely important, as delaying it can lead to scar tissue and strictures that cannot be reversed by medication, said Dr. Flint. Another possible serious complication is the development of a fistula – an abnormal connection between organs such as the colon and bladder that requires surgical repair, which in turn can cause further damage to the bowel.

Understandably, significant stress, anxiety, and depression can accompany the illness and even worsen symptoms. Last summer when Mrs. Martin was sick suddenly After being treated with a drug to keep breast cancer at bay, she was out of control. She was tied to the bathroom in her Manhattan apartment due to severe diarrhea. Dr. Lichtenstein said the class of drugs Ms. Martin was taking, called checkpoint inhibitors, posed a particular challenge for Crohn’s patients, who may have to choose between trying to prevent cancer from recurring and suppressing their bowel disease, as the ones Cancer drugs can sometimes cause inflammation of the colon.

If the inflammation and debilitating symptoms are severe when Crohn’s disease is diagnosed, patients are usually treated with steroids to control the disease before they are given drugs that are specific for the disease. “Steroids,” said Dr. Feuerstein, “are a band-aid to stop the inflammatory process, but then we have to do something to suppress the disease and allow the body to heal.”

Sometimes, before starting medication, patients are temporarily placed on a restricted liquid diet to rest the bowel and give it a chance to heal, said Dr. Lichtenstein, the lead author of the latest Crohn’s Disease Management Guidelines developed by the American College of Gastroenterology.

There are now several drug options for the treatment of Crohn’s disease, although symptom control is often trial and error. For example, after Ms. Martin’s diagnosis five years ago, the specialist she consulted told her that four possible oral medications could be tried one after the other. Each worked for several months, but after the fourth drug failed to relieve her symptoms, she was given an infusion of a drug called Entyvio, which she said “worked like an instant miracle”.

Entyvio, the trade name for vedolizumab, is a so-called biological agent, a drug made from living cells that is typically administered by infusion or injection. It is one of several such drugs currently available for Crohns. It works specifically on the intestines to reduce inflammation, and since her colon is still inflamed, Ms. Martinne must be treated with the drug every four weeks. When this one stops working, she can try one of the others.

However, Ms. Martin knows that there is no cure for Crohn’s disease and that most patients are on medication indefinitely. That can create another stumbling block. The biologics are very expensive, averaging over $ 100,000 a year. Although they are usually covered by insurance, there is a large co-payment. In order to afford therapy, many patients rely on co-pay assistance programs administered by the drug companies, said Dr. Flint.

As Ms. Martin recently learned, Medicare pays the cost if she receives the IV in a hospital or if her doctor can arrange for a nurse to come to her home to administer the drug.

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Covid was third main reason for dying in U.S. in 2020, behind coronary heart illness and most cancers, CDC says

The body of a deceased patient is considered a health care worker treating individuals infected with coronavirus disease (COVID-19) on December 30, 2020 at the United Memorial Medical Center in Houston, Texas, United States.

Callaghan O’Hare | Reuters

Coronavirus was the third leading cause of death in the United States in 2020, after heart disease and cancer, according to a new study by the U.S. Centers for Disease Control and Prevention.

More than 3.3 million deaths were reported in the US last year, up 16% from 2019. This is according to early data released Wednesday by the National Vital Statistics System, which provides annual mortality statistics based on death certificates investigates and reports.

The deadliest weeks of last year were at the start of the pandemic and then in the middle of the holiday flood in the weeks leading up to April 11, with 78,917 deaths, and December 26, when 80,656 people died, the CDC found.

According to the study published on Wednesday, Covid-19 was listed as the root cause of 345,323 deaths. More Americans died in the process than accidental injuries, strokes, chronic lower respiratory diseases, Alzheimer’s, diabetes, influenza and pneumonia, and kidney disease.

Only heart disease and cancer killed more people than Covid-19 in the US in 2020 – heart disease killed 690,882 people and cancer killed 598,932.

Covid-19 replaced suicide in the top 10 leading causes of death in the United States, the study found. Overall, the annual death rate rose nearly 16% year over year in 2020, the first time since 2017, according to the CDC.

The highest annual death rates were reported among men, people age 85 and over, and people who are not Hispanic Black and Native American and Alaskan native, according to the CDC.

However, if you just look at Covid-19, Hispanic and Native American and Alaskan Native Americans, as well as those aged 85 and over, were more likely to die of the disease compared to any other group. Men died more often from Covid-19 than women.

CDC director Dr. Rochelle Walensky said after the study was published the results should “act as a catalyst” for Americans to reduce the spread of the virus and get vaccinated when it is their turn to get vaccinated.

“I know this is not easy and so many of us are frustrated with the disruption this pandemic has had in our daily lives, but we can do this as a nation that works together,” Walensky said during a White House press conference Covid-19

The agency’s first results were released months ahead of schedule as “freshness has improved and there is an urgent need for updated quality data during the global COVID-19 pandemic,” the researchers wrote.

Typically, it takes researchers 11 months after the end of the calendar year to “investigate specific causes of death and process and review data”. The daily Covid deaths reported by the CDC, while current, may underestimate the actual number of deaths due to “incomplete or late reports”.

“Preliminary death estimates provide an early indication of shifts in mortality trends and can guide public health policies and actions aimed at reducing the number of deaths directly or indirectly linked to the COVID-19 pandemic “write the researchers.

Some have tried to sow doubts about the real number of Covid-19 deaths, claiming they may have been overstated. However, in a separate CDC study released Wednesday, the agency found that the death certificates accurately reflected the number of reported coronavirus deaths.

The agency checked death certificates listing Covid-19 and at least one other concurrent illness. The CDC found that Covid-19 was reported in 97% of deaths alongside another condition that the virus might have caused, such as pneumonia or respiratory failure, or that contributed significantly to its severity, such as diabetes or high blood pressure.

A small fraction of them – 2.5% of the certificates – documented conditions not currently associated with Covid-19, the CDC noted.

“These results support the accuracy of COVID-19 mortality monitoring in the US using official death certificates,” the researchers said.

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A Terrifying Illness Stalks Seaside Australia: Flesh-Consuming Ulcers

He has treated over a thousand patients in Australia and overseas for the disease. Many of those in Australia are older, others are young teachers, workers and even children.

He carefully measures her lesions with a ruler and marks them to track their progress. Although they look like nightmares – some have ulcers that eat to the bone – most patients describe them as painless. The carnivorous toxin produced by the bacteria is a particular horror: it both weakens the immune response and numbs the meat it consumes. It is “really quite an extraordinary organism,” said Dr. O’Brien on the bacterium, “and a formidable enemy.”

In Mr. Courtney’s case, the ulcer had devastated the upper half of his foot before doctors could make a diagnosis. They have since performed surgeries to remove the necrotic, concrete-like tissue. “If you don’t get rid of this dead flesh, the skin will never heal,” said Dr. Adrian Murrie, a doctor in the clinic who treated Mr. Courtney.

Other patients with less severe cases sometimes decline treatment and choose natural remedies such as heat and clay instead. Although the body can occasionally fight off smaller ulcers, such treatments can pose real danger in severe cases, said Dr. O’Brien.

In most cases, the treatment will be antibiotics. In the past, the disease was largely operated on, but with better medication, the prognosis has improved significantly in recent years. “The antibiotics were thought to be ineffective,” said Dr. O’Brien. “Because it actually gets worse before it gets better.”

At the moment, however, prevention is next to impossible.

“We don’t know how to stop it,” he said. But if the answer can be found anywhere, he said, it is in Australia.

For Mr. Courtney, his battle with the disease is far from over. Doctors expect his treatment to last at least six months.

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The second dose of Covid vaccine is required for full immunity, infectious illness specialist says

According to Dr. Paul Offit, director of the Vaccine Education Center at Philadelphia Children’s Hospital, the second dose of the Covid-19 vaccine is critical to creating longer and complete immunity as well as preventing variants of the virus.

“We need to know that this is a two-dose vaccine,” Offit told CNBC’s The News with Shepard Smith. “The second dose of the Pfizer or Modern vaccine increases it dramatically, inducing the type of cells that suggest you have longer long-term memory, which means the vaccine would last a few years. I think when we have humans Getting only one dose of the vaccine that gives you shorter and less complete immunity will only lead to variants. “

His comments came after a recent study suggested that the second shot of the Pfizer vaccine could be delayed as the first offered high protection, according to a letter published in the New England Journal of Medicine.

To date, more than 15 million people in the US have received both shots of a two-dose Covid vaccine, according to the Centers for Disease Control and Prevention. Almost 25 million additional people in the country have received their first vaccination shot.

Moderna said last month that it plans to test a booster shot of its Covid vaccine a year after the first two-dose immunization.

“If you get a booster shot of this virus, which is the most common virus in circulation and produces more cross-reactive antibodies … you don’t necessarily have to load up with another vaccine when a variant reaches the point of being completely resistant to immunity, then we have to develop the second generation vaccine, “said Offit. “Right now it could mean a booster shot of the vaccines we’ve already made.”

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