Brief19
Daily Review of Covid-19 Research and Policy
by Doctors on the Frontlines

RESEARCH BRIEFING

Moderna's vaccine continues to demonstrate a strong immune response, 4 months out

Many have worried that any immunity to SARS-CoV-2 after infection or vaccination may be short-lived. These fears were especially rampant after early reports emerged of recovered patients not having detectable antibodies after some period of time. Mostly, though, that narrative has been overturned as better antibody tests have become standard. 

 The abiding concern that vaccines, like Moderna's mRNA-1273 which was recently announced to have an efficacy rate of 94.5 percent in preventing covid-19, might not be enough to end this crisis. Yesterday, the vaccine's investigators shared further data suggesting promising immune responses from the vaccinated subjects collected 119 days after the initial inoculation (90 days after the second booster dose). In a letter printed in the New England Journal of Medicine the authors describe the most recent immune response data from the participants enrolled in the phase 1 trial that previously demonstrated a strong immune response in all 34 participants at 57 days. Most promising in this data was the comparison between the phase 1 participants and a group of 41 control participants, all of whom had been naturally infected with SARS-CoV-2. The titers (i.e. the concentration of antibodies) for the vaccine participants exceeded those of the control group, implying that the vaccinated group developed more robust immunity than was generated after a naturally occurring immune response to covid-19 infection. While there was a slight decline in the titer over time, this was expected. The reported levels show promise for long-lasting immunity with Moderna's vaccine. Additionally, no serious adverse events have been attributed to the vaccine over this time period, and the investigators will continue to monitor the phase 1 participants and assess long term immunity. 

This new data adds to growing body of promising literature suggesting that the forthcoming vaccine candidates will change the way the United States, and the world, proceed with tackling the covid-19 pandemic. Nevertheless, it will be important to stay vigilant with public health measures such as social distancing and mask use for the foreseeable future. 

Editor-at-Large

POLICY BRIEFING

With compliance in mind, CDC shortens quarantine

Due to a recent uptick in reported covid-19 cases following the Thanksgiving holiday, the Centers for Disease Control and Prevention (CDC) updated its quarantine recommendations this week. While still endorsing symptom monitoring for two weeks after a possible exposure, the agency has created two new options for a more abbreviated quarantine period. Those without symptoms may return to normal activities after ten days without a negative screening test, or after seven with negative testing. Despite these updates, the CDC stresses that it still believes that the fourteen day period is ideal, and continues to promote masking and social distancing. This policy may also be problematic because some patients spread disease longer than 10 days after initial exposure, regardless of symptoms. Nevertheless, the reduced restrictions may help unburden the healthcare system and critical industries struggling to maintain adequate staffing and may encourage better compliance. The CDC.


Past Week

(Review)
RESEARCH
  • Trial of convalescent plasma for covid-19 falls flat, another setback for hyped treatment
  • US pediatric testing results for covid-19: The kids are...just ok. And not immune

(Review)
POLICY
  • Highest risk factors with incarceration
  • PPE problems persist. How is the Strategic National Stockpile looking?
  • Numbers don't lie
  • California begins curfew. But will it do anything to slow the spread?

RESEARCH
  • An inflammatory truth about kids getting sick with covid-19. MIS-C rates by race
POLICY
  • States to determine vaccine prioritization, not a federal plan

RESEARCH
  • Breaking News: Immune-suppressed patients may be contagious with covid-19 for weeks or longer. Guidelines may need changing
POLICY
  • An autopsy of Scott Atlas' tenure at the White House: A portrait of disgrace

RESEARCH
  • Filipino nurses at highest risk of developing covid-19 among registered nurses in the United States
POLICY
  • More vaccine questions and concerns

RESEARCH
  • Was there an increase in overdose-related cardiac arrests during the pandemic? Maybe
POLICY
  • United Kingdom approves Pfizer/BioNTech covid-19 vaccine

Featured

New trial of convalescent plasma for covid-19 falls flat, another setback for hyped treatment

Is convalescent plasma the miracle treatment we were promised? The answer in the latest published clinical trial appears to be no. This is more worrisome news for a proposed treatment that has been bandied about and for which the US Food and Drug Administration granted emergency use authorization, d...

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Moderna announces interim covid-19 vaccine data – reports 94.5% effectiveness

As we mentioned last week with our briefing on Pfizer's mRNA covid-19 vaccine, the short-term future of the country may be riding on an effective vaccine. A glimmer of hope was revealed last week as Pfizer and BioNTech released interim data from their phase 3 ...

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Another hope dashed - Tocilizumab not as promising as hoped in a new trial

Earlier this week we covered three JAMA Internal Medicine papers assessing drug called tocilizumab, a monoclonal antibody that targets interleukin-6 receptors, thought to contribute to the human body's counterproductive immune response to SARS-CoV-2, the vir...

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Monoclonal Antibody Trial Halted for Safety Concern

Brief19 has learned that the ACTIV-3 monoclonal antibody trial for the treatment of covid-19 has been paused due to a potential safety concern. An email obtained by Brief19 (below) made the announcement today. 

The ACTIV-3 trial is a randomized...

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Final remdesivir results published after 139 days of waiting

The preliminary results of the Adaptive Covid-19 Treatment Trial (ACTT-1) randomized trial were published May 22 in The New England Journal of Medicine and covered by Brief19. ACTT-1 was a double-blind, randomized, placebo-controlled trial of the antiviral drug remdesivir, given to patients intr...

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President Trump and First Lady of the United States have SARS-CoV-2

Last night, President Trump announced that he and the First Lady, Melania Trump have tested positive for SARS-CoV-2. The President's physician, Sean Conley, released a memorandum for Kayleigh McEnany stating that he had "received confirmation" of the results. Conley stated that both are "well at thi...

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