Vaccine effectiveness in the US: Moderna 93%, Pfizer 88%, J&J 71%

Comparative Effectiveness of Moderna, Pfizer-BioNTech, and Janssen (Johnson & Johnson) Vaccines in Preventing COVID-19 Hospitalizations Among Adults Without Immunocompromising Conditions — United States, March–August 2021
Adults aged ≥18 years without an immunocompromising condition admitted to 21 hospitals within the Influenza and Other Viruses in the Acutely Ill (IVY) Network were prospectively recruited for a case-control analysis. 3,689 patients were included (1,682 case-patients and 2,007 control-patients). Vaccine effectiveness against COVID-19 hospitalization during March 11–August 15, 2021, was higher for the Moderna vaccine (93%) than the Pfizer-BioNTech vaccine (88%) and the Janssen vaccine (71%).

Vaccination after prior COVID-19 infection: Implications for dose sparing and booster shots
[Commentary.] A major current issue is that all vaccines express the ancestral SARS-CoV-2 Spike, whereas currently circulating variants such as Delta have several mutations that evade much of the response. Neutralizing antibody responses are typically ∼4-fold lower to Delta than to the ancestral strain. The current vaccines boost neutralizing responses to all strains but the responses to the variants typically remain proportionally lower. Reformulated vaccines expressing variant Spike are undergoing evaluation and are likely to improve the neutralizing response to variants.

Factors Associated With COVID-19 Disease Severity in US Children and Adolescents
Among 19,976 COVID-19 encounters, 15,913 (79.7%) patients were discharged from the emergency department (ED) and 4063 (20.3%) were hospitalized. The clinical severity distribution among those hospitalized was moderate (3222, 79.3%), severe (431, 11.3%), and very severe (380, 9.4%). Factors associated with hospitalization vs discharge from the ED included private payor insurance (adjusted odds ratio [aOR],1.16; 95% CI, 1.1-1.3), obesity/type 2 diabetes mellitus (type 2 DM) (aOR, 10.4; 95% CI, 8.9-13.3), asthma (aOR, 1.4; 95% CI, 1.3-1.6), cardiovascular disease, (aOR, 5.0; 95% CI, 4.3-5.8), immunocompromised condition (aOR, 5.9; 95% CI, 5.0-6.7), pulmonary disease (aOR, 5.3; 95% CI, 3.4-8.2), and neurologic disease (aOR, 3.2; 95% CI, 2.7-5.8). Among children and adolescents hospitalized with COVID-19, greater disease severity was associated with Black or other non-White race; age greater than 4 years; and obesity/type 2 DM, cardiovascular, neuromuscular, and pulmonary conditions. Among children and adolescents presenting to US children’s hospital EDs with COVID-19, 20% were hospitalized; of these, 21% received care in the ICU. Older children and adolescents had a lower risk for hospitalization but more severe illness when hospitalized.

COVID-19: transferring learning from the pandemic response to non-communicable disease control
We believe there are three interdependent ‘transfer learning opportunities’. Firstly, countries with developed health systems have set up robust surveillance systems to collect COVID-19 case, hospitalisation and death data in near real time. Secondly, a well-coordinated pandemic response runs on established battle rhythms deployed at local, regional and national levels with clear lines of communication between each. Key meetings, in which situation reports and briefings are shared, enable discussion, debate and joined-up decisions. Thirdly, a wealth of scientific expertise has been unleashed and resulted in rapid progress in our understanding of the transmission, vaccine effectiveness, behavioural insights and genomics of COVID-19. embedding the learning from the pandemic response is needed to achieve a significant and sustained step change in non-communicable disease management at the system level.

Changes in patients’ outlook, behaviors, and attitudes toward COVID-19 after hospitalization and their experiences of discrimination and harassment
This prospective observational study surveyed discharged patients who had been admitted to Hyogo Prefectural Tamba Medical Center in Japan for COVID-19. Responses were obtained from 27 patients aged 50 ± 17 years, including 16 men (59.3%). We found most patients feared infection before hospitalization (88.5%) and had taken some preventive measures (96.3%), however after discharge, all (100%) practiced social distancing and infection prevention. Twenty patients (80%) considered changing their lifestyles, and 19 (79.2%) decided to use sick leave when they felt ill; these trends were more prominent during the second wave. Six patients (23.1%) reported experiencing discrimination or harassment after discharge. While most patients with COVID-19 had a strong fear of infection before hospitalization, their views about health and health behaviors changed after hospitalization.