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Decline in COVID vaccine efficacy indicates need for enhancers

December 10, 2021 – The effectiveness of the two most common COVID-19 vaccines decreased over time in an older group of patients, suggesting that booster doses may be needed to protect long-term recipients, according to a new study.

Also seen in that group of American veterans, who had a median age of 67: Those who “receive the Modern” vaccine had consistently higher antibodies, compared to recipients of the Pfizer-BioNTech vaccine, across age groups and time since vaccination, ‚ÄĚsays Kristina L. Bajema, MD, of the CDC’s COVID-19 response team, and collaborators.

The efficacy of the Moderna vaccine was 89.6% at 14-119 days after patients received the second dose, compared to 86.0% for the Pfizer vaccine. After 120 or more days, vaccine efficiencies dropped to 86.1% for Moderna and 75.1% for Pfizer, the researchers reported in the Morbidity and Mortality Weekly Report.

Levels of the relevant antibodies – counter-peak immunoglobulin (IgG) and anti-receptor binding domain (RBD) IgG – showed a similar pattern: Lower after the 120-day point for both vaccines, but higher in both periods for Moderna than for Pfizer. These differences in antibody levels are consistent with other studies, researchers said, and may be due to the Moderna vaccine’s higher antigen content and the longer dose interval between doses.

All 1,896 veterans in the study were enrolled while hospitalized with COVID-like disease at five Veterans Affairs medical centers across the country (Atlanta, Houston, Los Angeles, New York City and Palo Alto, CA). The group included patients who tested positive and those who were negative for COVID-19 when they were first admitted to the hospital; 799 were eventually fully vaccinated. About 58% of the group were 65 years or older.

Both vaccines were more effective in younger patients: 89.4% for those under 65 years of age and 72.9% for those 65 and older in the Pfizer group, compared with 94.5% and 78.6% for Moderna, respectively. . The same decrease in effectiveness after 120 days was seen for both age groups, the researchers noted.

The age effect may be cause for concern.

“In general, for both vaccine products, antibody levels in this group of older U.S. veterans with a high incidence of underlying medical conditions were significantly lower than levels seen among younger, healthy volunteers, or health care professionals in other studies,” they said, and added that booster doses may be needed “to help maintain long-term protection against severe COVID-19.”

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