New News about COVID, an RSV Vaccine Update & the Ohio Train Derailment
Three Things Thursday (on Friday)
Three Things Thursday highlights three things I am paying attention to as an epidemiologist each week.
And, yes — I am a day late (and at least a dollar short). But I have a really, really, really good reason. CDC’s Advisory Committee on Immunization Practices (ACIP) met Wednesday through Friday (early afternoon) this week. And they were discussing things that are super important to all of us. In order to bring you the most up-to-date vaccine information, I held off a day.
So here is Three Things Thursday — the Friday, post-ACIP meeting edition.
Hoping these posts help to educate and empower you
to be healthy and create healthy communities.
COVID Updates
Cases of COVID (diagnosed with a PCR test) continue to decline in the United States (but the speed of decline is slowing). COVID hospitalizations are also declining, as are deaths (though the number of deaths per day — 341 — is still very high and many of these deaths are preventable with the COVID vaccine).
This week results from two new studies were released — both focused on the connection between COVID infection and an increased risk of cardiac events (think: heart attacks and strokes). The results of the first study were presented by researchers from Columbia University at the 67th Annual Biophysical Society Meeting. The research team conducted autopsies of individuals who died of COVID and conducted laboratory experiments with mice. They found that individuals with COVID had increased oxidative stress and inflammation in their hearts as well as changes in the calcium levels as a result of damage to the system that regulates the heart (caused by the SARS-CoV-2 virus). These findings were further supported by research with ice that found increased fibrosis and dilation of fibers in the heart, which makes it hard for the heart to pump blood appropriately.
These results provide evidence of a clear mechanism between COVID infection and heart damage or cardiac events, like heart attacks and strokes.
The second study released this week (peer-reviewed) was published in the Journal of the American College of Cardiology. The data from this study show that COVID vaccines protect against major cardiac events caused by the virus. The lead researcher on the study — Joy Jiang said in the press release,
"Given the magnitude of SARS-CoV-2 infection worldwide, we hope our findings could help improve vaccination rates, especially in individuals with coexisting conditions.”
As medical researchers are calling for improvements in COVID vaccination rates, today’s ACIP conversation about COVID vaccines centered on the need to make vaccination guidance/recommendations easy to understand.
Let’s be honest — the current recommendations are complicated (check out slide #5 here). We are navigating different primary series, different primary series by age, and booster shots regular vs bivalent boosters.
If I had a dollar for every time I’ve been asked when can I get my second/next bivalent booster shot? I would not be staying home for spring break this year!
We need an easy-to-understand, easy-to-communicate, and clear recommendation regarding COVID vaccines. And while there was no COVID vaccine vote at today’s ACIP meeting, there was agreement that simplifying the messaging around COVID vaccines is the priority.
While I think we are moving toward an annual COVID booster shot that will be created using the common variant in circulation each year, nothing has been decided officially.
Ultimately, this means — if you have already received your bivalent booster shot, you are fully boosted and no additional shots are needed (or available to you).
RSV Vaccine Updates
On Monday, Pfizer shared that the FDA accepted its licensing application for an RSV vaccine. This officially starts the process that could lead to the approval of an RSV vaccine for pregnant people to help protect babies against RSV. According to Pfizer —
“If approved, RSVpreF (the vaccine’s trade name) would help protect infants at their first breath from the devastating effects of this infectious disease, which though well-known, has been particularly evident throughout this RSV season.”
According to Pfizer’s press release, a decision from the FDA regarding the safety and efficacy of the RSV vaccine is expected by August 2023 (before the start of RSV season in the fall).
Data from Pfizer’s Phase 3 clinical trial, was shared yesterday afternoon at the ACIP meeting. The results — both the vaccine’s safety and its ability to effectively prevent severe RSV — were extremely positive.
At this point in time, neither FDA nor CDC has officially approved the RSV vaccine for use. We expect to see more data and hear more discussions over the summer. And then FDA and CDC’s vaccine advisory committees will vote on whether to recommend the vaccine or not. Stay tuned…
Public Health Concerns Associated with the Ohio Train Derailment
(In non-vaccine related news) Two weeks ago a train derailed in East Palestine, Ohio, and hazardous chemicals spilled onto the ground and into nearby waterways. In the days following the derailment, vinyl chloride gas was intentionally released from several train cars and burned in order to avoid an explosion.
Residents in the area of the derailment — and those living near the contaminated waterways — are worried (and rightfully so) about how exposure to the toxic chemicals spilled during the derailment will impact their health. Already, residents in East Palestine have experienced burning eyes, sore throats, rashes, and migraines, among other symptoms associated with exposure to hazardous chemicals.
3500 fish have also (reportedly) died.
From a public health perspective, the train derailment has both short- and long-term health consequences. In the short/immediate term, individuals have been exposed to a number of really toxic substances, several of which are known carcinogens, including vinyl chloride, dioxin, and butyl acrylate.
The long-term human health and ecological healthy consequences are unknown. Individuals exposed to dioxin may have to wait 20+ years before their cancer is diagnosed. It could take decades before the water is free of toxic substances that spilled during the derailment. Only time will tell…
The train derailment in Ohio is a clear example of the need to infuse health into all policies. In the days after the derailment, we have learned (thanks to StatNews) —
“Because the Norfolk Southern train had some cars containing semolina wheat and vegetables as well as about 20 cars carrying hazardous chemicals, the entire train was not labeled hazardous, and officials were not notified the train would be passing through the state…
A 2014 Obama-era regulation required high-hazard freight trains to be equipped with electronically controlled pneumatic brakes by 2023. This allows the trains to brake faster. But in 2017, the Trump administration repealed this regulation.”
We can only create healthy communities by looking upstream and identifying the causes of potential cancer and working to prevent them. We must have comprehensive healthcare systems that are rooted in prevention, clear communication, and risk reduction.
We cannot continue on as is and assume that our current/broken healthcare system (which is really a system of care for those who are sick) will keep up healthy.
Thoughts? Questions?