TWiVTLDR 1066

My summary for This Week in Virology Clinical Update #1066:

• Some discussion over the microbiologist Siouxsie Wiles in New Zealand suing her employer (University of Auckland) for failing to protect her from harassment when doing her job of communicating science. Dr. Racaniello says researchers should be paid by their universities (and considered re: tenure) to communicate science to the public, but they’re not.
• Dr. Racaniello asserts that the global initiative of oral poliovirus vaccine to prevent paralysis has been a failure. Everyone should be using the inactivated vaccine, which is injected. (The U.S. has used the inactivated vaccine since 2000.) This is an issue of cost and equity - the oral vaccine is cheaper and easier to administer.
• Older adults getting an RSV and flu vaccine at the same time is safe and effective! Older adults get hospitalized from RSV because of pneumonia. Over 10,000 adults die from RSV every winter. Get those shots!
• A study reported that drinking 1-2 cups of coffee a day (morning and afternoon for a dose every 6 hours) apparently reduces risk of getting COVID, as well as COVID severity. They claim decaf works too, and you can add milk and sugar and other stuff. The thing is, they looked at virus binding in vitro in generic immortalized cell lines. Which puts a downer on things: Dr. Griffin wishes they used lung organoid cells instead of the generic HEK293T cells, which are human embryonic kidney cells. (Like, these are the cell lines I used in my molecular biology job 10 years ago and I was not studying respiratory viruses.) Dr. Racaniello is also super dubious of extrapolating an infection model from an in vitro study. Like, the coffee is going to go into your stomach and processed by your body a bunch before it reaches your respiratory tissues. Dr. Griffin jokes about choking on coffee and actually having that be helpful. (The study also had some kind of human trial with 64 people drinking various strengths of coffee, but that didn’t look at actual infection rates.)
• Pregnant people who got COVID before 2022 were far more likely to give birth prematurely. This effect generally disappeared by 2022, and disappeared a year earlier in places that adopted the COVID vaccines early. So uh, pregnant folks really need to get vaccinated if they aren’t yet!
• A population-based cohort study in Sweden of over 580K people found that the more vaccine doses you had, the more protective it was against long COVID. Vaccine effectiveness against LC was 21% for 1 dose, 59% for 2 doses, and 73% for 3 doses. Also, with their definition of LC, 0.4% of the vaccinated population had LC, which Dr. Racaniello observes is in line with what he expects. (Vs like, 20% in other LC studies.) The study included any vaccine available in Sweden, and note that the most common were Pfizer, Moderna, and AstroZeneca.
• “Imprinting” (the idea that an immune response is strongest for an original strain like ancestral COVID) can be overcome if updated vaccines are used. Meaning, if the vaccines don’t have the original strain and only use Omicron variants.
  Immunity from a COVID vaccine seems to be more protective against hospitalization and death than the immunity from a prior COVID infection. So that supports getting boosted than believing that an infection is as good as a vaccine for a boost. Dr. Griffin says this jives with what he’s been seeing - he’s seen people on their third COVID infection (but not maximally vaxxed) sick enough to end up in the hospital.
• The COVID Novovax vaccine reportedly results in less side-effects than the mRNA vaccines, so go get that one if the Pfizer and Moderna have been tough! There are still some cases of pericarditis with Novovax, just not as many as with the mRNA vaccines. (And it was still rare, at any rate...vaccines are still better than getting COVID in that respect.)
  COVID vaccines boost your long-term T-cell response, in addition to B-cell/antibody response. So even if you’re deficient in B cells, it’s still worth it to get vaccinated!
• An oral antiviral VV116 helped people recover completely from COVID symptoms 2 days faster compared to placebo (11 days vs 13 days). Dr. Griffin says this isn’t as impressive as he would like. VV116 works similarly to remdesivir, and doesn’t have drug-drug interactions like with Paxlovid.
• Hospitalized-but-not-in-ICU patients given a therapeutic dose of heparin helped with symptoms that affected quality of life (pain, activities, self-care). Note that the study data was from 2020/2021, so not the more recent strains.
• From listener q: Loss of taste and smell does not count as a “symptom” when you’re talking about being “symptom-free” for transmission purposes. There are people out there who still can’t taste or smell a year out....