Coronavirus Files: Vaccine-makers seek booster approval while antivirals go underused

coronavirus
August 30, 2021

Since April 2020, the Center for Health Journalism has been publishing a special newsletter geared to journalists as they report on one of the biggest and most complex stories of our times. Each Monday, while the pandemic runs its course, The Coronavirus Files will provide tips and resources and highlight exemplary work to help you with your coverage. This week, The Center for Health Journalism’s Coronavirus Files Monday newsletter is curated and reported by science writer Amber Dance, PhD. Have a suggestion or a request? Write us at editor@centerforhealthjournalism.org.

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Racial disparities narrow on vaccines

Since vaccines became available last winter, they’ve gone disproportionately to white people over Black and Hispanic people. But that may be starting to change, writes Nada Hassanein in USA Today. In recent weeks, as cases have soared, more people of color received a first shot, compared to their overall population share, than white people. “It shows a glint of promise,” experts told Hassanein. In Southern states where the delta variant is raging, Black and Hispanic vaccination rates are rising particularly fast, according to Bloomberg Equality’s COVID-19 tracker — but, “overall, states are still generally lagging in vaccinating Black and Hispanic people.”
 
Those analyses are based on government data, which are incomplete, but an NBC News poll suggests a different picture: When asked, 76% of Black respondents said they’d been vaccinated, along with 71% of Latinos and just 66% of whites.
 
“It appears that continued outreach and education has shifted the trend of vaccination in Black communities for the better,” writes Terrell Jermaine Starr at The Root. “This news certainly runs in stark contradiction to Republicans’ claims that Black people are refusing to get the jabs.” Fear of delta is also driving overall vaccination rates back up to an average of nearly 900,000 doses per day. Another contributor to the racial differences in vaccination rates, writes Philip Bump at The Washington Post, is ongoing vaccine hesitancy among white Republicans. In NBC’s poll, Republicans overall reported a 55% vaccination rate; it was even lower among Trump supporters and rural residents.
 
Mandates follow Pfizer's approval
 
Though full FDA approval of the Pfizer vaccine was hotly anticipated in recent months, it was still hailed as a pandemic milestone last week. The vaccine also got a new brand name, “Comirnaty,” which isn’t winning a lot of fans. We already knew the shot was safe and effective, but the approval could encourage holdouts to get the vaccination. Back in June, about three in 10 unvaccinated adults told the Kaiser Family Foundation poll that full approval would make them more likely to take the shot. That has led to estimates that 6 million to 18 million Americans might now want to be vaccinated. But the Kaiser polling data is more nuanced; a majority of those polled either didn’t know if the vaccines were fully approved, or assumed they already were. And as KFF survey research director Liz Hamel told The Washington Post, “most people have multiple reasons and concerns about getting vaccinated.” What might change more minds, writes Post reporter Dan Diamond, are the vaccine mandates by employers who feel the approval gives them legal cover. “That’s what’s going to do it,” said Dr. Robert Murphy, director of the Institute for Global Health at Northwestern University. “If they realize they’re going to lose their job, they’re going to really think twice about whether they really want to avoid the vaccine.”
 
The approval also means that physicians could prescribe Comirnaty off-label to those eager for booster shots or to children under 12, for whom it has not yet been authorized at all. But the FDA, CDC and American Academy of Pediatrics quickly put the kibosh on the latter idea, citing uncertainty about safety and dosing in that age group. (Emergency authorization of Comirnaty for children 5 to 11 could come as early as October.)
 
Meanwhile, Moderna completed its own application for full FDA approval last week, and Pfizer has also begun the submission process for approval of a third, booster shot. And that booster data may convince the agency to approve the third shot as early as six months after the second one, rather than the eight months currently suggested, report Stephanie Armour and Jared S. Hopkins at The Wall Street Journal. Johnson & Johnson also joined the booster club last week with a report than a second injection, six to eight months after the first, amplified antibodies nine-fold. Vaccine researcher Dr. Dan Barouch of Harvard Medical School told CNN’s Maggie Fox, “I’m quite certain that the FDA, CDC, NIH, White House will use these data to likely justify or recommend a booster for J&J-vaccinated people.”
 
Hay is for horses, and so is ivermectin
 
If you have roundworms, your doctor may prescribe the worm-killing drug ivermectin. If you have a horse with a similar problem, you might give it a high-dose, animal-grade version of the same medication. But what you should not do, the FDA unequivocally stated last week, is take ivermectin, especially the kind meant for livestock, to treat or prevent COVID-19 infection. “You are not a horse. You are not a cow,” tweeted the federal agency. “Seriously, y’all. Stop it.”
 
There is a smidge of science behind the idea; scientists reported in summer 2020 that large doses of ivermectin blocked viral replication in cells growing in a dish, and a number of clinical trials are underway, but the results are not in, writes Peter G. Lurie at STAT. Use of the drug for COVID-19 took off in Latin America last summer, and it’s now selling out in U.S. farm-supply stores, reports Sofia Andrade at Slate. The CDC announced last Thursday that ivermectin prescriptions have skyrocketed increased 24-fold over their baseline rate since winter, while calls to poison control centers are up five-fold. CNN’s Oliver Darcy points to right-wing media personalities such as Tucker Carlson, Sean Hannity and Laura Ingraham of Fox News as the source of the dangerous misinformation about the deworming drug.
 
There is, however, an authorized COVID-19 treatment that’s effective, low on side effects, and free: monoclonal antibodies. But few people are getting it, report Lenny Bernstein and Laurie McGinley at The Washington Post. The reasons the pair cite include the attention focused on vaccines over treatments and a lack of access in many communities. Yet the antibodies can both prevent symptomatic infection in people who were exposed to the virus and knock down symptoms in people who are already infected. “It is absolutely the standard of care for COVID-19,” said pharmacist Erin McCreary, director of stewardship innovation at the University of Pittsburgh Medical Center.
 
Time may be running out for origin investigation
 
Three months ago, it wasn’t clear where the coronavirus came from — an animal or a lab — so President Joe Biden ordered intelligence officials to investigate further and report back in 90 days. Last week, the report came in, but it did little to clarify the virus’s path to humans. Experts told The Washington Post that a final answer could take years, but the members of a World Health Organization team investigating the origins noted in Nature, “the window of opportunity for conducting this crucial inquiry is closing fast.” That’s because antibodies against the virus are already waning in the first people infected, and because many farm animals have been culled, eliminating any evidence they might have carried.
 
From the Center for Health Journalism
 
2021 Data Fellowship: The 2021 Center for Health Journalism Data Fellowship (Oct. 25–29) is designed for skilled journalists who want to learn how to mine data sources to reveal key insights essential to high-impact journalism. Fellows receive five days of intensive training on data acquisition, cleaning, analysis and visualization, as well as an introduction to important data sets that can serve as the basis for groundbreaking journalism. Fellows receive a $2,000 grant plus six months of guidance from our expert data journalism mentors. Learn more here. Application deadline: Sept. 1.
 
Covering Coronavirus: Do vaccines need a boost?
The delta surge has ushered in a growing number of breakthrough infections, while new studies have fueled fresh worries about waning vaccine effectiveness. In our next webinar, we’ll discuss our latest understanding of COVID-19 immunity, what role booster shots are likely to play, and how reporters can responsibly report this complex and fast-moving story. Sign up here! 
 
What we're reading
  • “Holes in reporting of breakthrough COVID cases hamper CDC response,” by Erin Banco, Politico
  • “Vaccine mandates and COVID testing — or neither? Colleges test the limits of ‘normal’ fall,” by Chris Quintana, Lindsay Schnell, Mela Seyoum and Alison Steinbach, USA Today
  • “A crisis within a crisis,” by Nicquel Terry Ellis and Adrienne Broaddus, CNN
  • “Solutions and struggle: Native American tribes receive federal relief,” by Nancy Marie Spears, Beth Wallis and Mackenzie Wilkes, News21
  • “Humanitarians push to vaccinate in conflict zones,” by Madeline Drexler, Undark
  • “The coronavirus could get worse,” by Katherine J. Wu, The Atlantic
  • “A lucky few seem ‘resistant’ to COVID-19. Scientists want to know why,” by Amitha Kalaichandran, STAT