Effectiveness Over Time & Delta

On Sunday, Metropole brings you a COVID-19 update from Prof. Dr. Florian Krammer, an Austrian virologist who works and teaches at the Icahn School of Medicine at Mount Sinai, New York City.

August 15, 2021

As promised, here’s an out-of-tour update on vaccinating children after some of you asked me about it. Let’s start with the basics:

Children and adolescents aged 12 years and older are already being vaccinated with mRNA vaccines, clinical trials for children under 12 years are ongoing. Basically, it remains the case that children and adolescents are at less risk of severe SARS-CoV-2 infection than adults. However, children and adolescents can also contract and transmit the virus.

Recently, however, there have been increasing reports of clusters of more severe illness in children (last week, for example, 1,600 children with SARS-CoV-2 infections were admitted to hospitals in the US). This could be because the delta variant is more contagious and also replicates faster and in greater numbers in the body.

But it could also be – and there are only a few studies on this topic– that the rate of severe disease in the age group has not changed and that there are simply more infections in children due to the delta variant and thus more severe cases.

Back to Vaccines – What Do We Know?

Basically, the RNA vaccines are safe and effective in the 12-16/18 age group. Here, for example, is a new study with Moderna’s mRNA vaccine among about 3,700 teenagers aged 12-17. Of course, a great many doses of mRNA vaccine have now been given to 12-18-year-olds. When you vaccinate a large number of people, you also find quite rare side effects.

So far, one side effect has been found to occur mostly in male adolescents (16+) and young adults, and that is mostly quite mild myocarditis. Taken together (adults and adolescents), about 1,250 heart muscle inflammations have been reported in the US to date, and 730 appear to be truly related to vaccination. Just as a reminder, 351 million doses of vaccine have been given in the US tuntil now. So the risk is low, even if you just look at the appropriate age group (it’s about 40 cases per million male vaccinated in the 12-29 age group, https://www.cdc.gov/mmwr/volumes/70/wr/mm7027e2.htm).

So those are the basics. By the way, the 12-16/17 age group currently gets the dose that adults get (30ug RNA at Pfizer, 100 ug RNA at Moderna). Pfizer and Moderna have meanwhile started clinical trials to test the respective vaccines in the age group below 12 years. And that’s where reduced doses are being tested.

Tests Under Way

Pfizer originally tested doses of 30, 20 and 10 ug of RNA, but now appears to be focusing on a 10 ug dose for 5-11-year-olds and a 3 ug dose for the 6-months to 5-years age group. Pfizer expects results for the 5-11-year-olds in September, for the 2-5-year-olds group shortly thereafter, and for the 6-months to 2-years age group in October or November.

Moderna seems to have gone down with the dosage at least from 100 to 50 ug, but it’s not quite that clear from the published clinicaltrials.gov entries. I assume Moderna will have initial data fairly soon as well. The trials include a few thousand children at Pfizer and about 13,000 children at Moderna (all told).

Where AstraZeneca currently stands with a vaccine for children is not clear to me.

Low Risk, But Not No Risk

In summary, children have less risk, but by no means no risk. For the risk-benefit calculus to work, vaccines have to be very safe. Based on this consideration, reduced doses are being tested. Initial results are expected in September, but it may take some time before approval is granted.

If the vaccine is safe (which I assume – but we have to wait for the data), I would definitely recommend getting it for the protection of the children themselves, but also for the protection against transmission to others.

You will get my next regular update on August 30.

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Prof. Dr. Florian Krammer
Prof. Krammer is the Principal Investigator of the Sinai-Emory Multi-Institutional Collaborative Influenza Vaccine Innovation Center (SEM-CIVIC). Currently Prof. Krammer holds a position as a Professor of Vaccinology at the Department of Microbiology at the Icahn School of Medicine at Mount Sinai. He has published more than 100 papers, is member of the editorial boards of the Journal of Virology, Plos One and Heliyon and is a peer reviewer for more than 30 journals.

Current Status

If you live in Vienna, make sure to register for getting a vaccine against COVID-19 under impfservice.wien.  Here you can book your vaccination appointment.

The City of Vienna offers free vaccinations without an appointment to everyone – regardless of citizenship, residency or insurance status – at multiple locations across the city. 

Vienna has reinstated a number of coronavirus restrictions for the fall. The Austrian government has presented a plan for schools and universities.  

Here’s an overview of where you can get tested for COVID-19 in Vienna and how the free PCR “gargle” tests at home work. 

If everything is a bit much for you or you experience domestic violence of any kind, here is our mental health resource article.

Numbers

For current coronavirus numbers, check the website of Ministry of Health and the AGES dashboard.

The Austrian Ministry of Health also publishes daily vaccination statistics and a preview of scheduled deliveries.

Resources

The City of Vienna has compiled comprehensive information on questions and answers regarding coronavirus and the COVID-19 disease in English.

The Austrian Ministry of Health has put together FAQs on the coronavirus and also provides material to download on how to protect yourself and others from the disease, also in English.

Furthermore, the ministry will constantly update its German-language website with information on the number of people tested and cases of COVID-19 in Austria.

Hotlines

Health advice by telephone1450

If you show symptoms (fever, cough, shortness of breath, breathing difficulties) or fear that you are ill, stay at home and dial health number 1450 for further procedures (diagnostic clarification).

Coronavirus hotline AGES+43 0800 555 621

The Austrian Agency for Health and Food Safety (AGES) answers questions about the coronavirus (general information on transmission, symptoms, prevention) 24 hours a day at +43 0800 555 621.

VKI hotline for travel law questions+43 0800 201 211

For legal questions concerning trips that have already been booked (e.g. whether a trip can be cancelled free of charge), the experts of the Association for Consumer Information (VKI) provide advice free of charge from Monday to Sunday between 09:00 and 15:00 at +43 0800 201 211.