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Aug 25, 2023 • 5:03 pm CDT
by Keith Johnston

The U.S. CDC today published a Morbidity and Mortality Weekly Report (MMWR) that indicates, for the first time in ten years, human papillomavirus (HPV) vaccination initiations did not increase among adolescents in the United States.

Furthermore, coverage with one or more HPV vaccine dose among Medicaid beneficiaries declined by 3.3% in 2022 compared with coverage in 2021.

The cross-sectional analysis published on August 25, 2023, showed that HPV vaccination remained lowest among the uninsured (two of the four groups that constitute the Vaccines for Children (VFC) eligible population.

And the CDC disclosed that VFC vaccine ordering data provide additional evidence that HPV vaccination coverage might continue to decline in VFC-eligible populations.

VFC provider orders for HPV vaccines decreased 24% in 2020, 9% in 2021, and 12% during 2022 compared with 2019.

However, orders for non-HPV vaccines have rebounded to prepandemic levels (Whitlatch F, CDC unpublished data, 2023).

The HPV vaccine is the most expensive of all routinely recommended adolescent vaccines. And reimbursement levels for costs by private payers are adequate, but return margins are small for nonpediatric specialties, according to a study published in Annals of Family Medicine in July 2023.

In the U.S., the CDC's Advisory Committee on Immunization Practices recommends that children aged 11–12 years receive HPV vaccines, and some children can be started at age 9. 

The CDC says HPV vaccination is the most effective way of preventing cervical cancer in women and other sexually transmitted HPV cancers.

Various HPV vaccines are available at most health clinics and pharmacies in the U.S.

This CDC report used two analyses of 2022 NIS-Teen data to examine vaccination coverage among U.S. adolescents 13 to 17 years of age.

Aug 25, 2023 • 2:47 pm CDT
WHO / GPEI polio case map August 8, 2023

The World Health Organization (WHO) today announced that although encouraged by the reported progress, the Committee unanimously agreed that the risk of international spread of poliovirus remains a Public Health Emergency of International Concern (PHEIC) and recommended the extension of Temporary Recommendations for a further three months.  

As of August 25, 2023, only two genetic clusters of WPV1 were identified, compared to three in 2022 and five in 2021.

However, there have been multiple chains of transmission within these two genetic clusters, detected primarily in the endemic zones of Eastern Afghanistan and South KP of Pakistan, including an extreme orphan virus, indicating some gaps in surveillance.

And there is a large pool of unvaccinated "zero dose" children in Afghanistan, which could reintroduce wild-type poliovirus into the southern region.

The also noted suboptimal immunization coverage during campaigns in southeastern Africa, Malawi, Mozambique, Zambia, and Zimbabwe. The nOPV2 vaccine has been deployed over 700 million times in Africa.

Based on the current situation and the reports provided by affected countries, the WHO Director-General accepted the Committee's assessment. It determined that the poliovirus situation continues to constitute a PHEIC.

While poliovirus has been detected in southern New York in 2022 and 2023, no outbreak has been confirmed.

Various polio vaccines are approved and available in August 2023 in the U.S. and globally.

Aug 25, 2023 • 8:25 am CDT
by Gerd Altmann

Since the global shortage of oral cholera vaccines (OCV) is forecast to continue until 2025, including in the United States, two companies today announced they are taking action to increase supply.

On August 25, 2023, GC Biopharma confirmed that it signed an MOU with Eubiologics for a co-production of Euvichol®, a World Health Organization (WHO) certified vaccine.

The two companies will coproduce Eubiologics in the first half of 2024 to supply to UNICEF, which has requested an additional supply to cope with the recent spread of cholera infection in many regions, including Africa.

Kyeong-Ho Min, Vice President of Eubiologics, commented in a press release, "With the more frequent floods and droughts due to climate change and global warming, the world is currently experiencing rapid spread of cholera, leading to a shortage of vaccine supply."

Under the MOU, Eubiologics, a developer and producer of Euvichol, takes charge of the bulk vaccine production, and GC Biopharma will be in control of the packaging process, including vial bottling.

Euvichol is an OCV jointly developed by Eubiologics and the International Vaccine Institute that obtained WHO Prequalification in 2015.

Since supplying to UNICEF in 2016, the cumulative supply has exceeded 100 million vaccine doses. Eubiologics is currently providing 100% of cholera vaccines administered by UNICEF.

During 2023, about 49 million OCV doses have been requested, of which 39% were approved for 11 countries, according to WHO report #5. 

The WHO stated in August 2023, the current cholera epidemic has deteriorated. Therefore, the WHO assessed the risk of cholera outbreaks at the global level as very high.

Aug 24, 2023 • 4:10 pm CDT
Bird flu case map in Finland August 24, 2023

The Republic of Finland recently reported another H5N1 avian influenza outbreak at a fur farm involving blue foxes. This outbreak, reported by EuroNews on August 24, 2023, increases the number of 'bird flu' outbreaks at such farms to 23.

In June 2023, several outbreaks of H5N1 were identified among larids in Finland. The first cases in fur farms were detected in July.

Given these findings, the Finnish authorities decided to cull 120,000 foxes and mink on farms affected by the epidemic.

Finland is Europe's leading producer of fox fur, with around 400 fur farms. For example, FashionFinFur is owned by a fur-farming family in Vörå, Finland, that has been In the business since the 1980s.

In the northern hemisphere, bird flu outbreaks among birds, mammals, and people continue in 2023.

As of August 2023, access to bird flu vaccines is controlled by government agencies.

Aug 24, 2023 • 3:00 pm CDT
WHO/PAHO disease map Aug. 2023

According to recent reports from South America, infectious diseases may continue spreading in late 2023.

A new study forecasrs a 20% increase in dengue, Zika, and chikungunya cases over the next 30 years. Higher temperatures are already causing the diseases carried by the Aedes aegypti mosquito to spread in cooler regions like southern Brazil and southern Europe.

A study conducted at the University of Michigan concluded after analyzing the incidence of these mosquiuteo-transmitted diseases in Manaus, Recife, Rio de Janeiro, and São Paulo, Brazil.

"Brazilian health agencies need to be prepared not only for the increased incidence of diseases like dengue and Zika but also for longer transmission seasons and broader geographic areas of occurrence," affirms epidemiologist Andrew Brouwer, co-author of the study and researcher at the University of Michigan School of Public Health.

According to Brazil's Center for Arbovirus Emergency Operations, 635 fatal dengue cases had been reported by June 11, 2023, an increase of 22% compared to the same period in 2022.

The agency's most recent update, released by the Ministry of Health, shows 1.3 million probable dengue cases so far this year, while the total number for 2022 was 1,450,270 cases.

The study also showed more potential for Zika epidemics than current levels in all the analyzed climatic scenarios, where the threat had been expected to drop because of extreme heat.

Zika and dengue spread most quickly at average daily temperatures around 30° Celsius, but outbreaks are still possible at 35°C.

As of August 24, 2023, two dengue vaccines are available in certain countries. However, there are no approved Zika vaccines available.

Aug 24, 2023 • 11:53 am CDT
U.S. CDC August 25, 2023

The U.S. Centers for Disease Control and Prevention (CDC) published a Morbidity and Mortality Weekly Report (MMWR) on August 25, 2023, with updated recommendations of the Advisory Committee on Immunization Practices (ACIP) for the 2023–24 Influenza Season.

The primary updates to this new MMWR include the following two topics: 1) the composition of 2023–24 U.S. seasonal influenza vaccines and 2) updated recommendations regarding influenza vaccination of persons with egg allergy.

First, the composition of 2023–24 U.S. influenza vaccines includes an update to the influenza A(H1N1)pdm09 component. U.S.-licensed influenza vaccines will contain HA derived from:

1) an influenza A/Victoria/4897/2022 (H1N1)pdm09-like virus (for egg-based vaccines) or an influenza A/Wisconsin/67/2022 (H1N1)pdm09-like virus (for cell culture-based and recombinant vaccines).

2) an influenza A/Darwin/9/2021 (H3N2)-like virus (for egg-based vaccines) or an influenza A/Darwin/6/2021 (H3N2)-like virus (for cell culture-based and recombinant vaccines).

3) an influenza B/Austria/1359417/2021 (Victoria lineage)-like virus.

4) an influenza B/Phuket/3073/2013 (Yamagata lineage)-like virus.

Second, the ACIP recommends that all persons aged ≥6 months with egg allergy should receive an influenza vaccine.

Any influenza vaccine (egg-based or non-egg-based) that is otherwise appropriate for the recipient’s age and health status can be used.

It is no longer recommended that persons with allergic reactions to eggs involving symptoms other than urticaria should be vaccinated in an inpatient or outpatient medical setting supervised by a healthcare provider who can recognize and manage severe allergic reactions if an egg-based vaccine is used.

Egg allergy alone necessitates no additional safety measures for influenza vaccination beyond those recommended for any vaccine recipient, regardless of the severity of a previous reaction to an egg.

Furthermore, all flu shots for 2023-2024 should be administered in settings in which personnel and equipment needed for rapid recognition and treatment of acute hypersensitivity reactions are available.

A summary of these recommendations is posted on this CDC webpage.

Aug 24, 2023 • 8:54 am CDT
U.S. CDC August 2023

The U.S. Centers for Disease Control and Prevention (CDC) today announced a meeting of the Advisory Committee on Immunization Practices (ACIP) will be held on September 12, 2023, at 10 a.m. ET.

The agenda for this ACIP meeting will include, but is not limited to, a discussion of COVID-19 vaccines and related votes.

 For more information on the meeting agenda, visit https://www.cdc.gov/vaccines/acip/meetings/index.html.

The CDC's website publishes Interim Clinical Considerations for the use of COVID-19 vaccines in the U.S., which include a FAQs webpage.

As of August 18, 2023, more than 307 million doses of various COVID-19 vaccines had been administered and reported by the Federal Retail Pharmacy Program. A total of 21 retail pharmacy partners are participating in the program, with more than 41,000 locations nationwide, including long-term care pharmacies.

UPDATED on September 12, 2023 - CDC slide presentations.

Aug 24, 2023 • 5:36 am CDT
Vaxxas technology platform 2023

SK bioscience today announced that the company has entered into a collaboration agreement with Vaxxas to develop a second-generation typhoid conjugate vaccine.

SK bioscience’s SKYTyphoid™ vaccine will be reformulated to be ‘printed’ onto the thousands of tiny microprojections covering the Vaxxas patch to be delivered directly to the abundant immune cells just under the skin surface.

This reformulation aims to enhance access and broaden markets where traditional intramuscular delivery using needles and syringes has been employed.

Under the agreement announced on August 23, 2023, SK bioscience will supply the antigen utilized by its typhoid conjugate vaccine, SKYTyhpoid™, jointly developed by SK bioscience and the International Vaccine Institute.

Vaxxas, an Australian company, will be responsible for reformulating the SKYTyphoid antigen so that it can be applied to its proprietary HD-MAPs and then conduct preclinical studies, which, if successful, will be followed by a Phase I human clinical trial.

Jaeyong Ahn, CEO of SK bioscience said in a press release, “Typhoid fever is a dangerous disease that frequently occurs in low- and middle-income countries, but the utilization of typhoid vaccines has been limited due to the requirement for vaccines that remain stable under varying temperatures and those that can be administered without medical supervision."

This collaboration with Vaxxas provides an opportunity to overcome those challenges."

The project is expected to be completed within two years from initiation to reporting the data from the Phase I clinical trial and is supported by grant funding received from Wellcome.

 

According to the World Health Organization, an estimated 9 million cases of typhoid fever occur globally each year. Symptoms include prolonged high fever, fatigue, headache, nausea, abdominal pain, and constipation or diarrhea, with mortality rates up to 30%.

As of August 24, 2023, typhoid vaccines are available in the U.S. and internationally.

Aug 24, 2023 • 5:16 am CDT
WHO statement August 23, 2023

The U.S. Centers for Disease Control and Prevention (CDC) website reported yesterday that a new variant of SARS-CoV-2 betacoronavirus called BA.2.86 was detected in samples from people in Denmark and Israel, and at least two cases have been identified in the United States.

This variant is notable because it has multiple genetic differences from previous versions of SARS-CoV-2.

BA.2.86 may be more capable of causing infection in people who have previously had COVID-19 or who have received COVID-19 vaccines.

Scientists are evaluating the effectiveness of the forthcoming, updated COVID-19 vaccine. CDC’s current assessment is that this updated vaccine will effectively reduce severe disease and hospitalization.

Based on what the CDC knows on August 23, 2023, there is no evidence that this variant is causing more severe illness.

This CDC assessment may change as additional scientific data are developed.

Aug 23, 2023 • 4:26 pm CDT
The Centre for Health Protection of the Department of Health Aug. 23, 2023

The Government of Hong Kong Special Administrative Region's Centre for Health Protection (CHP) of the Department of Health today announced it is closely monitoring a human case of avian influenza A(H5N6) in the Mainland.

The CHP report on August 23, 2023, says the 27-year-old woman lives in Dazhou, Sichuan, and was admitted for treatment on July 22. This report did not disclose how or where she became infected with 'bird flu' nor the outcome.

On July 23, 2023, the Alert Response Level under the Government's Preparedness Plan for an Influenza Pandemic was activated.

From 2014 to date, 86 human cases of avian influenza A(H5N6) have been reported by Chinese health authorities. A high percentage of infections (52%) lead to death.

The CHP says that travelers to the Mainland or other affected areas must avoid visiting wet markets, live poultry markets, or farms. And they should strictly observe personal and hand hygiene when visiting any place with live poultry.

The Food and Agriculture Organization of the United Nations, the World Health Organization (WHO), and the World Organisation for Animal Health urged countries in July 2023 to work together across sectors to save as many animals as possible and to protect people. 

The current outbreaks of avian influenza ("bird flu") have caused devastation in animal populations, including poultry, wild birds, and some mammals. Although primarily affecting animals, these outbreaks pose ongoing risks to humans, says the WHO.

Since the annual flu shot is not designed to be effective against bird flu viruses, the U.S. government has invested in various avian influenza vaccines.

In June 2023, the U.S. Centers for Disease Control and Prevention confirmed about 20 million H5N1 and 12 million H7N9 vaccines were available in the U.S. National Strategic Stockpile.

Aug 23, 2023 • 11:18 am CDT
J&J Blue Knight award August 22, 2023

The U.S. Administration for Strategic Preparedness and Response's Biomedical Advanced Research and Development Authority (BARDA) today awarded $10 million to Johnson & Johnson Innovation for a competition through project Blue Knight™.

"As the virus continues to evolve, we need new tools that keep pace with those changes," said Assistant Secretary for Preparedness and Response Dawn O'Connell in a press release on August 22, 2023.

This BARDA award is in alignment with 'Project NextGen' which focuses on advancing solutions aimed at addressing health security threats and improving preparedness,

Announced in May 2023, the U.S. Department of Health and Human Services Project NextGen is a $5 billion initiative led by BARDA in partnership with the National Institute of Allergy and Infectious Diseases, coordinates activities across the federal government and the private sector to advance innovative vaccines and therapeutics into clinical trials, regulatory review, and potential commercial availability for the American people.

Announced on May 11, 2023, the Blue Knight challenge offers current and alumni Blue Knight residents and their collaborators the opportunity to apply for the chance to receive funding to help them reach their critical developmental milestones.

Learn more about Blue Knight and hear from current companies at this Johnson & Johnson Innovation LLC link.

Aug 23, 2023 • 9:14 am CDT
from Pixabay

Regeneron Pharmaceuticals, Inc. today announced that the U.S. Biomedical Advanced Research and Development Authority (BARDA) entered into an agreement with the Company to support the clinical development, clinical manufacturing, and regulatory licensure process of a next-generation COVID-19 monoclonal antibody (mAb) therapy for the prevention of SARS-CoV-2 infections, which cause COVID-19 in people.

The agreement is part of the U.S. Department of Health and Human Services (HHS) 'Project NextGen' initiative to advance innovative vaccines and therapeutics for COVID-19.

Regeneron's most advanced next-generation antibody candidate under this agreement is expected to enter clinical trials in 2023.

For the new COVID-19 program announced on August 22, 2023, HHS will fund up to 70% of Regeneron's costs for certain clinical development activities for a next-generation mAb therapy. 

The new BARDA contract has an estimated value of up to approximately $326 million of government funding.

Regeneron's first COVID-19 mAb cocktail, REGEN-COV, was granted Emergency Use Authorization in November 2020, with nearly 3 million doses delivered to the U.S. Government between 2020 and 2022.

"We're pleased to expand our longstanding BARDA relationship, which is predicated on Regeneron's decades of investment in deep scientific research and enabling technologies," said Leonard S. Schleifer, M.D., Ph.D., Board Co-Chair, President and Chief Executive Officer of Regeneron, in a press release.

"Although COVID-19 has moved to an endemic stage, many people – including those with immunocompromising conditions – continue to face exposure that impacts their everyday life and could cause serious health consequences."

Previously, the U.S. CDC wrote some immunocompromised people benefit from mAb therapy instead of COVID-19 vaccination.

Under the NextGen project structure, Regeneron independently invents and proposes an antibody candidate, which BARDA and Regeneron will evaluate and agree upon for further development, manufacturing, and regulatory activities.

BARDA and Regeneron have previously worked together to deliver novel medicines for Ebola.

The new program announced today falls under Regeneron and BARDA's ongoing Other Transactions Agreement initiated in 2017 to develop a portfolio of antibodies targeting up to ten pathogens that pose significant risks to public health.

Aug 22, 2023 • 2:34 pm CDT
U.S. CDC RSV detection map August 22, 2023

In the United States, the timing of seasonal respiratory syncytial virus (RSV) outbreaks throughout the country is generally reported between October - April most years.

The 2022–23 season it started later than in 2021–2022 but earlier than prepandemic seasons, suggesting a return toward normal seasonality.

Furthermore, the state of Florida is often a bell-weather state for RSV detections, as it is in 2023.

Florida’s RSV season is longer than the rest of the nation and has distinct regional patterns. For this reason, the state is segmented into five RSV regions, each with its own season. 

The Florida Department of Health recently announced RSV activity during week #33 had increasing detection and admission rates.

As of August 19, 2023, two RSV outbreaks were confirmed in Martin County, located north of Jupiter. Last week, one RSV outbreak occurred in Jacksonville, Florida.

In the U.S., RSV infections cause thousands of hospitalizations among young children and adults aged ≥65. The U.S. Centers for Disease Control and Prevention (CDC) RSV detection 5-week moving average graphs for each state are displayed at this link.

This RSV season, the U.S. government has approved RSV vaccines and monoclonal antibody therapeutics available in specific clinics and pharmacies as of August 22, 2023.

The CDC says people should speak with a healthcare provider if these new therapeutics are appropriate for their health. 

Aug 22, 2023 • 9:02 am CDT
by Markus Winkler

Novavax, Inc. today announced that its updated protein-based XBB COVID vaccine candidate induced neutralizing antibody responses to the EG.5.1 and XBB.1.16.6 subvariants in small pre-clinical studies.

As of August 22, 2023, SARS-CoV-2 coronavirus XBB sublineage variants are overwhelmingly responsible for the majority of current COVID-19 cases in the U.S. and European Union.

"Our data have shown that Novavax's protein-based COVID vaccine induces broadly neutralizing responses against XBB subvariants, including EG.5.1 and XBB.1.16.6," commented Filip Dubovsky, President of Research and Development, Novavax, in a press release.

Non-clinical data previously showed that Novavax's COVID vaccine candidate induced functional immune responses for XBB.1.5, XBB.1.16, and XBB.2.3 variants, indicating a broad response that could potentially be applicable for forward-drift variants.

Novavax is submitting applications for its XBB.1.5 COVID vaccine candidate to regulatory authorities globally.

Novavax COVID-19 vaccine brands (Nuvaxovid, CovoVax, NVX-CoV2373, TAK-019) have been authorized in about 40 markets.

The Novavax COVID-19 Vaccine, Adjuvanted, has not been approved or licensed by the U.S. FDA but is authorized for emergency use. Novavax vaccines are available in specific clinics and pharmacies in the U.S.

Aug 21, 2023 • 5:37 pm CDT
US FDA approval Aug, 21, 2023

The U.S. Food and Drug Administration (FDA) today approved ABRYSVO™, the first vaccine approved for use in pregnant women to prevent lower respiratory tract disease (LRTD) and severe LRTD caused by respiratory syncytial virus (RSV) in infants from birth through six months of age.

Abrysvo is approved for use at 32 through 36 weeks gestational age of pregnancy, says the FDA.

Previously, the FDA approved Pfizer Inc.'s Abrysvo in May 2023 to prevent LRTD caused by RSV in individuals 60 and older.

"RSV is a common cause of illness in children, and infants are among those at highest risk for severe disease, which can lead to hospitalization," said Peter Marks, M.D., Ph.D., director of the FDA's Center for Biologics Evaluation and Research, in a press release on August 21, 2023.

"This approval provides an option for healthcare providers and pregnant individuals to protect infants from this potentially life-threatening disease." 

Recently, the FDA approved Beyfortus™ for infants born during or entering their first RSV season and for children up to 24 months of age who remain vulnerable to severe RSV disease through their second RSV season.

On July 17, 2023, Beyfortus became the first extended half-life monoclonal antibody offering passive immunization to prevent LRTI caused by RSV. 

RSV is a highly contagious virus that causes respiratory infections in individuals of all age groups, causing frequent outbreaks. Most individuals can be expected to be infected with RSV by the time they reach two years of age, says the FDA.

In most parts of the U.S., RSV circulation is seasonal, typically starting in Florida and peaking in the winter.

A study published by PLOS Medicine in July 2023 concluded RSV disease burden is high in the nearly 600 million children under five living in 121 low-income and middle-income countries. The peak age of community-based RSV incidence is 4.8 months.