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COVID-19 Scan for Nov 04, 2021
COVID vaccines and older adults; Bamlanivimab against COVID-19 hospitalization
US COVID vaccine rollout tied to fewer cases, hospital visits in older adults
The initial COVID-19 vaccine campaign in the United States was associated with fewer infections, emergency department (ED) visits, and hospitalizations among adults 65 and older, finds a study yesterday in The Lancet.
Researchers at the Centers for Disease Control and Prevention (CDC) analyzed population-based COVID-19 data reported to US federal agencies from Nov 1, 2020, to Apr 10, 2021. Starting in mid-December, healthcare workers were prioritized for vaccines, followed by adults 75 years and older, those aged 65 to 74, and those 16 to 64 at high-risk for poor COVID-19 outcomes.
COVID-19 vaccination was linked to a 53% reduction in infection among adults aged 65 to 74 years and a 62% reduction among those 75 years and older, relative to those aged 50 to 64. Similarly, ED visits decreased 61% in adults 65 to 74 and 77% in those 75 and older, relative to the younger age-group.
Hospitalizations fell 39% among adults aged 60 to 69 years, 60% in those 70 to 79 years, and 68% in those 80 and older, compared with the younger age-group. Likewise, COVID-19 deaths dropped a relative 41% among adults 65 to 74 years and 30% in those 75 and older, but the study authors said the impact of the vaccines on deaths was not clear.
"Although it is not possible to conclusively attribute these declines solely to vaccination given the ecological design of this analysis, these results suggest that the initial phases of the US COVID-19 vaccination programme led to a meaningful reduction in COVID-19 burden among US people aged 65 years and older, a group at high risk of severe outcomes from COVID-19," the researchers wrote.
In a commentary in the same journal, Justin Ortiz, MD, and Kathleen Neuzil, MD, MPH, both of the University of Maryland, said that it will be important to evaluate public health outcomes in diverse settings because of differences in circulation and the emergence of SARS-CoV-2 variants, vaccines and vaccination schedules, and the diversity of targeted populations.
"Future COVID-19 vaccine impact studies in the USA will need to be timely to keep pace with critical public health needs," they wrote. "Finally, as the largest vaccine roll-out in history expands even further, we must ensure that low-income and lower–middle-income countries are supported in their efforts to establish immunisation programme monitoring and evaluation to guide appropriate and context-specific decision making."
Nov 3 Lancet study and commentary
Study: Bamlanivimab protects against COVID-19 hospitalization in seniors
A new case-control study shows the monoclonal antibody bamlanivimab offered good protection against hospitalization in 1,257 adult US outpatients who were either 65 or older or obese. The study was published yesterday in Open Forum Infectious Disease.
The patients in the study sought treatment in the Mass General Brigham (MGB) health system, where a lottery system had been put in place for the monoclonal antibody therapy beginning in December 2020. This study was based on patients who entered the lottery from Dec 9, 2020 and Feb 25, 2021, and were 65 years and older and had a body mass index (BMI) of 35 or higher.
According to the researchers, patients who received bamlanivimab had a statistically significant, 68% reduction in the odds of hospitalization, and a statistically significant difference in the odds of death (odds ratio, [OR], 0.03; 95% confidence interval [CI], 0 to 0.25; P<0.01), compared with those who did not receive bamlanivimab.
Despite the promising results, bamlanivimab is no longer administered alone, only in combination with other monoclonal antibody therapies, per the Food and Drug Administration.
"Not withstanding these limitations, the study supports the effectiveness of monoclonal antibody therapy for Covid-19 under real world conditions in reducing the rate of hospitalization for adult patients with BMI ≥ 35 or age ≥ 65 and suggests that there may be a mortality benefit in this population," the authors concluded.
Nov 3 Open Forum Infect Dis study
