Keith Mayer: University of Virginia study gives nod to Moderna vaccine for the most at risk of COVID
Apr. 23—The University of Virginia recently tracked its COVID-vaccinated employees who wanted to participate in a study, then monitored the antibodies that the vaccinations produced.
The study produced these findings:
—The antibodies generated by Pfizer's vaccine rise more slowly and decline more quickly than those generated by the Moderna vaccine.
—The study also found that older recipients of the Pfizer vaccine generated fewer antibodies than did younger recipients, but that wasn't the case for Moderna, where age did not appear to be a factor.
—The researchers determined that both vaccines generated similar peak levels of antibodies.
—A week to 20 days after their second dose, recipients of Pfizer's and Moderna's mRNA vaccines had antibody levels that were approximately 50 times higher those seen in the Johnson & Johnson single-shot recipients. Shortly thereafter antibodies from both Pfizer and Moderna began to drop, but the drop was more precipitous for Pfizer.
—After six months, Pfizer vaccine recipients had antibody levels lower than both the Moderna recipients and patients who had been hospitalized with severe COVID-19 six months prior.
The Pfizer vaccine is given the majority of the time in the nation, and by a wide margin over Moderna and the Johnson & Johnson product. However, mixing vaccines is also done, though it's unclear how often that happens.
Dr. Jeffrey Wilson, one of the chief authors said that highest risk groups should go with Moderna.
"(If you're) 25 it doesn't matter, but if you're 75 maybe you think more about it," Wilson told the Reading Eagle about personal deliberations over vaccines.
Wilson said that antibodies are not the only measure of vaccine effectiveness.
"I just recommend that people get vaccinated," he said. "Not everybody is quite equal. There are different conditions. Measuring antibodies is only one thing, but it's one of the markers."
The study monitored 114 people who received the Pfizer shot and 114 who took the Moderna. The 114 for both was a coincidence, Wilson said.
Reading Hospital's vaccination effort has seen Pfizer shots at 63 percent and Moderna shots at 36 percent.
Dr. Debra Powell, chief, Division of Infectious Diseases and medical director, infection prevention, at Reading Hospital provided this emailed response regarding the University of Virginia's study:
"It's important to remember that antibody levels are only one part of the immune response, and we expect to see antibody levels to decline over time. The COVID-19 vaccines protect patients from severe illness, hospitalization, and death, which is our primary goal. We also expect that we will see some breakthrough infections but most of these infections will be mild. For those who are vaccinated, the currently circulating variant, Omicron BA.2, the most common symptoms are upper respiratory including runny nose, sore throat, cough, and fever and most patients can recover at home.
"We encourage patients that qualify for a COVID-19 booster to obtain a shot at their local pharmacy or primary care provider. This is especially important for higher risk patients. Patients can choose to select a different mRNA vaccine or continue with the same mRNA vaccine for their COVID-19 vaccine booster doses."
The proportions of the vaccines by Tower Health are similar to the distribution figures nationally, which are 59% Pfizer and 38% Moderna, with a smattering of Johnson & Johnson.
"It is not surprising that antibody levels fall after vaccination," said Behnam Keshavarz, an immunologist at the University of Virginia School of Medicine in a written statement. "But we were struck by how rapidly the antibodies fell after the mRNA vaccines, particularly the Pfizer/BioNTech vaccine."
Vaccinations in Berks County continue at a low level, about 500 to 800 people a week have been finishing the two-dose course of the Pfizer or Moderna vaccines. There are usually more boosters being given. But the picture of how many people are involved is muddied by the fact that second boosters are lumped in with the tally of first boosters and all the shots given to the immunocompromised.
Overall shot-giving was down to trickle in February and March but has picked up a bit in April. Health experts plan to ramp up vaccination campaigns ahead of colder weather in fall since the antibody levels in many people will have declined significantly.
Asked about the future, Wilson said, "I think everyone's done with it (COVID), whether it's done with us ... ." His voice trailed off.
Weekly case numbers
The COVID case numbers were up for Berks and in Pennsylvania overall in the latest weekly Early Warning Monitoring Dashboard from the Pennsylvania Department of Health.
The dashboard compares the week ending Thursday with the week ending April 14.
Berks County had an increase of 43 cases for the week, a rate of 36.8 new cases per 100,000 population and a positivity rate of 6.6%, which was a big jump from 3.9% a week earlier.
Pennsylvania overall was plus 688 cases, 55.6 per 100,000 and a 7.2% positivity rate.
The report again shows the heavily populated counties — except for Philadelphia this time — driving the state surge:
—No. 2, Allegheny: plus 243, 79.8 and 9.5%
—No 3, Montgomery: plus 146, 80.6 and 9.1%
—No. 5, Delaware: plus 78, 71.1 and 7.5%
—No. 7, Chester: plus 66, 78.3 and 10.1%.
After contributing to a big state increase the previous week, No. 1 Philadelphia offset the increases elsewhere with minus 450 cases for the week, a rate 64.9 per 100,000 and 6.2% positivity.
Cases had already begun turning up in the weekly Pennsylvania report that compared April 7 with the week ending March 31, after two months of declines.
Berks is the ninth-most-populous county in the state.
The other more populated counties are No. 4 Bucks, No. 6 Lancaster and No. 8 York, which all had more modest weekly increases in cases and positivity.
The national picture
In the latest figures from the U.S. Centers for Disease Control and Prevention, there are now four omicron strains of COVID circulating in the U.S.
The BA.2 strain remains the majority at 74.4% of the cases, though it has lost some of its share to a fast-growing strain with the moniker BA.2.12.1, that has 19.0% of the cases. The original omicron and its earliest offspring have been nearly squeezed out of existence.
For the mid-Atlantic region, the BA.2.12.1 is at 23.5% of the cases and might be responsible for the recent surge.
The number of cases remain a fraction of the worst of the omicron surge.
The latest seven-day COVID case average is 40,744, according to the CDC. That's up about 30% from a week ago, and about a 40% increase from the low point on March 29 following the big omicron surge to start 2022.
But it's only 5% of the official cases at the height of the omicron surge at nearly 807,000 on Jan. 15.
COVID in Berks
The updates for Berks County on Saturday of the Pennsylvania Department of Health COVID-19 dashboard and the U.S. Centers for Disease Control and Prevention county tracker yielded the following statistics for Berks that are good through Friday:
37: new cases and reinfections
102,662: pandemic total
32: seven-day case average
27: 14-day case average
1,594: pandemic deaths, state
1,452: pandemic deaths, coroner
0: ICU count
5: COVID hospital admissions past week
255,023: fully vaccinated individuals; 64.0% of the population age 5 and older
111,300: boosters given; includes second boosters
5.85%: Positivity rate; a daily rate that differs from the weekly
Low: Community risk level
429,000: Berks population
Notable: There was one death of a Berks resident in the daily report. About 700 Berks residents became fully vaccinated in the past week. Three rural counties on or near the New York state line are now high risk, and one more is moderate risk. The rest of Pennsylvania is low. A drop-off in daily case levels is likely with the next two reports because of a weekend dip in processing.