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AVAC's weekly COVID News Brief provides a curated perspective on what COVID news is worth your time.
"Widespread vaccination is a critical tool to help stop the pandemic. People need to believe in science: the vaccine is being administered elsewhere and it is saving lives. But they can only do so when armed with the right information. If no action is taken to sensitize the masses and end the skepticism, we will be fighting a losing battle."
— Chege Ngugi in The Standard ([link removed])


** Share of Population Fully Vaccinated Against COVID-19
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September 30, 2021
Source: Our World in Data ([link removed])


** Table of Contents
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* If You Are in a Hurry (#hurry)
* COVID and Pregnant People (#pregnant)
* Combatting Disinformation (#combat)
* Activists Protest Biden Administration, Moderna and Others (#activists)
* Promising New Vaccine from China (#promising)
* Getting Vaccines to Rural Areas (#getting)
* COVID and HIV (#hiv)


* Boosters (#boosters)
* The Next Viruses to Worry About (#viruses)
* Vaccine Mandates (#mandate)
* The Role of Community Health Workers (#role)
* Antibodies: More Positive Data and Calls for Affordability and Access (#antibodies)
* School Mask Mandates Work (#school)
* Hope for COVID Pills (#hope)

Globally, more than 45 percent of the world population have received at least one COVID vaccine, but in low-income countries only just over two percent of people have received at least one shot. The New York Times ([link removed]) (US) reports “Only nine African countries have met a target of vaccinating 10 percent of their populations against COVID-19 by the end of September, the World Health Organization said on Thursday — a statistic that illustrates how far the continent is lagging behind global vaccination rates…. ‘In Africa, the major issue has been a supply issue rather than a demand issue,’ [Dr. Richard Mihigo, the WHO’s program coordinator for vaccine development in Africa] said, adding that vaccine hesitancy has been a concern ‘here and there.’ The WHO said it was working to identify bottlenecks in countries where limited technical capacity to deliver vaccines has hampered inoculation campaigns.” VOA
(The%20WHO%20reports%20monthly%20vaccine%20deliveries%20to%20Africa%20have%20increased%2010-fold%20since%20June.%20However,%20it%20notes%20more%20than%20double%20that%20amount%20is%20needed%20to%20reach%20the%2040%20percent%20immunization%20target%20of%20Africa’s%201.3%20billion%20people%20by%20the%20end%20of%20the%20year.) (US) reports, “The WHO reports monthly vaccine deliveries to Africa have increased 10-fold since June. However, it notes more than double that amount is needed to reach the 40 percent immunization target of Africa’s 1.3 billion people by the end of the year.”


**
If You Are in a Hurry
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* Read an editorial in Science ([link removed]) that calls for scientists to actively engage on Facebook to fight disinformation.
* Read The Guardian ([link removed]) on an Amnesty International report ([link removed]) that accuses major pharma companies human rights violations over COVID vaccine access.
* Read an opinion piece on combatting vaccine disinformation from Kenya in The Standard ([link removed]) and another from the US in MedPage Today ([link removed]) .
* Then head to Daily Maverick ([link removed]) to read about a doctor in South Africa combatting myths about the vaccine’s effect on men’s virility.
* Read Bhekisisa ([link removed]) on successful vaccine roll out in some rural areas in South Africa.
* Read AFP ([link removed]) on the devastating impact of COVID-19 on HIV programs in Eastern Europe.
* Read a Devex ([link removed]) opinion piece by John Nkengasong and Ellen Johnson Sirleaf on the vital role of community health workers.
* Read Science ([link removed]) on promising new data for a Chinese vaccine candidate that could help COVAX meet its goals.
* Read AP ([link removed]) and USA Today ([link removed]) on promising research for pills to treat and prevent COVID.




** COVID and Pregnant People
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NBC News ([link removed]) (US) reports, “The Centers for Disease Control and Prevention on Wednesday issued its strongest guidance ([link removed]) to date urging pregnant women to be vaccinated against COVID-19. The guidance comes as more than a quarter million cases of COVID in pregnant women have been reported, 22,000 of whom were hospitalized, according to the CDC. A total of 161 pregnant women have died of COVID, the CDC said, with 22 deaths in August alone. Yet, less than a third of pregnant women have been vaccinated, the agency reported…. ‘I strongly encourage those who are pregnant or considering pregnancy to talk with their health care provider about the protective benefits of the COVID-19 vaccine to keep their babies and themselves safe,’ CDC Director Dr. Rochelle Walensky said….”



** Combatting Disinformation
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An editorial in Science ([link removed]) (US) focuses on the disinformation that spreads on Facebook noting, “the pandemic has revealed shocking ineptness by the scientific establishment at conveying messages about masks, vaccination, or the dangers of consuming horse drugs and aquarium cleaners—even in the face of a rising death toll from COVID-19. One puzzling element of this crisis is how social media has been skillfully exploited by antiscience forces. Given all of this, what is the right move for science communication as it relates to social media? Unfriend Facebook or beat it at its own game?” The answer is to beat it at its own game with scientists and communicators with “a knack for cutting through the caveats and conditions and forcefully conveying the bottom line. Like their opponents, they need to be adept at strategically exploiting the algorithms that can push a post to the forefront or bury it in the never-ending racket…. Since the
end of World War II, scientists have clung to the idea that if they stay objective and state the science, then the rest of the world will follow. As climate change rages and the pandemic cycles on, it’s time to face the fact that this old notion is naive.”

The Washington Post ([link removed]) (US) reports, “YouTube is taking down several video channels associated with high-profile anti-vaccine activists including Joseph Mercola and Robert F. Kennedy Jr., who experts say are partially responsible for helping seed the skepticism that’s contributed to slowing vaccination rates across the country…. YouTube will ban any videos that claim that commonly used vaccines approved by health authorities are ineffective or dangerous. The company previously blocked videos that made those claims about coronavirus vaccines, but not ones for other vaccines like those for measles or chickenpox…. But as the companies increasingly come under fire from regulators, lawmakers and regular users for contributing to social ills—including vaccine skepticism—YouTube is again changing policies that it has held onto for months.”

An opinion piece in The Standard ([link removed]) (Kenya) says, “A recent survey by the Africa CDC indicated that vaccine hesitancy is a major cause for concern, as it compounds the COVID-19 threat. Respondents viewed the new COVID-19 vaccines as less safe than vaccinations in general, while more than half said the seriousness of COVID-19 is exaggerated…. Hesitancy is rife, even among health workers who should be the vaccine ambassadors. Isn’t it ironical that when COVID-19 hit, we worried about finding a vaccine, yet when vaccines are finally here, we now doubt them? Fear about the vaccines can be linked to lack of information and misinformation to far-fetched conspiracy theories.” The author argues, “Widespread vaccination is a critical tool to help stop the pandemic. People need to believe in science: the vaccine is being administered elsewhere and it is saving lives. But they can
only do so when armed with the right information. If no action is taken to sensitize the masses and end the skepticism, we will be fighting a losing battle. Low vaccination rates in Africa give the virus an opportunity to mutate and spin out of control.”

An opinion piece in MedPage Today ([link removed]) (US) argues for using “values-based communication” to reach vaccine holdouts. “Maximizing the immunization of Americans is necessary to stop the pandemic, but so far, our attempts to get the holdouts vaccinated has proven futile. It's time for a new approach. One focused less on the facts and the benefits of vaccination, and more on tapping into the deeply held values of the resisters…. Traditional public health education emphasizing the dissemination of scientific knowledge and demonstration of benefit has been useless in changing their behavior, has been rejected, and in some ways, has made matters worse. Understanding this paradox will lead to a more effective approach. The crucial point is: ignorant, aberrant, or selfish behavior is not the issue; self-esteem, values, and pride are. Their public iconoclasm is akin to the enthusiasm of avid sports
fans, but self-protective, infused with a core impact on life or death decisions.”

Daily Maverick ([link removed]) (South Africa) reports on an Eastern Cape doctor who is trying to get more men in the region vaccinated. Dr Thami Hewu is trying to combat myths that the vaccine affects virility. “’I said to them right there, where everybody was listening, I am vaccinated and there is happiness at my house. I haven’t seen a decrease in my libido. Even in my patients, I have seen no such thing. You hear these stories, but there really is no evidence that the vaccine will lower libido…. People are in denial about many things here. Smoking, drinking, being overweight and a lack of exercise can all cause a drop in libido, but now the poor vaccine gets the blame and impotence becomes an excuse not to take it,’ Hewu said.”



** Activists Protest Biden Administration, Moderna and Others
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The New York Times ([link removed]) (US) reports, “A small band of longtime AIDS activists, fed up with what they regard as President Biden’s failure to scale up coronavirus vaccine manufacturing for global use, deposited a fake mountain of bones outside the home of Ron Klain, his chief of staff, on Wednesday to represent the lives that they say have been lost to the president’s inaction…. ‘Nobody wants to be here in front of Ron Klain’s house, protesting a president that most of us all voted for,’ said Gregg Gonsalves, a Yale University epidemiologist [and activist]…. With less than 10 percent of people in many poor nations ([link removed]) fully vaccinated and a dearth of doses contributing to the suffering of millions, pressure has been growing on both Mr. Biden and drug makers ([link removed]) to provide more
low-cost vaccines to the world.”

The Harvard Crimson ([link removed]) (US) reports, “A group of Harvard-affiliated doctors protested outside the home of Moderna’s CEO Wednesday, calling on the Cambridge-based biotech company to expand global access to its COVID-19 vaccine. Standing in front of a towering pile of artificial bones meant to symbolize the coronavirus’s ever-growing death toll, four Harvard Medical School faculty members said the company and its top executive, Stéphane Bancel, have a responsibility to increase supply of the vaccine outside of wealthy nations.”

The Guardian ([link removed]) (UK) reports, “Amnesty International has accused six pharmaceutical companies that have developed COVID-19 vaccines of fuelling a global human rights crisis, citing their refusal to sufficiently waive intellectual property rights, share vaccine technology and boost global vaccine supply…. Despite calls to ensure a fair global vaccine supply, some companies have continued to disproportionally distribute vaccines to wealthy countries, according to Amnesty’s report ([link removed]) …."



** Promising New Vaccine from China
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Science ([link removed]) (US) reports, “findings announced by China’s Clover Biopharmaceuticals on 22 September—in a press release and a slide deck full of unusually fine-grained information—stood out. Two doses of Clover’s vaccine, based on a modified SARS-CoV-2 protein, offered solid protection against five variants of the virus, including the highly infectious Delta strain now dominant across the world. The shots lowered the risk of disease both in people naïve to the virus and those who had previously been infected. And the Clover vaccine can be stored in a refrigerator, unlike messenger RNA (mRNA) products, which require freezers. Kathleen Neuzil of the University of Maryland School of Medicine, who co-leads a US COVID-19 vaccine trials network, says the data are ‘terrific’ and ‘welcome news for the world.’”



** Getting Vaccines to Rural Areas
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Aisha Abdool Karim and Joan van Dyk write for Bhekisisa ([link removed]) (South Africa) about successful vaccine programs in rural parts of South Africa. “In the Eastern Cape, the Bulungula Incubator and the provincial health department have vaccinated 95 percent of people over the age of 60 with their first dose of Pfizer in the hard-to-reach villages around Xhora Mouth on the Wild Coast, the organisation’s data shows.” Successful strategies have included transporting people to vaccination sites via taxis, mobile vaccine sites and a taking vaccines and information to taverns. “’We have included taverns in our vaccination campaign because we want to go where men socialise and spend their free time after work and on weekends,’ said health MEC Nomakhosazana Meth. The Mthatha tavern campaign aimed to dispel myths and counter concerns men may have about getting the jab—such as
that it causes impotence (it doesn’t) and can kill you after two years (it can’t). The idea is that once men commit to being vaccinated, they will then go on to encourage others to do the same.”



** COVID and HIV
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AFP ([link removed]) (France) reports on the devastating impact of the COVID-19 pandemic on HIV programs in Eastern Europe. “UNAIDS data shows 140,000 new infections in Eastern Europe and Central Asia in 2020, compared with 170,000 in 2019, which experts attribute to a dramatic slowdown in screening, not a drop in cases…. The pandemic has disrupted supply chains and the transport of medicines, exacerbating historic shortages in countries such as Romania despite huge scientific strides that have dramatically improved outcomes for HIV patients in rich nations.

Contagion Live ([link removed]) (US) reports “A study presented virtually at IDWeek ([link removed]) …reported the cumulative incidence and incidence rate ratios (IRR) for COVID-19 across a long-term, multi-site cohort of [People with HIV] PWH across the US…. Throughout the course of the study, 651 PWH were confirmed positive for COVID-19, making the cumulative incidence 4.13 percent.... At the December 2020 peak, cumulative incidence in Hispanic PWH was 2.35 fold (P< .0001) higher than in white PWH, and 1.68 fold (p=.033) higher in Black PWH than white PWH. These trends remained constant despite geographic difference in pandemic wave and access to COVID-19 testing.”



** Boosters
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CNBC ([link removed]) (US) reports, “vaccinated people say the third dose approved by US regulators last week shows that scientists are trying to make the shots more effective while 71 percent of unvaccinated Americans say it’s proof the vaccines don’t work, according to a survey released Tuesday ([link removed]) by the Kaiser Family Foundation…. The split in attitudes toward vaccines more broadly continues to be a largely partisan one, the survey data shows, with 90 percent of respondents who are Democrats saying they have received at least one vaccine dose compared with 58 percent of Republicans.”

Medscape ([link removed]) (US) reports, “The FDA is leaning toward authorizing half-dose booster shots of Moderna's COVID-19 vaccine. Federal regulators believe the half-dose shot could provide enough protection. The move could broaden the US booster campaign…though it's unclear when an official announcement about the Moderna vaccine will come.”

NPR ([link removed]) (US) reports on concerns that people who received the one-shot J&J vaccine may need a booster. “The Johnson & Johnson booster is a ‘bigger’ issue, several [US CDC vaccine advisory committee] panelists noted, because people who received that vaccine may need a booster more urgently than those who received the Pfizer or Moderna…. The problem is the efficacy of the Johnson & Johnson vaccine for preventing severe disease has dropped to the same level for people of all ages, according to data presented by the CDC, says Monica Gandhi, an infectious disease physician at the University of California, San Francisco…. ‘Though we couldn't officially recommend it, we supplied Pfizer mRNA booster shots to anyone who had gotten Johnson & Johnson vaccines over the last two months,’ she adds.”



** The Next Viruses to Worry About
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Nature ([link removed]) (UK) reports, “Scientists have found three viruses in bats in Laos that are more similar to SARS-CoV-2 than any known viruses. Researchers say that parts of their genetic code bolster claims that the virus behind COVID-19 has a natural origin ([link removed]) —but their discovery also raises fears that there are numerous coronaviruses with the potential to infect people…. Together with relatives of SARS-CoV-2 discovered in Thailand, Cambodia and Yunnan in southern China^, the study demonstrates that southeast Asia is a ‘hotspot of diversity for SARS-CoV-2-related viruses’, says Alice Latinne, an evolutionary biologist at the Wildlife Conservation Society Vietnam in Hanoi.”



** Vaccine Mandates
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Public health lawyer Safura Abdool Karim writes in Bhekisisa ([link removed]) (South Africa), “The South African government says it won’t make COVID vaccinations compulsory for its employees for now—but that they won’t stand in the way of private businesses who want to introduce mandatory vaccinations…. The practice is not new, and South Africa already has some mandates in place to encourage specific vaccinations…. [One] example is the yellow fever vaccine passport, which was instituted in line with the World Health Organisation’s International Health Regulations. Anyone who wants to travel to an area with a high risk of yellow fever must prove that they have been vaccinated against the disease before being allowed to enter that country or to re-enter South Africa. Those who do not want to be vaccinated are not forced to take a vaccine, but are prohibited from travelling.”

The Conversation ([link removed]) (US) reports, “Several surveys have shown that as many as half of unvaccinated workers insist they would leave their jobs if forced to get the shot, which has raised alarms among some that more mandates could lead to an exodus of workers in many industries.” In a June survey researchers “found that 16 percent of employed respondents would quit, start looking for other employment or both if their employer instituted a mandate. Among those who said they were ‘vaccine hesitant’—almost a quarter of respondents—we found that 48 percent would quit or look for another job…. But while it is easy and cost-free to tell a pollster you’ll quit your job, actually doing so when it means losing a paycheck you and your family may depend upon is another matter. And based on a sample of companies that already have vaccine mandates in
place, the actual number who do resign rather than get the vaccine is much smaller than the survey data suggest.”



** The Role of Community Health Workers
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In an opinion piece in Devex ([link removed]) (US), John Nkengasong and Ellen Johnson Sirleaf write, “The key role of community health workers in crisis response—from Ebola to COVID-19—cannot be overstated. They offer critical surveillance, provide testing and referrals, and maintain access to lifesaving primary care. We saw this during the Ebola epidemic in West Africa from 2014 to 2015, and we are seeing it now while community health workers around the world serve as crucial connectors to health care in ‘last mile’ communities…. We must solidify commitments and political will with dedicated investments to support the successful implementation and scale up of community health worker programs on the continent.”



** Antibodies: More Positive Data and Calls for Affordability and Access
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Medscape ([link removed]) (US) reports, “A monoclonal antibody combination of casirivimab and imdevimab (REGEN-COV) significantly reduced the risk of COVID-19–related hospitalizations and death from any cause in the phase 3 portion of an adaptive trial of outpatients. Researchers… found in the randomized trial that the combination also resolved symptoms and reduced the SARS-CoV-2 viral load more quickly compared with placebo. Findings were published online ([link removed]) Wednesday in the New England Journal of Medicine.” One expert noted “these findings confirm benefits of REGEN-COV and are very good news for a patient group that includes those age 65 and older with high blood pressure, diabetes or obesity; and for people not vaccinated, who are all at high risk of hospitalization or death if they get COVID-19.”

Al Jazeera ([link removed]) (Qatar) reports WHO “has added the Regeneron antibody drug cocktail—casirivimab and imdevimab—to its list of treatments for people with COVID-19, urging the manufacturer to reduce the price and ensure equitable distribution…The health agency urged Regeneron, which holds the patent, to lower the drug’s price and work on equitable distribution worldwide. It should also share technology to allow for the manufacturing of biosimilar versions, the WHO added. Swiss drugmaker Roche is working in partnership with Regeneron to produce the antibody treatment.”

In a statement Médecins Sans Frontières/Doctors Without Borders ([link removed]) called on Regeneron “to take immediate actions to ensure they are affordable and accessible for everyone who needs them and forego any monopoly on these new treatments…. Given that Regeneron received significant public funding to develop casirivimab/imdevimab, and that manufacturing costs of mAbs are estimated to be below $100 per gram when produced at large scale, the company should immediately drop the price to reflect the cost of production and engage in technology transfer to other producers. Facing the foreseeable supply constraints of this treatment, governments should make use of all possible legal and policy measures to remove barriers to access to technologies and to accelerate development and introduction of biosimilar alternatives to ensure sustainable supply and access.”



** School Mask Mandates Work
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Results from a study in the US CDC’s MMWR ([link removed]) , “indicate that increases in pediatric COVID-19 case rates during the start of the 2021–22 school year were smaller in US counties with school mask requirements than in those without school mask requirements.”



** Hope for COVID Pills
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AP ( ([link removed]) US) reports Merck says, “that its experimental COVID-19 pill reduced hospitalizations and deaths by half in people recently infected with the coronavirus and that it would soon ask health officials in the US and around the world to authorize its use. If cleared, the drug would be the first pill shown to treat COVID-19, a potentially major step forward in global efforts to control the pandemic ([link removed]) . All COVID-19 therapies ([link removed]) now authorized in the US require an IV or injection."

USA Today ([link removed]) (US) reports on pills being tested for early treatment of COVID. At least three promising antivirals for COVID-19 are being tested in clinical trials, and results are expected as soon as late fall or winter, said Carl Dieffenbach, director of the Division of AIDS at the National Institute of Allergy and Infectious Diseases, who is overseeing antiviral development. ‘I think that we will have answers as to what these pills are capable of within the next several months,’ Dieffenbach said…. They work by interfering with the virus’s ability to replicate in human cells…. Only one antiviral drug, remdesivir, has been approved to treat COVID-19. But it is given intravenously to patients ill enough to be hospitalized and is not intended for early, widespread use. By contrast, the top contenders under study can be packaged as pills.”

Reuters ([link removed]) (UK) reports, “Pfizer Inc. said on Monday it has started a large study testing its investigational oral antiviral drug for the prevention of COVID-19 infection among those who have been exposed to the virus…The mid-to-late-stage study will test Pfizer's drug, PF-07321332, in up to 2,660 healthy adult participants aged 18 and older who live in the same household as an individual with a confirmed symptomatic COVID-19 infection. In the trial, PF-07321332, designed to block the activity of a key enzyme needed for the coronavirus to multiply, will be administered along with a low dose of ritonavir, an older medication widely used in combination treatments for HIV infection.

Fact checking website Full Fact ([link removed]) (UK) reports, “A Facebook post falsely suggests that a potential new COVID-19 treatment from Pfizer is essentially the same as ivermectin. In fact, the two drugs are structurally very different. The post shows a screenshot of a Pfizer press release announcing the trial of a new antiviral agent against SARS-CoV-2, alongside a screenshot of a paper about ivermectin published in the journal Future Virology. But even if both drugs do have a protease inhibitor effect (slowing down the enzyme protease, which breaks down proteins), Pfizer’s new drug trial candidate and ivermectin are completely different chemical compounds. According to Dr Stephen Griffin, a virologist and Associate Professor at Leeds Institute of Medical Research, they are ‘extremely structurally different’.”
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