Embargoed for release until 5:00 p.m. ET on Monday 30 August 2021
Annals of Internal Medicine Tip Sheet
@Annalsofim
Below please find summaries of new articles that will be published in the next issue of Annals of Internal Medicine . The summaries are not intended to substitute for the full articles as a source of information. This information is under strict embargo and by taking it into possession, media representatives are committing to the terms of the embargo not only on their own behalf, but also on behalf of the organization they represent.
All coronavirus-related content published in Annals of Internal Medicine is free to the public. A complete collection is available at https://www.acpjournals.org/topic/category/coronavirus .
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1. COVID-19 vaccination elicits antibody response in vast majority of immunocompromised patients receiving immunosuppressive therapy
Abstract : https://www.acpjournals.org/doi/10.7326/M21-1757
URL goes live when the embargo lifts
A prospective cohort study found that nearly 90 percent of immunocompromised patients taking glucocorticoids or other immunosuppressive therapy had an antibody response following SARS-CoV-2 vaccination. The response was about a third as strong as that of participants with healthy immune systems but suggests that vaccines could offer some protection to those at risk for severe illness. The findings are published in Annals of Internal Medicine.
Researchers from Washington University School of Medicine in St. Louis and the University of California, San Francisco recruited 133 adults with confirmed chronic inflammatory diseases and 53 immunocompetent volunteers to receive an mRNA vaccine for SARS-CoV-2. Participants provided blood samples within 2 weeks before receiving the first dose of the mRNA vaccine and within 3 weeks after receiving the second dose. The researchers measured each participants’ antibody levels and counted the number of antibody-producing cells in their blood samples. All patients stayed on their prescribed drug regimens, except for three whose medications were paused within one week of immunization.
The researchers found that about 9 out of 10 immunocompetent participants developed antibodies in response to the vaccine, although the response was weaker than for those in the healthy group. Patients taking glucocorticoids and those taking B cell-depleting therapies were at higher risk for not developing an antibody response.
According to the researchers, these findings should encourage immunocompromised patients to get their COVID-19 vaccine. The CDC recently recommended a third dose of vaccine for this patient population, which could elicit an even stronger response.
Media notes : Full text of this article is available free to the public at the link listed above. For an embargoed PDF, please contact Angela Collom at acollom@acponline.org . The corresponding author, Alfred Kim, MD, PhD, can be reached through Diane Williams at williamsdia@wustl.edu .
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2. High vaccination levels the single most powerful determinant of college campus safety
Colleges planning a return to pre-COVID campus activities without broad vaccination coverage or other aggressive safety measures place students and staff at substantial risk
Abstract : https://www.acpjournals.org/doi/10.7326/M21-2965
URL goes live when the embargo lifts
A modeling study found that vaccination level will be the single most powerful determinant of campus safety this fall. According to the authors from Yale School of Public Health, colleges that can achieve vaccination rates higher than 90% may safely return to normalcy with minimal additional distancing, masking, or testing. The findings are published in Annals of Internal Medicine.
To help college administrators design and evaluate customized COVID-19 safety plans, the researchers developed a dynamic, compartmental model using a modified "susceptible-exposed-infected-recovered" (SIER) framework for a hypothetical population of 5,000 students, faculty, and staff living and working within close proximity on campus. The model captured essential features facing college decision-makers including the epidemiology of SARS-CoV-2, the natural history of COVID-19 illness, and the availability and accuracy of testing technologies. The model also considered decision-maker values and preferences.
Under base-case assumptions, the model showed that if 90% coverage can be attained with a vaccine that is 85% protective against infection and 25% protective against asymptomatic transmission, the campus activities could safely be resumed while holding cumulative cases below 5% of the population without the need for routine, asymptomatic testing. With 50% population coverage using such a vaccine, a similar cap on cumulative cases would require either daily asymptomatic testing of unvaccinated persons or a combination of less frequent testing and resumption of aggressive distancing and other nonpharmaceutical prevention policies.
Based on these findings, the authors say that college administrators planning a return to pre-COVID campus activities without either broad vaccination coverage or high-frequency asymptomatic testing and aggressive distancing/masking interventions are placing their students and staff at risk of widespread viral transmission. Even with high vaccination rates, however, the authors warn that administrators should remain prepared to reinstitute or expand testing and distancing policies on short notice, if needed.
Media notes : Full text of this article is available free to the public at the link listed above. For an embargoed PDF, please contact Angela Collom at acollom@acponline.org . The corresponding author, David Paltiel, PhD, can be reached through Karen Peart at Karen.Peart@yale.edu .
Annals of Internal Medicine