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Monday, July 5, 2021

S. Korea in Talks With MRNA Vaccine Makers to Make up to 1 Billion Doses

 South Korea is in talks with mRNA vaccine makers including Pfizer and Moderna to produce COVID-19 shots in the country and is ready to offer the capacity to make up to 1 billion doses immediately, a senior government official said.

The plan, if agreed, would help ease tight global supply of COVID-19 vaccines, particularly in Asia which lags North America and Europe in vaccine rollouts, and put South Korea a step closer to its ambition to become a major vaccine manufacturing centre.

South Korea already has deals to locally produce three coronavirus vaccines developed by AstraZeneca/Oxford University, Novavax, and Russia. It also has a vaccine bottling and packaging deal with Moderna.

"We've been holding frequent talks with big pharmaceutical companies to produce mRNA vaccines," Lee Kang-ho, director general for the global vaccine hub committee under South Korea's health ministry, told Reuters in an interview.

"There are only a few mRNA vaccine developers - Pfizer, Moderna, CureVac and BioNTech. Thus there's a limit to how much they can produce to meet global demand... South Korea is keen to help by offering its facilities and skilled human resources," Lee said.

It's not immediately clear how advanced these talks are and whether and when a deal will be agreed.

BioNTech declined to comment, Moderna and CureVac did not reply to Reuters' requests for comments.

A Pfizer spokesperson said the company is making efforts to enhance its COVID-19 vaccine supply chain but added "we do not have anything specific to announce at this time."

Lee declined to name local vaccine makers which have the capacity to produce mRNA vaccines immediately, but a government source said they include Hanmi Pharmaceuticals Co Ltd and Quratis Co Ltd.

Hanmi confirmed that it has a big capacity reserved for Sanofi's diabetes drug and it can be used for COVID-19 vaccine production as the Sanofi project has stalled.

"We happen to have this facility available right now because our clinical trial (with Sanofi) was discontinued in the middle of last year," Kim Soo-jin, senior vice president of Hanmi, told Reuters.

"It’s very timely that we have a fully ready, GMP, state-of-the-art facility available," she said, referring to good manufacturing practice.

Quratis, which makes a tuberculosis vaccine, said its new factory built last year can now be used for mRNA vaccine production.

Shares in Hanmi erased early losses and rose nearly 7% on Monday after the Reuters report, and its top shareholder Hanmi Science jumped 10.3%.

COLLABORATION WITH WHO

South Korea has stepped up its effort to produce more vaccines since U.S. President Joe Biden in May agreed with South Korean President Moon Jae-in on a comprehensive partnership on COVID-19 vaccines.

Lee said his team is having frequent video conference calls with the vaccine makers and the World Health Organization (WHO).

WHO spokesman Tarik Jasarevic told Reuters the organisation is "talking with South Korea and other countries," but did not elaborate.

The WHO said last month it will set up a hub in South Africa to manufacture mRNA vaccines within 9-12 months that will give companies from poor and middle-income countries the know-how and licenses to produce COVID-19 vaccines.

Lee said mRNA vaccine makers may be reluctant to share their technology, but they can take advantage of South Korea's raw material suppliers to address a global shortage of such ingredients as lipids, nucleotides and capping reagents.

"They're capable of manufacturing and developing such raw materials to help vaccine makers... and the South Korean government is committed to provide all necessary support including financial and administrative aid."

Lee said the country also has a capacity for at least another 500 million doses of fill-and-finish vaccines apart from the deal Moderna announced with Samsung BioLogics in May.

South Korea has deals to buy 106 million doses of mRNA vaccines from Pfizer and Moderna to cover full vaccination of its population of 52 million this year. The government said last week it would purchase more mRNA shots to use them as a booster shot next year.

Leaked Memo Raises Thai Concern About Sinovac Vaccine's Efficacy

 A leaked health ministry document has prompted calls in Thailand for medical staff inoculated against COVID-19 to be given a booster of an mRNA vaccine, after it included a comment that such a move could dent public confidence in Sinovac Biotech's vaccine.

The internal memo, which included various opinions, was reported by local media and shared widely on social media. It was confirmed by Thai Health Minister Anutin Charnvirakul as being authentic.

It included a comment from an unnamed official who recommended authorities do not give a booster shot of Pfizer-BioNTech's vaccine to frontline health workers, because such a move would be "admitting that the Sinovac vaccine is not effective".

Thailand has administered Sinovac's inactivated virus vaccine to most health workers and its real-world study showed two doses were 95% effective in reducing mortality and severe symptoms. The study showed it was 71% to 91% effective in stopping infection with the Alpha variant.

The comment in the leaked document prompted calls from prominent Thai health experts, including a top medical council official, to give health workers a Pfizer-BioNTech booster shot.

The hashtag "Give Pfizer to medical personnel" was trending on Thai Twitter with more than 624,000 tweets on Monday.

Senior health official Opas Karnkawinpong told reporters the document was not real, however, contradicting health minister Anutin.

Anutin said the comment on the booster shot was "just an opinion" and there was an expert panel to set vaccine policy.

He said two doses of Sinovac's vaccine were effective and "deliver results beyond the standard".

Thai experts have urged the government to use various types of coronavirus vaccine to better protect the population.

It is relying mainly on AstraZeneca's locally manufactured viral vector vaccine, while authorities say Moderna's mRNA vaccine will also be available.

Thailand has procured 20 million doses of the Pfizer-BioNTech vaccine for future delivery and will this month receive 1.5 million doses donated by the United States.

World Health Organization experts found the Sinovac vaccine was efficacious in preventing COVID-19 in adults under 60, but some quality data on the risk of serious adverse effects was lacking.

https://www.usnews.com/news/world/articles/2021-07-05/leaked-memo-raises-thai-concern-about-sinovac-vaccines-efficacy

Sunday, July 4, 2021

Combined Metabolic Activators Accelerates Recovery in Mild-to-Moderate COVID-19

 Ozlem AltayMuhammad ArifXiangyu LiHong YangMehtap AydınGizem AlkurtWoonghee KimDogukan AkyolCheng ZhangGizem Dinler-DoganayHasan TurkezSaeed Shoaie

DOI:  

https://doi.org/10.1002/advs.202101222

PDF: https://onlinelibrary.wiley.com/doi/epdf/10.1002/advs.202101222

Abstract

COVID-19 is associated with mitochondrial dysfunction and metabolic abnormalities, including the deficiencies in nicotinamide adenine dinucleotide (NAD+) and glutathione metabolism. Here it is investigated if administration of a mixture of combined metabolic activators (CMAs) consisting of glutathione and NAD+ precursors can restore metabolic function and thus aid the recovery of COVID-19 patients. CMAs include l-serine, N-acetyl-l-cysteine, nicotinamide riboside, and l-carnitine tartrate, salt form of l-carnitine. Placebo-controlled, open-label phase 2 study and double-blinded phase 3 clinical trials are conducted to investigate the time of symptom-free recovery on ambulatory patients using CMAs. The results of both studies show that the time to complete recovery is significantly shorter in the CMA group (6.6 vs 9.3 d) in phase 2 and (5.7 vs 9.2 d) in phase 3 trials compared to placebo group. A comprehensive analysis of the plasma metabolome and proteome reveals major metabolic changes. Plasma levels of proteins and metabolites associated with inflammation and antioxidant metabolism are significantly improved in patients treated with CMAs as compared to placebo. The results show that treating patients infected with COVID-19 with CMAs lead to a more rapid symptom-free recovery, suggesting a role for such a therapeutic regime in the treatment of infections leading to respiratory problems.

https://onlinelibrary.wiley.com/doi/10.1002/advs.202101222

Delayed 2nd dose, 3rd doses of Oxford-AstraZeneca vaccine lead to heightened immune response

 Research on the ChAdOx1 nCoV-19, also known as the Oxford-AstraZeneca vaccine, indicates that a long interval between first and second doses does not compromise the immune response after a late second dose.

Additionally, a third dose of the vaccine continues to boost antibodies against SARS-CoV-2. The results were released in a preprint today.

COVID-19 vaccine supply shortages are causing concerns in some countries about compromised immunity as the interval between first and second dose extends due to limited vaccine availability. When examining the effects of a delay of up to 45 weeks between first and second doses in study participants, results demonstrated that antibody levels were increased after a delayed second dose. Additionally, a longer delay between first and second doses may be beneficial, resulting in an increased antibody titre and enhanced immune response after the second dose.

Professor Sir Andrew Pollard, Professor of Paediatric Infection and Immunity and Lead Investigator of the Oxford University trial of the vaccine, says, ‘This should come as reassuring news to countries with lower supplies of the vaccine, who may be concerned about delays in providing second doses to their populations. There is an excellent response to a second dose, even after a 10 month delay from the first.’

Conversely, some countries are considering administering a third ‘booster’ dose in the future. Studying the impact of a third vaccine dose, the researchers found that antibody titres increased significantly with a third dose. T-cell response and the immune response against variants were also boosted.

‘It is not known if booster jabs will be needed due to waning immunity or to augment immunity against variants of concern,’ says Associate Professor Teresa Lambe OBE, lead senior author for these studies. ‘Here we show that a third dose of ChAdOx1 nCoV-19 is well tolerated and significantly boosts the antibody response. This is very encouraging news, if we find that a third dose is needed.’

Side effects of the vaccine itself were also found to be well-tolerated, with lower incidents of side effects after second and third doses than after first doses.

Further research is required to follow up with study participants who received third doses beyond the period that was part of the initial study.

https://www.research.ox.ac.uk/article/2021-06-28-delayed-second-dose-and-third-doses-of-the-oxford-astrazeneca-vaccine-lead-to-heightened-immune-response

Scientists quit journal board, protesting ‘grossly irresponsible’ study claiming COVID-19 vaccines kill

 Several reputed virologists and vaccinologists have resigned as editors of the journal Vaccines to protest its 24 June publication of a peer-reviewed article that misuses data to conclude that “for three deaths prevented by [COVID-19] vaccination, we have to accept two inflicted by vaccination.”

Since Friday, at least six scientists have resigned positions as associate or section editors with Vaccines, including Florian Krammer, a virologist at the Icahn School of Medicine at Mount Sinai, and Katie Ewer, an immunologist at the Jenner Institute at the University of Oxford who was on the team that developed the Oxford-AstraZeneca COVID-19 vaccine. Their resignations were first reported by Retraction Watch.

“The data has been misused because it makes the (incorrect) assumption that all deaths occurring post vaccination are caused by vaccination,” Ewer wrote in an email. “[And] it is now being used by anti-vaxxers and COVID-19-deniers as evidence that COVID-19 vaccines are not safe. [This] is grossly irresponsible, particularly for a journal specialising in vaccines.”

The paper is a case of “garbage in, garbage out,” says Helen Petousis-Harris, a vaccinologist who directs the Vaccine Datalink and Research Group at the University of Auckland and who also resigned as a Vaccines editor after reading the paper. Diane Harper, an epidemiologist at the University of Michigan, Ann Arbor, who was founding editor-in-chief of Vaccines, also resigned, as did Paul Licciardi, an immunologist at Murdoch Children’s Research Institute in Parkville, Australia, and Andrew Pekosz, a respiratory virologist at the Johns Hopkins University Bloomberg School of Public Health.

The resignations began Friday, the day after the paper was published. By early Monday, Fanny Fang, the journal’s managing editor, wrote to the editorial board members that Vaccines—a reputable open-access journal launched in 2013 by Basel, Switzerland–based publisher MDPI—had opened an investigation into the paper. “We are treating this case with the utmost seriousness and are committed to swiftly correcting the scientific record,” she wrote.

Later on Monday, Vaccines’s editors published an Expression of Concern about the paper. “The major concern is the misrepresentation of the COVID-19 vaccination efforts and misrepresentation of the data,” they wrote. (On 2 July, the journal officially retracted the paper.)

The paper has drawn nearly 350,000 readers as of 1 July and has been tweeted by antivaccination activists with hundreds of thousands of followers.

None of the paper’s authors is trained in vaccinology, virology, or epidemiology. They are: Harald Walach, a clinical psychologist and science historian by training who describes himself as a health researcher at Poznan University of Medical Sciences in Poland; Rainer Klement, a physicist who studies ketogenic diets in cancer treatment at the Leopoldina Hospital in Schweinfurt, Germany; and Wouter Aukema, an independent data scientist in Hoenderloo, Netherlands.

The three peer reviewers on the paper, two of them anonymous, did not offer any substantial criticism of the authors’ methodology in these brief reviews. One of them, Anne Ulrich, a chemist who directs the Institute of Biological Interfaces and is chair of biochemistry at the Karlsruhe Institute of Technology in Germany, wrote that the authors’ analysis “is performed responsibly … and without methodological flaws … and the results were interpreted with the necessary caveats.”

Ulrich reiterated that view in a 1 July email to ScienceInsider: “The analysis by Walach et al. was done in my opinion responsibly and without flaws,” she wrote.

One of the anonymous reviewers wrote that the manuscript “is very important and should be published urgently,” offering almost no other comment.

Vaccines did not respond to a list of questions, including how the peer reviewers were chosen.

Petousis-Harris says: “It’s very evident from their reviews that they don’t have any topic expertise. The authors don’t either. It’s a bit remiss when you don’t bring any of a large body [of expert vaccine safety scientists] into your study and manuscript review.”

To draw their conclusions, the paper’s authors computed COVID-19 deaths prevented by vaccines by using data from a study of 1.2 million Israelis, half of whom received the Pfizer-BioNTech vaccine and half of whom did not. They estimated that 16,000 people needed to be vaccinated to prevent one COVID-19 death—a measure that is problematic, critics say, because as a vaccine succeeds, the number of people that must be vaccinated to prevent a death grows ever-larger.

To compute deaths “caused” by vaccine side effects, they used EU data on the number of vaccine doses delivered in the Netherlands and data from that country’s national database for adverse drug reaction reporting, which was more voluminous than registry data from other EU countries.

The Netherlands Pharmacovigilance Center, called Lareb, is similar to the United States’s VAERS reporting system, in which anyone can file a report of an adverse event that occurs after vaccination; the existence of a report in the database does not prove a vaccine caused an adverse event or death. Such databases are not used to systematically assess vaccine risks, but to search for early signals of rare but real vaccine side effects, such as the clotting disorder associated with some COVID-19 vaccines, that can then be followed up with systematic study.

The website of the Dutch registry clearly notes its reports do not imply causality. But the authors reported that, using it, they found “16 serious side effects per 100,000 vaccinations and the number of fatal side effects is at 4.11/100,000 vaccinations. For three deaths prevented by vaccination we have to accept two inflicted by vaccination.”

On 25 June, the day after the paper’s publication, Lareb’s head of science and research, Eugène van Puijenbroek, sent an email to Vaccines’s editors, criticizing the paper and requesting a correction or retraction.

A reported event that occurred after vaccination is … not necessarily being caused by the vaccination, although our data was presented as being causally related by the authors,” van Puijenbroek wrote. “Suggesting all reports with a fatal outcome to be causally related is far from truth.”

He also took the authors to task for stating in the paper that “the Dutch [registry] data, especially the fatal cases, were certified by medical specialists.”

“This point is simply incorrect,” van Puijenbroek wrote. “The authors seem to refer to [Lareb’s] policy plan. However, in this plan (in Dutch), it is nowhere mentioned that the reports are ‘certified’ by medical specialists.”

In an email to ScienceInsider, van Puijenbroek also worried that the paper will erode public willingness to report to the Dutch registry. “[People who report adverse events to us] have to be sure that the data they are contributing will be used in a correct and scientific sound way. Articles like this undermine this confidence.”

Walach, the first author, says he stands by the paper. He adds that the clinical trials of the vaccines that are now authorized for emergency use, which involved tens of thousands of people, “were not big enough or long enough to really see whatever safety concerns you will have.”

Aukema adds that he’s pleased about the controversy, because it means “the [COVID-19 vaccine safety] topic is getting a lot of attention. I’m happy about that.”

The three authors submitted a rebuttal to Vaccines’s expression of concern on 29 June. In it, they write that they interpreted Lareb’s public statements “to mean that those reports that are obviously without any foundation are taken out such that the final data-base is at least reliable to some degree.”

The authors also insist that they did not imply that the side effects reported in the Dutch registry were necessarily caused by COVID-19 vaccines. “Currently we only have association, we agree, and we never said anything else.”

Petousis-Harris says she has been pleased with what she sees as a speedy and serious response from the leadership at Vaccines, and that her resignation may not be permanent.

“It has been a good, solid, respectable journal. And if [the paper] is going to be retracted … then I would still be happy to part of the team.”

*Update, 2 July, 12:10 p.m.: This article has been updated to note Vaccines retracted the paper.

https://www.sciencemag.org/news/2021/07/scientists-quit-journal-board-protesting-grossly-irresponsible-study-claiming-covid-19

Best And Worst Performing Assets Of The First Half

 As we enter the second half of the year, a quick look at asset returns in June, Q2 and the first half shows that it has been a stellar performance across most financial markets, with 33 of the 38 non-currency assets tracked by Deutsche Bank moving higher over the last three months in local currency terms.

Having been left for dead in much of 2020, it should come as no surprise that the star performer in both H1 and Q2 was oil, with WTI up +51.4% and +24.2% respectively. Even in June it was up +10.8%. On the other end, Gold (-6.8% YTD) saw its worst month in June (-7.2%) since November 2016 with the Federal Reserve’s hawkish shift allaying concerns about inflation that had been very supportive for the precious metal. Silver (-6.8%) lost ground too, but the losses weren’t just confined to precious metals, with the industrial metal of copper (-8.1%) experiencing its worst monthly decline since March 2020 when the initial pandemic selloff took place, amid a Chinese crackdown on commodity prices, but it was still up +7.5% in Q2 and +22.1% YTD keeping it near the top of the pile.

Meanwhile, a favorite of many traders in 2021, DB's Jim Reid notes that the reopening trade stumbled in Q2 and especially in June with the delta variant spreading. This is best highlighted in more micro numbers with the Euro Stoxx Travel & Leisure index -8.4% in Q2 on a total returns basis, bringing to an end a run of 4 successive quarterly gains as it recovered after the pandemic. Meanwhile in the US, the S&P 500 airlines index is down -11.4% over Q2 and -11.6% in June, similarly ending a run of 4 quarterly advances.

Despite the June swoon in reflation stocks, equities overall had another decent month for the most part that saw them cement their YTD gains, with the S&P 500 (+2.3%) and the STOXX 600 (+1.5%) both rising on a total returns basis in June, leaving their gains for the quarter at +8.5% and +6.8% respectively.

To round things off, after climbing 82.7bps in Q1, 10yr USTs rallied -27.2bps in Q2. Where this goes in Q3 is probably one of the most important variables going forward as it will tell us a lot about inflation, growth, delta, the Fed and more generally about the funding glue that holds financial markets together.

Last but not least, and sadly not on the Deutsche Bank graph, Bitcoin continued to deflate as it fell for a 3rd consecutive month with another -5.7% decline, and was down -41.3% in Q2 meaning it is now ‘only’ +19.3% YTD having been +123.7% at its intraday peak on April 14.

In terms of other currencies, the main story for June was the dollar’s +2.9% gain after the Fed meeting saw the median dot bring forward the first hike into 2023, which (in the reverse image of gold) is the currency’s best month since November 2016. However, for the quarter as a whole the dollar remains -0.9% lower. EM currencies also saw some pretty sizeable moves, with the Brazilian real strengthening +13.4% over Q2 against the US Dollar, whereas the Turkish Lira fell another -2.5% in June as part of its 5th consecutive monthly decline.

The sovereign bonds in the DB sample all remained in negative territory on a YTD basis, though Q2 saw a more divergent performance as Treasuries (+1.9%) and gilts (+1.8%) recovered, whereas their European counterparts including bunds (-0.4%) and BTPs (-0.8%) lost ground. Separately in credit, HY has continued to outperform on a YTD basis.

And here is the performance charted for the month of June in local currency and in USD...

... Q2...

... and YTD.

Russia launches booster shots amid soaring infections

 Russian health authorities on Thursday launched booster coronavirus vaccinations for people immunized more than six months ago, as the country faces a surge in new infections and deaths.

Moscow Mayor Sergei Sobyanin said he had received a booster shot and urged city residents to follow suit.

"In view of the difficult epidemiological situation today, doctors recommend having booster shots six months after vaccination," Sobyanin said on his blog. "I'm pleading with you not to miss a chance to get additional protection from the virus, which is particularly important amid the spread of a more aggressive delta variant."

Moscow health authorities on Thursday started offering booster shots with the domestically produced, two-shot Sputnik V vaccine and its one-shot Sputnik Light version. Other Russian regions are also starting to offer booster shots.

Health Minister Mikhail Murashko told a government meeting Tuesday that the ministry has issued guidelines allowing those who contracted COVID-19 to get vaccinated six months after they recovered, and those who have been immunized to get booster shots six months after their first vaccination.

Health authorities said the more contagious delta variant of the virus has accounted for the bulk of recent new infections in Moscow and some other regions. The nation's chief sanitary doctor, Anna Popova, confirmed Tuesday that authorities also registered the first infection with the "delta plus" variant, which has an extra mutation, although its significance is unclear.

The Health Ministry's guidelines indicated that the booster shots will be rolled out until at least 60% of the population has immunity against COVID-19. Once that goal is reached, booster shots will be delivered once a year.

With most vaccinations, scientists believe people get more protection if there is an extended interval between the shots. There is no evidence that having more vaccines within a short amount of time increases the amount of immune protection. It's also unclear how long protection from COVID-19 vaccines lasts and who will need a booster.

The new guidelines come as infections in Russia are soaring and vaccination rates lag behind those of many other nations.

Russia's state coronavirus task force has been reporting over 20,000 new COVID-19 infections daily since last Thursday, more than double the average in early June. On Thursday, it reported 23,543 new cases and 672 deaths—the highest daily death toll since the start of the pandemic.

Russian officials have blamed the rise in cases on Russians' lax attitude toward taking precautions, the growing prevalence of more infectious variants and vaccine hesitancy. Although Russia was among the first countries to announce and deploy a coronavirus vaccine, just over 23 million people—or 15% of its 146 million population—have received at least one shot.

St. Petersburg, Russia's second-largest city which is set to host the quarterfinal Euro 2020 match between Spain and Switzerland on Friday, has seen a sharp spike in infections recently.

"There are a lot of soccer fans here, both Russian and those who came from other countries," said local resident Antonina Milenina. "That undoubtedly impacts the situation."

President Vladimir Putin revealed during Wednesday's call-in show that he had received the Sputnik V vaccine earlier this year and stressed the importance of getting vaccinated. The Russian leader, who had received the shots out of the public eye, had previously refused to identify the vaccine he got to avoid offering a competitive advantage to its maker. Sputnik V is the most widespread of the four domestically-designed vaccines in circulation.

Russia's vaccination rates have picked up in recent weeks, after authorities in many regions made shots mandatory for employees in certain sectors, such as government offices, retail, health care, education, restaurants and other services.

While reaffirming his position that vaccinations should be voluntary, Putin emphasized that mandatory inoculation for some workers was based on the law and voiced hope that it could help prevent a nationwide lockdown.

In accordance with new rules effective since Monday, restaurants, bars and cafes in Moscow have only been admitting customers who have been vaccinated, have recovered from COVID-19 in the past six months or can provide a negative test in the previous 72 hours—a measure that helped ramp up the pace of vaccination.

"In the past week, there has been an influx of people getting vaccinated," said Natalia Kuzenkova, a doctor who was administering shots at the GUM shopping mall on Red Square. "We have increased our carrying capacity more than three times."

A spike in vaccination over the past days was quickly followed, however, by reports of vaccine shortages in a number of Russian regions, and some experts have questioned whether Russia will have enough vaccines to go around.

Officials said earlier this week that 36.7 million sets of four domestically-developed coronavirus vaccines have been released into circulation, and 30 more million are expected to be produced in July.

As a new wave of contagion spread, authorities in some regions have started imposing travel restrictions.

From Thursday the southern Krasnodar region, which has a long stretch of the Black Sea coast, required incoming hotel and resort clients to produce a certificate of vaccination, a negative COVID-19 test or a document showing they had been previously sick with the virus.

Starting Aug. 1, only those with proof of vaccination or a document showing recovery from COVID-19 will be allowed into hotels and resorts. The stringent rules have triggered a wave of tour cancellations that has shaken the nation's tourist industry.

https://medicalxpress.com/news/2021-07-russia-booster-shots-soaring-infections.html