Contagion Staff

This article was originally published on ContagionLive.

The US Food and Drug Administration (FDA) has now expanded the indication for 

 booster shots to children as young as 12 years old, in light of the rapid spread of the Omicron variant.

Previously, booster doses, including a third shot for Pfizer-BioNTech and Moderna or a second shot for Janssen (Johnson & Johnson) recipients, were indicated for all persons aged 16 years and older. Now, booster dose eligibility has expanded the indication to children aged 12 - 15 years.

The decision will be reviewed by Centers for Disease Control and Prevention (CDC) Director Rochelle Walensky and could go into effect once endorsed.

Additionally, the administration moved to shorten the time in between the second and third dose from 6 months to 5 months for recipients of the Pfizer-BioNTech vaccine.

Currently, the Pfizer-BioNTech vaccine is the only approved COVID-19 vaccination for children aged 12 - 17 years old. Following the CDC’s decision, these populations should receive a booster dose of Pfizer-BioNTech 5 months after their second.

As the Omicron variant has shown more effectiveness at causing breakthrough infections among vaccinated individuals, federal health agents have moved quickly to approve booster doses once indicated to be safe and effective.

Children are less likely to experience severe or fatal COVID-19 infection, but vaccinations may further inhibit them from taking up valuable space in overcrowded hospitals and prevent children from spreading the virus to immunocompromised groups of individuals.

Articles

The FDA moved to shorten the time between the second and third vaccine dose from 6 months to 5 months for recipients of Pfizer-BioNTech. 

FDA Expands COVID-19 Booster Shot Indication For Children Aged 12 and Older

An original version of this article was published by sister publication Contagion.

A new, large-scale prospective assessment of 

 in US patients to date showed 22% of patients admitted to hospitals in New York City became critically ill, and that 79% of critically ill patients required mechanical ventilation to support breathing.

The new findings from clinicians at the Columbia University Irving Medical Center in northern Manhattan detailed trends and patterns among 1150 adult patients hospitalized with COVID-19 in March this year.

Investigators, led by Matthew Cummings, MD, observed the status and progression of adults admitted to the hospital with laboratory-confirmed coronavirus between March 2 and April 1.

They found 257 (22%) were critically ill, requiring treatment in either a high-dependency or intensive care unit (ICU). Common symptoms among these patients were shortness of breath, fever, cough, muscle pain, and diarrhea. As of April 28, 101 (39%) of these patients had died, and 94 (37%) remained hospitalized.

Just 58 (23%) had been discharged from the hospital.

Two-thirds of all critically-ill patients were male (171 [67%]), with a median patient age of 62 years. That said, 55 patients (22%) were <50 years old. Four in every 5 critically ill patients were minorities—Hispanic or Latino (62%) and black or African American (19%) comprised 198 of the 257 observed patients.

Healthcare workers made up 5% (13) of the observed critically ill patient population.

At least 1 chronic illness was prevalent in more than 80% of all critically-ill coronavirus patients; hypertension (162 [63%]) and diabetes (92 [36%]) were the most commonly reported conditions. Patients with pre-existing lung or heart conditions had the greatest risk of poorer outcomes.

Cummings and colleagues reported that 203 (79%) of critically-ill COVID-19 patients required mechanical ventilation, for a man duration of 18 days (range, 9-28).

Another 79 patients (31%) developed severe kidney damage while hospitalized, and required therapy including dialysis to support their kidney function.

Though the rate and severity of ventilator use was greater than that previously observed by clinicians in a Washington state hospital, the New York-based findings correlate with those reported recently in Italy facilities.

In fact, the report is similar to those to have come from China, Italy, and the UK.

“Of particular interest is the finding that over three quarters of critically ill patients required a ventilator and almost one third required renal dialysis support,” senior author Max O’Donnell, MD, said. “This has important implications for resource allocation in hospitals, where access to equipment and specialized staff needed to deliver this level of care is limited.”

Study author Natalie Yip, MD, emphasized the need for identified risk factors associated with mortality in US-based patients with critically ill COVID-19 status. As of the study’s publishing, the country has neared 100,000 deaths from the virus.

“Although the clinical spectrum of disease has been characterized in reports from China and Italy, until now, detailed understanding of how the virus is affecting critically ill patients in the US has been limited to reports from a small number of cases,” Yip said.

Epidemiology, clinical course, and outcomes of critically ill adults with COVID-19 in New York City: a prospective cohort study

A new study from Columbia University Irving Medical Center shows about 22% of hospitalized patients are sent to the ICU.