Measles surging as COVID-19 curbs disrupt vaccinations

By Kate Kelland

LONDON (Reuters) – Measles surged to infect almost 870,000 people across the world in 2019, the worst figures in almost a quarter of a century as vaccination levels fell below critical levels, a report said on Thursday.

Millions of children are at risk of the disease again this year as restrictions imposed to contain the COVID-19 pandemic further disrupt immunization programs, the report co-led by the World Health Organization (WHO) said.

Measles is one of the most contagious known diseases – more so than COVID-19, Ebola, tuberculosis or flu.

More than 207,000 people died of it last year alone, the report found. With immunization coverage below the critical 95% needed for community protection, infections rose in all WHO regions last year to the worst levels since 1996, it said.

“These data send a clear message that we are failing to protect children from measles in every region of the world,” the WHO’s Director-General, Tedros Adhanom Ghebreyesus, said in a statement.

The surge in fatal cases means global measles deaths have risen nearly 50% since 2016.

The report, co-led by the United States Centers for Disease Control and Prevention (CDC), cited a collective failure to fully immunize children on time with two doses of measles vaccine as the main driver of the deadly increases.

Looking ahead to 2020, the report warned that disruptions to vaccination due to the COVID-19 pandemic have crippled efforts to curb measles outbreaks.

As of this month, more than 94 million people were at risk of missing measles vaccinations due to paused immunization campaigns in 26 countries, it said.

“COVID-19 has resulted in dangerous declines in immunization coverage,” Seth Berkley, chief executive of the GAVI global vaccine alliance, said.

He described the “alarming” measles report was “a warning that, with the COVID-19 pandemic occupying health systems across the world, we cannot afford to take our eye off the ball.”

After steady downward progress from 2010 to 2016, measles cases began rising again from 2017. The report said there were a total of 869,770 measles cases, with 207,500 deaths, in 2019.

WHO and the UN children’s fund UNICEF urged governments last week to act now to prevent epidemics of measles, polio and other infectious diseases.

(Reporting by Kate Kelland, editing by Andrew Heavens)

Explainer – Shot in the dark: Early COVID-19 vaccine efficacy explained

By John Miller

ZURICH (Reuters) – This week has seen a flurry of good news from COVID-19 vaccine developers, with Pfizer Inc. and BioNTech SE trumpeting early data indicating their mRNA candidate is more than 90% effective.

A Russian project came out a day later, touting 92% efficacy for the Sputnik V candidate, named after the Soviet-era satellite, based on a smaller data set.

HOW DO MANUFACTURERS ARRIVE AT EFFICACY NUMBERS?

In Pfizer’s case, it waited until 94 volunteers in its late-stage clinical trial of more than 43,500 people – half got the vaccine, the other half got a placebo – tested positive after developing symptoms.

For 90%-plus efficacy, no more than eight people among those who tested positive had received the vaccine, with the rest having received the placebo.

“Roughly speaking, it’s probably around eight to 86 cases in the treated and placebo groups,” David Spiegelhalter, a Cambridge professor of risk and an expert in statistics, told Reuters.

“You don’t need a lot of fancy statistical analysis to show that this is deeply impressive. It just hits you between the eyes.”

In Russia, Sputnik V-developer Gamaleya Institute reached its preliminary 92% efficacy figure based on 20 illnesses in 16,000 volunteers as its late-stage trial progresses. It aims to reach 40,000 people.

Of the 16,000 people, about quarter got the placebo.

“It suggests that there is some effect, but it’s insufficient to estimate the magnitude of it,” Spiegelhalter said.

HOW MANY PEOPLE MUST GET SICK IN BIG VACCINE TRIALS?

Some experts say that, ideally, 150 to 160 people in a trial of tens of thousands of participants must get sick before making a reliable assessment of a vaccine’s efficacy. That’s a bit of a rule of thumb, though, open to interpretation.

“There is no such regulatory standard requiring X number of events for making a reliable decision,” the government-funded Swiss Clinical Trial Organization said. “The amount of (infections) has to be seen in relation to the disease and its risk profile. It’s rather a case-by-case evaluation.”

Typically, regulators strive to have at least 95% certainty that the trial read-out is not the result of random variations with nothing to do with the tested compound.

For trial sponsors there is safety in numbers as a large enough trial can ensure that 95% reliability hurdle is cleared. But the larger the underlying clinical benefit, the fewer trial participants needed to create that clarity.

In Pfizer and BioNTech’s trial, they planned a final analysis when 164 people had become sick, with multiple, pre-planned interim analyses along the way. They skipped an analysis at 32 patients, and once they were ready to release a look at the 62-person mark, 94 had come down sick.

Details from the Russian trial are unclear, without access to its protocol.

HOW DO THESE RESULTS STACK UP TO OTHER DRUGS, OR VACCINES FOR OTHER ILLNESSES?

In normal drug trials, for diseases like terminal cancer, benefits of new medicines may be less apparent, with survival benefits of just a few months sometimes revolutionary for patients at death’s door.

For vaccines, however, marginal protection is inadequate, and the World Health Organization ideally wants to see at least 70% efficacy in trials, while the U.S. Food and Drug Administration wants at least 50%.

The 90% efficacy reported in the Pfizer and Russian trials beats those, and appears to exceed that of typical flu vaccines, which the U.S. Centers for Disease Control and Prevention (CDC) estimate reduce the risk of sickness by 40%-60%.

For other shots, the CDC estimates the efficacy of a two-shot measles vaccine at 97%, and a two-dose chicken pox vaccine at 90%. Two doses of polio vaccine are 90% effective, rising to nearly 100% with a third.

CAN WE EXPECT EFFICACY RATES TO HOLD UP AS TRIALS ADVANCE?

Pfizer acknowledged on Monday that its final vaccine efficacy percentage may vary. Still, Spiegelhalter said the study’s design seems likely to generally hold up, based on the 94 sick participants.

“In this case, the effect is so huge, even if there is a little bit of fallback – if the effects become slightly smaller over time – that is very unlikely to be significant.”

WHAT ABOUT REAL-WORLD EFFICACY, SHOULD THE VACCINES BE APPROVED?

The interim data is promising, since it appears to demonstrate that a vaccine can be effective in preventing COVID-19.

The jump to mass vaccinations, however, presents new hurdles, in particular for an mRNA vaccine like Pfizer and BioNTech’s that must be stored and shipped at minus 70 degrees Celsius (-94°F).

Moreover, the Pfizer-BioNTech vaccine requires two doses, ideally 21 days apart. If people do not stick to the timetable, it may affect the vaccine’s efficacy.

Protection against the mumps, for instance, drops from nearly 90% to 78%, if people don’t get a follow-up shot.

Swiss epidemiologist Marcel Tanner, president of Switzerland’s Academies of Arts and Sciences and one of the government’s top COVID-19 science advisers, expects possible variations in efficacy among older people, whose immune systems wane with time, or those with immune disorders.

“Efficacy says, ‘Does it work?’ Effectiveness says, ‘Can it be applied? Can you carry the efficacy to the people?'” Tanner said. “But no question: 90% efficacy, at that stage, is a pretty good result.”

(Reporting by John Miller in Zurich, Kate Kelland in London, Ankur Banerjee in Bengaluru, Julie Steenhuysen in Chicago and Polina Ivanova in Moscow; Editing by Josephine Mason and Nick Macfie)

U.S. CDC reports 234,264 deaths from coronavirus

(Reuters) – The U.S. Centers for Disease Control and Prevention (CDC) on Friday reported 9,581,770 cases of the new coronavirus, an increase of 117,988 cases from its previous count, and said that the number of deaths had risen by 1,135 to 234,264.

The CDC reported its tally of cases of the respiratory illness known as COVID-19, caused by a new coronavirus, as of 4 pm ET on Nov. 5 versus its previous report a day earlier.

The CDC figures do not necessarily reflect cases reported by individual states.

(Reporting by Dania Nadeem in Bengaluru; Editing by Aditya Soni)

U.S. CDC reports 230,893 deaths from coronavirus

(Reuters) – The U.S. Centers for Disease Control and Prevention (CDC) on Tuesday reported 9,268,818 cases of the novel coronavirus, an increase of 86,190 cases from its previous count, and said that the number of deaths had risen by 510 to 230,893.

The CDC reported its tally of cases of the respiratory illness known as COVID-19 as of 4 p.m. ET on Nov. 2, compared with its previous report released a day earlier.

The CDC figures do not necessarily reflect cases reported by individual states.

(Reporting by Mrinalika Roy in Bengaluru)

U.S. CDC reports 215,194 deaths from coronavirus

(Reuters) – The U.S. Centers for Disease Control and Prevention (CDC) on Wednesday reported 7.8 million cases of the new coronavirus, an increase of 47,459 from its previous count, and said the number of deaths had risen by 748 to 215,194.

The CDC reported its tally of cases of the respiratory illness known as COVID-19, caused by the new coronavirus, as of 4 pm ET on Oct. 13 versus its previous report a day earlier.

The CDC figures do not necessarily reflect cases reported by individual states.

(Reporting by Vishwadha Chander in Bengaluru; Editing by Anil D’Silva)

U.S. CDC reports 214,446 deaths from coronavirus

(Reuters) – The U.S. Centers for Disease Control and Prevention (CDC) on Tuesday reported 7,787,548 cases of the new coronavirus, an increase of 46,614 from its previous count, and said that the number of deaths had risen by 338 to 214,446.

The CDC reported its tally of cases of the respiratory illness known as COVID-19, caused by a new coronavirus, as of 4 pm ET on Oct. 12 versus its previous report a day earlier.

The CDC figures do not necessarily reflect cases reported by individual states.

(Reporting by Dania Nadeem in Bengaluru; Editing by Devika Syamnath)

U.S. CDC reports 214,108 deaths from coronavirus

(Reuters) – The U.S. Centers for Disease Control and Prevention (CDC) on Monday reported 7,740,934 cases of the new coronavirus, an increase of 46,069 from its previous count, and said that the number of deaths had risen by 494 to 214,108.

The CDC reported its tally of cases of the respiratory illness known as COVID-19, caused by a new coronavirus, as of 4 pm ET on Oct. 11 versus its previous report a day earlier.

The CDC figures do not necessarily reflect cases reported by individual states.

(Reporting by Dania Nadeem in Bengaluru; Editing by Devika Syamnath)

U.S. CDC reports 210,232 deaths from coronavirus

(Reuters) – The U.S. Centers for Disease Control and Prevention (CDC) on Wednesday reported 7,475,262 cases of the new coronavirus, an increase of 38,984 from its previous count, and said that the number of deaths had risen by 672 to 210,232.

The CDC reported its tally of cases of the respiratory illness known as COVID-19, caused by a new coronavirus, as of 4 pm ET on Oct. 6 versus its previous report a day earlier.

The CDC figures do not necessarily reflect cases reported by individual states.

(Reporting by Dania Nadeem in Bengaluru; Editing by Devika Syamnath)

U.S. CDC reports 209,560 deaths from coronavirus

(Reuters) – The U.S. Centers for Disease Control and Prevention (CDC) on Tuesday reported 7,436,278 cases of the new coronavirus, an increase of 39,548 from its previous count, and said that the number of deaths had risen by 361 to 209,560.

The CDC reported its tally of cases of the respiratory illness known as COVID-19, caused by a new coronavirus, as of 4 pm ET on Oct. 5 versus its previous report a day earlier.

The CDC figures do not necessarily reflect cases reported by individual states.

(Reporting by Dania Nadeem in Bengaluru; Editing by Shounak Dasgupta)

Trump compares COVID-19 to flu in tweet, Twitter raises red flag

(Reuters) – U.S. President Donald Trump played down the COVID-19 pandemic again, comparing it to the flu in a tweet on Tuesday, and Twitter Inc responded by putting a warning label on the tweet, saying the post included potentially misleading information.

“Flu season is coming up! Many people every year, sometimes over 100,000, and despite the Vaccine, die from the Flu. Are we going to close down our Country? No, we have learned to live with it, just like we are learning to live with Covid, in most populations far less lethal!!!” Trump had tweeted.

Earlier in the day, Facebook Inc removed a similar post by Trump, according to CNN.

The tweet comes hours after Trump was discharged from Walter Reed National Military Medical Center in Bethesda, Maryland.

On Monday, Trump told Americans “to get out there” and not fear COVID-19 as he returned to the White House after a three-night hospital stay to be treated for the new coronavirus and removed his white surgical mask to pose for pictures.

During the 2019-2020 influenza season, the flu was associated with 22,000 deaths, according to U.S. Centers for Disease Control and Prevention estimates.

(Reporting by Subrat Patnaik in Bengaluru; Editing by Bernard Orr)