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Neuroscience

Suffering in silence: two-thirds of older adults say they won’t treat their depression – Newswise

Newswise SALT LAKE CITY, November 16, 2020 - A new nationwide poll, the GeneSight Mental Health Monitor, shows that nearly two-thirds (61%) of Americans age 65 or older who have concerns about having depression will not seek treatment. In fact, nearly 1 in 3 (33%) seniors who are concerned they might be suffering from depression believe they can "snap out" of it on their own.

"The 'pull yourself up by your bootstraps' mindset of some seniors and reluctance to talk about mental health are hindering them from getting the help they need - especially now when the pandemic is having an enormous impact on the mental health of older Americans," said Dr. Mark Pollack, chief medical officer of Myriad Neuroscience, makers of the GeneSight test. "People will seek treatment for conditions like heart disease, high blood pressure or diabetes. Depression is no different. It is an illness that can and should be treated."

Yet, while depression is a condition that needs to be treated:

"In my experience, there is a commonly held view that depression is a normal part of aging; it is not," said Dr. Parikshit Deshmukh, CEO and medical director of Balanced Wellbeing LLC in Oxford, Florida, which provides psychiatric and psychotherapy services to nursing and assisted living facilities. "I've found older adults have a very difficult time admitting that they have depression. When they do acknowledge it, they are still reluctant to start treatment for a wide variety of reasons."

Depression remains a taboo topic among older Americans, despite about one-third of those over the age of 65 who are concerned they have depression recognizing that depression has interfered with their relationships and their ability to enjoy activities.

"There is such a stigma about depression among people my age," said Carmala Walgren, a 74-year-old resident of New York. "I am proof that you do not have to accept living with depression. Although it may not be easy to find treatment that helps you with your symptoms without causing side effects, it is certainly worth it."

Walgren's doctor used information from the results of her GeneSight test, a genetic test that identifies potential gene-drug interactions for depression medications, to help inform Walgren's medication selection.

"The GeneSight test made such a difference in my life," said Walgren. "My doctor has used the test results to find medications that helped me."

###

The GeneSight Mental Health Monitor is a nationwide survey of US adults conducted by Acupoll from August 12-September 27, 2020. The survey was conducted among a statistically representative sample of US adults age 18+, including a US representative sample of adults age 65 and older. The margin of error in survey results for those Age 65+ who are concerned they may have depression but have not been diagnosed is +/-5%.

For more information on older adults and depression, please visit genesight.com/olderadult

Myriad Neuroscience

Myriad Neuroscience is a business unit of Myriad Genetics, Inc. (NASDAQ: MYGN). Through its GeneSight Psychotropic test, Myriad Neuroscience provides information to healthcare providers about their patient's genetic variations, which may impact how they metabolize or respond to certain psychiatric medications. Learn more at genesight.com/about-myriad-neuroscience/

The GeneSight Test

The GeneSight Psychotropic test from Myriad Neuroscience is the category-leading pharmacogenomic test for depression medications. The GeneSight test can help inform doctors about genes that may impact how patients metabolize or respond to certain psychiatric medications. It has been given to more than one million patients by tens of thousands of clinicians to provide genetic information that is unique to each patient. It supplements other information considered by a doctor as part of a comprehensive medical assessment. Learn more at GeneSight.com.

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Suffering in silence: two-thirds of older adults say they won't treat their depression - Newswise

Neuroscience

Brain conditions, mental and neurological alike – Open Access Government

Brain conditions, mental and neurological alike, account for a large burden on the European population. In 2017, 307.9 million neurological disease diagnoses alone were counted in the EU28 countries 540.3 million neurological diseases in the WHO European region. Across Europe, neurological disorders alone accounted for an estimated 21% of all deaths. (1) Additionally, psychiatric conditions such as depression, anxiety disorders and alcohol and drug use disorders, affect more than one in six people across the European Union in any given year. (2) It was estimated conservatively that every year, 27% of the total adult EU population are affected by a mental disorder, amounting to over 82.7 million affected persons. (3)

Despite this high prevalence, numerous conditions of the brain are shrouded in mystery and remain without disease-modifying treatments or cures. Compared to other disease areas, the pace of innovation in this field has traditionally been hindered by multiple factors, starting with the complexity of the brain itself.

Continued research and development in the brain space are crucial. Despite considerable advances in basic neuroscience, the complete understanding of brain functions and the mechanisms behind brain disorders remains a future perspective, mainly due to the complexity of the system itself. As a consequence, a large number of brain conditions remain without a disease-modifying therapy or cure and both fundamental and translational research is still highly needed. Furthermore, failure rates in drug development are higher in neuroscience than in other areas and new treatments take, on average, longer to reach the market than in other disease areas.

Understanding the brain, how to prevent brain ill-health and how to treat and cure brain diseases, mental and neurological, are the only solutions to help society cope. Prevention begins by raising awareness, developing resources and providing proper support, but concrete solutions can only be attained through well-supported and well-coordinated research efforts.

We need to change the pace: we need to innovate, remaining conscious that in brain science, innovation must be considered as a broad and inclusive concept: from novel approaches and ideas of brain researchers to translational research, to novel policy recommendations. To shift momentum, innovation in the brain needs to open to all possible prospects and through a multi-stakeholder approach.

Major developments in non-communicable diseases have demonstrated the immense benefits to be gained from a dynamic collaboration between all stakeholders committed to progress, encompassing patient organisations, academics, scientists, medical experts and industry.

Discoveries and advances in basic neuroscience are the prerequisites for describing the normal functioning of the nervous system and improving our understanding of the aetiology and pathophysiology of brain disorders. Researchers play a key role yet without patient engagement, public and policymaker support, pharmaceutical R&D, entrepreneurial inventions, and more, the brain space remains stagnant and fragmented. Without these key players working together, no progress can be made. Enhanced multi-stakeholder engagement in the brain ecosystem is needed to foster dialogue, exchange knowledge, accelerate investment in research and innovation and facilitate treatment and cure development.

The EU-funded European Brain Research Area (EBRA) project (4), coordinated by the European Brain Council in partnership with the Human Brain Project, ERA-NET NEURON and the EU Joint Programme on Neurodegenerative Disease Research (JPND) is a prime example of the European Commissions vision for improved facilitation of research across Europe. The project in itself was designed as a catalysing initiative for brain research stakeholders to streamline and better coordinate brain research across Europe while fostering global initiatives.

Patient organisations are continuously mobilising for better awareness and calls for inclusion. EU-funded projects like MULTI-ACT (5) exist to create pathways for responsible research for and with the patients the research ultimately impacts. Collaboration in the field of brain disorders is less prevalent than in other fields such as oncology for example, public-private partnerships, which bring together top academic institutions and the pharmaceutical industry, are still relatively underdeveloped. (6)

The brain community has many examples of successful collaborations and more continue to exist. Through projects like the above, community-building activities such as the Brain Innovation Days (7) and continued policy work, improved solutions are in sight. Ongoing work in the field of innovation and demonstrating the value of innovation are currently underway to help create an enabling environment to foster investment in innovation in brain disorders in Europe and propose concrete avenues to remove existing barriers.

European Institutions can play a key role in the improvement of key policies in health and research. A long-term research ecosystem that helps support interdisciplinary networks, cross-border initiatives, health data infrastructures, robust collaboration, medical education and regulatory flexibility is necessary. In order to tackle our major health challenges, we need to develop a coordinated and strategic approach to plan (brain) health research, linked to the need of wider health and research policy.

To reduce the societal impact of neurological disorders and mental ill-health, European authorities must devise and implement a plan to tackle brain health in an integrated and comprehensive manner in cooperation with all EU Member States. Acknowledgement of urgency and prioritisation are needed to make sure that brain disorders remain high on the health policy agenda at the country level and globally.

References

(1) The Lancet Public Health, VOLUME 5, ISSUE 10, E551-E567, OCTOBER 01, 2020, The burden of neurological diseases in Europe: an analysis for the Global Burden of Disease Study 2017; Deuschl, G, et al. https://doi.org/10.1016/S2468-2667(20)30190-0

(2) OECD/European Union (2018), Health at a Glance: Europe 2018: State of Health in the EU Cycle, OECD Publishing, Paris/European Union, Brussels, https://doi.org/10.1787/health_glance_eur-2018-en

(3) Wittchen HU, Jacobi F, Rehm J, Gustavsson A, Svensson M, Jnsson B, Olesen J, Allgulander C, Alonso J, Faravelli C, Fratiglioni L, Jennum P, Lieb R, Maercker A, van Os J, Preisig M, Salvador-Carulla L, Simon R, Steinhausen HC. The size and burden of mental disorders and other disorders of the brain in Europe 2010. Eur Neuropsychopharmacol. 2011 Sep;21(9):655-79. doi: 10.1016/j.euroneuro.2011.07.018. PMID: 21896369.

(4) European Brain Research Area, https://www.ebra.eu

(5) MULTI-ACT, http://www.multiact.eu

(6) Phillips AG, Hongaard-Andersen P, Moscicki RA, Sahakian B, Quiron R, Krishnan KR, Race T. (2014) Proceedings of the 2013 CINP Summit: innovative partnerships to accelerate CNS drug discovery for improved patient care. Int J Neuropsychopharmacol. 18(3). pii: pyu100. doi: 10.1093/ijnp/pyu100.

(7) https://www.braininnovationdays.eu

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Neuroscience

Hyperbaric oxygen treatments in healthy adults can reverse the aging process, finds study – News-Medical.Net

Reviewed by Emily Henderson, B.Sc.Nov 19 2020

A new study from Tel Aviv University (TAU) and the Shamir Medical Center in Israel indicates that hyperbaric oxygen treatments (HBOT) in healthy aging adults can stop the aging of blood cells and reverse the aging process. In the biological sense, the adults' blood cells actually grow younger as the treatments progress.

The researchers found that a unique protocol of treatments with high-pressure oxygen in a pressure chamber can reverse two major processes associated with aging and its illnesses: the shortening of telomeres (protective regions located at both ends of every chromosome) and the accumulation of old and malfunctioning cells in the body. Focusing on immune cells containing DNA obtained from the participants' blood, the study discovered a lengthening of up to 38% of the telomeres, as well as a decrease of up to 37% in the presence of senescent cells.

The study was led by Professor Shai Efrati of the Sackler School of Medicine and the Sagol School of Neuroscience at TAU and Founder and Director of the Sagol Center of Hyperbaric Medicine at the Shamir Medical Center; and Dr. Amir Hadanny, Chief Medical Research Officer of the Sagol Center for Hyperbaric Medicine and Research at the Shamir Medical Center. The clinical trial was conducted as part of a comprehensive Israeli research program that targets aging as a reversible condition.

The paper was published in Aging on November 18, 2020.

For many years our team has been engaged in hyperbaric research and therapy - treatments based on protocols of exposure to high-pressure oxygen at various concentrations inside a pressure chamber. Our achievements over the years included the improvement of brain functions damaged by age, stroke or brain injury.

In the current study we wished to examine the impact of HBOT on healthy and independent aging adults, and to discover whether such treatments can slow down, stop or even reverse the normal aging process at the cellular level."

Professor Shai Efrati, Sackler School of Medicine and the Sagol School of Neuroscience at TAU

The researchers exposed 35 healthy individuals aged 64 or over to a series of 60 hyperbaric sessions over a period of 90 days. Each participant provided blood samples before, during and at the end of the treatments as well as some time after the series of treatments concluded. The researchers then analyzed various immune cells in the blood and compared the results.

The findings indicated that the treatments actually reversed the aging process in two of its major aspects: The telomeres at the ends of the chromosomes grew longer instead of shorter, at a rate of 20%-38% for the different cell types; and the percentage of senescent cells in the overall cell population was reduced significantly - by 11%-37% depending on cell type.

"Today telomere shortening is considered the 'Holy Grail' of the biology of aging," Professor Efrati says. "Researchers around the world are trying to develop pharmacological and environmental interventions that enable telomere elongation. Our HBOT protocol was able to achieve this, proving that the aging process can in fact be reversed at the basic cellular-molecular level."

"Until now, interventions such as lifestyle modifications and intense exercise were shown to have some inhibiting effect on telomere shortening," Dr. Hadanny adds. "But in our study, only three months of HBOT were able to elongate telomeres at rates far beyond any currently available interventions or lifestyle modifications. With this pioneering study, we have opened a door for further research on the cellular impact of HBOT and its potential for reversing the aging process."

Source:

Journal reference:

Hachmo, Y., et al. (2020) Hyperbaric oxygen therapy increases telomere length and decreases immunosenescence in isolated blood cells : a prospective trial. Aging. doi.org/10.18632/aging.202188.

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Hyperbaric oxygen treatments in healthy adults can reverse the aging process, finds study - News-Medical.Net

Immunology

Evommune, Inc. Raises $12.5M in Seed Funding to Accelerate the Development of Transformative Medicines for Chronic Inflammatory Diseases – PRNewswire

LOS ALTOS, Calif., Nov. 18, 2020 /PRNewswire/ --Evommune, Inc., an innovation engine inchronic inflammation, announced the successful completion of a $12.5million seed financing by Pivotal bioVenture Partners. This financing will enable Evommune to build a pipeline of unique therapies for patients with chronic inflammatory diseases.

Approximately 60 percent of Americans live with chronic inflammatory diseases, and it is expected that the prevalence will increase steadily over the next 30 years.1 Evommune wants to improve the quality of life for patients living with these conditions. The company is using the skin as the lens to uncover new approaches for accelerating the development of vital medicines across immunology with a focus on inflammation and dermatology. By utilizing a novel screening platform, the company will identify molecules that are differentiated and have a greater probability of being effective in treating patients with chronic inflammatory conditions.

"There has been tremendous progress in the treatment of inflammatory diseases, but there are still many conditions that lack safe and effective therapies. This is where Evommune will make a difference," said Luis Pea, president and chief executive officer, Evommune, Inc. "This initial seed funding will be used to set up and drive the execution of our longer-term strategy. We have established both academic and industry collaborations and are building a pipeline that will include both discovery and clinical-stage development programs."

Evommune was co-founded by industry veterans Luis Pea, Eugene A. Bauer, MD, chief medical officer, and Hans Hofland, PhD, senior vice president, research. In addition to the founders Janice Drew, MPH joins the executive team as senior vice president, product development. All of the executives were former senior leaders at Dermira, Inc. which was subsequently sold to Eli Lilly and Company for approximately $1.1 billion in 2020. Together, the team is highly accomplished in global drug development and has an outstanding 30-year track record of rapid regulatory approvals and successful development of medicines across multiple therapeutic areas, including immunology and dermatology.

"We are always looking to invest in talented and passionate founders who are on a mission to develop new and innovative therapeutics," said Rob Hopfner, RPh, PhD, MBA, managing partner at Pivotal bioVenture Partners. "The Evommune team's years of immunology and dermatology experience gives them an edge in identifying and developing therapies that will improve the lives of patients with debilitating diseases."

Ash Khanna, PhD, MBA, venture partner at Pivotal bioVenture Partners noted, "There is a great need for new solutions to address chronic inflammation and we are delighted to partner with the stellar Evommune team for Pivotal's first seed-stage investment."

About Evommune, Inc. Evommune is a private, R&D company and innovation engine in chronicinflammation. Evommune is taking a tissue-based approach to advance insights and accelerate the development of transformative medicines in inflammatory diseases. Evommune was founded in 2020 by a successful and experienced leadership team focused on building a robust pipeline of unique therapies that help patients with chronic inflammatory diseases. The company is headquartered in Los Altos, California. For more information please visit Evommune.com.

About Pivotal bioVenture PartnersPivotal bioVenture Partners is a $300 million life sciences venture capital fund located in San Francisco, California. The fund invests in privately held companies developing innovative therapeutic products and platforms to address major unmet medical needs. Investments range from seed-stage deals to cross-over financings at all stages of the preclinical and clinical development spectrum.Pivotal's investment team brings diverse experience in venture capital, company building, and drug discovery and development to the table in working with entrepreneurs to advance their businesses. For more information please visit https://pivotalbiovp.com

1 Pahwa R, Goyal A, Bansal P, et al. Chronic Inflammation. [Updated 2020 Aug 10]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2020 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK493173/

Media Contact:Sheryl Seapy 949-903-4750[emailprotected]

SOURCE Evommune, Inc.

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Evommune, Inc. Raises $12.5M in Seed Funding to Accelerate the Development of Transformative Medicines for Chronic Inflammatory Diseases - PRNewswire

Immunology

University of Miami Health System Gastroenterologist Honored with Lifetime Disruptor Award – Newswise

Newswise Maria T. Abreu, M.D., a renowned gastroenterologist at the University of Miami Miller School of Medicine, was honored with the Lifetime Disruptor award at the American College of Gastroenterologys 2020 virtual meeting. Healio, an in-depth specialty clinical information service, presented the award, which was based on votes from her peers.

I am always challenging the accepted wisdom, said Dr. Abreu, who is professor of medicine and microbiology and immunology, and director of the University of Miami Health System Crohns & Colitis Center. There is always more to learn about a certain condition or treatment to see if we can do something more to help our patients.

A leader in basic science, translational research, clinical care and education, Dr. Abreu focuses her work on finding better treatments for inflammatory bowel disease (IBD) and other debilitating gastrointestinal conditions. She is also a leader in bringing the genetic and environmental factors of IBD development in the Hispanic population into research and clinical care.

In my laboratory work, I look for new approaches to improving patient care, such as reducing an inflammatory response from the immune system or providing a healthy diet to reduce IBD flare-ups, she said.

The Healio Lifetime Disruptor award, presented this year on Oct. 26, goes to a gastroenterologist or hepatologist who has consistently pushed the gastroenterology field forward through innovative treatments, practice management, patient care, or research. This year more than 1,000 readers and followers voted on eight awards for Healio Disruptive Innovators.

In 2019 Dr. Abreu received the Sherman prize awarded by The Bruce and Cynthia Sherman Charitable Foundation to recognize outstanding achievements in the fight to overcome Crohn's disease and ulcerative colitis. Taking care of patients and finding new ways to help them has been my lifes purpose, she said at the time. Thats what inspires my research the possibility of helping both my patients, as well as those that Ill never see.

Earlier this year, Dr. Abreu was honored with the Research Mentor Award by the American Gastroenterological Association(AGA) Institute CouncilsImmunology, Microbiology & Inflammatory Bowel Diseases Section. It is so important to be educating and mentoring young professionals and help them move ahead with their careers, Dr. Abreu said. They are the future of medicine.

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Immunology

Study reveals the metabolic signaling mechanisms that regulate function of eTreg cells – News-Medical.Net

Reviewed by Emily Henderson, B.Sc.Nov 17 2020

Effector regulatory T cells (eTreg cells) are a specialized subset of white blood cells that keep the immune system in check. St. Jude Children's Research Hospital scientists have revealed the metabolic signaling mechanisms that regulate function of eTreg cells. The work may aid efforts to better understand and treat inflammatory diseases. The findings were published online today in Cell Metabolism.

This process is quite fascinating to us, and helps explain how metabolites can drive selective signaling pathways to enforce the differentiation, persistence and function of eTreg cells. We were looking specifically at suppression of autoimmunity that can develop spontaneously in our models, but we also know Treg cells play a role in multiple diseases."

Hongbo Chi, Ph.D., Corresponding Author, St. Jude Immunology

Although eTreg cells are involved in prevention of autoimmune diseases, including lupus and rheumatoid arthritis, they are detrimental in other diseases, such as cancer. Understanding how metabolic signaling regulates Treg cell heterogeneity or function may help scientists develop more specific drugs to target these pathways to help treat disease. How metabolic pathways regulate the differentiation and persistence of eTreg cells, especially at the level of intracellular signaling, has been unclear until now.

The researchers showed that two-way metabolic signaling that intersects with T cell receptor signaling is critical to regulating eTreg cell function.

Investigators identified a class of metabolites called isoprenoids that are essential for the suppressive activity of activated Treg cells such as eTreg cells. Isoprenoids are required for cellular processes called posttranslational lipid modifications, specifically protein farnesylation and geranylgeranylation. These processes are mediated by Fntb and Pggt1b, respectively. Disruption of these processes by Treg cell-specific deletion of Fntb or Pggt1b causes mice to develop autoimmunity.

Further research into the metabolic signaling mechanisms revealed the discrete details of Treg cell-mediated immune suppression downstream of T cell receptor signaling. Fntb acts through two parallel pathways to promote eTreg cell persistence: the protein kinase mTORC1, which regulates metabolic reprogramming of Treg cells, and the immune receptor ICOS. Pggt1b enforces signaling through the small G protein Rac to support eTreg cell differentiation.

"We were able to dissect how metabolic regulation controls eTreg cell differentiation and maintenance," said first author and graduate student Wei Su of St. Jude Immunology. "This bidirectional interplay between intracellular signaling and metabolism allows eTreg cells to maintain the self-tolerance in our body."

"These pathways have been of long-standing interest outside of the immune system for a way to inhibit inflammatory responses," said study author Nicole Chapman, Ph.D., of St. Jude Immunology. "Our study provides a deeper understanding of the molecular interplay between signaling and metabolism and could allow for more potent and selective targeting of downstream metabolic functions in Treg cells."

Source:

Journal reference:

Su, W., et al. (2020) Protein Prenylation Drives Discrete Signaling Programs for the Differentiation and Maintenance of Effector Treg Cells. Cell Metabolism. doi.org/10.1016/j.cmet.2020.10.022.

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Immunology

Most Vaccines Can Be Give Safely, Even After Reactions – Medscape

For the majority of vaccine reactions, the vaccine can still be administered in graded doses, according to John Kelso, MD, from the UC San Diego School of Medicine.

John Kelso

"All anaphylactic reactions to vaccines should be evaluated in an attempt to determine the culprit allergen," but do not simply avoid giving the vaccine, he said during his presentation on the vaccine research frontlines at the American College of Allergy, Asthma & Immunology 2020 Annual Scientific Meeting.

It might be tempting to simply label the patient as "allergic to the vaccine," but that "may leave the patient inadequately immunized," he said.

It's best to investigate the allergy with available resources and following allergy investigation procedures, said Kelso.

If the patient has had a previous reaction to a vaccine and has a reaction immediately after receiving the vaccine, do a skin-prick test or an invitro lgE test of the vaccine and its components, Kelso recommended.

All ingredients in every vaccine are listed in the vaccine excipient summary appendix of the Pinkbook, which is published by the Centers for Disease Control and Prevention.

And an online compilation of excipients in vaccines per 0.5mL dose, from the John Hopkins Bloomberg School of Public Health, breaks down vaccines by component, and lists the excipients and allergens, alphabetically, including the amount per dose.

If the test is negative and additional doses of the vaccine are required, administer the vaccine as indicated. If the test is positive and additional doses of the vaccine are needed, they can be administered in graded doses.

The same procedure is recommended if a patient has a clinical history of allergy to gelatin, latex, or yeast, which are common ingredients in vaccines.

"Although there are possibilities of false positives, a 1to 100 dilution for the intradermal test has been shown to be nonirritating," Kelso reported. What's more, "it's important to note that there are no reports of patients who have had intradermal skin tests and have gone on to have a reaction."

If the patient has a reaction to the vaccine, but not immediately, usually no allergy workup needed. In almost all such cases, the vaccine can be administered, on the recommended schedule, in graded doses at 15minute intervals, under observation, he said. If a physician is reluctant to give additional doses, a lab test can be done to measure the patient's lgG antibodies to see if they are protected.

"Most influenza vaccines are literally grown in egg," Kelso said, and "they contain a residual amount of egg protein, or ovalbumin."

However, this has been thoroughly studied with injectable influenza vaccine and intranasal influenza vaccine, live and attenuated, and reactions are rare.

In 27 studies of inactivated vaccine administered to more than 4100 children, including those who have had anaphylactic reactions to egg, there were no reactions, he reported. And published reports describe 1129 children with egg allergy who received live attenuated intranasal flu vaccine, with no immediate systemic reactions.

"It turns out there's just not enough egg protein present to cause a reaction even in the most severely egg allergic patient," Kelso explained. The maximum amount of ovalbumin is less than 1g per 0.5mL dose of influenza vaccine, and amounts measured in independent laboratories are usually much lower than the amounts claimed.

"It is not necessary to inquire about egg allergy before the administration of any influenza vaccine, including on screening forms," according to the Recommendations for Prevention and Control of Influenza in Children, 20202021, issued recently by the American Academy of Pediatrics.

This is one of three main changes in vaccine administration that clinicians "may wish to make" in practice, Kelso said.

The second is that clinicians should be aware that Tdap, a vaccine for tetanus diphtheria and pertussis, can be given regardless of when a previous Tdvaccination was given. Limb swelling, which occurs in 2% to 3% of people after four or five doses, is not a contraindication to the vaccine, he explained.

And the third is that pregnant women can receive injectable (inactivated) influenza vaccine and Tdap, but not live vaccines.

Lisa Saiman

Social media focuses predominantly on negative experiences, which "are easier to perceive than the positive benefits of vaccination: the absence of disease," Lisa Saiman, MD, from the Columbia University Irving Medical Center in New York City, pointed out during her presentation.

The result is a cognitive bias against vaccination, "a disbelief of vaccine efficacy, and a mistrust in pharmaceutical companies and, of course, government," she said.

"But there is a spectrum of vaccine hesitancy and refusal," Saiman said. And there are several resources that physicians can use to explain the importance of vaccines to those who fall into the "cautious acceptor" and "fence sitter" categories, which will help providers maximize the number of patients they vaccinate.

Saiman recommends that providers use talking points from the Countering Vaccine Hesitancy clinical report to guide discussions with parents who are worried about vaccines.

Regular courses of immunization need to be followed, she emphasized. "During the COVID-19 pandemic, measles vaccination rates have declined," and we "clearly are at increased risk of future outbreaks."

"We need to provide catch-up vaccinations expeditiously, and pediatricians must communicate the effectiveness and safety of all vaccines," she stressed.

Kelso and Saiman have disclosed no relevant financial relationships.

American College of Allergy, Asthma & Immunology (ACAAI) 2020 Annual Scientific Meeting: Presented November3, 2020.

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Immunology

Analysis | Experts have doubts the first Covid-19 vaccines will bring herd immunity – News24

NEWS

Governments and officials are voicing hopes that Covid-19 coronavirus vaccines could bring herd immunity, with some calculating that immunising just two-thirds of a population could halt the pandemic and help protect whole communities or nations.

But the concept comes with caveats and big demands of what vaccines might be capable of preventing. Some experts say such expectations are misplaced.

For a start, figuring out whats needed to achieve herd immunity with Covid-19 vaccines involves a range of factors, several of which are unknown.

Read:Covid-19: No deal yet to access 90% effective vaccine tested in SA

What is the rate of the spread of the Covid-19-causing virus? Will the first vaccines deployed be able to stop transmission of the virus, or just stop people getting ill? How many people in a population will accept a vaccine? Will vaccines offer the same protection to everyone?

Herd immunity is sometimes wrongly understood as individual protection, said Josep Jansa, an expert in health emergency preparedness and response at the Stockholm-based European Centre for Disease Prevention and Control (ECDC).

Its inappropriate to think I will not be affected myself because there is herd immunity. Herd immunity refers to community protection, not to how an individual is protected.

The idea of herd community is to protect the vulnerable, said Eleanor Riley, a professor of immunology and infectious disease at the University of Edinburgh.

The ECDC uses an estimated herd immunity threshold of 67% for its models, while Chancellor Angela Merkel said this month that Covid-19 restrictions in Germany could be lifted if 60% to 70% of the population acquired immunity, either via a Covid-19 vaccine or through infection.

World Health Organisation experts have also pointed to a 65% to 70% vaccine coverage rate as a way to reach population immunity through vaccination.

The idea of herd community is to protect the vulnerable, said Eleanor Riley, a professor of immunology and infectious disease at the University of Edinburgh.

And the idea behind it is that if, say, 98% of a population have all been vaccinated, there will be so little virus in the community that the 2% will be protected. Thats the point of it.

REPRODUCTION RATE IS CRUCIAL

Central to the public health calculations on this concept for Covid-19 is the reproduction rate, or R value, of the virus that causes it.

This is a measure of how many other people an average infected person passes a pathogen on to in normal, or restriction-free, circumstances.

Assuming complete vaccine efficacy, herd immunity percentage thresholds for infectious diseases are calculated by dividing 1 by the R value, deducting the result from 1, and multiplying by 100.

Read:Herd immunity, second wave ... forget the jargon; this is what you need to know

For instance, herd immunity from highly contagious measles, with an estimated R value of 12 or higher, will kick in only if 92% or more within a group are immune. For a seasonal flu strain that could have an R value of 1.3, the threshold would be just 23%.

The problem is that for now we dont know exactly how fast the virus spreads without any precautions and with the normal travel and social activities we had a year ago, said Winfried Pickl, professor of immunology at the Medical University of Vienna.

With so many countries still operating in far from normal circumstances, the assumption should be that the Covid-19 R value would be closer to 4 than to 2, he said, since even with semi- or full lockdown measures the R value is around 1.5.

Additionally, anything less than 100% vaccine efficacy - such as the 90% or so suggested in early data on the Pfizer-BioNTech and Moderna Covid-19 shots - would require a matching rise in percentage of coverage to reach herd threshold.

Amesh Adalja, a scholar at the Johns Hopkins Center for Health Security, said a good target for immunity in the United States would be for more than 70% of the population to be inoculated, but added that the figure could go up if vaccines are less effective.

The idea of herd community is to protect the vulnerable,

Eleanor Riley, a professor of immunology and infectious disease at the University of Edinburgh

STOP TRANSMISSION IN THE HERD?

Experts say another important factor is whether the Covid-19 vaccines a government chooses to deploy can stop transmission of the virus.

Evidence so far suggests the first Covid-19 vaccines to come to market will at least stop people developing the disease. But it cannot be ruled out that people will still catch the Covid-19 coronavirus and pass it on to others unnoticed.

The idea of herd community is to protect the vulnerable, said Eleanor Riley, a professor of immunology and infectious disease at the University of Edinburgh. said Penny Ward, a visiting professor in pharmaceutical medicine at Kings College London.

Bodo Plachter, a professor and deputy director of the Institute of Virology at Germanys Mainz University teaching hospital, said that respiratory infections in particular can be hard to block completely with vaccines - although the shots will go some way to reducing the amount of circulating virus.

It may well be that vaccinated people will shed fewer viruses, he said. But it would be a mistake to assume vaccination alone can suppress a pandemic.

Read:The party of Luthuli is imploding

FOCUS ON PROTECTING THE VULNERABLE?

Edinburghs Riley said this suggests that for now, pursuing an idea of herd immunity through Covid-19 vaccination is fruitless.

A better approach, she said, could be to turn herd immunity on its head, and use the first limited supplies of vaccines to protect those most in need, without worrying about the more robust members of the herd who can live relatively happily with the virus.

Lets forget about protecting the masses to protect the vulnerable, she said. Lets directly protect the vulnerable. Reuters

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Analysis | Experts have doubts the first Covid-19 vaccines will bring herd immunity - News24

Immunology

AAAAI-Supported Food Allergy Bill Passes the House of Representatives – Benzinga

MILWAUKEE, Nov. 17, 2020 /PRNewswire-PRWeb/ -- The Food Allergy Safety, Treatment, Education, and Research (FASTER) Act (H.R. 2117), a bill supported by the AAAAI, passed the House of Representatives today with a unanimous voice vote. The FASTER Act directs the Centers for Disease Control and Prevention (CDC) to expand data collection of information related to food allergies and specific allergens, and revises the definition of major allergen to specifically include sesame. House Energy and Commerce Committee Chairman Frank Pallone (D-NJ), Ranking Member Greg Walden (R-OR), and Representative Doris Matsui (D-CA) spoke in support of the bill.

"The AAAAI joins with our Patient Advocacy Organization partners in celebrating the news that H.R. 2117 has successfully passed the House of Representatives," said AAAAI President Mary Beth Fasano, MD, MSPH, FAAAAI. "While it still needs to pass the Senate before it can be signed into law, this bill will do several things to improve the health and safety of Americans living with food allergies, including revising the definition of major allergens to include sesame, which is tremendously significant."

H.R. 2117 is sponsored by Representative Doris Matsui, who was joined by more than 90 bipartisan cosponsors. "Food allergies impact the daily lives of so many Americans, including our friends and family members," said Congresswoman Matsui. "Some of these food allergies can be serious and potentially be life-threatening diseases, and it's become abundantly clear to me that we need more research and evidence-based solutions to help understand, treat, and maybe one day prevent food allergies. I hope this legislation will provide progress treating allergies and improving the lives of those suffering from them."

The AAAAI continues to advocate for congressional adoption of H.R. 2117 which would advance recommendations from the National Academy of Medicine report "Finding a Path to Safety in Food Allergy: Assessment of the Global Burden, Causes, Prevention, Management, and Public Policy," including strengthening data collection on the prevalence of food allergies, and adding sesame to the list of allergens required to be listed on food labels, as well as providing flexibility for the Secretary of Health and Human Services to add any other food ingredients determined by regulation to be a major food allergen. The AAAAI joins its stakeholder partner FARE in support of this important legislation.

Passage of the FASTER Act comes after the Food and Drug Administration (FDA) recently issued a draft guidance titled "Voluntary Disclosure of Sesame as an Allergen". The document encourages food manufacturers to voluntarily declare sesame in the ingredient list on food labels. Comments on the draft guidance are due January 11, 2021. Additionally, the recently released Senate appropriations bill included a statement about allergen labeling expressing concern that the FDA has failed to take further action to require labeling for sesame and urging the agency to act swiftly to address this risk by requiring the same labeling for sesame as other major food allergens. Also included was report language requested by the AAAAI and other stakeholders which recognizes the prevalence of food allergy in the pediatric and adult communities, commends the ongoing work of the National Institute of Allergy and Infectious Diseases (NIAID) and the Consortium of Food Allergy Research (CoFAR), and encourages the NIAID to expand its clinical research network to add new centers of excellence in food allergy clinical care and to select such centers from those with a proven expertise in food allergy research.

AAAAI's professional governmental relations team and physician leadership continue to make a priority of encouraging federal research support for food allergies and related advocacy activities.

You can learn more about food allergies on the American Academy of Allergy, Asthma & Immunology website, aaaai.org.

The American Academy of Allergy, Asthma & Immunology (AAAAI) represents allergists, asthma specialists, clinical immunologists, allied health professionals and others with a special interest in the research and treatment of allergic and immunologic diseases. Established in 1943, the AAAAI has more than 7,100 members in the United States, Canada and 72 other countries. The AAAAI's Find an Allergist/Immunologist service is a trusted resource to help you find a specialist close to home.

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Media Contact

April Presnell, The American Academy of Allergy, Asthma & Immunology, 414-272-6071, apresnell@aaaai.org

SOURCE The American Academy of Allergy, Asthma & Immunology

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AAAAI-Supported Food Allergy Bill Passes the House of Representatives - Benzinga

Immunology

Analysis: Can first COVID-19 vaccines bring herd immunity? Experts have doubts – Reuters

FRANKFURT/LONDON (Reuters) - Governments and officials are voicing hopes that COVID-19 vaccines could bring herd immunity, with some calculating that immunising just two-thirds of a population could halt the pandemic disease and help protect whole communities or nations.

But the concept comes with caveats and big demands of what vaccines might be capable of preventing. Some experts say such expectations are misplaced.

For a start, figuring out whats needed to achieve herd immunity with COVID-19 vaccines involves a range of factors, several of which are unknown.

What is the rate of the spread of the COVID-19-causing virus? Will the first vaccines deployed be able to stop transmission of the virus, or just stop people getting ill? How many people in a population will accept a vaccine? Will vaccines offer the same protection to everyone?

Herd immunity is sometimes wrongly understood as individual protection, said Josep Jansa, an expert in health emergency preparedness and response at the Stockholm-based European Centre for Disease Prevention and Control (ECDC).

Its inappropriate to think I will not be affected myself because there is herd immunity. Herd immunity refers to community protection, not to how an individual is protected.

The ECDC uses an estimated herd immunity threshold of 67% for its models, while Chancellor Angela Merkel said this month that COVID-19 restrictions in Germany could be lifted if 60% to 70% of the population acquired immunity, either via a COVID-19 vaccine or through infection.

World Health Organization experts have also pointed to a 65%-70% vaccine coverage rate as a way to reach population immunity through vaccination.

The idea of herd community is to protect the vulnerable, said Eleanor Riley, a professor of immunology and infectious disease at the University of Edinburgh. And the idea behind it is that if, say, 98% of a population have all been vaccinated, there will be so little virus in the community that the 2% will be protected. Thats the point of it.

Central to the public health calculations on this concept for COVID-19 is the reproduction rate, or R value, of the virus that causes it. This is a measure of how many other people an average infected person passes a pathogen on to in normal, or restriction-free, circumstances.

Assuming complete vaccine efficacy, herd immunity percentage thresholds for infectious diseases are calculated by dividing 1 by the R value, deducting the result from 1, and multiplying by 100.

For instance, herd immunity from highly contagious measles, with an estimated R value of 12 or higher, will kick in only if 92% or more within a group are immune. For a seasonal flu strain that could have an R value of 1.3, the threshold would be just 23%.

The problem is that for now we dont know exactly how fast the virus spreads without any precautions and with the normal travel and social activities we had a year ago, said Winfried Pickl, professor of immunology at the Medical University of Vienna.

With so many countries still operating in far from normal circumstances, the assumption should be that the COVID-19 R value would be closer to 4 than to 2, he said, since even with semi- or full lockdown measures the R value is around 1.5.

Additionally, anything less than 100% vaccine efficacy - such as the 90% or so suggested in early data on the Pfizer-BioNTech and Moderna COVID-19 shots - would require a matching rise in percentage of coverage to reach herd threshold.

Amesh Adalja, a scholar at the Johns Hopkins Center for Health Security, said a good target for immunity in the United States would be for more than 70% of the population to be inoculated, but added that the figure could go up if vaccines are less effective.

STOP TRANSMISSION IN THE HERD?

Experts say another important factor is whether the COVID-19 vaccines a government chooses to deploy can stop transmission of the virus.

Evidence so far suggests the first COVID-19 vaccines to come to market will at least stop people developing the disease. But it cannot be ruled out that people will still catch the SARS-CoV-2 virus and pass it on to others unnoticed.

While protection against illness has a value for an individual, it will not prevent circulation of virus and risk of disease in unvaccinated (people), said Penny Ward, a visiting professor in pharmaceutical medicine at Kings College London.

Bodo Plachter, a professor and deputy director of the Institute of Virology at Germanys Mainz University teaching hospital, said that respiratory infections in particular can be hard to block completely with vaccines - although the shots will go some way to reducing the amount of circulating virus.

It may well be that vaccinated people will shed fewer viruses, he said. But it would be a mistake to assume vaccination alone can suppress a pandemic.

Edinburghs Riley said this suggests that for now, pursuing an idea of herd immunity through COVID-19 vaccination is fruitless.

A better approach, she said, could be to turn herd immunity on its head, and use the first limited supplies of vaccines to protect those most in need, without worrying about the more robust members of the herd who can live relatively happily with the virus.

Lets forget about protecting the masses to protect the vulnerable, she said. Lets directly protect the vulnerable.

Reporting by Kate Kelland in London and Ludwig Burger in Frankfurt, Additional reporting by Carl ODonnell in New York, Editing by Timothy Heritage

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Analysis: Can first COVID-19 vaccines bring herd immunity? Experts have doubts - Reuters