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Three doses of the Moderna mRNA COVID-19 vaccine were more effective against infection with the SARS-CoV-2 Delta variant than against Omicron but were highly protective against hospitalization with either subtype, according to a study yesterday in Nature Medicine. (Beusekom, 2/22)

Knowing whether COVID-19 vaccine effectiveness wanes is crucial for informing vaccine policy, such as the need for and timing of booster doses. We aimed to systematically review the evidence for the duration of protection of COVID-19 vaccines against various clinical outcomes, and to assess changes in the rates of breakthrough infection caused by the delta variant with increasing time since vaccination. (Felkin, MD, et al, 2/21)

In this systematic review and meta-analysis of 22 studies including 1366 patients revaccinated under the supervision of an allergist, there was a low incidence (0.16%) of immediate severe allergic reactions associated with receiving a second dose of SARS-CoV-2 mRNA vaccine among individuals who had an immediate allergic reaction to their first dose. There were no deaths. (Chu, M.D., Ph.D., et al, 2/21)

The use of COVID-19 vaccines has been prioritised to protect the most vulnerable—notably, older people. Because of fluctuations in vaccine availability, strategies such as delayed second dose and heterologous prime-boost have been used. However, the effectiveness of these strategies in frail, older people are unknown. We aimed to assess the antigenicity of mRNA-based COVID-19 vaccines in frail, older people in a real-world setting, with a rationed interval dosing of 16 weeks between the prime and boost doses. (Vinh, et al, MD, 2/21)

Of every 6 antibiotic prophylaxis prescriptions, 5 were inconsistent with guidelines. Improving prophylaxis appropriateness and shortening duration may have substantial implications for stewardship. Guidelines should state whether antibiotic prophylaxis is indicated for extractions, implants, and immunocompromised patients. (Suda, et al, 2/22)

The UK government says its scientists, working in collaboration with industry and academia, have found that a fluoroquinolone antibiotic used to treat ear infections may also work against plague and melioidosis. The antibiotic, finafloxacin, was approved by the US Food and Drug Administration in 2014 for the treatment of acute otitis externa (infection of the outer ear canal) and is also in clinical trials for use in patients with complicated urinary tract infections. But German pharmaceutical company Merlion Pharma says finafloxacin has also demonstrated efficacy against Burkholderia pseudomallei, the bacterium that causes melioidosis, and Yersinia pestis, which causes plague, in mouse models of infection. (2/17)

Respiratory syncytial virus (RSV) infection causes substantial morbidity and mortality among infants, older adults, and immunocompromised adults. EDP-938, a nonfusion replication inhibitor of RSV, acts by modulating the viral nucleoprotein. (Ahmad, Ph.D, et al, 2/17)

Sickle cell disease is characterized by the painful recurrence of vaso-occlusive events. Gene therapy with the use of LentiGlobin for sickle cell disease (bb1111; lovotibeglogene autotemcel) consists of autologous transplantation of hematopoietic stem and progenitor cells transduced with the BB305 lentiviral vector encoding a modified β-globin gene, which produces an antisickling hemoglobin, HbAT87Q. (Kanter, M.D, et al, 2/17)

It is time to close a loophole that allows certain types of diagnostic lab tests to be exempt from regulatory oversight, putting people at risk of making consequential medical decisions on the basis of unreliable results. (2/22)