Childhood Trauma May Influence Vaccine Hesitancy:

 

COVID-19 vaccine hesitancy may be associated with traumatic events in childhood that undermine trust, including domestic violence, substance abuse in the home, or neglect, data published Tuesday suggest.

 

The results are especially significant, the authors say, because of the prevalence of adverse childhood experiences (ACEs) globally, with proportions of people experiencing multiple traumas in some countries at 10% or more of the population.

The authors write that hesitancy or refusal to get the vaccine increased with the number of traumas reported.

For example, hesitancy was three times higher among people who had experienced four or more types of childhood trauma than those who did not report any traumatic events.

Bellis told Medscape Medical News that though their work suggests that higher levels of ACEs are linked with higher vaccine hesitancy, it is by no means the only reason people choose not to get vaccinated.

 

People with more ACEs were more likely to have low trust in National Health Service COVID-19 information.

"Other sociodemographics and a history of either chronic disease or COVID-19 infection were not significantly associated with low trust," the authors point out.

People reporting higher ACEs also were more likely to report that they felt they were unfairly restricted by the government. People with four or more ACEs were twice as likely than those with no ACEs to say they felt unfairly restricted and wanted rules such as mandatory masking to stop.

Additionally, people with four or more types of trauma were almost twice as likely to ignore the restrictions as those who hadn't experienced any — 38% vs 21% — to ignore the restrictions, even after accounting for associations with sociodemographic factors and previous COVID-19 infection or a history of long-term conditions. 

"Clinicians can be a powerful voice to counter more alarmist or even conspiratorial messages that might otherwise resonate with those who find trust difficult," Bellis said.

He said that the effect of childhood adversity needs to be considered at all levels in health systems. Overarching public health strategists should include ways to earn trust to counter resistance in some of the most vulnerable communities where ACEs can be higher.

 

It will also be important in the short-term to "provide reassurance, build community champions, and understand the low base from which trust needs to be built," he said.

 

The researchers estimated the likely rates of vaccine hesitancy according to childhood trauma and age, and the numbers ranged from around 3.5% among those aged 70 and older with no experience of childhood adversity to 38% among 18- to 29-year-olds who had experienced four or more types of childhood trauma.

New review highlights impact on cardiovascular system

 

The wide-ranging effects of Long COVID and the associated issues for healthcare providers have been revealed in a new review of the major studies into the condition, co-authored by a consultant cardiologist at Royal Brompton and Harefield hospitals.

Published in the European Heart Journal, the review specifically highlights the impact of Long COVID on the cardiovascular system. 

According to one of its co-authors, Professor Thomas Lüscher, Director of Research, Education and Development at Royal Brompton and Harefield Clinical Group, this is “the first review to summarize the diverse evidence on Long COVID and provide a balanced picture of this important issue.”

Professor Lüscher said: “The pandemic brought not only acute illness and death, it became a chronic disease of many organs, not just the lungs, but the heart, brain and kidney, among others.”

“Long COVID is, besides its huge impact for the affected individual, of great societal and economic importance as it leads to leave of absence from work, reduced work performance and hence unforeseen costs.”

The review was conducted by researchers from the University of Oxford, the University of Wisconsin School of Medicine and Public Health, Royal Brompton Hospital and Imperial College, London, and the University of Zurich, Switzerland.

The review spans each step from a patient’s original coronavirus infection and the direct impacts, such as myocardial infarction or inflammatory myocarditis, to the long-term impacts on aspects of wellbeing such as mental health and fatigue.

The researchers also concluded that current evidence for the treatment of Long COVID is lacking and that our current understanding of pathophysiological mechanisms and treatment options remains limited. They also found that the vast inequalities in healthcare provision exposed by COVID-19 continue to be magnified by Long COVID, a problem that calls for global humanitarian efforts to promote and fund equitable access to healthcare, social and welfare support and vaccines across the world.

Dr Betty Raman, of Oxford’s Radcliffe Department of Medicine, said: “Long COVID is emerging as a major public health issue, which makes it important that we better understand the long-term effects of COVID-19 to improve our treatment of it.

“This review highlights the wide range of short and long-term health impacts and the mechanisms behind them, which is key to providing treatment and ongoing care.”

Professor Stefan Neubauer, Head of the Division of Cardiovascular Medicine, Radcliffe Department of Medicine, said: “Long COVID is a huge medical challenge. This review gives a comprehensive update on its effect on the cardiovascular system and will also be important in guiding future research into the condition and for finding new treatments.”

Dr Betty Raman is leading one of the first randomized, double-blind, placebo-controlled studies in the UK. The team’s work is supported by the NIHR Oxford Biomedical Research Centre, a partnership between Oxford University Hospitals NHS Foundation Trust and the University of Oxford. Other trials to date have been open-label or non-random assignment of therapy. 

Subvariant May Be More Dangerous Than Omicron

 

The Omicron subvariant, BA.2, is not only more transmissible than the original Omicron strain, BA.1, but may cause more severe disease, a lab study from Japan says.

"Our multiscale investigations suggest that the risk of BA.2 for global health is potentially higher than that of BA.1," the researchers said in the study published on the preprint server bioRxiv. The study has not been peer-reviewed yet.

The researchers infected hamsters with BA.1 and BA.2. The hamsters infected with BA.2 got sicker, with more lung damage and loss of body weight. Results were similar when mice were infected with BA.1 and BA.2.

"Infection experiments using hamsters show that BA.2 is more pathogenic than BA.1," the study said.

BA.1 and BA.2 both appear to evade immunity created by COVID-19 vaccines, the study said. But a booster shot makes illness after infection 74% less likely, CNN said.

What's more, therapeutic monoclonal antibodies used to treat people infected with COVID didn't have much effect on BA.2. 

BA.2 was "almost completely resistant" to casirivimab and imdevimab and was 35 times more resistant to sotrovimab, compared to the original B.1.1 virus, the researchers wrote. 

"In summary, our data suggest the possibility that BA.2 would be the most concerned variant to global health," the researchers wrote. "Currently, both BA.2 and BA.1 are recognised together as Omicron and these are almost undistinguishable. Based on our findings, we propose that BA.2 should be recognised as a unique variant of concern, and this SARS-CoV-2 variant should be monitored in depth."

If the World Health Organization recognized BA.2 as a "unique variant of concern," it would be given its own Greek letter.

But some scientists noted that findings in the lab don't always reflect what's happening in the real world of people.

"I think it's always hard to translate differences in animal and cell culture models to what's going on with regards to human disease," Jeremy Kamil, PhD, an associate professor of microbiology and immunology at Louisiana State University Health Shreveport, told Newsweek. "That said, the differences do look real."

"It might be, from a human's perspective, a worse virus than BA.1 and might be able to transmit better and cause worse disease," Daniel Rhoads, MD, section head of microbiology at the Cleveland Clinic in Ohio, told CNN. He reviewed the Japanese study but was not involved in it.

Another scientist who reviewed the study but was not involved in the research noted that human immune systems are evolving along with the COVID variants. 

"One of the caveats that we have to think about, as we get new variants that might seem more dangerous, is the fact that there's two sides to the story," Deborah Fuller, PhD, a virologist at the University of Washington School of Medicine, told CNN. "Our immune system is evolving as well. And so that's pushing back on things."

Scientists have already established that BA.2 is more transmissible than BA.1. The Omicron subvariant has been detected in 74 countries and 47 U.S. states, according to CNN. About 4% of Americans with COVID were infected with BA.2, the outlet reported, citing the CDC, but it's now the dominant strain in other nations.

It's not clear yet if BA.2 causes more severe illness in people. While BA.2 spreads faster than BA.1, there's no evidence the subvariant makes people any sicker, an official with the World Health Organization said, according to CNBC