COVID-19 Alaska Clinical Update
Friday, April 9, 2021

Alaska vaccinations

As of April 8, 251,011 Alaskans (over 45% of the population 16 years and older) have received at least one dose of vaccine and 192,177 Alaskans are fully vaccinated.

Vaccine news

• An MMWR found that under real-world conditions, mRNA vaccines were 90% effective at preventing SARS-CoV-2 infection ≥14 days after second dose and were 80% effective at preventing SARS-CoV-2 infection ≥14 days after the first dose but before the second dose. This was the first MMWR to show the vaccines’ ability to prevent asymptomatic infections in addition to symptomatic and severe infections.
• Both Moderna and Pfizer have released data demonstrating antibody persistence and vaccine efficacy for at least six months post-vaccine.
• In a March 31 press release, Pfizer claimed its mRNA vaccine was 100% effective at preventing SARS-CoV-2 infection in a trial of 2,260 adolescents aged 12-15 years old. The data has not yet been published or peer-reviewed.
• Both Moderna and Pfizer have begun early phase trials examining the safety and efficacy of their mRNA vaccines in children <12 years old.
• 15 million doses of Johnson & Johnson’s vaccine spoiled at a Baltimore factory after being accidentally cross-contaminated with ingredients from another vaccine. The factory had not yet been certified by the FDA and no doses had shipped from that factory.

Vaccine hesitancy

• We continue to hear in Alaska and nationwide that the most motivating factor for someone to receive a COVID-19 vaccine is that their doctor or medical provider recommends it to them.
• Ways to help:
• If you or your healthcare practice are not currently a COVID-19 vaccine provider – enroll today!
• If you are enrolled, order vaccine and begin offering vaccine to patients during regular office visits
• Ask your patients if they have any questions about the vaccine, even if you are not providing vaccine
• Consider taking a short video of yourself explaining why you chose to get vaccinated and post it on social media or send it out in a patient email update
• Resources for talking with your patients about vaccines
• CDC - Making a Strong Recommendation for COVID-19 Vaccination
• CDC - Answering Vaccine Recipients’ Questions
• Alaska - COVID-19 vaccine website
• Alaska - Communication and Education Toolkit
• Alaska – Vaccine Safety

Variant Tracking

• The CDC added two new variants – B.1.427 and B.1.429 - to the list of Variants of Concern. Alaska is adjusting surveillance practices and public outputs, however B.1.427 and B.1.429 cases are not currently included in this summary
• As of April 7, the CDC Director said B.1.1.7 is now the most common COVID-19 variant in the US
• Nine new variants of concern were found over past two weeks.

COVID-19 science news

• An MMWR found higher SARS-CoV-2 incidence, mortality, and case-fatality rates among American Indian/Alaska Native persons than White persons in Montana. The incident rate was 2.2 times higher among AI/AN persons, the mortality rate was 3.8 times higher, and the case-fatality rate was 1.7 times that among White persons.
• A case-control study of more than 107,000 patients found no association between ABO blood type, susceptibility to SARS-CoV-2 infection, or disease severity.
• A large retrospective cohort study of more than 236,000 patients diagnosed with COVID-19 found 33.6% were subsequently diagnosed with a neurologic or psychiatric illness during the following six months.

Monoclonal Antibody Update

On April 8, the NIH updated their monoclonal antibody treatment recommendations to include Regeneron’s combination mAb product. The NIH now recommends using one of the following combination anti-SARS-CoV-2 monoclonal antibodies to treat outpatients with mild to moderate COVID-19 who are at high risk of clinical progression, as defined by the EUA criteria (listed in alphabetical order):

• Bamlanivimab 700 mg plus etesevimab 1,400 mg; or
• Casirivimab 1,200 mg plus imdevimab 1,200 mg.

Treatment should be started as soon as possible after the patient receives a positive result on a SARS-CoV-2 antigen or nucleic acid amplification test (NAAT) and within 10 days of symptom onset. There are no comparative data to determine whether there are differences in clinical efficacy or safety between bamlanivimab plus etesevimab and casirivimab plus imdevimab

Vaccine status

• All Alaskans and people who work in Alaska aged 16 years and older are now eligible for vaccination. Appointments can be made at covidvax.alaska.gov.