Fighting Current and Future Coronaviruses with a Single Vaccine

National Institutes of Health | By Sharon Reynolds

Vaccines against SARS-CoV-2, the virus that causes COVID-19, have greatly reduced the risk of severe disease and death. However, SARS-CoV-2 continues to mutate in unpredictable ways that can reduce the effectiveness of the current vaccines. The risk of a new coronavirus spilling over from animals to people also remains a serious concern.

Researchers are trying to produce a vaccine that would protect people from both future SARS-CoV-2 variants and related coronaviruses that might pose a threat. To this end, an NIH-funded team led by Dr. Pamela Bjorkman from the California Institute of Technology created a nanoparticle-based vaccine that prompts B cells, which produce antibodies, to recognize parts of coronaviruses that mutate less often.

Current COVID-19 vaccines target parts of the SARS-CoV-2 virus that quickly mutate. Like those, the nanoparticles in the investigational vaccine display a part of the coronavirus spike protein called the receptor binding domain (RBD), which coronaviruses use to enter human cells.

However, the team combined RBDs from eight different coronaviruses for their vaccine. Each nanoparticle included 60 RBDs, so that any two adjacent RBDs were rarely from the same coronavirus. B cell receptors bind strongly to identical targets that are near each other. So, this design encouraged B cells to target areas that were similar across the RBDs—ones that tend to mutate more slowly.

The researchers tested the new vaccine, called mosaic-8, as well as a nanoparticle vaccine made only with RBDs of SARS-CoV-2. Results were published on August 5, 2022, in Science.

The team used mice that were engineered to make the human ACE2 protein—the target of the SARS-CoV-2 spike. Following vaccination with mosaic-8, the mice produced antibodies that recognized a range of coronaviruses. As expected, the antibodies recognized parts of the RBDs that remained similar between coronaviruses.

When challenged with SARS-CoV-2, mice that received either of the nanoparticle vaccines were protected against symptoms of severe COVID-19. However, only the mosaic-8 vaccine also protected mice against a related virus, SARS-CoV, which caused the SARS outbreak of 2003. This protection occurred even though SARS-CoV wasn’t part of the mosaic-8 nanoparticle.

Similar results were seen in non-human primates. Monkeys that received either the mosaic-8 nanoparticle or the SARS-CoV-2 nanoparticle were protected against severe COVID-19. But those that received the mosaic-8 vaccine were also protected against the SARS-CoV-2 Delta variant and SARS-CoV, neither of which were included in the vaccine.

“We can't predict which virus or viruses among the vast numbers in animals will evolve in the future to infect humans to cause another epidemic or pandemic,” Bjorkman says. “What we're trying to do is make an all-in-one vaccine protective against SARS-like [coronaviruses]. This sort of vaccine would also protect against current and future SARS-CoV-2 variants without the need for updating.”

The researchers are now preparing to test mosaic-8 in a human clinical trial.

Whole Person Health: What You Need to Know

What is whole person health?

Whole person health involves looking at the whole person—not just separate organs or body systems—and considering multiple factors that promote either health or disease. It means helping and empowering individuals, families, communities, and populations to improve their health in multiple interconnected biological, behavioral, social, and environmental areas. Instead of treating a specific disease, whole person health focuses on restoring health, promoting resilience, and preventing diseases across a lifespan.

Why is whole person health important?

Health and disease are not separate, disconnected states but instead occur on a path that can move in two different directions, either toward health or toward disease.

On this path, many factors, including one’s biological makeup; some unhealthy behaviors, such as poor diet, sedentary lifestyle, chronic stress, and poor sleep; as well as social aspects of life—the conditions in which people are born, grow, live, work, and age—can lead to chronic diseases of more than one organ system. On the other hand, self-care, lifestyle, and behavioral interventions may help with the return to health.

Chronic diseases, such as diabetes, cardiovascular disease, obesity, and degenerative joint disease, can also occur with chronic pain, depression, and opioid misuse—all conditions exacerbated by chronic stress. Some chronic diseases increase the immediate and long-term risks with COVID-19 infection. Understanding the condition in which a person has lived, addressing behaviors at an early stage, and managing stress can not only prevent multiple diseases but also help restore health and stop the progression to disease across a person’s lifespan.

Is whole person health being used now in health care? . . .

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Free COVID-19 Home Tests for Blind and Low-Vision Users Now Available

Comagine Health | Aug 31st, 2022

Online ordering has resumed for free COVID-19 home tests for blind and low-vision users.

Officials ask those who order the Ellume COVID home tests only make the request if they do not have a way to use the other types of tests, such as assistive technology or a trusted family member or friend who can assist.

The tests will be available until supplies run out and can be ordered through a dedicated webpage or by calling 1-800-232-0233.

If you are able to use the other COVID-19 at-home tests and have not placed a third order, you can order online through the main ordering page or by calling 1-800-232-0233. This program will be suspended on Sept. 2.

CMS: ACOs Saved Medicare $1.6B Overall in 2021 as Big Changes on the Horizon

Fierce Healthcare | By Robert King
 
Accountable care organizations saved Medicare $1.66 billion last year as value-based care providers brace for potential major changes to the program like new health equity measures.
 
The Centers for Medicare & Medicaid Services (CMS) announced [last] Tuesday that 2021 was the fifth year in a row that ACOs generated overall savings for Medicare and met quality targets. The announcement comes roughly a month after the agency proposed several changes to entice smaller ACOs to enter the program and prevent an erosion of participation. 
 
“Accountable Care Organizations are a true Affordable Care Act (ACA) success story, and it is inspiring to see the results year after year,” said CMS Administrator Chiquita Brooks-LaSure in a statement.
 
CMS reported that 99% of all ACOs in the Medicare Shared Savings Program (MSSP) met quality standards, and approximately 58% earned shared savings for abiding by spending targets. An ACO agrees to take on a certain degree of financial risk and to meet spending and quality benchmarks.
 
The ACO gets a share of any savings if Medicare spending is below the benchmark and must repay the federal government if it spends too much. 
 
“The type of ACOs that saw more net savings tended to be low-revenue, meaning they were mainly made up of physicians, included a small hospital, or served rural areas,” according to a CMS release on the findings. 
 
A low-revenue ACO generated $237 in savings per capita while higher-revenue programs got $124 in net savings per capita. 
 
CMS also found that physician-led ACOs generated particularly high savings. ACOs that are comprised of 75% primary care physicians or more saw $281 in net savings compared with $149 in net savings for ACOs that had fewer physicians.
 
“These results underscore how important primary care is to the success of the Shared Savings Program and demonstrate how the program supports primary care providers,” CMS said.
 
CMS told Fierce Healthcare that ACOs overall generated $3.6 billion in gross savings for Medicare when not accounting for shared savings payments.
 
In 2020, ACOs generated $4.5 billion in gross savings for Medicare and nearly $2 billion after factoring in the shared savings payments. 
 
The additional savings were notable since ACOs were still facing the financial impact of the COVID-19 pandemic, advocates say. 

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