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Hundreds of Indonesian healthcare workers contract COVID-19 despite vaccination, dozens hospitalised

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JAKARTA: More than 350 Indonesian doctors and healthcare workers have contracted COVID-19 despite being vaccinated with Sinovac and dozens have been hospitalised, officials said, as concerns rise about the efficacy of some vaccines against more virulent virus strains.

Most of the doctors were asymptomatic and self-isolating at home, said Badai Ismoyo, head of the Kudus district health office in Central Java, but dozens were in hospital with high fevers and declining oxygen saturation levels.

Kudus is battling an outbreak believed to be driven by the more transmissible Delta variant which has pushed bed occupancy rates above 90 per cent in the district.

Designated as a priority group, Indonesian healthcare workers were among the first to be vaccinated when the inoculation drive started in January.

Almost all have received the COVID-19 vaccine developed by Chinese biopharmaceutical company Sinovac, according to the Indonesian Medical Association.

While the number of Indonesian healthcare workers dying from COVID-19 has decreased significantly – dropping from 158 deaths this January to 13 this May, according to data initiative group LaporCOVID-19 – public health experts say the Java hospitalisations are cause for concern.

“The data shows they have the Delta variant so it is no surprise that the breakthrough infection is higher than before because as we know the majority of healthcare workers in Indonesia got Sinovac, and we still don’t know yet how effective it is in the real world against the Delta variant,” said Dicky Budiman, an epidemiologist from Australia’s Griffith University.

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China’s Covid-19 vaccine flops in Singapore too

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New Delhi: In a major setback to Chinas Covid vaccines, Singapore is not counting its citizens who received Sinovac Biotech shots as being vaccinated against Covid-19 due to lack of data to show that the doses are effective against coronavirus, especially the Delta strain.

“We don’t really have a medical or scientific basis or have the data now to establish how effective Sinovac is in terms of infection and severe illnesses on Delta,” local media cited health minister Ong Ye Kung as saying at a press conference on Wednesday.

The decision comes close on the heels of serious doubts arising over Chinese vaccines in Indonesia as those who have received the shots are also contracting Covid-19 and infections are surging in the country.

The Delta variant is currently the dominant strain of Covid-19 in Singapore and was identified in the city state in May. Only people who have received the Moderna and Pfizer shots, are being considered as vaccinated in the official records.

Singapore had allowed some private clinics to offer the Sinovac shot, CoronaVac, from mid-June. Around 17,000 people are reported to have received one dose of CoronaVac.

Local media had also reported Singapore’s director of medical services saying last month that evidence from other countries showed people who had taken CoronaVac were still getting infected.

Most of the vaccines being used by Indonesia have also come from China’s Sinovac Biotech. Some health workers inoculated with Sinovac jabs have been hospitalized due to Covid-19. A few have even died despite being fully immunized, according to a report in Nikkei Asia.

The Indonesian Doctors Association says that of the 14 doctors who died from the virus between February and May, ten had been fully vaccinated with Sinovac, while the rest had been given one dose.

Although there is a serious problem with Chinese vaccines due to inadequate data to show their efficacy, some countries are being forced to opt for them because of the cute shortage of vaccines worldwide amid the devastating pandemic.

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102 people qualify for S$451,000 in Covid-19 vaccine injury financial aid to date: Ong Ye Kung

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SINGAPORE — The authorities have approved S$451,000 worth of financial aid to people who had suffered serious side effects from Covid-19 vaccines in Singapore, Health Minister Ong Ye Kung said on Tuesday (July 6).

The payments have either been paid out or are being processed to 102 applicants under the Vaccine Injury Financial Assistance Programme (Vifap) introduced by the Government in January.

They were among a total of 292 applicants who had submitted a complete Vifap application as of June 25, Mr Ong said.

Of these, 159 did not meet the eligibility criteria and 31 applications are waiting to be reviewed by an independent clinical panel or pending more medical information from the applicant’s doctor.

Mr Ong was responding in a written answer to a parliamentary question filed by Ms He Ting Ru, Member of Parliament for Sengkang Group Representation Constituency, who had asked about the applications made and payments approved under the programme.

TODAY has asked the Ministry of Health (MOH) for details of these approved payouts.

Vifap provides three tiers of support to people assessed to be adversely affected by their Covid-19 inoculation.

The first is a one-time payout of S$2,000 for patients who need hospitalisation and medical intervention and who later recover.

The second is a payout of up to S$10,000 that will be given to those who were hospitalised and required care in a high dependency or intensive care unit, but later recover from the side effects caused by the vaccine.



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Myocarditis in Young People After mRNA COVID-19 Vaccination Higher Than Expected

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(UPDATED) The US Centers for Disease Control and Prevention (CDC) is reporting a higher-than-expected number of myocarditis cases among young people who received the Pfizer/BioNTech or Moderna mRNA-based COVID-19 vaccines, according to a new report presented yesterday at a meeting of the US Food and Drug Administration’s Vaccines and Related Biological Products Advisory Committee.

Those findings, which are based on observational data from the Vaccine Adverse Event Reporting System (VAERS) and Vaccine Safety Datalink (VSD), come on the heels of a newly published case report in Pediatrics that also highlighted the potential risks of myocarditis among young people who received the Pfizer/BioNTech COVID-19 vaccine: seven adolescents, all boys ages 14 to 19, developed symptomatic myocarditis or myopericarditis within 4 days of receiving the second dose.

Judith Guzman-Cottrill, DO, a pediatric infectious disease specialist who was senior author of the case report, told TCTMD that she has taken care of several critically ill children with COVID-19, including those who developed pneumonia and respiratory failure, myocarditis, and shock from multisystem inflammatory syndrome in children (MIS-C), and stressed the significant benefits of vaccination at present.

“Over 2.3 million teens 16 to 17 years old have received two doses of Pfizer vaccines in the US, so [myocarditis/myopericarditis] appears to be a rare side effect,” she said. “Currently the benefits outweigh the risks, but our country’s safety monitoring systems—VAERS and VSD—will need to watch this very closely to determine if benefit continues to outweigh the risk.”

Uri Shoshan, MD (Hillel Yaffe Medical Center, Hadera, Israel), who co-authored a recent Israeli report in Vaccine that documented six patients (median age 23 years) diagnosed with myocarditis following mRNA vaccination, said the cases they’ve encountered thus far are mild and that no patient has required hemodynamic or respiratory support. Nonetheless, “we do think that there is causation between the administration of the vaccine (more so with the second dose) and the incidence of myocarditis,” he said in an email. While the numbers are small, and clinical presentation is mild, he suspects that more and more cases will be diagnosed globally as increasing numbers of younger people are vaccinated against COVID-19. Even with that concern, the benefits to vaccination continues to outweigh the risk, said Shoshan. 

“Despite the incidence of myocarditis in patients that received the COVID-19 vaccine, we still recommend vaccination versus the cause of this pandemic,” he told TCTMD.

Jacob Udell, MD, MPH (University of Toronto, Canada), who has previously shown there is CVD benefit associated with influenza vaccination, still advises all young people to get vaccinated against COVID-19 but stressed to TCTMD that there is an urgent need to collect data on all patients with myocarditis/pericarditis.

“One of the things the pandemic has cruelly unmasked, beyond all the inequities in our society, is how archaic our grant review system is,” Udell said. “We should be able to get a cohort study up and running and funded to accrue patients in a systematic way, so that we can study these young men very quickly. Everyone is saying we need more data, but how are we going get it? The CDC is reaching out to people in the vaccine reaction program, but we’re only going to catch the tip of the iceberg there.”

Udell is not yet convinced myocarditis is only affecting men, or even just young men. Other unknowns include the degree of cardiac enzyme elevation with myocarditis and whether the ECG changes are consistent across all patients who develop the adverse reaction to mRNA vaccination. Additionally, it’s not known if there is any left ventricular dysfunction associated with vaccine-induced myocarditis/pericarditis, he said.

“I know this has hit a nerve because it’s young people and it’s a vaccine where you’d otherwise think you might prevent the illness by not getting the vaccine, but I think the cure in this case is well worth it compared with the illness that is circulating in society,” said Udell.

Mohammad Madjid, MD (McGovern Medical School/University of Texas at Houston Health Science Center), has also studied the association between influenza and CVD, and like Udell, he believes the true incidence of myocarditis/pericarditis might be underestimated, as asymptomatic cases won’t be identified without active investigation. Right now, everyone is still trying to figure out the nature, severity, and extent of the problem, he said.  

“However, the clinically significant cases appear to be very rare and the vaccine’s benefit-risk ratio is still overwhelmingly positive,” said Madjid.

The American Heart Association (AHA) has issued a statement in response to the latest findings, stating that myocarditis is a rare adverse event in adolescents and young adults. Based on the evidence available to date, the AHA continues “to urge all adults and children ages 12 and older in the US to receive a COVID vaccine as soon as they can, as recommended by the CDC.”  

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