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By Neha Mathur Sep 20 2023 Reviewed by Lily Ramsey, LLM

In a recent article published in Jama Network Open, researchers estimated the association between receipt of BNT162b2 vaccine and coronavirus disease 2019 (COVID-19)-related ambulatory visits in United States (US) children below the age of five years.

Study:  Receipt of BNT162b2 Vaccine and COVID-19 Ambulatory Visits in US Children Younger Than 5 Years. Image Credit: Ground Picture/Shutterstock.com Background

In the US, messenger ribonucleic acid (mRNA) technology-based COVID-19 vaccines based on wildtype severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) strain became available for young children from June 18, 2022, onward. However, vaccine uptake was low, and <5% of US children completed a primary SARS-CoV-2 vaccination series by May 24, 2023.

A previous study that examined COVID-19 vaccination and disease outcomes among children younger than five years did not include children younger than three years. About the study

In the present study, researchers included children aged six months to four years diagnosed with an acute respiratory infection and tested for COVID-19 using reverse transcriptase-polymerase chain reaction (RT-PCR) in the urgent care (UC), emergency department (ED), or outpatient settings of Kaiser Permanente Southern California (KPSC) between July 23, 2022 and May 19, 2023. 

Additionally, they used a test-negative case-control design to compare the risk of COVID-19 outcomes requiring medical attention between vaccinated COVID-19 cases and RT-PCR test-negative controls.

The team exclusively included children who received 3μg BNT162b2 as a three-dose series. The time gap between doses two and one was three to eight weeks, and doses 3 and 2 were eight weeks minimum.

Further, the researchers computed odds ratios (ORs) and 95% confidence intervals (CIs) using logistic regression models that included variables such as date of viral encounter, age, gender, race/ethnicity, COVID-19 history, and pediatric risk score. Results

During the study period, 24,261 children aged six months to four years met the inclusion criteria of the criteria, of which 11,615, 7,074, and 5,572 sought admission into the ED, UC, and outpatient settings of KPSC.

Overall, 2,337 children tested SARS-CoV-2-positive (cases), of which 76 (3.3%) received two or three doses of BNT162b2. Of 21,924 controls, 1,382 (6.3%) also received two or three doses of BNT162b2. Related StoriesPhase 3 study: The efficacy of monovalent SARS-CoV-2 vaccine with AS03 adjuvant in adultsModernas adapted COVID-19 vaccine that targets Omicron XBB.1.5 approved by MHRACDC recommendations for pneumococcal vaccine in adults

The median number of days between doses two and three was 61. Likewise, among two-dose recipients, the median number of days since dose two was 59.

Compared with unvaccinated children, the adjusted ORs for children who received a BNT162b2 vaccine (n=1457) were 0.70, 0.60, and 0.67 (95% CI) for a COVID–19–related ED/UC visit, outpatient visit, and either outcome, respectively. 

Note that an adjusted OR of 0.67 equates to vaccine effectiveness (VE) of 33%, computed as one minus the OR, which is lower than ~70% efficacy against symptomatic COVID-19 observed during a clinical trial when Omicron BA.2 sublineages were predominant.

Compared to BNT162b2's three-dose recipients, two-dose recipients were at a lower risk of SARS-CoV-2 encounters during ED, UC, and outpatient visits, although with wide CIs.

By the time young children received their third dose, more immune-evasive Omicron sublineages had emerged and were circulating globally, and the median time since the third versus second dose was longer.

Nonetheless, wildtype BNT162b2 vaccination (at least two doses) reduced the risk of COVID-19 ED, UC, and outpatient visits in children below five years.

To preserve the immunity of young children against SARS-CoV-2 strains circulating in the future, updated COVID-19 vaccines will likely be needed. Journal reference:

Tartof, SY., (2023) Receipt of BNT162b2 Vaccine and COVID-19 Ambulatory Visits in US Children Younger Than 5 Years, JAMA. doi:10.1001/jama.2023.17473. https://jamanetwork.com/journals/jama/fullarticle/2809748#:~:text=Receiving%20at%20least%202%20doses,children%20younger%20than%205%20years.

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Claudia Cardinale: Star of The Pink Panther and Once Upon A Time In The West dies aged 87

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Claudia Cardinale: Star of The Pink Panther and Once Upon A Time In The West dies aged 87

Acclaimed Italian actress Claudia Cardinale, who starred in The Pink Panther and Once Upon A Time In The West, has died aged 87, according to French media reports.

The actress, who starred in more than 100 films and made-for-TV productions, died in Nemours, France, surrounded by her children, her agent told the AFP news agency.

At the age of 17 she won a beauty contest in Tunisia, where she was born to Sicilian parents, and was rewarded with a trip to the Venice Film Festival, kick-starting her acting career.

She had expected to become a schoolteacher before she entered the beauty contest.

Claudia Cardinale at the Prix Lumieres awards ceremony in Paris in January 2013. Pic: AP
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Claudia Cardinale at the Prix Lumieres awards ceremony in Paris in January 2013. Pic: AP

Cardinale gained international fame in 1963 when she starred in both Federico Fellini’s 8-1/2 and The Leopard.

She went on to star in the comedy The Pink Panther and Sergio Leone’s Once Upon A Time In The West in 1968.

She considered 1966’s The Professionals as the best of her Hollywood films.

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When she was awarded a lifetime achievement at the Berlin Film Festival in 2002, she said acting had been a great career.

“I’ve lived more than 150 lives, prostitute, saint, romantic, every kind of woman, and that is marvellous to have this opportunity to change yourself,” she said.

“I’ve worked with the most important directors. They gave me everything.”

Cardinale was named a goodwill ambassador for the UN Educational, Scientific and Cultural Organisation for the defence of women’s rights in 2000.

She is survived by two children.

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Sports

Cubs’ Horton exits after 3 IP ‘as a precaution’

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Cubs' Horton exits after 3 IP 'as a precaution'

CHICAGO — Right-hander Cade Horton was removed after three innings of his start in the Chicago Cubs‘ game against the New York Mets on Tuesday because of back tightness. The club said Horton was removed “as a precaution” after throwing just 29 pitches.

Horton, a leading NL Rookie of the Year candidate, allowed a leadoff homer to New York’s Francisco Lindor but settled down and looked sharp for the remainder of his short outing. Horton allowed two hits, struck out two and departed with the Cubs leading 5-1.

After the Cubs extended the advantage to 6-1, New York rallied against the Chicago bullpen, scoring five unearned runs against Michael Soroka to tie the game and later grabbing the lead in a matchup with playoff implications for both clubs.

Horton, 24, is 11-4 on the season with a 2.67 ERA over 118 innings. The win total leads all rookie pitchers and the ERA leads rookies who have logged at least 100 innings.

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World

Trump disparages Russian military – and backs Ukraine to retake all lost territory

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Trump disparages Russian military - and backs Ukraine to retake all lost territory

Donald Trump disparaged the Russian military and backed Ukraine to retake all its occupied territory in an astonishing about-turn on the war.

In a post on Truth Social, made after talks with Volodymyr Zelenskyy at the United Nations in New York, the US president said a return to “the original borders from where this war started is very much an option”.

“I think Ukraine, with the support of the European Union, is in a position to fight and WIN all of Ukraine back in its original form,” he wrote.

Mr Trump said “time, patience, and the financial support of Europe and, in particular, NATO” could help Kyv win back lost territory, and said Russia was in “economic trouble”.

He said Moscow had been “fighting aimlessly” for three-and-a-half years – and had it been a “real military power” it would have defeated Ukraine in less than a week.

“This is not distinguishing Russia. In fact, it is very much making them look like ‘a paper tiger’,” he added.

Mr Zelenskyy told Sky News US correspondent Mark Stone it was a “big shift” from his US counterpart.

He later admitted he was surprised by Mr Trump’s comments, telling Fox News’ Special Report he has a better relationship with the president than before.

Read more: Why emboldened Trump has changed his stance on Ukraine

Donald Trump and Volodymyr Zelenskyy at the United Nations. Pic: Reuters
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Donald Trump and Volodymyr Zelenskyy at the United Nations. Pic: Reuters

Trump’s patience not ‘infinite’

Mr Trump also appeared to pour cold water on his hopes of persuading Vladimir Putin to sign a peace deal.

Speaking to Emmanuel Macron at the UN summit, he said their relationship had turned out to be meaningless.

Just last month, Mr Trump rolled out the red carpet for the Russian president at a summit in Alaska – in a push to expedite the war’s conclusion.

Before returning to the White House, he repeatedly claimed he’d be able to end the conflict in 24 hours.

Speaking at the UN Security Council, his secretary of state, Marco Rubio, admitted ending the war had proven an “extraordinary challenge”.

He said Mr Trump had “worked on it tirelessly”, but warned Russia his patience is not “infinite”.

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The US president has previously suggested Ukraine will never be able to reclaim all the territory Russia has occupied since seizing the Crimean Peninsula in 2014.

Ukraine has lost large areas of land in the east of the country.

In the Donetsk region, Russia now controls about 70% of the territory. Kyiv’s forces have been pushed back to four cities analysts have dubbed the “fortress belt”.

Moscow has partly annexed three other regions, too: Luhansk in the east, Zaporizhzhia and Kherson further west.

The situation in Ukraine on 19 September
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The situation in Ukraine on 19 September

Trump tells NATO to shoot down Russian jets in its skies

Meanwhile, Russia appears to be provoking its neighbours to the west. Last week, Estonia said three Russian MiG-31 fighter jets violated its airspace for 12 minutes before Italian NATO jets escorted them away.

The week before, about 20 Russian drones entered Polish airspace, prompting NATO jets to shoot some of them down and the alliance to beef up its defence of Europe’s eastern flank.

While talking to Mr Zelenskyy at the UN, Mr Trump was asked by reporters whether he thought NATO should shoot down any Russian planes that entered NATO airspace.

“Yes, I do,” Mr Trump replied.

On Truth Social, he said the US would continue to supply weapons to NATO, and it was for the alliance to “do what they want with them”.

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Mr Trump also suggested the Russian people are not aware of “what is really going on with this war”.

He added: “Most of their money is being spent on fighting Ukraine. Putin and Russia are in big economic trouble and this is the time for Ukraine to act.”

He has called on European and NATO allies to increase economic sanctions on Moscow.

In a joint statement following the president’s comments, G7 foreign ministers said discussions were ongoing about additional economic sanctions on Russia.

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