Booster vaccines, anyone

WELLNEWS

Victor Romulo Gallardo Dumaguing MD

Alert level 1 is implemented at the National capital region and most urbanized cities; daily cases have been steadily going down, positivity rate is lower than global rate, although the daily mortality (death) rate still see-saws, most active cases are mild or asymptomatic, hospitalization of Covid patents is less thus, our heavily-overworked medical front liners are having a much-deserved rest. Understandably, some Filipinos, with patriotism and national pride burning in their hearts, might just tell the statisticians of Bloomberg if they may objectively adjust their ranking of our vaccination drive.
    However, the Department of Health is quick to warn that we are not out of the woods yet. With the virus and its variants still in our midst, plus the reality that we have not achieved our initial goal of 70% herd immunity; or as some very concerned experts hope to even increase the so-called population protection, we should not let our guard down.
    While trimedia outlets –TV, radio and print- acknowledge the overwhelming positive response of the populace to improvement of the health status and downgrading of alertness level, there are still worrisome breakthrough infections with sad news of morbid patients among the unvaccinated or among elderlies, especially those with co-morbidities like hypertension, diabetes, heart disease and other debilitating diseases like tuberculosis.
    The World Health Organization initially recommended booster doses with most of Covid vaccines which needed two-injections whose interval is spread out in weeks, then issued a stricter
protocol with the arrival of the Delta variant followed by the Omicron variant, thus obedient countries heeded the call and started giving booster doses three months after the second vaccine dose, instead of originally-planned 6 months.
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Antibody levels wane within 3-6 months, a collective opinion of immunologists and health experts all over the world, which the WHO in Geneva fully concurred with, thus our Philippine government went into high-gear, not only in encouraging first and second dose vaccinations but also to emphasize the need for a booster dose to further strengthen the immune system of very Juan and Juana de la Cruz.
    A brief note on the different types of Covid-19 jabs might be useful. Most of the vaccines we got early on our young life were made from dead microbes, thus the classification of “inactivated vaccines” to which Sinovac and Sinopharm belong.  The mRNA vaccines, Pfizer and Moderna are manufactured using a segment of the genetic material of the Sars-CoV2 virus, which our human body will recognize as ‘alien, foreign non-self thus an enemy”, therefore challenging and stimulating our immune system to mount a strong defensive, protective response in the form of antibodies. A non-replicating adenovirus is used as a vector in the formulation of the AstraZeneca, Janssen and Sputnik V vaccine. These are the different types of Covid-19 vaccines that are approved for booster doses.
    Lately, a protein-subunit vaccine technology was used as platform in the manufacture of the Novovax vaccine by India intended for the Omicron variants.
    Homologous booster vaccine is of the same type the patient got for his/her first and second jabs.
    Heterologous, as the name implies, refers to vaccines which are different from the initial vaccines the patient received. On this matter, with the availability of different types of Covid-19 vaccines, Filipinos had and still have the luxury of choosing, which booster vaccines be jabbed into their deltoid muscle, with the assurance that except for the mild signs and symptoms similar to their initial experience, these vaccines are safe and will further give them protection from possible variant attack in the future.
    At this juncture, with the kind indulgence of our dear readers, allow me, in my capacity as an ordinary citizen and a vaccine-recipient- not as a doctor- to extend my gratitude and appreciation for the tireless almost heroic efforts of Gentlemen Carlito Galvez Jr, Francisco Duque , Vincent Dizon ; fine ladies Maria Rosario S. Vergeire, our Baguio-girl Myrna Cabotaje, together with the selfless assistance of experts in genetics, infectious diseases and immunology; in the procurement of vaccines, information drive, ramping up the roll-out of vaccines, with the full support of our President Rodrigo Roa Duterte
    The author would like to extend my appreciation to Dr.Gilbert Vilela, President of the Philippine Heart Association, who echoed DOH protocols regarding usefulness of vaccines and booster doses, who stressed the mortality rate of 2.3% of the general public and compared it to the alarming high 6% death rate of   unvaccinated persons, especially those with co-morbidities like hypertension, heart disease and diabetes.
Booster doses, anyone?
Next Week: The Obesogenic Culture of Filipinos
 

 WELLNEWS

Being fat linked with worse heart  health even in people who exercise

      
Sophia Antipolis France: Physical activity does not undo the negative effects of excess body weight on heart health. That’s the finding of a large study published in the European Journal of Preventive Cardiology, a journal of the European Society of Cardiology
    “One cannot be ‘fat but healthy’,” said study author Dr. Alejandro Lucia of the European University, Madrid, Spain. “This was the first nationwide analysis to show that being regularly active is not likely to eliminate the detrimental health effects of excess body fat. Our findings refute the notion that a physically active lifestyle can completely negate the deleterious effects of overweight and obesity.”
    There is some evidence that fitness might mitigate the negative effects of excess body weight on heart health. It has been suggested that in adults and children, being “fat but fit” might be associated with similar cardiovascular health to being “thin but unfit”. Dr. Lucia said: “This has led to controversial proposals for health policies to prioritize physical activity and fitness above weight loss. Our study sought to clarify the links between activity, body weight, and heart health.”
    The study used data from 527,662 working adults insured by a large occupational risk prevention company in Spain. The average age of participants was 42 years and 32% were women.
    Participants were categorized as normal weight (body mass index [BMI] 20.0–24.9 kg/m2), overweight (BMI 25.0–29.9 kg/m2), or obese (BMI 30.0 kg/m2 or above). Additionally, they were grouped by activity level: 1) regularly active, defined as doing the minimum recommended for adults by the World Health Organization2 (WHO); 2) insufficiently active (some moderate to vigorous physical activity every week but less than the WHO minimum); 3) inactive (no exercise). Cardiovascular health was determined according to three major risk factors for heart attack and stroke, namely diabetes, high cholesterol, and high blood pressure.
    Approximately 42% of participants were normal weight, 41% were overweight, and 18% were obese. The majority were inactive (63.5%), while 12.3% were insufficiently active, and 24.2% were regularly active. Some 30% had high cholesterol, 15% had high blood pressure, and 3% had diabetes.
    The researchers investigated the associations between each BMI and activity group and the three risk factors. At all BMI levels, any activity (whether it met the WHO minimum or not) was linked with a lower likelihood of diabetes, high blood pressure or high cholesterol compared to no exercise at all. Dr. Lucia said: “This tells us that everyone, irrespective of their body weight, should be physically active to safeguard their health.”
    At all weights, the odds of diabetes and hypertension decreased as physical activity rose. “More activity is better, so walking 30 minutes per day is better than walking 15 minutes a day,” he said.
    However, overweight and obese participants were at greater cardiovascular risk than their peers with normal weight, irrespective of activity levels. As an example, compared to inactive normal weight individuals, active obese people were approximately twice as likely to have high cholesterol, four times more likely to have diabetes, and five times more likely to have high blood pressure. Dr. Lucia said: “Exercise does not seem to compensate for the negative effects of excess weight.     This finding was also observed overall in both men and women when they were analysed separately.”
    He concluded: “Fighting obesity and inactivity is equally important; it should be a joint battle. Weight loss should remain a primary target for health policies together with promoting active lifestyles.”

Next Week: Health Risks of Obese Children 

WELLNEWS
Childhood obesity and high blood pressure warn of future heart disease

SOPHIA, ANNAPOLIS, France  -- A large study in adolescents and children, some as young as 3 years of age, shows a link between obesity, high blood pressure, and later damage to blood vessels. The research is presented at a scientific platform of the European Society of Cardiology (ESC).
    “The results of this study highlight the need to adopt healthy lifestyles from an early age,” said study author Ms. Julia Bueschges, a PhD student at the Robert Koch Institute, Berlin, Germany. 
    Until now, there has been little information on the connection between risk factors present in childhood – such as obesity and high blood pressure – and cardiovascular disease later in life.
    The study used data from the nationally representative German Health Interview and Examination Survey for Children and Adolescents. Children from diverse backgrounds were enrolled from all over Germany irrespective of their health status; they were selected using a sophisticated sampling design to ensure they represented the German population.
    Three study teams travelled over three years and set up temporary examination centers in 167 locations across the country. The baseline examination of 4,716 participants aged 3 to 17 included blood pressure, height and weight. The measurements were repeated 11 years later in the 14 to 29-year-olds, who also had an ultrasound of their arteries. The ultrasound assessed the thickness of the inner two layers of the carotid artery: thicker lining is an early indicator of clogged arteries.
    High blood pressure (hypertension) at baseline was associated with a 33% increased risk of having a thicker lining of the artery 11 eleven years later, while baseline obesity was linked with a 38% elevated risk of thicker artery lining. Thicker lining was defined as the top 25% of measurements according to current guidelines. Being hypertensive at both examinations was linked with a 63% raised risk of thicker artery lining, while being obese at both examinations carried a 53% greater risk.
    Ms. Bueschges said: “The study provides evidence from a large general population sample for a connection between cardiovascular risk factors in children and adolescents – namely high blood pressure and obesity – and subsequent deleterious changes in the blood vessels.” She cautioned that individual risk prediction is only moderate, meaning that not all children and adolescents with high blood pressure or obesity will develop subclinical atherosclerosis. 
    She said: “These findings underline the importance of good cardiovascular health from an early age. Physical activity and a healthy diet can help prevent high blood pressure and obesity. Alcohol and tobacco should be avoided. Last but not least, it is important to manage stress.”
    She concluded: “Tackling these unhealthy behaviours does not depend on children and their families alone but also on the promotion of healthy environments and the reduction of social inequalities which are strongly associated with cardiovascular disease.”
    Next Week: Booster Vaccines, anyone?