Becker's Clinical Quality & Infection Control

11 INFECTION CONTROL No rush on boosters for people who've had breakthrough COVID-19, experts say By Erica Carbajal P reliminary research shows fully vaccinated people who've contracted a breakthrough COVID-19 infection have strong protection, indicating they don't need to rush to get a booster dose, The Wall Street Journal reported Oct. 10. Speaking on the topic of people who get COVID-19 after full vaccination, Paul Offit, MD, told the Wall Street Journal: "I wouldn't ask them to get a booster dose. I think they just got it." Dr. Offit is a member of the FDA's vaccine advisory committee. A number of preliminary studies have indicated a bout with COVID-19 aer full vaccination essentially acts as an extra dose, prompting the immune system to generate B cells and T cells. e Wall Street Journal cited early findings from a U.K. study that found real-world infection aer two doses of Pfizer's vaccine offered 94 percent protection for up to six months aer vacci- nation, relative to about 80 percent protection from vaccination alone, and 65 percent protection from infection alone. People with hybrid immunity "are likely the last group that really needs the booster because they really had three exposures," Akiko Iwasaki, PhD, immunologist at New Haven, Conn.-based Yale Univer- sity, told the news outlet. at's because the infection exposes the body to more than just the spike protein that the vaccines target, she added. However, this doesn't mean people with hybrid immunity won't ever need a booster shot, as protection may still wane over time, experts said. Pfizer or Moderna vaccine recipients are eligible for a booster six months aer their initial vaccination if they are: age 65 and older, live in long-term care settings, have underlying medical conditions or work or live in high-risk settings. Booster shots are recommended for all adults who received Johnson & Johnson's vaccine two or more months ago. More than 15 million people had received a booster as of Oct. 29, according to CDC data. n 10 things to know about Valley fever, a fungal infection rising in the southwest US By Erica Carbajal I n recent years, cases of Valley fever have been on the rise in the Southwestern region of the U.S., Grist reported Sept. 15. It's estimated to kill about 200 people in the country each year. Nine more things to know about the disease: 1. Valley fever is caused by a strain of fungus called Coccidioides, or Cocci for short. Symptoms include cough, fever, shortness of breath, rash on the upper body or legs, among others that may linger for weeks to months in some cases. 2. The fungus lives in soil and is endemic in certain regions of the world where weather conditions are hot and dry. 3. Valley fever can't be spread from person to person. People can contract the infection by breathing in micro- scopic fungal spores from the air. 4. About 60 percent of Valley fever cases produce no symptoms or mild symptoms that are often confused with the common cold, while 30 percent of people infected develop a moderate illness that requires medical attention. The remaining 10 percent get severe infections where the fungus spreads to other parts of the body from the lungs. 5. The CDC estimates about 150,000 Valley fever cases are undiagnosed every year in the U.S. CDC data also shows cases in the U.S. rose 32 percent from 2000 to 2018, Grist reported. In California, cases rose 800 per- cent from 2000 to 2018, according to a CDC study from December 2020. 6. As of Sept. 15, Arizona had the highest rate of Valley fever in the country. 7. Health professionals aren't sure why Cocci makes some people sicker than others, but people with im- munocompromising conditions, African Americans and Filipinos are especially at risk. 8. Antifungal medications such as fluconazole are used to treat the disease and no vaccine currently exists. 9. Researchers aren't certain why cases have been on the rise, though they widely suspect climate change plays a role. n

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