SARS-CoV-2 Vaccine Update

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In this episode, we review what we know, as of November 29, 2020, about the major SARS-CoV-2 vaccine candidates – their mechanisms of action and preliminary data. Be aware that most of the data is preliminary and exact numbers may change (and long-term data is not yet available)

Moderna vaccine data

Phase I dose-escalation trial (Jackson et al NEJM 2020) and small 40 patient study of immunogenicity in older adults (Anderson et al NEJM 2020). (phase III study protocol )

Phase III trial results (Baden et al, NEJM)

  • >30,000 participants within the US
    • 37% from racial/ethnic minority groups (>6000 Hispanic participants, >3000 African American participants)
    • 22% healthcare workers
    • >14,000 female
    • >7000 >65 years old

Pfizer/BioNTech vaccine data

Data from the FDA Emergency Use Authorization Briefing and Polack et al in NEJM

About 19,000 participants were followed for ≥2 months

  • Looked at common side effects in 8,000 of the participants. Fatigue 3.7% after 2nd dose, headache 2%

Distribution fact sheet

AstraZeneca vaccine data

Phase I/II safety/immunogenicity study (Folegatti et al Lancet 2020)

Press Release data (11/23/20) from an interim (phase III trial protocol)

Lancet manuscript Phase 2/3 trial results

Johnson & Johnson vaccine data

Phase I/IIa safety/immunogenicity study (Sadoff et al MedRxiv.org [pre-print])

Novavax vaccine data

Phase I/II safety/immunogenicity trial

Phase III information (US trial not yet underway)

Cannabinoid Hyperemesis Syndrome

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In this episode we review Cannabinoid Hyperemesis Syndrome (CHS / Cannabis Hyperemesis Syndrome) which is characterized by

  • daily cannabis use on a chronic basis
  • typically use high doses
  • and symptoms generally resolve within days of cessation of cannabis use

The nausea and vomiting may be temporarily relieved by hot showers but can be refractory to traditional antiemetics, such as ondansetron and the butyrophenones (haloperidol/droperidol) have been anecdotally used with success, as has capsaicin. We review new articles on the treatment of CHS

Ruberto et al Ann Emerg Med. 20200; in press
Dean et al. Acad Emerg Med 2020. In press