Paul Offit returns to TWiV for a discussion of SARS-CoV-2 bivalent boosters containing ancestral and Omicron spike mRNAs, including their composition, why they are being recommended by CDC, and who would benefit the most from them.

In his weekly clinical update Dr. Griffin discusses increased acute respiratory illnesses among children and adolescents, estimates of monkeypox incubation period, generation time, and reproduction number, rapid increase in suspected SARS-CoV-2 reinfections, interim infection prevention and control recommendations for healthcare personnel during COVID-19, SARS-CoV-2 secondary attack rates in vaccinated and unvaccinated household contacts during replacement of delta with omicron variant, breakthrough infection by SARS-CoV-2 delta and omicron variants elicited immune response comparable to mRNA booster vaccination, interval between prior SARS-CoV-2 infection and booster vaccination impacts magnitude and quality of antibody and B cell responses, further humoral immunity evasion of emerging SARS-CoV-2 BA.4 and BA.5 subvariants, short-course early outpatient Remdesivir prevents severe disease due to COVID-19 in organ transplant recipients during the Omicron BA.2 wave, effectiveness of Molnupiravir in high risk patients, and primary care and a distinct symptom pattern for long COVID.

In his weekly clinical update Dr. Griffin reviews the public health response to poliovirus in New York, impact of mandatory influenza vaccination, monkeypox in a young infant, health care worker exposure to monkeypox virus, monkeypox testing delays, transmission potential of monkeypox virus, TPOXX trial for monkeypox, detection of SARS-CoV-2 subgenomic mRNA, mucosal IgA against SARS-CoV-2, BNT262b2 against Omicron, awareness and use of SARS-CoV-2 antivirals, comparable outcomes for Bebtelovimab and Nirmatrelvir, and COVID-19 and Alzheimer’s disease.

From the European Society for Clinical Virology 2022 Conference in Manchester UK, Vincent speaks with Emma Thomson about the recent outbreak of pediatric hepatitis of unknown etiology and the finding that it is linked to infection by adenovirus-associated virus 2.

In his weekly clinical update Dr. Griffin discusses detection of a highly divergent type 3 vaccine-derived poliovirus in a child with a severe primary immunodeficiency disorder, severe respiratory illnesses associated with rhinoviruses and/or enteroviruses including EV-D68, effects of vaccination and previous infection on Omicron infections in children, COVID-19-associated hospitalizations among vaccinated and unvaccinated adults 18 years or older in 13 US states, effectiveness of COVID-19 vaccines over time prior to Omicron emergence in Ontario, Canada, nasal IgA wanes 9 months after hospitalization with COVID-19 and is not induced by subsequent vaccination,  resistance of SARS-CoV-2 Omicron subvariant BA.4.6 to antibody neutralization, persistent circulating SARS-CoV-2 spike associated with post-acute COVID-19 sequelae, and impact of COVID-19 vaccination on the risk of developing long-covid and on existing long-covid symptoms.

In his weekly clinical update Dr. Griffin discusses variant influenza virus infections: recommendations for identification, treatment, and prevention for summer and fall 2022, low levels of monkeypox virus neutralizing antibodies after MVA-BN vaccination in healthy individuals, using the right tools at the right time for SARS-COV-2 infection, onset and window of SARS-COV-2 infectiousness and temporal correlation with symptom onset, transmission of SARS-COV-2: a review of viral, host, and environmental factors, antibody persistence and safety through 6 months after heterologous orally aerosolized Ad5-nCoV in individuals primed with two-dose vaccine, timely administration of tocilizumab improves outcome of hospitalized COVID-19 patients, administration of anti–SARS-COV-2 monoclonal antibodies after US Food and Drug Administration deauthorization, and clinical and genetic risk factors for acute incident venous thromboembolism in ambulatory patients with COVID-19.

TWiV discusses a new henipavirus from fruit bats in Madagascar, and attenuation of SARS-CoV-2 Omicron disease in mice caused by genome mutations outside of the spike protein coding region.