TWiV reviews evidence that COVID-19 mRNA vaccination of both uninfected and previously infected persons elicits cross-variant neutralizing antibodies, and directed evolution of a bacterial protein to form a virus-like capsid that specifically packages its encoding mRNA.

In COVID-19 clinical update #70, Daniel Griffin discusses efficacy of portable air cleaners, vaccine induced serum neutralizing antibodies against variants, prevention and attenuation of disease with mRNA vaccines, ivermectin to prevent hospitalization, IL-6 antagonists and mortality, and impact of vaccination on long COVID.

Ron Fouchier explains why increased transmission of SARS-CoV-2-variants has not been demonstrated, and their ability to displace ancestral variants is due to greater fitness, much like influenza virus antigenic variation leads to better fitness and replacement of previously circulating variants.

In COVID-19 clinical update #69, Daniel Griffin covers effectiveness of mRNA vaccines against the delta variant, depression among public health workers, correlates of protection against asymptomatic and symptomatic infection, BNT162b2 in ChAdOx-1-S primed individuals, prior infection rescues B and T cell responses to variants after vaccination, effect of vaccination on household transmission, germinal responses induced by mRNA vaccines, phase 3 results of Novavax vaccine, and long COVID as our next national health disaster.

In COVID-19 clinical update #68, Daniel Griffin discusses children acquiring infection at birthday parties, immunogenicity of vaccines in solid organ transplant patients, reinfection rates in recovered patients, lack of efficacy of azithromycin, bacterial and fungal infections in hospitalized patients, effect of monoclonal antibody treatment on clinical outcomes of ambulatory patients, and reduction in mortality of hospitalized patients treated with remedesivir.

In COVID-19 clinical update #67, Daniel Griffin reviews antibodies to the virus early in the US, serology testing of blood donations, MIS-C in children under 21, myocarditis in competitive athletes, ER visits for suspected suicide attempts, delta variant in Scotland, Novavax vaccine phase 3 results, vaccine coverage in pregnant women, early monoclonal administration reduces hospitalization and mortality, casirivimab and imdevimab recovery trial results, and CDC guidance on postacute sequelae.

In COVID-19 clinical update #66, Daniel Griffin covers treatment guidelines from IDSA, hospitalization of adolescents, estimating epidemiological dynamics from viral load distributions, incidence of infection according to baseline antibody status, assessment of reinfection in Italy, need for vaccination in previously infected individuals, assessment of protection against reinfection, antimicrobial use in hospitalized patients, effect of single dose ivermectin, and a trial of aspirin in hospitalized patients.

David joins TWiV to relate how his near-death experience with Castleman’s disease motivated him to found the Center for Cytokine Storm Treatment & Laboratory and the CORONA project to identify and track all treatments reported for COVID-19 in an open-source data repository.

TWiV reviews the new nomenclature for SARS-CoV-2 variants, effectiveness of Pfizer/BioNTech vaccine against variants, modified Moderna vaccine against variants, impact of COVID-19 interventions on influenza in China and the US, and binding of RaTG13 spike protein to ACE2 of multiple species.

In COVID-19 clinical update #65, Daniel Griffin summarizes effects of non-pharmaceutical interventions, updated summer camp guidance from CDC, serology testing not recommended by FDA, antigen tests during a music event, inhibition of vaccine immunogenicity by methotrexate, phase 3 trial results for colchicine, and small airway disease as a post-acute sequelae.