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To this end, FDA recommends that either the primary endpoint or a secondary endpoint (with or without formal hypothesis testing) be defined as virologically confirmed SARS-CoV-2 infection with one or more of the following symptoms: Fever, chills, Cough, Shortness of breath, Fatigue, Muscle or body aches, Headache, New loss of taste or smell, Sore throat, Congestion or runny nose, Nausea or vomiting, Diarrhea
respiratory rate ≥ 30 per minute, heart rate ≥ 125 per minute, SpO2 ≤ 93% or PaO2/FiO2 < 300 mm Hg, Respiratory failure (defined as needing high-flow oxygen, noninvasive ventilation, mechanical ventilation or ECMO), Evidence of shock, Significant acute renal, hepatic, or neurologic dysfunction, Admission to an ICU, Death
the primary efficacy endpoint point estimate for a placebo-controlled efficacy trial should be at least 50%, and the statistical success criterion should be that the lower bound of the appropriately alpha-adjusted confidence interval around the primary efficacy endpoint point estimate is >30%...A lower bound ≤30% but >0% may be acceptable as a statistical success criterion for a secondary efficacy endpoint, provided that secondary endpoint hypothesis testing is dependent on success on the primary endpoint.
If three doses are successful at triggering a protective immune response, the companies expect to submit the data to regulators in the first half of next year.
“I think that a third dose will give a nice boost, and honestly, this is really exciting — as we know from the adult data, three doses is probably better for omicron. And I think it’ll be good to have similar data for children,” Talaat said.
This is a developing story. It will be updated.
Kawsar Talaat, one of the principal investigators of the Pfizer pediatric trial and a physician at Johns Hopkins Bloomberg School of Public Health, said that while the news may be disappointing, a third dose is expected to work well to provide protection, particularly against omicron.
(this last quote is an UNREAL conditional, meaning the results have not been positive.
Many parents and pediatricians hoped that if the results had been positive, Pfizer would be in a position to file for regulatory authorization early next year.
The companies have been testing two shots of a 3-microgram dose in children under 5, a small fraction of the adult dose. Because children’s immune systems are different from adults', smaller doses are expected to trigger equivalent immune protection. The trials were designed to test the safety and efficacy of the lower dose.
The companies reported that two doses of the pediatric vaccine failed in 2-, 3- and 4-year-olds to trigger an immune response comparable to what was generated in teens and older adults. The vaccine did generate an adequate immune response in children 6 months to 2 years old.
If three doses are successful at triggering a protective immune response, the companies expect to submit the data to regulators in the first half of next year.
“It is important to note that this adjustment is not anticipated to meaningfully change our expectations that we would file for emergency use authorization and conditional approvals in the second quarter of 2022,” said Kathrin Jansen, head of vaccine research and development for Pfizer in a call with investors.
That means some kind of a lab test of biological samples that detects the presence of the virus either directly or indirectly.
Test result must be evaluated in conjunction with other data available to the physician.
If the differentiation of specific SARS viruses and strains is needed, additional testing, in consultation with state or local public health departments, is required.
Positive test results do not rule out co-infections with other pathogens.
Positive tests do not differentiate between SARS-CoV-2 and SARS-CoV.
HBV, HCV, HIV, Pneumocystis jirovecii (PJP) and Staphylococcus salivarius are not tested.
I assume that a diagnosis of severe covid would also require one of the mentioned symptoms together WITH a virologically confirmed detection
so that would require further research to verify.
In any case, wearing surgical masks does not result in lowering blood oxygen levels below 93%:
Objectives. This study was undertaken to evaluate whether the surgeons' oxygen saturation of hemoglobin was affected by the surgical mask or not during major operations.
Methods. Repeated measures, longitudinal and prospective observational study was performed on 53 surgeons using a pulse oximeter pre and postoperatively.
Results. Our study revealed a decrease in the oxygen saturation of arterial pulsations (SpO2) and a slight increase in pulse rates compared to preoperative values in all surgeon groups. The decrease was more prominent in the surgeons aged over 35.