This update was originally posted on my site called Examined. It’s too long and pretty to fully repost here, but I’m going to share three important sections plus the conclusions with you now.
*
State of the States
In the US we are in a pretty nice Covid valley with infections and sewage analysis showing low SARS CoV-2 activity. It’s still nothing like the good old days of 2021 and 2022 when we had some real breaks, and I diagnosed/treated some Covid cases here and there in my practice last month. Many more went undiscovered of course. About 1 in every 210 Americans has infectious Covid right now. The graphic above comes from PMC. Most experts are seeing a predictable summer wave building, probably to hit around mid July, fueled by variants like NB.1.8.1.
FDA Approves Moderna's next-generation COVID-19 vaccine
The FDA has *gasp*, approved Moderna's new mRNA vaccines called mNexspike, a next-generation COVID-19 vaccine that represents a significant advancement in mRNA vaccine technology. Unlike the original Spikevax vaccine you might have received already, mNexspike targets a refined portion of the SARS-CoV-2 spike protein, allowing for a dramatically reduced dose of just 10 micrograms compared to Spikevax's 50 micrograms—one-fifth the amount. I’m hoping this produces less side effects for people, too.
The vaccine's precision design focuses the immune response on the most critical regions of the spike protein for virus neutralization (specifically the N-terminal domain and receptor-binding domain of the spike protein). Clinical trials involving 11,400 participants demonstrated that mNexspike achieved 9.3% higher relative vaccine efficacy in preventing infections overall compared to Spikevax, with a notable 13.5% higher efficacy in adults 65 and older.
The FDA approval is limited to adults 65 and older and people aged 12-64 with underlying health conditions that increase their risk of severe COVID-19. The vaccine is potentially refrigerator-stable, which could simplify distribution and expand access to high-risk populations. Moderna expects mNexspike to be available for this coming respiratory virus season alongside the existing Spikevax vaccine. I think both will target LP.8.1. Confusion exists about FDA approval without RCTs.
Some might call this target practice, while others might wax lyrical and call this new option a more surgical strike, smart bomb, force multiplier, or pincer movement. Moderna, you can use that. I won’t take a dime so that I can keep my conflicts of interest at zero.
Spike proteins may directly induce Parkinson’s disease. What does that mean for Covid infections versus vaccinations?
A German study found that intravenous spike protein administration in mice caused neuroinflammation and alpha-synuclein accumulation in Parkinson's-associated brain regions, along with sex-dependent changes in brain cells. These findings demonstrate that spike protein exposure alone can trigger neurodegenerative processes linked to Parkinson's disease, highlighting potential long-term neurological risks from Covid infection and supporting the importance of vaccination for protection.
This is not the first time Covid and Parkinson’s have been linked, but rather it builds upon studies like this one published in the journal Cell. If you think like me, you might have panicked a little that repeat exposures to spike proteins through vaccination might also be of major concern. But so far the evidence suggests otherwise, especially in a world where Covid is now endemic and never going away, ensuring repeated exposures and illnesses for most of us.
There are significant differences in spike protein persistence between Covid infection and vaccination, with important implications for neurological health.
Following infection, SARS-CoV-2 spike protein accumulates in the skull-meninges-brain axis for up to four years, even after viral clearance, as demonstrated by this 2024 study of human brain samples. In contrast, vaccination produces spike protein primarily at the injection site for weeks to months, with mRNA vaccines reducing brain accumulation after subsequent infections by approximately 50%.
So in a mostly reassuring conclusion, studies linking spike protein to Parkinson's disease through α-synuclein aggregation and neuroinflammation suggest that natural infection poses considerably higher neurological risks than vaccination due to prolonged brain-adjacent spike protein persistence versus the more localized and temporary exposure from vaccines.
Key Takeaways from May's Covidlandia Update:
-
State of Covid: The US is currently in a relatively calm period with low SARS-CoV-2 activity based on infections and sewage analysis, though not as quiet as the 2021-2022 breaks
-
Coming summer wave: New variant NB.1.8.1 is driving surges across Asia and may become dominant in the US by mid-July, potentially causing a significant wave of infections
-
LP.8.1 and NB.1.8.1 variants: Fall vaccines will target LP.8.1 strain, while emerging NB.1.8.1 shows stronger binding to human receptors and modest immune evasion; current and future vaccines should still protect against severe disease
-
Covid shots for fall: FDA has instructed manufacturers to update vaccines for LP.8.1, with flexibility for Novavax to potentially stick with JN.1 due to production constraints
-
Next-generation Moderna shot: New mNexspike vaccine approved for high-risk adults uses only 10 micrograms (one-fifth the dose) and shows 9.3% higher efficacy overall, 13.5% higher in seniors
-
N-acetylcysteine treatment: Despite promising headlines of 41% mortality reduction, clinical evidence remains weak and inconsistent with wide confidence intervals making results unreliable
-
Nicotinamide treatment: Vitamin B3 supplement showed modest benefits in 900-patient trial, with 57.6% recovery by week two versus 42.6% placebo, and potential long Covid prevention benefits
-
Policy shenanigans: FDA officials are restricting fall vaccines to high-risk groups only, while HHS stopped recommending vaccines for pregnant women and children, bypassing proper scientific review
-
Combined flu-Covid vaccine fate: Moderna withdrew its application for the combination vaccine, citing political climate, while $766 million in pandemic preparedness contracts were canceled
-
Spike proteins and Parkinson's risk: Covid infection causes prolonged spike protein accumulation in brain areas for up to 4 years, while vaccination produces temporary, localized exposure with 50% less brain accumulation after subsequent infections
-
Kids and Covid: 15-23% of infected children develop long Covid, with unvaccinated kids facing up to 20 times higher risk; vaccination significantly reduces hospitalizations and long Covid in pediatric populations
-
Mitochondrial damage: SARS-CoV-2 hijacks cellular mitochondria for replication, disrupting energy production; metformin may help protect these cellular powerhouses through AMPK activation
-
Antivirals still worthwhile: Paxlovid and Lagevrio reduce adverse outcomes by 23% and death risk by 83% in high-risk patients, though only 26% of eligible patients receive treatment; each day of delay increases hospitalization risk by 20%
-
Updated shots still worthwhile: repeat shots did not reduce robust immune responses in a small study, but consistent with other larger studies, and older folks with 4 or more Covid vaccine doses get diagnosed with long Covid 40% less of the time
The evidence continues to support vaccination and early antiviral treatment, even as we navigate political interference in public health decision-making.
Despite what nouveau puissant individuals publish in the NEJM, it takes a village to manage science, truth, and nuance among risks and benefits. We are fortunate enough to have made it to this point in the pandemic where patient choices can be informed by science, experience, and personal medical freedoms. They shouldn’t be hypocritical and take this away from babies and pregnant women, not to mention anyone who wants to stay up to date on Covid vaccines like the flu shots we are more accustomed to.
Keep speaking truth to power and fellow patients.
And if you want to read more (while supporting my work curating actionable, useful science and primary care ideas), please do head over to the original post and take out a free or paid subscription. I’m tired of misinformed charlatans having all the fun in health and wellness. Signing up will also keep you in the loop, with future posts delivered to your email inbox, though I will keep crossposting a good amount here :)
Have a great week! Have a healthy summer if you can, and hang in there if your health is a challenge!
