The United States has donated 200 million vaccine doses globally, Merck has applied for emergency use authorization of its antiviral Covid-19 drug, and more in this week's roundup of Covid-19 news.

• Covid-19 patients who were overweight or obese experienced a greater number of and longer-lasting symptoms compared with patients who were not, according to a study published in Influenza and Other Respiratory Viruses. In the study, researchers analyzed data from 547 participants, including 308 adults and 239 children, from June 17, 2020 to Jan. 31, 2021. Of the participants, around 62% were overweight or obese, including 75% of adults and 62% of children. In total, 470 participants tested positive for Covid-19. The researchers found that 59% of overweight and obese Covid-19 patients developed symptoms compared with 47% of other Covid-19 patients. Overweight and obese Covid-19 patients also had a higher number of median symptoms, including cough, shortness of breath, and altered taste. In addition, the researchers found that overweight and obese adolescents were more likely to develop symptoms (67% vs. 34%) and had higher median days of respiratory symptoms (seven vs. four) compared with other adolescents. Ultimately, the researchers concluded that vaccination is especially important in overweight or obese populations to "ameliorat[e] preventable complications in an at-risk population." (Walker, MedPage Today, 10/20; Cheng et al., Influenza and Other Respiratory Viruses, 10/19)

• The World Health Organization (WHO) has hired Afrigen Biologics and Vaccines to decode the formula for Moderna's mRNA Covid-19 vaccine and develop a similar vaccine, NPR reports. Previously, Moderna said it would not enforce intellectual property of its vaccine during the pandemic, meaning other manufacturers can produce virtually identical vaccines without fear of a lawsuit. According to WHO, once the vaccine is completed, Afrigen will become a teaching center where manufacturers from low- and middle-income countries can learn the formula and necessary processes. "We call it a 'technology transfer hub,'" said Martin Friede, the WHO official in charge of the effort. "Manufacturers from around the world will be invited to come and learn the entire process. So this will accelerate the availability of the technology, not to one manufacturer but to many manufacturers." (Aizenman, "Goats and Soda," NPR, 10/19)

• A study published in JAMA Health Forum found that statewide lotteries were not associated with increased Covid-19 vaccinations in the 19 states that implemented them, Becker's Health IT reports. In the study, the researchers compared vaccination rates between April 28 and July 1 in states without lotteries with the 19 states that imposed them, both before and after the lotteries were announced. According to the researchers, the difference was "statistically indistinguishable from zero." Andrew Friedson, one of the study's authors, said the results indicate a need to reassess how governments encourage Covid-19 vaccinations. "Drawings were not, by any means, an informative vaccine promotional strategy," he said. "It's highly possible that putting funds toward clear and complete messaging on vaccination would have been far more effective, such as awareness campaigns or more aggressive countermeasures against misinformation." (Adams, Becker's Health IT, 10/18; Dave et al. JAMA Health Forum, 10/15)

• Merck last week submitted an application to FDA for emergency use authorization of its oral antiviral Covid-19 drug, molnupiravir, the New York Times reports. In a clinical trial, the drug reduced the risk of hospitalization or death in study participants with mild to moderate Covid-19 by around 50%. According to AP/Modern Healthcare, FDA's expert advisory committee will meet on Nov. 30 to review the antiviral drug—making this the first time the committee will discuss a Covid-19 treatment and not just a vaccine. "We believe that, in this instance, a public discussion of these data with the agency's advisory committee will help ensure clear understanding of the scientific data and information that the FDA is evaluating," said Patrizia Cavazzoni, director of FDA's Center for Drug Evaluation and Research. If Merck's drug is authorized, it will likely be first pill to treat Covid-19, AP/Modern Healthcare reports. (Robbins, New York Times, 10/11; Garfinkel, Axios, 10/14; AP/Modern Healthcare, 10/14)

• The Biden administration last week announced the United States will donate an additional 17 million doses of Johnson & Johnson's Covid-19 vaccine to the African Union (AU), The Hill reports, adding to the 50 million vaccine doses the United States has already donated to the AU. Currently, the United States has donated 200 million Covid-19 vaccine doses to more than 100 countries around the world. In a statement, Samantha Power, the administrator of the U.S. Agency for International Development (USAID), said, "President Biden has pledged that the U.S. will be the world's arsenal of vaccines, and USAID continues to play a pivotal role in fulfilling the ambitious goal of vaccinating 70% of the eligible global population by next year." According to The Hill, the United States has pledged to donate more than one billion vaccine doses over this year and the next. (Chalfant, The Hill, 10/14; Franklin, NPR, 10/14; Gangitano, The Hill, 10/21)

• A study from Pfizer and BioNTech found that a third dose of their Covid-19 vaccine was highly protective against symptomatic Covid-19, the Wall Street Journal reports. In the study, researchers analyzed data from more than 10,000 participants ages 16 and older who had been fully vaccinated with Pfizer-BioNTech's vaccine. Half of the participants received a booster dose, and half received a placebo. Overall, there were 109 symptomatic infections among participants who received a placebo compared with five symptomatic infections among participants who received a booster—resulting in a 95.6% efficacy. In addition, the companies said the study was conducted when the delta variant was prevalent, suggesting an additional vaccine dose can protect against the highly contagious variant. "These results provide further evidence of the benefits of boosters as we aim to keep people well-protected against this disease," Pfizer CEO Albert Bourla said. Both companies said they plan to submit the study data to health authorities in the United States and other countries, the Journal reports. (Hopkins, Wall Street Journal, 10/21)