The Briefing provides an at-a-glance view of some important developments in the information universe surrounding COVID-19. The views presented here are solely those of ECRI Horizon Scanning and have not been vetted by other stakeholders.

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Viral loads in people infected with the Delta variant of SARS-CoV-2 are higher in the nose and throat. As Delta cases surge in their state, two scientists from Alabama have suggested that next-generation COVID vaccines—or, at minimum, boosters—should be intranasal. Vaccines delivered as a nasal spray could drive a different immune response that might be better at defeating the virus before it reaches the lungs. Currently, all available vaccines are intramuscular (ie, a shot in the arm muscle) which protects best against viruses that reach the lungs. Combining primary intramuscular vaccines with an intranasal booster could deliver the best of both worlds. In the United States, only three nasal vaccines are in very early clinical trials.

In the previous scan, we explored the reemergence of mask mandates as the Delta variant overtook the country. Now we see an increase in vaccine mandates (see Topics to Watch). Currently, various states, cities, and employers are creating a patchwork of individualized mandates, such as New York City’s requirement that people prove they are vaccinated before eating inside at restaurants. Meanwhile, the US Food and Drug Administration (FDA) is now expected to grant full approval to the Pfizer vaccine by early September, much earlier than originally anticipated. Many hope this move will either encourage the vaccine-hesitant to take the shot, provide a strong base of support for national vaccine mandates, or both.

Deupirfenidone (LYT-100) to Treat Adults with Post-Acute COVID-19 Respiratory Complications

At a Glance

  • Deupirfenidone (LYT-100) is an oral small-molecule drug being investigated to treat respiratory complications after recovery from the acute phase of COVID-19–related pneumonia.
  • Deupirfenidone is a deuterated form of pirfenidone, an anti-inflammatory and antifibrotic drug approved by the FDA to treat idiopathic pulmonary fibrosis. The chemical modification purportedly slows down metabolism of the drug, which might reduce adverse effects associated with the accumulation of pirfenidone metabolites.
  • Deupirfenidone purportedly reduces inflammation and cytokine release, and slows lung fibrosis, which might improve functional exercise capacity and shortness of breath, facilitating recovery from respiratory complications and preventing further lung injury.
  • An ongoing phase 2 randomized clinical trial evaluating deupirfenidone in 168 adults with respiratory complications after hospitalization for COVID-19–related pneumonia has primary completion expected in August 2021.

Vaccine Mandates to Prevent COVID-19 

At a Glance

  • Vaccine mandates are being required by many government bodies, health care companies, and universities for their constituents to limit the surge of COVID-19 cases occurring around the United States.
  • People must show proof of vaccination or submit to weekly COVID-19 testing, and those unqualified for exemptions may face penalties such as job loss or removal from classes.
  • Although employees have quit and filed lawsuits against such mandates, the US Department of Justice determined that vaccine requirements are legal, even though the vaccine is only authorized under Emergency Use Authorization.
  • With just under 60% of eligible Americans vaccinated, vaccine mandates for employees and students have the potential to help prevent the spread of COVID-19 and keep those unable to get vaccinated or awaiting vaccination safe.

Commentary in this COVID-19 Scan reflects preliminary views of ECRI Horizon Scanning and internal ECRI stakeholders.
The information contained in this document has not been vetted by other stakeholders.

We welcome your comments on this Scan. Send them by email to [email protected].

Posted: August 20, 2021

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