COVID-19 Vaccine Mandates At The Supreme Court: Scope And Limits Of Federal Authority healthaffairs.org
The World Health Organization (WHO) updated its vaccine guidance on Tuesday to recommend the administration of COVID-19 booster shots, marking a reversalfrom what the United Nations organization has previously said about additional vaccine doses.
In a statement, the WHO said theTechnical Advisory Group on COVID-19 Vaccine Composition "strongly supports urgent and broad access to current COVID-19 vaccines for primary series and booster doses, particularly for groups at risk of developing severe disease."
TheWHO has previously spoken out against administering COVID-19 booster shots, arguing that wealthier countries should abstain from administering additional doses while low- and middle-income countries have struggledto provide initial rounds of vaccinations for their populations.
WHO Director-GeneralTedros Adhanom Ghebreyesus called for a moratorium on booster shots for healthy adults through the end of 2021.
"We do not want to see widespread use of boosters for healthy people who are fully vaccinated," Tedros said in September.
The WHO on Tuesday cited how the "near- and medium-term supply of the available vaccines has increased substantially," but reiterated that vaccine inequity remains an "important challenge" that should be addressed.
The COVID-19 vaccines currently being administered around the world are based around a form of the virus that circulated early on in the pandemic, and the WHO noted that these vaccines may need to be updated. Taking into account the wide spread of the omicron variant, the WHO said a new mutation of the virus was likely to occur.
Two years have passed since the first case of COVID-19 was detected in Connecticut. The first case was announced on March 8, 2020.
It would not be long before the pandemic changed life as we knew it. Social distancing became an everyday practice and face masks became a necessity when interacting with anyone outside your household.
In the last two years, there have been 727,542 cases of COVID-19 in the state and 10,515 COVID-19 related deaths.
Two years later, COVID-19 is still affecting lives, but vaccinations have provided hope and many restrictions put in place have been lifted, including face mask requirements.
Here is a look back at the early days of the pandemic.
The first case of COVID-19 in Connecticut was announced on March 8, 2020.
Two years after being hospitalized, Chris Tillett, who was Connecticut's first COVID-19 patient, says he hopes the pandemic can be a learning experience for everyone.
In the initial days of the pandemic, the state lab was able to complete between 15 and 20 COVID-19 tests per day and there were only a few labs that could handle tests and people getting tested needed to be referred by a physician in advance.
On March 10, 2020, Gov. Ned Lamont declared civil preparedness and public health emergencies in response to the pandemic, which allowed him to temporarily suspend some state laws and regulations.
By March 12, 2020, the governor banned all events in the state with more than 250 people.
Schools were beginning to close because of the pandemic and the governor signed an order to modify the state law requiring schools to be in session for at least 180 days.
Among the actions the governor took was an order for the state Department of Motor Vehicles to extend license renewals.
Restrictions were placed on visits to nursing homes.
On March 14, a moratorium on all utility shut-offs went into place and several state agencies rolled out measures to promote social distancing.
At that point, there had been 20 positive cases of COVID-19 in the state.
Lamont signed his third executive order, which relaxed in-person open meeting requirements and eased telework requirements, allowing more state employees to work from home.
On March 15, 2020, Lamont canceled classes at all public schools statewide, which was originally supposed to be in effect from March 17 through at least March 31.
In May 2020, Gov. Ned Lamont would announce that schools would be closed for the rest of the academic year.
He authorized the DMV commissioner to close branches to the public, conduct business remotely, and extend deadlines.
Amid a national shortage of hand sanitizer, the state allowed pharmacies to make and sell their own.
Many businesses were closing their doors and the governor announced on March 16, 2020 that small businesses and nonprofit organizations in Connecticut that were negatively impacted by the pandemic would be eligible for disaster relief loans.
By March 16, 2020, gatherings of more than 50 people were prohibited, drive-through COVID-19 testing started at some hospitals and several businesses were ordered to closed by 8 p.m.
The governor also announced that the State Department of Education was working with school districts to develop distance learning plans and ensure students had access to nutritious meals.
The governors of Connecticut, New York and New Jersey worked together with a regional approach to dealing with COVID-19, which included that restaurants and bars that served food would temporarily be required to move to take-out and delivery services only and bars that did not serve food would have to close.
Price gouging had become an issue and by March 17, 2020, Attorney General William Tong reported receiving 71 complaints about price gouging on basic supplies.
On March 18, 2020, the governor announced the first COVID-19 death in the state. https://portal.ct.gov/Office-of-the-Governor/News/Press-Releases/2020/03-2020/Governor-Lamont-Statement-on-the-First-Coronavirus-Death-in-Connecticut
On March 18, 2020, Lamont announced that indoor malls and places of amusement other than parks and open space areas would close by the night of March 19.
A day later, on March 19, Lamont postponed the states presidential primary, allowed eating establishments to sell alcohol with take-out food orders, closed barbershops, hair salons and tattoo and piercing parlors, and expanded telehealth.
On March 20, 2022, Lamont started Stay Safe, Stay Home, which directed non-essential businesses to close by 8 p.m. on March 23, 2020, and for those that had to remain open to implement social distancing.
He called for all non-essential public community gatherings of any size to be canceled or postponed.
People were also asked to limit outdoor recreational activities to non-contact and avoid activities where they come in close contact with other people.
By March 26, 2020, there were more than 1,000 cases of COVID-19 in Connecticut and 21 deaths.
As the pandemic extended, the state Department of Labor was inundated with unemployment claims and held frequent briefings on the status of processing what they called an overwhelming surge in claim applications resulting from the COVID-19 pandemic.
As the pandemic stretched to months, Lamont called in the National Guard for help.
To help reduce the spread of the virus, a regional travel advisory went into effect.
It required people coming in from states with a significant community spread of COVID-19 to self-quarantine for 14 days.
During the summer travel season of 2020, it affected where people could freely travel to and from or to quarantine upon returning home.
By Aug. 3, 2020, there had been more than 50,062 cases of COVID-19 in Connecticut and more than 4,400 deaths.
As of Monday, March 7, 2022, there have been 727,542 cases of COVID-19 in the state and 10,515 COVID-19 related deaths.
At the height of the pandemic, thousands of people were hospitalized with COVID-19.
As of Monday, 145patients were hospitalized with COVID-19,and 64, or 44.1%,are not fully vaccinated.
In countries outside the group of 92, the company expects those using Moderna-patented technologies will respect the Companys intellectual property, the statement said. Moderna remains willing to license its technology for COVID-19 vaccines to manufacturers in these countries on commercially reasonable terms.
Moderna also announced on Monday that it signed a memorandum of understanding with the government of Kenya to host an mRNA manufacturing facility, which aims to produce up to 500 million doses of vaccines a year. It will also expand its global public health portfolio to 15 vaccine programs targeting emerging or neglected infectious diseases, and start a program that will allow researchers to use Modernas mRNA technology in their search for new vaccines against those diseases.
As the United States and other wealthy nations are starting to look for ways to move on from the pandemic, only about 65 percent of the worlds population has received at least one Covid-19 vaccine dose, according to The New York Times vaccine tracker. In Africa, only about 11 percent of the population was fully vaccinated as of February, according to the WHO, as countries face obstacles in rolling out vaccine doses.
In June 2021, the WHO selected a South African consortium to operate a global mRNA transfer technology hub designed to help manufacturers in low- and middle-income countries produce their own Covid-19 vaccines and, more broadly, start to produce their own vaccines, medicines and supplies, instead of relying on Western firms.
Though South Africa is not one of the 92 AMC countries, Moderna says it will allow the WHO hub and Afrigen Biologics, a Cape Town-based company that has tried to replicate the Moderna vaccine for the hub, to access its technology for vaccines targeted at the specified group of nations.
Consistent with this pledge, Moderna will not enforce its patents for COVID-19 vaccines in South Africa against the efforts by Afrigen Biologics and/or the WHO hub targeted at AMC 92 countries, a Moderna spokesperson said in a statement to POLITICO on Monday.
The two year anniversary of the COVID-19 pandemic have brought up feelings of anxiety, exhaustion and loss for therapist Griselda Coreas Landor's clients. She said this is completely normal.
"When you sit back and look at the pandemic, that was very traumatic for everyone, and people aren't aware of the signs of what it means to experience trauma," Coreas Landor said.
Oftentimes it shows up in clients as a lack of energy, said the Frisco therapist, "when there's something really interfering and inhibiting" people's ability to get things done.
The Centers for Disease Control and Prevention (CDC) noted in multiple reports over the past two years that the COVID-19 pandemic caused increases in substance use and worse mental health outcomes.
"It's such a common, reoccurring theme to hear, 'I just wish things were back to normal. When are things gonna go back to normal?,'" Coreas Landor said of her clients. "The reality is that things are not going to go back to normal. It's a new norm, it's a new adjustment. We as humans do not do well with life adjustments."
She works with clients to practice "radical acceptance," which is a therapeutic technique to challenge negative beliefs and recognize the reality of situations without judgement.
"What is in your power? What is in your control?," Coreas Landor said. "Because you can't control what's happening out there. But what you can control and focus on is your life, to make sure that you're providing yourself with whatever it is that you can."
Instructing clients on kindness and compassion helped her recognize how the pandemic had changed her own life.
"I'm a single mom. In the middle of a pandemic, I was trying to build my career, trying to excel and navigate while also being a mother," Coreas Landor said. "Taking care of myself wasn't easy. I got my own therapist. I got my own psychiatrist. I think it shined a light on me that I can't just be an advocate for mental health, and supply my own services, without preaching what I say."
She encourages people, especially as they are processing difficult emotions and life changes, to recognize what they need to take care of themselves. That could be getting enough sleep, taking a walk, cooking a meal or practicing mindfulness, like meditation. The pandemic brought to light a lot of mental health issues, but Coreas Landor said this can be an opportunity for growth.
"Everyone has a right to be heard, to process, to go through whatever it is that they experience," Coreas Landor said. "There's no better time to say, this is what I want for me and now's the time."
Got a tip? Email Elena Rivera aterivera@kera.org. You can follow Elena on Twitter@elenaiswriting.
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Video: Study sheds more light on effectiveness of at-home COVID-19 testsAll U.S. households are now eligible to order four additional free COVID-19 tests from COVIDtests.gov. When the government site launched in January, it received more than 45 million orders. Now officials say fewer than 100,000 orders a day are coming in for the packages of four free rapid tests per household, delivered by the U.S. Postal Service.Experts say testing will become more important with mask requirements now easing."If infection control is still our priority, testing is central," said Dr. Leana Wen, a former Baltimore health commissioner and commentator on the pandemic. "Four tests per household for one family will only last you one time. There should be enough tests for families to test twice a week."The Associated Press contributed to this report.
Video: Study sheds more light on effectiveness of at-home COVID-19 tests
All U.S. households are now eligible to order four additional free COVID-19 tests from COVIDtests.gov.
When the government site launched in January, it received more than 45 million orders. Now officials say fewer than 100,000 orders a day are coming in for the packages of four free rapid tests per household, delivered by the U.S. Postal Service.
Experts say testing will become more important with mask requirements now easing.
"If infection control is still our priority, testing is central," said Dr. Leana Wen, a former Baltimore health commissioner and commentator on the pandemic. "Four tests per household for one family will only last you one time. There should be enough tests for families to test twice a week."
The Associated Press contributed to this report.
In a recent study posted to the bioRxiv* preprint server, researchers studied how messenger ribonucleic acid (mRNA)-based BNT162b2 coronavirus disease 2019 (COVID-19) vaccine altered the biochemical composition of glial and glioma brain cellsin vitro.
Raman spectroscopy imaging enables the examination of the biochemical composition of cell organelles non-invasively, valuable in monitoring molecular interactions in the tumor microenvironment and unraveling mechanisms governing immune response to pathogenic infections.
COVID-19 mRNA vaccine mimics COVID-19 infection, but instead of the whole virus, synthesize only severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) spike (S) protein for the immune response, without causing COVID-19 infection.
The harmful effects of mRNA vaccine-produced high levels of S protein are not yet completely understood. Researchers have cautioned that they induce complex reprogramming of innate immune responses; moreover, the vaccine-produced S protein remains near the vaccination site and even circulates in the bloodstream to directly affect the host cells with long-term consequences. Therefore, it is crucial to monitor the biodistribution and location of S protein from mRNA vaccines.
Studies have recovered COVID-19 mRNA from the cerebrospinal fluid of vaccinees, suggesting it can cross the blood-brain barrier (BBB). In addition, even without crossing the BBB, several cytokines induced by COVID-19 infection cross the BBB to affect central nervous system (CNS) function.
In this way, COVID-19 mRNA reaches the brain, infects astrocytes, and triggers neuropathological changes that contribute to the structural and functional alterations in the brain of COVID-19 patients. The researchers have also raised concerns that the lipid nanoparticles (LNPs) can diffuse quickly to the CNS through the olfactory bulb or blood. However, these phenomenons, including the role of innate memory responses to LNPs, need to be further explored in future research.
In the current study, researchers used Raman spectroscopy to examine several CNS-related symptoms, including loss of taste and smell, twitching, confusion, headaches, impaired consciousness and vision, nerve pain, dizziness, nausea and vomiting, seizures, hemiplegia, stroke, ataxia, and cerebral hemorrhage in human brain glial and glioma cellsin vitro. More specifically, they studied normal and tumor brain cells, including normal human astrocytes (NHA), human astrocytoma CCF-STTG1, and human glioblastoma cell line U87-MG.
To this end, they injected the BNT162b2 vaccine and incubated these cellsin vitro.Next, they monitored the effect of the vaccine on the biodistribution of different chemical components, particularly alterations in reduction-oxidation (redox) pathways related to cytochrome (cyt) c in cell organelles, including the nucleus, mitochondria, lipid droplets, cytoplasm, and membrane.
Raman imaging helped analyze the vibrational spectra of a sample area (here brain cells), including biodistribution of different biomolecules. Using two-dimensional (2D) spectroscopic data obtained by Raman imaging and cluster analysis algorithm, the researchers created Raman maps to visualize cellular substructures to learn about their composition.
The distinctive coding colors in the K-means cluster analysis represented seven clusters: the blue color represented lipids, including rough endoplasmic reticulum (RER) and lipid droplets filled with retinoids; likewise, orange, magenta, red, green, light grey, and dark grey colors represented lipid droplets filled with triacylglycerols of monounsaturated type (TAG), mitochondria, nucleus, cytoplasm, membrane, and the cell environment, respectively.
They recorded Raman spectra using a confocal Raman microscope that recorded images with a spatial resolution of 1 1m. It was calibrated daily before taking the measurements, using a silica plate with a maximum peak at 520.7 cm-1.
Among several study findings, a key one was that the human cellsin vitrodemonstrated a redox imbalance by downregulation of cyt c, similar to that observed in cancers. They noted that the Raman signal of oxidized cyt c was strongest for astrocytoma control cells and the weakest for the U-87 MG cells, indicating decreased oxidative phosphorylation and apoptosis.
The band intensity (at 1654 cm-1), corresponding to amide I, decreased for glioblastoma U87-MG upon incubation with mRNA, most likely due to deterioration of the adenine nucleotide translocator (ANT), representing about 10% of proteins in mitochondria.
The BNT162b2 vaccine reprogrammed innate immune responses by downregulation of cyt c. Cyt c creates a damage-associated molecular pattern (DAMP) that alarms the immune system of any potential danger in all cell types to help them mount an appropriate immune defense via activation of pattern recognition receptors (PRRs).
At 1584 cm-1, the Raman intensity of the reduced form of cyt c drastically increased upon incubation of U87 MG cells with retinoic acid (RA), indicating that RA is an essential innate immune system molecule with the capability to halt cytokine induction.
It is common knowledge that the mRNA vaccine never enters the cell nucleus, where the deoxyribonucleic acid (DNA) resides, to alter the human genome because - i) they do not have a reverse transcriptase; ii) they cannot travel from cytoplasm to the nucleus; iii) mRNAs are short-lived molecules.
The authors observed no statistically significant changes in cytochrome c activity for NHA and U87-MG at 60 L/mL dose. In contrast, they observed changes for astrocytoma at the 60 L/mL dose during incubation time of 96 hours and U87-MG glioblastoma cells at a low dose of one L/mL for 24 hours.
Since the mRNA vaccine does not introduce changes corresponding to DNA, these results indicated post-translational changes in histones of the nucleus upon incubation with the mRNA vaccine, not in DNA.
Furthermore, they noted a decreased cyt c signal at 1584 cm-1 for all types of glial cells and all periods of incubation and dosages, suggesting statistically significant changes in cyt c biochemical concentration in lipid droplets and lipid structures of RER.
The study highlighted how Raman imagingpresented exciting new possibilities to understand the associations between pathways of cancer and the immune system and recognize metabolites regulating these pathways.
Taken together, the study findings demonstrated that the mRNA-based BNT162b2 COVID-19 vaccine altered mitochondria by downregulation of cyt c resulting in lowered oxidative phosphorylation and adenosine triphosphate (ATP) production. This led to the lowering of the immune response.
A decrease of amide I concentration in mitochondrial membrane potential suggested functional deterioration of the ANT. Likewise, the BNT162b2 vaccine significantly modifiedde novolipids synthesis in lipid droplets; however, the role of signaling function of lipid droplets increased.
bioRxiv publishes preliminary scientific reports that are not peer-reviewed and, therefore, should not be regarded as conclusive, guide clinical practice/health-related behavior, or treated as established information.
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Note: Case counts in Idaho, Maine and Washington may be affected by ongoing data anomalies; Cartogram: Kavya Beheraj/Axios
Two years ago today, three Iowans tested positive for COVID-19 the first-known cases in our state.
Flashback: Here's a timeline of how things were back in March 2020:
Fast forward: We've been through the wringer, to say the least. From quarantining, multiple variants, and life-saving vaccinations, a lot has changed these past 24 months.
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X-ray of lung with heart attack
As we enter the third year of the pandemic, it is becoming increasingly clear that Covid-19 infection impacts our health beyond the acute stage of the illness. More than 40% of Covid-19 survivors globally have experienced longer-term symptoms. Now, a new study demonstrates that infection with Covid-19 appears to impact the risk of cardiovascular events up to 12 months post-infection, even in those who werent hospitalized or had mild cases. Risks increased regardless of age, race, sex, obesity, smoking, or other cardiovascular disease risk factors.
The study found the incidence of serious cardiovascular problems was 4.5% higher in the 12 months after people were diagnosed with Covid-19 compared to those who were not infected. This percentage may seem small until you consider that the CDC recently estimated that over 140 million people in the US have been infected with Covid-19, meaning approximately 6.3 million could be facing cardiovascular problems. Our ongoing case counts could create generations of patients with heart problems.
The study published in Nature used data from US Department of Veterans Affairs national health care databases to follow over 153,000 veterans with a history of Covid-19 infection for up to a year after their recovery. The researchers also used a contemporary and a historical control group to estimate risks and 1-year burdens of a set of pre-specified cardiovascular incident outcomes. The contemporary control group compromised of 5,637,647 patients with no evidence of SARS-CoV-2 infection who used VHA services in 2019. The historical control group compromised of 5,859,411 pre-pandemic patients who used VHA services in 2017.
The study population was largely made up of older white male patients. The Covid-19 cohort, which averaged 61 years old, included 89 percent males and about 71 percent white individuals. However because the study population was large, it also included almost 17,000 female patients; approximately 37,000 Black patients; and almost 8,000 Latino, Asian, American Indian, Native Hawaiian, and patients of other races with Covid-19.
The researchers found that in the year after recovering from the illnesss acute phase, patients had starkly increased risks of different cardiovascular problems, including abnormal heart rhythms, heart muscle inflammation, blood clots, strokes, myocardial infarction, and heart failure.
At the 12-month mark, for every 1000 people compared to the contemporary control group, Covid-19 infection was associated with:
Risks and burdens were assessed at 12 months in mutually exclusive groups comprising ... [+] non-hospitalized individuals with COVID-19 (green), individuals hospitalized for COVID-19 (orange) and individuals admitted to intensive care for COVID-19 during the acute phase (first 30 d) of COVID-19 (blue). Outcomes were ascertained 30 d after the COVID-19-positive test until the end of follow-up. The contemporary control cohort served as the referent category. Within the COVID-19 cohort, non-hospitalized (n=131,612), hospitalized (n=16,760), admitted to intensive care (n=5,388) and contemporary control cohort (n=5,637,647). Adjusted HRs and 95% CIs are presented. The length of the bar represents the excess burden per 1,000 persons at 12 months, and related 95% CIs were also presented.
While hospitalization did increase the likelihood of future cardiovascular complications, people who avoided hospitalization were still at higher risk for many conditions. Other subgroup analyses found increased risks regardless of age, race, sex, obesity, smoking, hypertension, diabetes, chronic kidney disease, hyperlipidemia, and preexisting cardiovascular disease.
The study was well designed, not only using extensive control cohorts but also accounting for external factors. Because some Covid-19 vaccines may be associated with very rare cases of myocarditis and pericarditis, the researchers conducted analyses to remove the effect of vaccination. The increased risk of myocarditis and pericarditis remained among people who were not vaccinated and was clear regardless of vaccination status.
Based on the results of this study, I recommend that everyone who has been infected with Covid-19, mild or otherwise get a cardiovascular workup within 12 months of infection. I urge anyone who has unexplained cardiovascular symptoms after a Covid-19 infection to take them seriously and seek medical care immediately. Physicians should also be adjusting their screening questions to include past infection with Covid-19 and assess for all Long Covid symptoms including cardiovascular. Early identification, diagnosis, and treatment of heart disease are essential to lessen the risk of adverse health impacts.
The cardiovascular disease risk associated with Covid-19 infection further highlights how we need a coordinated global response strategy to urgently address the challenges of dealing with the long-term health effects of Covid-19.
