June 9, 2022 - (Tarrant County) Tarrant County Public Health hosts numerous pop-up COVID-19 clinics across Tarrant County each week in partnership with public and private organizations listed below. Each site has the Moderna and Pfizer vaccines and at times the Johnson & Johnson. Children five and older are eligible for the vaccination. Parents need to bring proof of the childs age and their own ID for the vaccination. Booster vaccinations are available at all of the vaccination locations.
TCPH would like to bring a COVID-19 vaccination clinic to businesses, churches and organizations in the community who are interested in hosting a pop-up clinic. Its easy and free to host a clinic.In addition to the vaccination opportunities below, the cities of Arlington, Fort Worth, Mansfield, North Richland Hills, Hurst, and Tarrant County College have also added opportunities for vaccinations. To find a local vaccine site, the County created a vaccine finder page:VaxUpTC website.
Pop-Up COVID-19 locations:
Watermark at Broadway CityviewTuesday, June 14: 10 a.m. to 2 p.m.5301 Bryant Irvin Rd.Fort Worth, TX 76132
Advent Healthcare CenterWednesday, June 15: 1 p.m. to 5 p.m.301 Huguley BoulevardBurleson, TX 76028
Vaxmobile North Davis Church Thursday, June 16: 9 a.m. to 4 p.m.1601 N Davis Dr.Arlington, TX 76012
Cornerstone Assistance Network Thursday, June 16: 10 a.m. to 4 p.m.3500 Noble Ave.Fort Worth, TX 76111
Oakridge Alzheimer Special Care Friday, June 17: 11 a.m. to 3 p.m.4501 Silver Sage Dr.Haltom City, TX 76137
Tarrant County Public Health CIinics:
Northwest Public Health CenterMonday to Friday:8 a.m. to 12 p.m.and1 to 5 p.m.3800 Adam Grubb RoadLake Worth, TX 76135
Bagsby-Williams Health CenterMonday to Friday:8 a.m. to 12 p.m.and1 to 5 p.m.3212 Miller Ave.Fort Worth, TX 76119
Southeast Public Health CenterMonday to Friday:9 a.m. to 12 p.m.and1 to6p.m.536 W Randol MillArlington TX, 76011
Main Public Health CenterMonday to Friday:8 a.m. to 12 p.m.and1 to 6 p.m.1101 S. Main StreetFort Worth, TX 76104
Southwest Public Health CenterMonday to Friday:8 a.m. to 12 p.m.and1 to 5 p.m.6551 Granbury RoadFort Worth, TX 76133
Watauga Public Health CenterMonday to Friday:8 a.m. to 12 p.m.and1 to 5 p.m.6601 Watauga RoadWatauga, TX 76148
Gout is a type of arthritis that causes pain and swelling in your joints, usually in your feet. It often affects one joint at a time, most commonly your big toes.
Gout is caused by a buildup of uric acid, known as hyperuricemia. Gout usually manifests as sudden painful episodes (flares) that last from a few days to a couple of weeks followed by remission. Repeated flares of gout can lead to gouty arthritis, an advanced form of gout.
If you have gout, you may have heard that some people avoid COVID-19 vaccination because they are worried it may cause gout to flare up. Although its true that some vaccines can increase your risk for a flare, gout experts still strongly recommend not to opt out of the shot. Lets figure out why.
Some vaccines can increase your risk for a gout flare in the days following the shot. For example, a shingles vaccine can slightly increase your odds of having a gout episode.
But what about COVID-19 vaccines? Can they make your gout flare up? Scientists from China decided to answer this question by studying 462 people with gout who received COVID-19 vaccines. Researchers discovered that 44 percent of study participants did experience a gout attack, usually within 1 month after receiving the shot. The good news is that colchicine, a common gout drug, decreased the chance of a flare almost in half in those who were on it when they received their shot.
Dont skip your COVID-19 shot. Heres why.
An important thing to remember about this study is that it was done in China, which has different COVID-19 vaccines than the United States. Most people in this study received a vaccine called Sinovac Life, which is not used in the United States.
Additionally, this vaccine is based on an inactivated virus, while the most popular COVID-19 vaccines in the country, Pfizer and Moderna, are mRNA-based. The Johnson & Johnson vaccine is based on an inactivated virus, but there is no data suggesting it could cause a gout flare.
There is no need to take colchicine before your vaccine appointment. However, if you do decide do try it, speak to your doctor first.
If youre still on the fence about getting vaccinated, remember that COVID-19 can carry significant risks for those with gout.
Although gout doesnt increase your chances of getting COVID-19, if you do get it, you may develop complications. This is because people with gout often have other health issues alongside with it, such as:
In addition, if you take corticosteroids (for example, prednisone) for gout flares, this can also contribute to more severe case of COVID-19.
Centers for Disease Control and Prevention (CDC) recommends vaccine boosters to everyone who received their first series. This is because the effectiveness of COVID-19 vaccines decreases over time.
Even if you do catch COVID-19 after receiving a booster, it should protect you from a severe case. Since gout and its accompanying conditions make you more prone to COVID-19 complications, its important to get a booster if you have gout.
To find out how soon you can get a booster, check the CDC website.
Certain people are eligible to receive a second booster. Make sure to schedule this appointment if you are:
All of the vaccines approved in the United States do a good job of decreasing your chance for severe COVID-19, which you want to avoid if you have gout. However, the CDC now recommends either mRNA vaccine over the Johnson & Johnson vaccine. This is due to higher effectiveness of this type of vaccine and fewer severe side effects.
Effectiveness of different types of vaccines was not studied specifically in people with gout. But a recent study including over 5,000 people with rheumatic conditions from 30 different countries showed that available COVID-19 vaccines are equally safe and effective.
Although gout is not a contraindication for any COVID-19 vaccines (meaning medications for gout do not decrease the effectiveness of the vaccine), people with certain additional medical conditions should not receive some or any COVID-19 shots:
If you have gout, you should get vaccinated against COVID-19 to protect yourself from a severe disease. This is important because people with gout can develop complications from the virus that causes it.
Although one recent study suggests that COVID-19 vaccines used in China can trigger a gout flare, this shouldnt discourage you from getting vaccinated. Not only the risk is low and potentially preventable, but the vaccines used in China arent used in the United States.
Inactivated and mRNA COVID-19 vaccines appear to be safe for patients treated for hypothyroidism, according to a new study being presented at ENDO 2022, the Endocrine Societys annual meeting in Atlanta, Ga. The study found these vaccines do not cause significant fluctuations in thyroid function and are not associated with increased risks of emergency department visits or unscheduled hospitalizations.
No previous studies have looked at any possible relationship between COVID-19 vaccines and unstable thyroid function control among patients receiving thyroid hormone replacement for hypothyroidism, said lead researcher David T.W. Lui, M.B.B.S., of the University of Hong Kong in Hong Kong, China. Our reassuring findings should encourage patients treated for hypothyroidism to get vaccinated against COVID-19 for protection from potentially worse COVID-19-related outcomes.
The study evaluated an inactivated vaccine called CoronaVac and an mRNA vaccine, Pfizer BioNTech (BNT162b2) vaccine. CoronaVac uses a dead version of theSARS-CoV-2 virus. It is being used in vaccination campaigns in various countries in Asia, South America, Central America and Eastern Europe. Messenger RNA (mRNA) vaccines teach the bodys cells how to make a protein that will trigger an immune response. The Pfizer and Moderna vaccines are mRNA vaccines.
The researchers evaluated data from more than 47,000 COVID-19 vaccine recipients taking levothyroxine for hypothyroidism. Patients were divided into three groups: unvaccinated, those who received the CoronaVac vaccine and those who received the mRNA vaccine. Patients who received either type of COVID-19 vaccine were not at increased risk of needing to have their levothyroxine dosage reduced or increased. COVID-19 vaccination was not associated with a higher risk of emergency department visits or unscheduled hospitalization.
Lui will present at the Societys ENDO 2022 thyroid health news conference at 11:30 AM on Monday, June 13. Register to attend at www.endowebcasting.com.
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Endocrinologists are at the core of solving the most pressing health problems of our time, from diabetes and obesity to infertility, bone health, and hormone-related cancers. The Endocrine Society is the worlds oldest and largest organization of scientists devoted to hormone research and physicians who care for people with hormone-related conditions.
The Society has more than 18,000 members, including scientists, physicians, educators, nurses and students in 122 countries. To learn more about the Society and the field of endocrinology, visit our site at www.endocrine.org. Follow us on Twitter at @TheEndoSociety and @EndoMedia.
Journal of the Endocrine Society
Disclaimer: AAAS and EurekAlert! are not responsible for the accuracy of news releases posted to EurekAlert! by contributing institutions or for the use of any information through the EurekAlert system.
The Food and Drug Administration (FDA) could grant emergency use authorization of a COVID-19 vaccination for the youngest kids later this month. Pfizer asked the agency to review data and authorize its COVID-19 vaccine for children ages 6 months to 5 years.
If the FDA committee recommends authorization, the Centers for Disease Control and Prevention will still need to sign off on the vaccinations before they would go into the littlest of arms.
Once a COVID-19 vaccination is authorized for kids ages 6 months to 5 years, nearly everyone will be eligible for immunization.
Dr. Richard Kennedy, co-director of Mayo Clinic's Vaccine Research Group, says even though younger children have tended to fare better with COVID-19, the reality is that some are still getting sick and even dying of the disease.
More children were hospitalized during the omicron spike than during previous spikes not because the disease was worse but simply because omicron is so much more infectious and case numbers were so much higher.
"Having this vaccine will help prevent and reduce the level of severe disease and death in children. Even though the rate might be small now, let's get it reduced to zero if we can, or at least reduced as much as possible," says Dr. Kennedy.
Besides protecting children, he says it may also reduce the amount of transmission and exposure in places like day cares and schools.
"The best way to end the pandemic is to stop having the virus transmit," says Dr. Kennedy. "When it transmits, there's a chance for new variants to arise. That's what we're dealing with right now is multiple new variants. The only way to get ahead of that is to stop cases. And vaccines are one of our best preventive tools for doing that."
Parents can be assured that when a vaccination is approved for the most vulnerable of populations it will be safe.
"The FDA and other regulatory agencies do a very deep dive into the safety data. And that's why you typically see a rollout of a vaccine in several stages. Healthy adults can get it, and then they drop the age range a little bit, and they check it and make sure it's safe. And they drop it again," says Dr. Kennedy.
The stepwise approval follows sequential clinical trials. Once a vaccination is found to be safe in adults, the FDA allows trials in older children. Once safe in that population, clinical trials can begin in younger children.
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Information in this post was accurate at the time of its posting. Due to the fluid nature of the COVID-19 pandemic, scientific understanding, along with guidelines and recommendations, may have changed since the original publication date.
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2022 Mayo Clinic News Network. Visit newsnetwork.mayoclinic.org. Distributed by Tribune Content Agency, LLC.
By Amanda Sealy and Nadia Kounang, CNN
Modernas Covid-19 vaccine is safe and generated an immune response in children ages 6 months through 17 years thats comparable to the response in adults, according to documents posted by the US Food and Drug Administration ahead of key meetings of its independent vaccine advisory group.
The FDAs vaccine advisers will evaluate next week Modernas Covid-19 vaccines for children 6 months through 5 years and 6 years through 17 years should be granted emergency use authorization.
Children under 5 years old about 18 million people are the only US age group that still isnt eligible to receive a Covid-19 vaccine. Modernas vaccine is currently available only to people 18 and older. Pfizers Covid-19 vaccine is already authorized for children age 5 and older; FDAs advisers will also evaluate its vaccine for younger children next week.
Briefing documents posted ahead of the FDA committee meetings describe how Modernas vaccine was assessed by immunobridging studies to see if the immune response among younger people was comparable to that of 18-to-25-year-olds, who are already eligible to receive the vaccine.
Immunobridging success criteria were met for all four pediatric age cohorts, the FDAs document stated.
In trials evaluating more than 6,000 children 6 months to under 6 years old, Moderna found two 25-microgram doses of vaccine taken 28 days apart yielded a similar immune response to a two-dose series of vaccine given to18-to-25-year-olds.
For children ages 6 to 17 years, Moderna found two doses of its vaccine also provided a similar immune response as two doses in adults. Children age 6 to 11 received 50-microgram vaccines and adolescents ages 12 to 17 received 100-microgram vaccines.
The vaccine trials took place at different times, when different coronavirus variants circulated. While the FDA did not require vaccine makers to submit vaccine efficacy data for authorization, Modernas vaccine was estimated to be 93.3% effective against symptomatic disease for 12-to-17-year-olds during a time when the original coronavirus and the Alpha variant were dominant. The vaccine was estimated to be 76.8% effective against symptomatic Covid-19 for children 6 to 11 during a time the Delta variant was predominant. However, the FDA also noted for 6-11-year-olds the vaccine efficacy could not be reliably determined due to the small number of COVID-19 cases accrued during the study.
The vaccine was tested in children 6 months through 5 years during a time when the Omicron variant was dominant. It was estimated to be 36.8% effective against symptomatic disease for 2-to-5-year-olds and 50.6% protective against symptomatic disease for those 6-to-23 months old.
Vaccine efficacy estimates for each age cohort were generally consistent with what has been seen in adults, the FDA said.
The vaccine was also found to be safe in all age groups. Adverse reactions were mostly mild to moderate in severity, generally of short duration, and occurred more frequently after Dose 2 than Dose 1.
Injection site pain was the most commonly reported adverse reaction and the document said serious adverse events were infrequent and didnt raise any concerns. No deaths were reported.
While there were no known cases of myocarditis or pedicarditis inflammation of the heart among any trial participants, its one of the known risks with the Moderna Covid-19 vaccine, especially among males 18-to-24 years old.
The FDAs Vaccine and Related Biological Products Advisory Committee Meeting will evaluate Modernas Covid-19 vaccines for children ages 6 through 17 on June 14 and will evaluate Modernas Covid-19 vaccines for children 6 months through 5 years of age on June 15.
Pfizers Covid-19 vaccine for children under 5 will also be discussed on June 15.
After the FDA vaccine advisers vote, the agency must decide whether to authorize the vaccines. Shots cannot be administered until US Centers for Disease Control and Preventions vaccine advisers have voted whether to recommend the vaccines and the CDC director has signed off on the recommendation. The White House has said vaccines for the youngest age group could be administered starting the week of June 20.
The-CNN-Wire & 2022 Cable News Network, Inc., a WarnerMedia Company. All rights reserved.
WATCH TIME: 6 minutes
Matt Hoffman: I'm here with Dr. Daniel Kantor, sitting down at CMSC.
Daniel Kantor, MD: Thank you for having me.
Matt Hoffman: I want to talk a little bit about a poster you're presenting on COVID-19 vaccine response on patients treated with ozanimod (Zeposia; Bristol Myers Squibb) and other S1P receptor modulators. To start from a point if you weren't familiar with the workabroad overview, how did we get to this point? What prompted this study?
Daniel Kantor, MD: What prompted the study is this virus called coronavirus. The novel coronavirus-19 and the COVID-19 pandemic made a lot of questions for the MS community. The first question was, is the MS community more at risk? And the next question is, once there was a vaccine, what does that mean in terms of vaccine response?
For the first question, it looks like overall, people with multiple sclerosis are not more at risk than other people with other autoimmune diseases or frankly, with other conditions in general. People on certain medications may be at a higher risk, and one of the things we noticed is that when you deplete or push down the B cellswell, B cells are important in in response to viruses in response to vaccines. There are very popular medications we use now in multiple sclerosis or ocrelizumab (Ocrevus; Genentech), we use ofatumumab (Kesimpta; Novartis), and some people are still using off label rituximab (Rituxan; Genentech/Biogen). It looked like those people had more severe COVID-19, perhaps more intensive care unit visits, and so then, the question was overall, if you give a vaccine, would they have the same responses as it would in somebody without multiple sclerosis not on any of those medicines.
The first part of that question is that a lot of us around the world scrambled to try to answer that. Some people, what they did is they looked back at their patients, and they looked at case series, and they said, Well, these people were on these medicines, and they got the vaccine, how many of them got COVID, et cetera, et cetera. There are obviously problems with that kind of design. What we designed was a prospective study. The prospective study was looking at people who were in anyway choosing to get the vaccine because not everyone chose to get the vaccine. But in anyway choosing to get the vaccine, and then the question is, well, if we look at your immune markers beforehand, your lab markers beforehand, your questionnaires beforehand, and then after you get the vaccine and after you get the second shots, what happens when we follow those people out for the rest of the year?
The way it was designed was actually to look specifically at one of the novel S1P receptor modulators. Many people remember the legacy S1P receptor modulator, and it was unselective, this medicine Gilenya, or fingolimod. There have been questions and other peoples studies that suggested that well, it doesn't just look like B cells are a problem, it looks like if you sequester the immune cells inside the lymphoid organs, then maybe that's not good for that vaccine response. But maybe it's different when you don't have an effect on S1P4. When you think about ozanimod, it's selected for S1P1 and S1P5these two receptors, but not S1P4. Because of that, it might be that we see some sort of different response. So, we wanted to test that.
The primary end point of the trial is to look at the vaccine response. So, have they had a change in their immunoglobulin response to the spike protein, and has it happened 4 weeks after the second vaccine. We have the data, it's fresh, that's why it's late breaking here. The data shows us that yes, actually, when you gave it to people with ozanimod, 100% of the people actually went ahead and had the response.
Then we look in the poster at other questions, we looked at other disease modifying agents also. I would have loved to do the study where we actually have 30 subjects for patients in each arm for each disease-modifying agentbut were blessed in MS. Now there's more than 20depends on how you count themdisease-modifying agents. So, we looked at 30 on ozanimod, and we looked at 30 at all other comers. When looked at the other 30, what we saw is if you ignore the 1 patient who was on fingolimod and then the 3 patients on ocrelizumab, then yes, those people also had a really good response. When you looked at the peopleand I don't want to make conclusions about 1 and 3 patients, it's very hard to make anybut overall, the primary end point was really about ozanimod, and that actually did show an immune response.
Now, we didn't just look at the immune response, we looked at the quantitative the number of immune responses. What's interesting is the numbers are still protective. They're a little lower than other medications. So, a little lower than people who are taking glatiramer acetate (Copaxone; Teva), or the beta interferons, for example, but they're still protected. Then we also looked at T cell markers. Now the problem is, to do a really good T cell study, you need fresh samples. This study was distributed across the United States, the idea was to get virtual enrollment, and we send phlebotomists to people's homes. We couldn't necessarily send it to one of the very scientific labs that do amazing jobs at T cell response. But there is a company called Adaptive Biotechnologies that got an EUAemergency use authorizationto look at T cell response in a binary fashion: yes and no. It was made not for vaccine response, actually for whether you were infected with SARS-CoV-2 (COVID-19) or not, but many of us use it to also look at vaccine response. Remember, we're not getting a gradient of response, we're really just getting a yes versus no. Even though the patients on ozanimod had a lower, still protected, but a lower antibody response, they still have protective T cell responses. That was what was significant about this study.
Transcript edited for clarity.
COVID-19 vaccination efforts prove value of polio network for resilient health systems
As the first COVID-19 vaccines arrived into Somalia, polio programme staff were in position. Drawing on years of experience working to tackle polio and other health threats, staff had taken on key roles in logistics, cold-chain management and monitoring to ensure the success of the vaccine rollout.
Mohamud Shire, a WHO polio eradication officer working in the central zone of Somalia, explained, Regional and district polio officers acted as supervisors of the vaccine rollout. Some of the polio health workers worked as COVID-19 vaccinators, whereas others were social mobilizers.
A new WHO report entitled, Role of the polio network in COVID-19 vaccine delivery and essential immunization: lessons learned for successful transition, underscores the value of the polio network as an agile and experienced public health workforce, able to pivot to support national health programmes to deliver COVID-19 vaccines, and strengthen essential immunization. The introduction of COVID-19 vaccines in 2021 stretched country health systems, requiring all hands on deck to deliver vaccines to the most vulnerable. In this challenging context, hundreds of polio eradication staff led efforts in areas ranging from coordination and community mobilization, to training and surveillance. This work proves that sustaining these capacities is the way forward to build stronger, more equitable and resilient health systems.
The polio transition process aims to sustain the workforce and infrastructure set up to eradicate polio to strengthen immunization programmes, protect against outbreaks, and deliver essential health services to communities. A 2020 report documented the outstanding contributions of the polio network to the emergency stage of the COVID-19 pandemic, with over 5900 staff in the 20 priority countries for polio transition stepping up. The new report provides evidence of the role of polio staff to support essential immunization, and makes the case to transition their valuable skills and expertise to strengthen immunization programmes, building on the COVID-19 experience.
In Sudan, 13 polio staff coordinated with partner agencies, trained vaccinators and provided comprehensive technical support for the COVID-19 rollout. In Nepal, 15 polio and immunization officers monitored the quality of COVID-19 vaccine sessions, whilst in India, polio and immunization Open Data Kit software was used to record data from more than 450,000 COVID-19 vaccination sessions. In Nigeria, at least 121 polio staff worked to sensitize communities to COVID-19, support trainings for the e-registration of vaccine recipients, and manage Adverse Events Following Immunization (AEFI). In these countries, this work builds upon historical contributions of polio staff to essential immunization, including working with national essential immunization programmes for the co-delivery of polio with other vaccines, and using electronic surveillance tools developed for polio eradication to detect other vaccine-preventable diseases.
The report also details lessons learned from the COVID-19 vaccine rollout. One is the value of integrating polio functions into other health programmes. The pandemic response showed that with an integrated approach it is possible to achieve more with limited resources. For instance, in the Eastern Mediterranean Region, the pandemic experience has led to the introduction of Integrated Public Health Teams, which bring together public health staff to provide broader services to communities.
Another lesson is the value of transferable skills that can contribute to vaccination across the life-course. Polio personnel have specific strengths in childhood vaccination, but the pandemic has shown that their cross-cutting skills including coordination, disease surveillance, monitoring, data management and microplanning can be used to make progress towards global immunization goals. The pandemic has impacted rates of routine immunization, leading to an increase in numbers of un- or under-vaccinated children. Harnessing the skills of polio personnel, and integrating them into other programmes, is key to achieving the goals of the Immunization Agenda 2030.
The report further serves to emphasise that polio transition and polio eradication are interdependent, and must go hand-in-hand. In the context of ongoing polio outbreaks, the sustainable transition of functions in polio-free counties is a necessary step to ensure that health systems are resilient to future health threats, including poliovirus importations.
To support these aspects, sustainable financing for the integration and transition of polio essential public health functions is vital. As of 2022, over 50 countries have transitioned out of GPEI support, but still require funding and technical support from WHO and other partners. Long-term domestic and international support is needed to ensure that the knowledge, expertise and lessons learned from polio eradication continue to serve populations. This is especially important as governments face long-term financial constraints on their health spending due to the pandemic.
As we move towards health systems recovery, we must ensure that the polio infrastructure is transitioned in a sustainable manner, to support more resilient health systems.
ByJonathan Eichberger
People with HIV have a higher rate of breakthrough COVID-19 infections after vaccination compared to people without HIV, according to findings from a study led by researchers at the Johns Hopkins Bloomberg School of Public Health.
In the study, the researchers analyzed anonymized health records among nearly 114,000 people fully vaccinated with either two doses of mRNA vaccines or one dose of the J&J viral vector vaccine as of June 30, 2021 through December 31, 2021. Comparing vaccine recipients with and without HIV, the researchers found that the chance of a positive SARS-CoV-2 test result or a COVID-19 diagnosis within nine months after full vaccination, though low, was 28% higher among people with HIV. The risk of breakthrough infection during the period examined was 3.8% for the non-HIV group and 4.4% for the HIV group.
The results are published in JAMA Network Open.
Keri Althoff
Associate professor, Bloomberg School of Public Health
"These findings should alert all people with HIV to their greater risk of COVID-19 breakthrough, and can inform official recommendations about COVID-19 vaccination for people with HIV," says study senior author Keri Althoff, associate professor in the Bloomberg School's Department of Epidemiology.
Public health officials have had concerns about potentially elevated COVID-19 risk among people with weakened immune systems, including those with HIV, since the start of the pandemic. The Centers for Disease Control and Prevention currently recommends that people who are "moderately or severely immunocompromised"a category that includes people with HIV who are untreated or have low immune cell countsreceive an extra dose of vaccine as part of their primary vaccination series, followed by a booster. Studies so far have generated relatively little data on vaccination outcomes for people with HIV.
For their study, Althoff and her colleagues pooled individual-level data from four health systems in the U.S., to create a study population named the Corona-Infectious-Virus Epidemiology Team, or CIVET, cohort. The CIVET cohort contains de-identified records from private health insurers, the Veterans Affairs health care system, and an academic-affiliated health system. Patients in the study population had been receiving care for various conditions prior to the COVID-19 pandemic. The researchers examined the records of 113,994 people who had been fully vaccinated by June 30, 2021. Matching the 33,029 HIV-positive patients in the sample with the 80,965 HIV-negative patients (on age, race, sex, and date fully vaccinated), they compared the two groups' rates of SARS-CoV-2 breakthrough infections during the first nine months post-vaccination, or up to December 31, 2021, whichever came first.
The rates of breakthrough3.8% for the non-HIV group and 4.4% for the HIV groupare much lower than the rate of COVID-19 in unvaccinated people, suggesting a strong protective effect of vaccination. However, the analysis indicated the overall risk of breakthrough infection was 28% higher for the HIV group compared to the non-HIV group, after adjusting for differences between the groups.
Moreover, the study found an increasing risk of breakthrough with increasing immune suppression, measured via decreasing CD4 T-cell counts. Those with CD4 counts that signal moderate immune suppression in people with HIV had a statistically significant increase in the risk of breakthrough compared to people without HIV. That suggests, Althoff says, that people with HIV and moderate immune suppression may need to be included in the CDC's guidelines for additional doses of vaccine in the primary vaccination series.
"Policymakers who establish the guidelines should consider the benefits and risks of an additional dose of vaccine in the primary series not only for those with severe or untreated HIV, but also include those with moderate immune suppression or even all persons with HIV," says study first author Sally Coburn, a post-doctoral fellow in the Bloomberg School's Department of Epidemiology.
Althoff and colleagues are following up with a study to determine whether vaccinated people with HIV have not only higher breakthrough infection rates but also higher hospitalization rates after breakthrough infection.
I was 14 years old when I first read The Hot Zone by Richard Preston, a 1994 best seller detailing the horrors of hemorrhagic fever viruses like Ebola. Prestons descriptions of scientists in hazmat suits and patients vomiting out their dark, bloody insides fascinated me. I decided then that Id grow up to be a virologist.
Like many of my teenage dreams, that didnt come true, but I ended up pursuing biochemistryand I found my way back to viruses when I started my Ph.D., through what was supposed to be a quick and easy research project on bacteriophages, viruses that infect bacteria.
Viruses are the most abundant biological entity on Earth, but we struggle to categorize them. Some scientists consider viruses not fully dead, because they can copy themselves, but not fully living, either, because they need a host cell to help them do it. In living organisms, cells divide in multiple rounds, one to two to four to eight. Viruses can make thousands of copies in one round of replication. These peculiar life forms have likely been around as long as, or longer than, life on this planet. And theyre in us: According to some estimates, nearly 10 percent of our own DNA comes from endogenous retroviruses, ancient viruses that infected humans millions of years ago and have been passed down since then.
As I learned in my teen years, viruses can also entirely change how we live. HIV, with nine genes, can kill us, with our roughly 20,000 genes and 40 trillion cells. Although we now have good medications to both treat and prevent HIV, the effects of that pandemic still influence my life as a queer man.
Since the moment when it became obvious that the coronavirus would affect us all, another overlapping pandemic, Ive been haunted by plague memoriesand an unstoppable need to write what would become my new essay collection, Virology. In 2020, viruses seemed too complicated to explain only with science; I needed literature too. I read about cancer (which can be caused by viruses); about the viruses that do us no harm; about the ones that cause, for years or decades, deadly diseases. And I also needed to read about health, not just illness. I turned especially to texts from queer writers about HIV, which informs how I and many others think about the newest pandemic.
Narratives and theory about bodies, health, illness, and memory are necessary to understand how viruses shape our world. This reading list collects some of the books, from genres including queer theory, memoir, poetry, and scholarship, that helped guide me, and my writing, to a fuller understanding of our messy biology.
White Girls, by Hilton Als
In the first essay of White Girls, Als shows us what it was like to survive the 80s and 90s as a gay man in New York City. But even decades later, the specter of HIV never leaves him. Als mourns the loss of a friendship that dies, in part because he can never express a romantic and sexual desire to his friend. In all the years I loved him, I did not say I loved him, or, more specifically, how I loved him. If I did, wouldnt that end up in a garbage bag, too? he writes, referencing the early AIDS dead whom hospitals put in plastic bags. The prose holds the emotional terror of losing so many friends and would-be loversof not being able to take lovers because sex meant death. Alss work is an essential reminder that not all queer men were lost to the early HIV years; many are still here, writing. But the memories linger, and painfully so. Alss mournful essay shows how a virus upended an entire social world, and despite our effective treatments for the disease, the emotional scars havent healed.
Never Silent, by Peter Staley, and Let the Record Show, by Sarah Schulman
In these two books, two members of 80s and 90s ACT UP New York, the grassroots AIDS advocacy group, write completely orthogonal works about the same time and movement. Staleys is a traditional memoir, deeply seated in the first person, and Schulmans is a collection of oral histories. Never Silent follows Staleys years as a member of the ACT UP subgroup that worked on biomedical science. The chapter in which he details his own drug use after effective HIV treatments were available is eerily relevant to our current post-COVID moment: The medicine might have saved his life, but the trauma he experienced wasnt gone, and meth helped him deal with it, or just forget and feel good for a time. Schulman takes a different approach. Let the Record Show is a kaleidoscope, telling stories not of a few cisgender, white, male heroes; she attempts to tell all of the ACT UP stories together, including those of women and people of color, an absolutely necessary act. As is clear from Staleys book launch at the Strand, where his interview with Schulman turned contentious, the strain of the 90s lives on. Even though Staley is a friend of mine, given the choice, I tend more toward Schulmans collectivist perspective. Schulmans position as writer means it is her perspective, even if shes not always the one speaking. As The New Yorker noted, Schulmans ethical opposition to a famous clinical trial is still apparent in her recounting of it, although today, many consider the trial a crucial, if fraught, moment in HIV research. In this case, were lucky to have both books; they both have small failures, and theyre best read as a pair.
Read: Let the Record Show is an essential story of the AIDS movement
The Cancer Journals, by Audre Lorde
When we are ill, the priorities of our life become apparent in ways that can be masked by everyday routines. One of the most clarifying texts on the topic is by a queer woman who got cancer in the 70s and wrote a book that would forever change what that disease meant to me. You might think Im talking about Susan Sontags Illness as Metaphor. But Sontags work is frequently cited, whereas Lordes book The Cancer Journals, written under the same circumstances, is too often ignored. Unlike Sontags antiseptic essays, Lorde wrote and later published her journals, which focused on her body and the knowledge that sprang from it. The famous quote that Your silence will not protect you? It came from Lordes experience as a cancer patient: In looking at her own death, a forever silence, she forced herself to speak while she still could. Lordes work on the cycles of pain that she felt as a Black, lesbian cancer patient reminds readers that our ideas and identities arent inscribed, from birth, in our biology; instead, they can and do develop from our embodied experiences, feelings, and sensations. Lordes willingness to embrace her body and its knowledge extends to an inevitable end: Once I accept the existence of dying, as a life process, she wrote, who can ever have power over me again?
Disidentifications, by Jos Esteban Muoz, and The Gay Science, by Kane Race
The HIV/AIDS crisis caused great trauma and also radical and revolutionary disruption in queer identity, possibility, and history. Two queer-theory books stand out as necessary for understanding this moment. In Muozs first book, Disidentifications, he argues that living as a brown person or a queer person (or both) in the world can be exhausting because you either live with straight whiteness or live against it. He offers a third option: to disidentify, to invent new ways of being. His chapter on the HIV activist and reality-TV star Pedro Zamora (who died of AIDS) is perhaps his most applicable work about health, privacy, and disease. Zamora used fame to continue his activist work; he was an out HIV-positive Cuban American on national TV with a supportive family, running teach-ins for kids. In The Gay Science, Race invites readers to live in the world with HIV (and now, the coronavirus) differently, and to find maligned sites and practicesthings like poppers, molly, and unprotected sex on the dance flooras opportunities for pleasure and connection. Race also considers science an exuberant, constant state of questioning, much like Muozs later definition of queerness as walking toward a horizon that will never arrive. Race and Muoz both invite us to live otherwise, as the queer Black scholar Ashon Crawley says, to find self-indulgence in things that might be forbidden while still acting according to standards that support and protect ones community. These books may both be scholarly queer theory, but they are both a disrupting joy to read.
Read: The pandemic is following a very predictable and depressing pattern
Viral Cultures, by Marika Cifor
Are plague stories lost along with their dead? In Viral Cultures, an archivists work of scholarship, Cifor demonstrates how essential archives were to recovering and telling stories about HIV/AIDS, even as so many of the activists and artists chronicling the viruss effects were lost to it. She also implores readers to think critically about how they remember the work of organizations such as ACT UP. Some forms of nostalgia, she argues, can be flattening (or even harmful at a time of such mass death). The acts of creating, collecting, and preserving records that affirm the existence of communities that have been historically oppressed is political, and community AIDS archives are a manifestation of archival activism, she writes. It can be read as an entreaty to us today that we should similarly preserve our own pandemic memories. We all have the lethal constraints of a human body; Cifor offers us a pathway to ensure that our most important work, the messy work of living, cannot so easily be erased.
Funeral Diva, by Pamela Sneed
Like Viral Cultures, Sneeds book reanimates forgotten stories. Part poem, part memoir, part history, Sneed writes about her life as a Black lesbian artist in the midst of the HIV pandemic. Her words are full of passion, memory, joy, and pain in equal measure. She importantly considers the losses of Black women (in many cases to cancer, including Audre Lorde) alongside the losses of so many Black gay men to HIV. These Black women are erased in the NYC narratives of HIV/AIDS; Sneed places them there, central to the story. I moan complain, she writes, How the AIDS narrative only belongs to men / They never ask women / Black women / As if AIDS didnt happen to us. Sneeds writing, like Cifors and Schulmans, brings to mind the famous ACT UP slogan: Women dont get AIDS, they just die from it. Because Sneed, as a Black lesbian woman who lived in this time in NYC, is filling in a gap in the literature of this history, this book was canon the second it was printed. I read and reread it often.
Read: The LGBTQ health clinic that faced a dark truth about the AIDS crisis
Loves Instruments, by Melvin Dixon
As many of the books above show, we do have queer elders; not everyone in the generation above me was lost. But I want to end with some of the ones we did lose, and in particular examine the care and tenderness that queer people showed toward one another in that moment of mass viral death. So many poetry collections from the 80s and 90s capture loving in the face of an imminent end. A favorite of mine is Dixons posthumous 1995 collection, Loves Instruments (he died in 1992), including the poem Heartbeats. Dixon ends this poem Sweet heart. Dont stop. / Breathe in. Breathe out. In another poem in the collection, he writes of two lovers dying together, just as they always planned, but in their 40s, not their 80s: We promised to grow old together, our dream / since years ago when we began / to celebrate our common tenderness / and touch / You grip the walker and I hobble with a cane. / Two witnesses for our bent generation. Do you see how beautiful these men were to each other? In this moment of loss, people could have run, or turned into the worst versions of themselves. But no: Their love and care is our way forward. Go on. Breathe in. Breathe out.
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