Since the earliest days of the pandemic, weve been hearing about Californians abandoning their usual way of life for greener, cheaper pastures.
There are the San Franciscans who weathered lockdown orders in Lake Tahoe, and the Angelenos with new desert cabins in Joshua Tree. Tales abound of Silicon Valley types moving home to Miami and Seattle, or renting acres of land in Idaho.
The story goes like this: The coronavirus and the ability to work remotely have fundamentally reshaped where we want to live and large California cities, particularly Los Angeles and San Francisco, are not on the list.
But is any of that actually true?
Ill start with the short answer. There hasnt been an exodus from California, but pandemic forces have shifted where people reside within the state. Those patterns of relocation mirror what we were already seeing before Covid-19, but on overdrive.
Heres how this shakes out.
Californias population declined slightly in 2020, but it wasnt because of a mass migration to other states. To blame are coronavirus deaths, a lower birthrate and fewer international arrivals.
In fact, 82 percent of Californians who moved last year stayed in the state, according to a report from the California Policy Lab. That figure has been basically stable over the past five years.
A lot more people are moving around within the state than they are out of the state, Eric McGhee, a senior fellow with the Public Policy Institute of California, told me. That movement tends to be within a certain metropolitan area, and a lot of that is people moving to suburbs and exurbs.
Californians are likely to move from Los Angeles to the Inland Empire or from San Francisco to the fringes of the Bay Area or the Sacramento region, McGhee said. Thats because they want cheaper housing but dont want to end up so far away that they need to change jobs.
Its been that way for a long time. These were the largest county-to-county net migrations in California between 2015 and 2019, according to census data:
Los Angeles to San Bernardino (20,809 people)
Los Angeles to Riverside (13,949)
Los Angeles to Orange (11,879)
Alameda to Contra Costa (9,246)
Orange to Riverside (8,282)
Los Angeles to Kern (6,032)
San Diego to Riverside (5,892)
San Francisco to Alameda (5,469)
San Francisco to San Mateo (4,239)
Alameda to San Joaquin (4,134)
With the emergence of the pandemic in 2020, some of these trends kicked into high gear.
The Inland Empire tied Phoenix in 2020 for the biggest gain in households from migration nationwide, The Wall Street Journal recently reported. The flow of humanity into Riverside and San Bernardino Counties increased by 50 percent compared with the previous year.
This reflects Californians desire to escape the exorbitant home prices of more coastal regions. In Riverside County, the median single-family home price in August was $570,000, compared with $830,070 in Los Angeles County and $1.85 million in San Francisco.
As my colleagues noted in a recent analysis, pricey San Francisco experienced one of the most significant exoduses of the pandemic. While migration patterns during the pandemic have looked a lot like migration patterns before it, that wasnt the case for San Francisco, they wrote.
In the city, net exits the number of people leaving minus the number of people arriving increased to 38,800 in the last three quarters of 2020, compared with 5,200 during the same time the previous year, according to the California Policy Lab report. The city lost one-eighth of its total households last year by some estimates.
But perhaps this is good news for those us of fighting the myth of a California exodus: Two-thirds of San Franciscans who fled landed in other parts of the Bay Area and 80 percent stayed in the state.
For more:
Todays travel tip comes from Curtis Ridling:
For natural beauty I never get enough of Yosemite during the fall, when colorful leaves add to the experience. The winter with snow puts a different twist on the park with a sense of quiet not available at other times. Summer with its crowds is difficult but the views are still there as you look up and see climbers on El Capitan.
Tell us about your favorite places to visit in California. Email your suggestions to CAtoday@nytimes.com. Well be sharing more in upcoming editions of the newsletter.
Has your child been vaccinated against Covid-19?
Share stories of your children receiving their coronavirus shots and how it has affected your holiday plans. Please include your childs name, age and city of residence and even a photograph, if youd like.
Email me at CAtoday@nytimes.com and your submission may be included in a future newsletter.
One lucky Californian is about to become a multimillionaire.
All six numbers drawn in Saturdays Super Lotto Plus matched a ticket sold at a gas station in Santa Clarita, KCAL9 reports. The winner will claim $38 million.
Happy holidays, indeed.
COLUMBUS, Ohio (WCMH) Losing a loved one is never easy, but for Allison Brady, COVID-19 took the loss to an almost inconceivable level.
One of the scariest things about COVID-19 for Allison was the unknown, especially about how sick her parents might get due to being high risk.
Allison thought her worst fears were realized when she and her parents all got sick. Then the nightmare struck not once, but twice.
My mom was the first one to get sick, Allison said while thinking back, struggling to place the times and dates. Allison recalls it was eight days before her 17th birthday when her entire world was turned upside down.
It was just very scary. It didnt seem real, Allison said.
Her mom, Kimberly, worked as a hairstylist and had been in and out of hospitals battling diabetes as it progressed. When she moved to an assisted living facility, Kimberly was among the first wave of high-risk vaccine recipients last fall.
After being diagnosed with COVID-19 on Sept. 19, her condition quickly deteriorated.
Her funeral was Monday morning [the 27], said Allison, piecing together when her father got sick. Sunday night, he was rushed in an ambulance to the hospital, and Monday morning my father passed away from COVID.
Allison watched doctors take her mother off life support on Tuesday, Sept. 21. Six days after that, her father Jim was diagnosed. He died two months before the holidays.
Theyre going to be very difficult. Theyre going to be very, very difficult, said a tearful Allison a few days before Thanksgiving.
Jim had recently started the vaccination process so that he could visit his wife at the nursing facility. His sister Mimi said he died 12 hours after receiving his positive COVID-19 test.
He couldnt live without Kimberly, Mimi cried. Six days. He barely lasted six days. He just couldnt do it without her. Mimi is convinced her brother died of a broken heart.
Allison couldnt attend her mothers funeral because she was still sick.
I couldnt even get up and go down the stairs, Allison described. I was running really low on breath, not wanting to eat anything, not wanting to drink anything. Not wanting to do anything, just feeling really weak.
She feared for her own outcome.
Yeah, I thought that every day, said Allison as to whether she considered the risk to her own life.
Allison and Mimi sit side by side on the couch of Mimis Washington Courthouse home. The pair, even though they are family, now share a special bond.
I didnt have anywhere to live at the time, and then she Im going to start crying, Allison said with a cracking voice.
I didnt question it. Before she even got to the hospital, I said shes coming with me, Mimi said.
Kimberly and Jims wedding rings grace the coffee table as Allison and Mimi shared their favorite memories and some of the hardest.
Nov. 8 [1988] is when our mom passed away, and he texted me every year, Mimi said of her brother. I didnt get a text this year. It was quiet.
Even among a few laughs, the rings are a painful reminder of two lives ending far too soon.
It really has been hard, Allison described the last two months. I guess you get through it day-by-day.
They also want others to know there is never enough time to tell your loved ones how much they mean to you.
It is real. Be safe. Look what happened to me. Its not something fun to go through, so really try to be safe, Allison warns.
Patients queue to get vaccinated against COVID-19, in Aristotelous Square, in the center of the Greek city of Thessaloniki on November 26, 2021. Sakis Mitroldis /AFP via Getty Images hide caption
Patients queue to get vaccinated against COVID-19, in Aristotelous Square, in the center of the Greek city of Thessaloniki on November 26, 2021.
Facing a surge in coronavirus infections and stalled vaccination drives, two nations in the European Union are giving their citizens an ultimatum: take the COVID-19 vaccine or face the financial consequences.
Greece announced Tuesday that everyone 60 and older must be vaccinated by mid-January or face monthly fines of 100 euros (roughly $114).
Earlier this month, Austria said it would require its entire adult population to be vaccinated by Feb. 1. Those who refuse are set to pay up to 3,600 euros, or just over $4,000, in fines.
"It's not a punishment," Greek Prime Minister Kyriakos Mitsotakis told his cabinet in a televised meeting. "I would say it is the price for health. It is also an act of justice for the vaccinated. It's not right that they are deprived of health care services because others stubbornly refuse to do the obvious."
Greece is the first EU country to target an age group with a vaccination mandate. Citing government data, Mitsotakis said about 83% of older Greeks are vaccinated. Those who are not more than 500,000 people are more likely to get seriously ill and die. Greece recorded more than 7,500 infections, hundreds of hospitalizations and 88 deaths on Tuesday alone, according to Greece's National Organization for Public Health.
The monthly fine for refusing the vaccine is substantial for retirees. The average pension is 730 euros a month.
Both Greece and Austria turned to compulsory vaccinations after a series of measures including banning the unvaccinated from indoor venues failed. Both countries have anti-vaccination movements, fueled by conspiracy theories, religion and anti-authoritarianism. In Austria, an unvaccinated far-right politician has promoted the use of the horse deworming drug ivermectin to treat COVID-19. His party joined thousands who took to the streets to protest lockdown measures and the vaccine mandate.
"Society should be sticking together, taking care of each other, in times like these but instead we are splitting into two worlds, the vaccinated and the unvaccinated," said Christine Bertl, a biochemist from Vienna who supports the mandatory vaccination effort. "And the unvaccinated think only about themselves."
Bertl added that they are refusing vaccines procured by the EU that could have gone to nations who cannot afford them.
More than 61% of Greeks and 67% of Austrians are vaccinated, according to data from Johns Hopkins University, though those numbers could soon increase. Some reports show that mandates are pushing the unvaccinated to get their shots.
The vaccine mandates come as the world scrambles to respond to the new omicron variant. Scientists say omicron appears to be highly transmissible, though researchers still have limited information about the variant. Infections have already appeared in several EU nations, including Austria. Mitsotakis say he expects the variant will likely reach Greece as well.
Protection from COVID-19 comes from either contracting the SARS-CoV-2 virus and recovering or getting vaccinated.
Research has shown that those who have contracted SARS-CoV-2 have 85% protection against symptomatic disease 6 months after infection.
Meanwhile, as the authors of the recent study explain, vaccination has been reported to be 5095% effective at various time points.
Over time, the immune systems response to SARS-CoV-2 diminishes, meaning those who have recovered from the virus or received vaccination may be less protected as time progresses.
In a recent study, researchers from Israel and the United States conducted a study to investigate whether protection against infection waned over time following a second dose of the Pfizer-BioNTech mRNA vaccine.
They found that 90 days following a second Pfizer dose, individuals were at an increased risk of contracting SARS-CoV-2. The findings appear in the BMJ.
Israel was one of the first countries to successfully roll out a vaccination campaign in the population, so we were also among the first to observe the waning effect of the vaccination as time elapsed since the initial two shots of the vaccine, Dr. Ariel Israel, Ph.D., one of the studys authors, told Medical News Today.
Our study is an observational study, designed to evaluate whether protection provided by the Pfizer vaccine wanes with time by comparing the rate of positive [reverse transcription-polymerase chain reaction (RT-PCR) for SARS-CoV-2] in people vaccinated at different time intervals before the test.
We observed that after the excellent protection offered by the vaccine in the initial 3 months, there was a gradual increase in the infection rate, Dr. Israel explained.
The researchers gathered medical records from Leumit Health Services, a large healthcare provider in Israel that serves 700,000 people throughout the country.
For their analysis, they used health records from those aged 18 years and above who underwent a SARS-CoV-2 RT-PCR test between May 15, 2021, and September 17, 2021, after receiving two doses of the Pfizer vaccine.
The team performed tests at least 3 weeks following their second vaccination. They divided participants into three age groups to reflect different stages of the vaccine rollout:
They also divided the time between the second vaccination and RT-PCR tests into 30-day intervals after the initial 90 days, with the last category denoted as 180 days or more since the second vaccination. Altogether, the researchers analyzed health records from 83,057 individuals.
Their analyses accounted for potential confounding risk factors for SARS-CoV-2 infection, such as age, sex, socioeconomic status, and existing health conditions.
Among those the researchers studied, 9.6%, or 7,973 individuals, had a positive test result. The average time between the second vaccine dose and an RT-PCR test was 164 days.
The team found that the more time elapsed since the second vaccine, the more likely people were to contract SARS-CoV-2.
While 1.3% of participants received a positive test result 2189 days after their second vaccine, the same was true for 2.4% of people after 90119 days, 4.6% after 120149 days, 10.3% after 150179 days, and 15.5% after 180 days.
These results translated into a 2.37-fold higher chance of contracting the virus after 90 days from the second vaccination and a 2.82-fold higher likelihood after 150 days or more.
They also found that two injections 21 days apart provided more protection than one and that immune system changes relating to age influenced the immune response to the vaccines.
Dr. Israel explained that the reasons for waning immune protection are beyond the scope of their study. However, he suggested some possible mechanisms:
The most likely explanation is that antibodies, as well as cells of the immune system that produce antibodies or kill cells [with the infection], have a limited lifetime, so their numbers decrease gradually after the initial response triggered by the vaccine.
[Fewer] antibodies in the blood, and [fewer] cells able to kill the virus mean that the virus is more likely to evade the immune system in the first stages of infection, and this is probably why we observe an increased rate of positive PCR in individuals vaccinated earlier, he added.
The researchers concluded that SARS-CoV-2 immunity following a second Pfizer vaccine wanes after the initial 90 days and that a third vaccine, or booster dose, may be warranted for immunocompromised individuals.
They also note several limitations to their study. Due to its observational study design, they say that they possibly did not account for all contributing factors, which may have skewed their results.
For example, they note they only included individuals who chose to request an RT-PCR test for SARS-CoV-2 and that some may have had different thresholds for requesting a test.
They also noted that individuals vaccinated earlier might have had different physical distancing habits than those vaccinated later, which could have significantly influenced their level of risk.
Moreover, the researchers note that RT-PCR tests were not followed up with blood tests, meaning they cannot be sure that immunity had indeed waned.
In light of these results, public health authorities in Israel have recommended a booster shot for all age groups, and we have observed a subsequent dramatic reduction in COVID-19 incidence immediately following the rollout of the booster shot, said Dr. Israel.
It is too early to say for certain how long the protection would last following the booster shot. We are continuing to monitor the infection rate and will report our data in case we observe a reduction in the protection provided by the booster, he concluded.
For live updates on the latest developments regarding the novel coronavirus and COVID-19, click here.
Gov. Gavin Newsom takes questions during a press conference on COVID-19 vaccination and housing for homeless veterans at the West Los Angeles VA Medical Center in Los Angeles on Wednesday, November 10, 2021.
Sarah Reingewirtz | MediaNews Group | Los Angeles Daily News via Getty Images
The person in California who tested positive for the omicron variant of the virus that causes Covid-19 was fully vaccinated, has mild symptoms and is improving, officials said Wednesday.
The patient was otherwise healthy when they returned to the San Francisco Bay Area from traveling in South Africa on Nov. 22, developed symptoms three days later and tested positive for Covid on Nov. 29, according to public health officials in California.
Scientists at the University of California, San Francisco received the patient's sample around 3 p.m. Pacific time Tuesday and completed the sequencing in about five hours, lab director Dr. Charles Chiu told reporters at a press conference Wednesday with San Francisco Mayor London Breed.
Gov. Gavin Newsom, in a separate briefing Wednesday, said the patient is between 18 and 49 and had not received a booster shot because they were not six months out from their original vaccination course.
"This individual has not been hospitalized," Newsom said. "The individuals that this individual has come into contact with have not tested positive yet to our knowledge, and we are hopeful of full recovery and expect nothing less based on what we've learned."
The Centers for Disease Control and Prevention has recommended that all U.S. adults get a booster six months after their original Pfizer or Moderna two-dose course, and two months after their single J&J shot.
Dr. Mark Ghaly, California's Health and Human Services secretary, said the fact that the patient is improving underscores the importance of vaccination.
"We have been talking for months about the fact that vaccinations do one really, really important thing protect against severe disease, against hospitalization and death," Ghaly told reporters at the briefing with Newsom. "The evidence that an individual with omicron identified by sequencing actually has mild symptoms, is improving, I think is a testimony to the importance of the vaccinations."
Ghaly said there's still a lot to learn about the variant but encouraged Californians to get vaccinated and get a booster shot if eligible.
White House chief medical advisor Dr. Anthony Fauci told reporters Wednesday that the profile of the omicron variant suggests its mutations could reduce the effectiveness of the vaccines currently on the market, but more data is needed.
"The molecular profile of the kinds of mutations that you see [in omicron] would suggest that it might be more transmissible and that it might elude some of the protection of vaccines," Fauci said Wednesday. "But we don't know that now."
The CEOs of Moderna and Pfizer have said it will take about two weeks to determine omicron's impact on the effectiveness of the current vaccines.
"I don't think that the result will be the vaccines don't protect," Pfizer CEO Albert Bourla told CNBC on Monday. "I think the result could be, which we don't know yet, the vaccines protect less."
Bourla said Pfizer can develop a new vaccine within 100 days. The company was able to quickly create vaccines for the beta and delta Covid variants but ended up not using them because the original vaccine remained effective against the mutations, he said.
Moderna CEO Stephane Bancel said the vaccine maker can roll out a higher-dosage booster shot quickly but that it could take until early 2022 to develop and ship a vaccine that specifically targets omicron.
"The higher dose could be done right away but it will be months before the omicron-specific variant is ready to ship in massive quantities," Bancel told CNBC's "Squawk Box" on Monday.
Maria Van Kerkhove, the World Health Organization's Covid technical lead, said Wednesday that reports from South Africa indicate some patients infected with omicron show mild symptoms but in other cases the disease has become more severe. Van Kerkhove said studies are looking at those hospitalized to see whether they have the omicron variant.
"It is certainly possible that one of the scenarios is that the virus, as it continues to evolve, may still have a fitness advantage, meaning that it can become more transmissible than delta. We'll have to see," she said. "But we don't know quite yet about the severity."
A video shared widely on social media flashes through dozens of news clips of athletes who reportedly collapsed and, in some cases, died of heart problems.
Set to ominous music, it implies that the incidents were linked to COVID-19 vaccines. "24-year-old hockey player dies after collapsing on ice in cardiac arrest 80% of league is vaccinated," read one headline, which we found had been pulled from a website called Team Tucker Carlson.
The video was flagged as part of Facebooks efforts to combat false news and misinformation on its News Feed. (Read more about our partnership with Facebook.)
It was posted on a website called The HighWire, which is associated with the anti-vaccination group Informed Consent Action Network. The videos caption further ties the incidents to the vaccines with a question and a series of leading hashtags: "They are at the peak of health, and the top of their profession. So, why are dozens of amatuer and professional athletes around the world inexplicably collapsing on the field, with heart-related issues, in just the past few months? #CollapsingAthletes #Covidvaccine #Myocarditis #TheHighWire."
But there is no evidence COVID-19 vaccines led the athletes in the video to collapse. We reviewed the news reports mentioned in the video and spoke with a number of sports cardiologists, and we found the claim connecting the two is unfounded.
"To date, I am not aware of a single COVID vaccine-related cardiac complication in the professional sports," said Matthew Martinez, a sports cardiologist who works with the National Football League, National Basketball Association, National Hockey League and Major League Soccer and who is the director of sports cardiology at Morristown Medical Center in New Jersey.
The same goes for Jonathan Kim, an associate professor of medicine and chief of sports cardiology at Emory University in Atlanta. "I am not aware of any reports that vaccines in athletes are causing cardiac issues," he said. He called the HighWire video "a classic example of disinformation."
The video mentions Danish soccer player Christian Eriksen, 29, who, according to his team director, wasnt vaccinated for COVID-19 when he collapsed June 12. So the vaccine couldnt have been the reason he collapsed.
It also includes a clip about Keyontae Johnson, 22, a college basketball player who collapsed on Dec. 12, 2020, days before the COVID-19 vaccine was given to people in the U.S. His collapse also wasnt related to the COVID-19 illness, according to a Feb. 3, 2021, statement from his family.
Dutch speed skater Kjeld Nuis, 32, who is also included, did have a heart problem in July 2021 a week after he received the COVID-19 vaccine, according to news coverage at the time. Nuis posted on Instagram later that month saying that he was fine and that he was at training camp. He did not say whether his COVID-19 vaccination contributed to his heart problem or whether it was linked to his athletic activity. Nuis had tested positive for COVID-19 in October 2020.
A young athlete experiencing cardiac arrest is not common, but its also not unprecedented. And there are different reasons an athlete might collapse.
Michael Emery, co-director of the Cleveland Clinic Sports Cardiology Center, said that dehydration, heat stroke and genetic heart conditions, among other factors, can lead to collapse.
The COVID-19 disease and vaccine have, very rarely, led to heart problems. The virus or the vaccine can inflame the heart muscle, called the myocardium, or the heart muscle sac, called the pericardium, Martinez explained. That can lead to chest pressure, breathlessness and, in some cases, long-term damage to the myocardium or pericardium. Myocarditis and pericarditis in general are rare, but when they do occur, theyre often caused by viral infections, according to the Myocarditis Foundation and the Cleveland Clinic.
Among athletes, heart problems are rare even after having COVID-19 itself. In a study that Martinez co-published in March in the American Medical Associations journal JAMA, fewer than 1% of athletes who had COVID-19 were found to have inflammatory heart disease. Martinez said he hasnt identified any athletes who had the COVID-19 disease and a heart-related complication and then died.
Having a heart problem from the COVID-19 disease or vaccine is "super rare," according to Emery. And it is "way more rare from a vaccine than it is from a native infection from COVID-19."
The videos caption asks why dozens of athletes are collapsing "in just the past few months." But sports cardiologists arent seeing a sudden rise in athletes collapsing. "We have no data to suggest that the frequency of sudden cardiac arrest or sudden cardiac death in athletes is higher now than it was in the past," said Emery.
Our ruling
A video shows news clips of athletes collapsing to suggest that COVID-19 vaccines cause heart problems in otherwise healthy athletes. The video makes an assumption and offers no proof. Athletes in the video did not all collapse from COVID-19 vaccines, and leading sports cardiologists we reached out to said they havent seen athletes collapse after getting vaccinated for COVID-19.
We rate this claim False.
On December 15, 2020, a group of 13 healthcare workers in Seattle become the first people in Washington to receive a COVID-19 vaccine. The group of doctors, nurses, paramedics, medical assistants, and other healthcare providers receives the Pfizer vaccine at the University of Washington Medical Center. The vaccines are part of an initial shipment of 3,900 doses that had been shipped to Seattle the day before from Gerald Ford International Airport outside Grand Rapids, Michigan. Cheers, tears, and rounds of applause greeted the 13 healthcare workers who rolled up their sleeves to receive the state's first vaccine doses.
Shipping the Precious Cargo
The first reported coronavirus case in the U.S., confirmed by the Centers for Disease Control (CDC) on January 21, 2020, was transmitted unknowingly by a Washington resident who returned from Wuhan, China, on January 15, 2020. The first known death in the U.S. from COVID-19 occurred in Kirkland on February 26, 2020. As the country began to prepare for the long-awaited distribution of the coronavirus vaccine, frontline healthcare workers and residents of long-term care facilities were given priority. In the U.S., the Pfizer-BioNTech vaccine was granted approval first, with the Moderna vaccine expected to receive regulatory approval by the end of 2020.
Washington's coronavirus vaccine response was authorized by the Western States Scientific Safety Review Workgroup. The workgroup was made up of vaccine experts from Washington, California, Oregon, and Nevada who had been meeting regularly to review and analyze the data, making sure the vaccines were safe and effective.
The preparation and shipment of the Pfizer-BioNTech vaccine from the Pfizer Global Supply Kalamazoo manufacturing plant in Michigan were covered extensively by local and national media. The boxes were prepared for shipment on Sunday, December 13, 2020, kept ultra-cold in freezers registering minus-69 degree Fahrenheit. The first shipment of 3,900 doses of the Pfizer vaccine earmarked for Seattle was loaded onto a FedEx truck at Pfizer's Michigan plant and transported to Gerald Ford International Airport near Grand Rapids for the flight to Seattle.
The Lucky 13
The vaccine supply arrived on Monday, December 14, 2020, and distribution began on December 15, 2020. The selection process adhered to the guidelines established by the CDC. The first priority groups were healthcare personnel and those in long-term nursing facilities, followed by essential workers such as police, firefighters, transportation workers, and teachers.The third phase was to include high-risk adults and those over the age of 65.
"These guidelines helped University of Washington Medicine decide how to rollout their first round of COVID-19 vaccines. 'Provide vaccines to all healthcare workers in that first phase, specifically healthcare workers that are patient-facing,' explained Dr. Shireesha Dhanireddy, Director of Harborview Infectious Diseases Clinic" (Lafferty).
Thirteen individuals received the state's first vaccine. They were:
An Emotional Turning Point
Emotions were high on December 15 as each of the 13 received the vaccine. First in line was Amy Fry, a COVID intensive care nurse, followed by emergency room nurse Emily Agudo. Fry was in turn tearful and joyful after receiving her vaccine. "I feel excited. For the first time in a while, I feel hope" (Boiko-Weyrauch).
Representing the state's first responders was paramedic Alan Goto, a 22-year veteran of the Seattle Fire Department. Goto had spent the previous eight months on the department's Mobile Assessment Team, going into long-term care facilities and adult homes to test patients and staff for the virus. As he waited to receive his shot, Goto spoke of his role as a public servant and the responsibilities that came with it: "[Since we] have chosen to dedicate ourselves to protecting our community, getting vaccinated is the most relevant thing we can do in this moment to fulfill our commitment to serving the public" (Derrick).
Receiving the vaccine was emotional for oncology nurse Allison Miller, but for another reason. Miller had given birth in February, a month before the state lock-down began on March 23, 2020. "It's been a really isolating time for me because keeping a newborn safe during all these unknowns ... it's just held a lot of weight for me" (Bunin). The vaccine had given her hope that she could introduce her newborn son to family members he had not yet met.
Next Steps
After the vaccine was injected into the upper arm, each individual was asked to remain nearby for 15 minutes for observation. Clinical nurse specialist Kaitlyn Drew outlined the protocol: "We just have them sit and relax in a chair; we have some juice and water back there for them if they need it" (Boiko-Weyrauch).
At the end of the week, the state's Department of Health hoped to receive another 62,400 doses for distribution to 17 sites in 13 counties. By the end of December 2020, another 222,000 doses of the Pfizer vaccine were expected. Moderna was prepared to deliver some additional 183,000 doses once FDA approval was granted.
As of December 2020, Washington had 414,000 people in healthcare and in nursing homes who were given priority status to receive the vaccine. Since the start of the pandemic in early 2020, about 200,000 coronavirus cases in Washington were confirmed and more than 2,800 people had died from COVID-19.
HistoryLink.org Online Encyclopedia of Washington State History, "After Two People Die in Kirkland in the First Reported Deaths from COVID-19 in the United States, Governor Jay Inslee Declares a State of Emergency on February 20, 2020" (by Jim Kershner); http://www.historylink.org accessed November 30, 2021;Anthony Derrick, "Paramedic Alan Goto Becomes First Seattle Fire Department Member to Receive COVID-19 Vaccine," press release, Office of the Mayor, City of Seattle, December 16, 2020 (https://durkan.seattle.gov/2020/12/paramedic-alan-goto-becomes-first-seattle-fire-department-member-to-receive-covid-19-vaccine/);Steve Bunin, "Meet the First Medical Professional to Get the COVID-19 Vaccine in Washington," KING 5 TV, December 15, 2020 (https://www.king5.com/video/news/local/meet-the-13-frontline-workers-who-received-the-first-doses-of-covid-19-vaccine-in-washington/281-db56028a-205d-4440-bd3c-3ae1b61b33ef);Kaila Lafferty, "Enormously Complicated: Seattle Plans for COVID-19 Vaccine Rollout," KING 5 TV, December 10, 2020 (https://www.king5.com/article/news/health/coronavirus/vaccine/its-going-to-be-enormously-complicated-seattle-plans-for-covid-19-vaccine-rollout/281-b06e60de-3bca-45bb-a9a9-6f3da5917673);Anna Boiko-Weyrauch, "Excitement and Hope: First Seattle Health Care Workers Vaccinated Against Covid-19," KUOW Radio, December 15, 2020 (https://www.kuow.org/stories/first-seattle-health-care-workers-vaccinated-against-covid-19); "Coronavirus: Seattle Healthcare Workers Receive First Vaccinations in State," KIRO 7 TV, December 15, 2020 (https://www.kiro7.com/news/local/states-first-coronavirus-vaccinations-be-given-seattle-healthcare-workers-tuesday/ESWHMQOGJBAENAAZ5473LEPAAU/);"Coronavirus Daily News Updates, Dec. 15 2020," The Seattle Times, December 15, 2020 (www.seattletimes.com);"UW Medicine Gives its First Covid-19 Vaccinations," UW Medicine Newsroom, December 15, 2020 (https://newsroom.uw.edu/postscript/uw-medicine-gives-its-first-covid-19-vaccinations);Gene Johnson, "I Feel Hope: Nurse Among 1st to Get Vaccine in Washington," Associated Press, December 16, 2020 (https://www.usnews.com/news/best-states/washington/articles/2020-12-15/first-covid-19-vaccines-being-administered-in-washington).
Overall, the group identified 12 cases of myopericarditis in vaccinated study participants. Three of those cases came after the first dose of a COVID-19 vaccine, seven cases came after the second dose and the other two cases came after a single-dose vaccine. Meanwhile, there were five cases of myopericarditis reported in the control group.
The age-adjusted incidence rate of myopericarditis among men was higher in the vaccinated group than in the studys control group. This was not, however, the case among women.
Previous research has demonstrated that there are slightly higher rates of myopericarditis of any cause in men than in women, the authors wrote. One proposed potential mechanism for this difference in incidence is that the higher levels of estradiol in women may confer a cardioprotective effect. If COVID-19 vaccination is a causative factor in the development of myopericarditis in some people, the same mechanisms may be making men more susceptible than women after COVID-19 vaccination.
The team did note that this was not a randomized controlled trial. Also, using study subjects as their own controls likely kept selection bias to a minimum, but it does mean that all patients were two years old after they had been vaccinated.
Even with these limitations in mind, the authors said their work reaffirms the apparent increase in the diagnosis of myopericarditis in men (particularly aged 25 to 44 years) after COVID-19 vaccination.
They concluded, however, by highlighting the continued importance of these vaccines.
The benefits of COVID-19 vaccination to individual and public health outweigh the very small risks of myopericarditis diagnosed after vaccination, they concluded.
Read the full analysis here.
Vaccines have a long and complicated history in the United States. Despite overwhelming evidence that vaccinations for diseases ranging from smallpox to polio to influenza have helped save lives, vaccine hesitation remains evident in some segments of the US population, particularly in relation to COVID-19 vaccines. Although vaccine hesitancy is rooted in legitimate concerns, vaccine rejection is predicated on false information and is deadly.
One group of individuals who overwhelmingly support COVID-19 vaccination are those who have experienced and witnessed the ravages of HIV. We are the ones who have long awaited a vaccine to curtail the HIV/AIDS epidemic and would welcome it with open arms. For us, this rejection of COVID-19 vaccination is anathema, as we have witnessed more than 700,000 Americans die due to AIDS complications since 19811 and nearly 750,000 deaths to COVID-19 in the United States in the last 2 years.
Lest we believe that the HIV epidemic is over, in 2019 approximately 40,000 individuals were infected and more than 15,000,2 mostly marginalized poor Black people, succumbed to the ravages of the disease.3
The social, structural, and economic drivers of HIV are not so different from COVID-19, placing those with fewer means, less access to health care resources, and less power at higher risk.4 We remind our medical doctor colleagues that viruses are certainly biological entities but the conditions they perpetuate are socially produced diseases. Thus, medications or vaccines alone are never enough if we are to curtail epidemics.
This year, we commemorate 40 years after the initial diagnoses of HIV in the United States, and despite calls for bringing an end to AIDS by 2025, there is still much work to be done toward eradicating this disease, in part due to delays created by the infiltration of SARS-CoV-2, the virus that caused COVID-19. Case in point: While we had developed such a plan for New Jersey in 2019, our efforts became immobilized until recently, as we collectively combatted this newest pandemic.
Efforts to control viruses, particularly variola major and variola minor, the pathogens that cause smallpox, can be traced back to the Ottoman Empire in the 1600s through a now-obsolete technique known as variolation. In this method, a small amount of aged material from a small blister of someone who has had smallpox for some time (aged disease) was introduced into a person yet to be infected. This procedure resulted in a small reaction, likely much more severe than any faced with any of the COVID-19 vaccines, but eventually conferred immunity. Such physical reactions to bolster ones immunity is a small price to pay to protect ones health and the health of their families and communities. Over the centuries, variolation has led to the development of vaccines for numerous pathogens, including cholera and typhoid.
Vaccine development evolved at a rapid pace in the 20th century, highlighted by success against the poliovirus. Since the 1940s, polio had been disabling some 35,000 American children a year, and like COVID-19, prior to the widespread use of vaccines, parents were fearful to let their children play or socially interact with others lest they be infected. Sound familiar? Thanks to the vaccines developed by Jonas Salk, MD, using an inactive virus technology, and Albert Sabin, MD, using an attenuated virus technology, there here have been no cases of polio since 1979 in the United States.5 Sadly, the rejection of the COVID-19 vaccines will likely prevent us from full eradication of this diseaseat least over the next few yearsamid the ongoing battle with variants like Delta and Omicron, which are elevated with their Greek letter names because of their power to spread disease and incubate in the bodies of the unvaccinated. In less affluent nations, the lack of vaccine causes these mutations; in America, it is deadly misinformation that fuels both vaccine rejection and disease.
Today, according to the Kaiser Family Foundation,6 less than one-third of parents indicate a willingness to vaccinate their children for COVID-19 while another third indicate they would never have their children vaccinated. In contrast, parents did not show the same resistance against vaccinating their children for polio. Consider the fact that there have been 8498 COVID cases per 100,000 children in the population (17% of all cases)7 and that long COVID has been detected in children, which may lead to multisystem inflammatory syndrome.8 Long COVID9 likely affects millions around the globe and is characterized by lingering symptoms that interrupt peoples lives, much like HIV does. As is the case with others who are living with diseases, such as HIV, multiple sclerosis, or any other chronic condition, COVID long-haulers see an uncertain future in terms of their health and the ability to access care for their conditions. Why would any parent subject a child to such a life?
World AIDS Day 2021 is being commemorated 4 decades after detection of the first AIDS cases in the United States. Forty years after the initial diagnoses of HIV in the United States and numerous failed trails, there is still no safe and effective vaccine to combat HIV. Although advances in the treatment of HIV and the use of antiretrovirals, both as treatment and prevention, have heralded a breakthrough in the management of the virus,10 the disease continues to spread, primarily through sexual behavior, and primarily in sexual minority Black men.3 To date, while we can prevent people from acquiring HIV via the use of antiretrovirals, it is through reliance on pharmaceutical medications, regular interaction with health care providers, and the costs associated with this carecompared with what could be a single- or multidose vaccination.
A vaccine against HIV would champion a new era whereby new infections could eventually be eradicated, much like we have accomplished with polio. The groundbreaking work that has led to the development of mRNA vaccines used to combat COVID-19 is currently being tested as means of vaccinating against HIV.11 Perhaps, there is a glimmer of hope.
But the success of HIV vaccination or any other vaccination program is dependent on the actions and behaviors of people who seek to protect their health and the health of others. This requires compassion, empathy, altruism, a trust in science, and belief in truthcharacteristics some may lack and that lack of which could risk the health of others.
People living with HIV (PLWH) know what it like to try to live every day with a deadly virus. Much like the parents of children crippled by polio and those of us who have witnessed too many of our 20-something-year-old friends die of AIDS, PLWH know firsthand the deadly effects of viruses. Therefore, so many of us who have experienced the death of a loved one to HIV or COVID-19 scratch our heads at the rejection of the COVID-19 vaccine.
Our research center12 has been working with PLWH for over 2 decades and has continued to do so throughout the COVID-19 pandemic. Our efforts have shed light on the access and delivery to care that has been shaped by the COVID-19 pandemic and the resilience of PLWH. More recently, we have sought to understand how PLWH have experienced COVID-19 vaccination. Not surprising, we found that PLWH overwhelmingly gladly partook in the COVID-19 vaccination program.
In one study, we found that 64% of PLWH had already received 1 vaccine dose by May 2021, the very onset of the vaccination program, while 66% of those yet to be vaccinated indicated they would receive the vaccine. Of those who were in states in which they were eligible, 75% had received at least 1 dose. The majority of those not vaccinated at the time of the survey were in states where they were not eligible. Tellingly, about 86% of vaccinated individuals indicated they had done so to protect their own health, 76% acknowledged they were vaccinated to protect the health of others, and 69% did so to bring an end to the pandemic. These statistics highlight a segment of the population all too aware of the ravages that viruses can create personally, but also of their own responsibility in advancing the publics health. This is what empathy looks like.
Recently, conservative talk show host Dennis Prager made some comments we found disrespectful, that claimed the discrimination faced by those who refuse to get the COVID-19 vaccine was akin to the actual discrimination faced by the early victims of the HIV epidemic in the 1980s and 1990s.13 Loosely, he said it would have been inconceivable for gay men and intravenous drug users to be treated like pariahs in the way that people who are not vaccinated with COVID-19 are. This misrepresentation of history not only contributes to the spread of misinformation around HIV/AIDS and COVID-19, but also likens a group of people making an active choice to not be vaccinated with a viable, safe, and effective vaccine for COVID-19 to those who did and still do not have a choice when it comes to protecting themselves against HIV/AIDS. This communityour communitywould have willingly accepted an HIV vaccination in lieu of a life living with HIV and the ongoing stigma perpetuated against PLWH.
Had a vaccine for HIV been developed and rolled out as rapidly as that for COVID-19, hundreds of thousands of lives would have been saved. Many of us would have gladly signed on for that vaccine. Instead, 40 years later, we are eagerly waiting for this critical medical intervention to stop the spread of HIV and transform it from an endemic disease to an eradicated disease like polio.
For the 700,000-plus who have died of AIDS complications and the 1.2 million who are infected with HIV and who must live a life of constant treatment, such a vaccination is too late. It is them who we honor on this World AIDS Day in 2021.
References
1. The HIV/AIDS epidemic in the United States: the basics. Kaiser Family Foundation. June 7, 2021. Accessed November 8, 2021. https://www.kff.org/hivaids/fact-sheet/the-hivaids-epidemic-in-the-united-states-the-basics/
2. Basic statistics. CDC. Accessed November 9, 2021. https://www.cdc.gov/hiv/basics/statistics.html
3. HIV and African American people. CDC. Accessed November 8, 2021. https://www.cdc.gov/hiv/group/racialethnic/africanamericans/index.html
4. Halkitis PN. Managing the COVID-19 pandemic: biopsychosocial lessons gleaned from the AIDS epidemic. J Public Health Manag Pract. 2021;27(suppl 1):S39-S42. doi:10.1097/PHH.0000000000001267
5. Polio elimination in the United States. CDC. Accessed November 7, 2021. https://www.cdc.gov/polio/what-is-polio/polio-us.html
6. Hamel L, Kirzinger A, Lopes L, Kearney A, Sparks G, Brodie M. KFF COVID-19 vaccine monitor: January 2021. Kaiser Family Foundation.January 22, 2021. Accessed November 8, 2021. https://www.kff.org/coronavirus-covid-19/report/kff-covid-19-vaccine-monitor-january-2021/
7. Children and COVID-19: state-level data report. American Academy of Pediatrics. Accessed November 8, 2021. https://www.aap.org/en/pages/2019-novel-coronavirus-covid-19-infections/children-and-covid-19-state-level-data-report/
8. JoJack B. Long COVID in children: how long might it last? Medical News Today. September 21, 2021. https://www.medicalnewstoday.com/articles/long-covid-in-children-how-long-might-it-last
9. Taquet M, Dercon Q, Luciano S, Geddes JR, Husain M, Harrison PJ. Incidence, co-occurrence, and evolution of long-COVID features: a 6-month retrospective cohort study of 273,618 survivors of COVID-19. PLoS Med. Published online September 28, 2021. doi:10.1371/journal.pmed.1003773
10. Halkitis PN. Biomedical advances in the treatment of HIV and the evolution of U=U: New Jersey HIV Links. Spring 2018. https://fxbcenter.org/downloads/AIDSLINE/HIVLinks-Spring2018.pdf
11. A phase 1 study to evaluate the safety and immunogenicity of eOD-GT8 60mer mRNA vaccine (mRNA-1644) and Core-g28v2 60mer mRNA vaccine (mRNA-1644v2-Core). ClinicalTrials.gov. Updated September 30, 2021. Accessed November 8, 2021. https://clinicaltrials.gov/ct2/show/NCT05001373
12. Center for Health, Identity, Behavior & Prevention Studies. Rutgers School of Public Health. Accessed November 8, 2021. https://sph.rutgers.edu/centers/chibps/index.html
13. Guerrero D. Far right host Dennis Prager: unvaccinated are more ostracized than AIDS patients. The Advocate. November 9, 2021. Accessed November 9, 2021. https://www.advocate.com/news/2021/11/09/far-right-host-unvaccinated-are-more-ostracized-aids-patients
A health worker prepares a booster dose of a coronavirus disease (COVID-19) vaccine, as vaccinations jump in Italy after the government made inoculation mandatory for all workers, in Rome, Italy, September 21, 2021. REUTERS/Yara Nardi
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MILAN, Dec 1 (Reuters) - Italy's medicines agency AIFA on Wednesday gave the go-ahead for the use of Pfizer-BioNTech's COVID-19 vaccine for children between the ages of five and 11.
AIFA's decision, which was widely expected, came after the European Union's drug regulator (EMA) took the same step on Nov. 25.
The approvals come as Europe emerges as the epicentre of the latest phase in the coronavirus pandemic, accounting for about half of worldwide cases and deaths in recent weeks.
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EMA recommended on Nov. 25 that Pfizer-BioNTech's (PFE.N), (22UAy.DE) vaccine be given to 5-11 year olds as an injection in the upper arm in two 10 microgram doses, three weeks apart.
Adult doses contain 30 micrograms.
In making the same recommendation for use as the EU agency did, AIFA said the available data "shows a high level of efficacy, with no signs of alert at the moment in terms of safety."
The vaccine has been approved for European Union use in teenagers between 12 and 17 years old since May, with the same dosage as for adults. read more
Inoculating children and teenagers, who can unwittingly transmit COVID-19 to others, is considered by health authorities to be a crucial step towards taming the pandemic.
With infections on the rise in Italy, the government last week tightened the screws on people unwilling to take an anti-COVID shot, sharply restricting access to an array of services and making vaccines mandatory for a wider group of public sector workers. read more
Italy reported 103 coronavirus-related deaths on Wednesday, the first daily death toll of more than 100 since June 8.
The country has registered 133,931 COVID deaths since its outbreak emerged in February last year, the second-highest tally in Europe after Britain and the ninth-highest in the world. It has reported 5.04 million cases to date.
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Reporting by Emilio Parodi and Gavin Jones
Our Standards: The Thomson Reuters Trust Principles.
