As coronavirus cases continue to rise, the number of hospitals and health systems requiring COVID-19 vaccinations for employees is growing.
At least 175 hospitals and health care systems nationwide have shifted from simply encouraging staff to get vaccinated to requiring the shots.
Exemptions will be granted for medical or religious reasons.
And earlier this month, President Joe Biden announced that approximately 17 million workers at health care facilities that receive federal Medicare or Medicaid also will have to be fully vaccinated.
Locally, health systems and hospitals that require or will require employees to be vaccinated include Highmark Health and Allegheny Health Network and WVU Medicine, and Pennsylvania required its 25,000 employees in state-run health care facilities to be fully vaccinated by Sept. 7.
Both Canonsburg Hospital and Uniontown Hospital-WVU Medicine are among those requiring the shot.
Washington Health System does not require employees to be vaccinated, but strongly encourages them to get the COVID-19 vaccine.
The Sept. 30 deadline for AHNs 21,000 eligible staff to be vaccinated is approaching.
It is abundantly clear, however, that the single most important thing an individual can do to protect themselves and others, and to help us bring this difficult pandemic to an end, is to receive the vaccine. We expect all of our employees to heed that call, and the new requirements we are putting in place are intended to help us achieve that goal, said Dr. Brian Parker, AHNs Chief Quality and Learning Officer.
Unvaccinated AHN employees are required to wear a face shield at all times while working in a hospital or clinical setting, in addition to wearing the face masks that are required of all employees and visitors at the networks facilities.
Unvaccinated Highmark Health employees, too, will be required to wear masks at all times when working in the organizations facilities.
WVU Medicine requires employees of its health system facilities in Pennsylvania, West Virginia, Ohio, Maryland, and Virginia to be fully vaccinated by Oct. 31.
Albert L. Wright, Jr., president and CEO of WVU Health System, said last month, Were doing this because it is the right thing to do. We are the states leading health care provider and largest employer, and we have a higher obligation to our patients as well as to each other. I want WVU Medicine hospitals and clinics to be as safe as possible for our patients and staff. A fully vaccinated workforce will help ensure that safety.
Wright said the vaccinations also could help prevent a situation from developing where several hundred employees at hospitals and health systems, which are bearing the brunt of the pandemic, are out due to COVID.
We know one thing for certain: the vaccine is extremely safe and effective, said Wright.
More than 50 prestigious national health care organizations have advocated that all health professionals be vaccinated, including the American Medical Association, the American Hospital Association, the American Academy of Pediatrics, the American Nurses Association, the American College of Surgeons and the Department of Veteran Affairs.
The AHA supports hospitals and health systems that adopt mandatory COVID-19 vaccination policies for health care personnel, with local factors and circumstances shaping whether and how these policies are implemented, the organization wrote in a statement. COVID-19 vaccines protect health care personnel when working both in health care facilities and in the community. They provide strong protection against workers unintentionally carrying the disease to work and spreading it to patients and peers.
BRANDON, S.D. (KELO) -- The owners of a 143-year-old farm on the outskirts of Brandon are worried about their land. They believe the city of Brandon, which is rapidly growing, wants to annex their farm into the city. The Elofson family says they are looking for answers from the city, but so far, communication has been limited.
Like a lot of towns surrounding Sioux Falls, the city of Brandon is growing. Some landowners around Brandon welcome annexation into the city.
Multiple Sclerosis (MS) patients may receive various treatments that are thought to interfere with coronavirus disease 2019 (COVID-19) disease progression and the efficacy of the COVID-19 vaccines. Early reports have suggested that patients receiving specific monoclonal antibody and receptor modulator treatments for MS are at greater risk of hospitalization and death from COVID-19.
Study: Impact of multiple sclerosis disease-modifying therapies on SARS-CoV-2 vaccine-induced antibody and T cell immunity. Image Credit: Lightspring/ Shutterstock
Several studies have demonstrated reduced antibody titers against the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) spike protein in these individuals following vaccine administration. In a paper recently uploaded to the preprint server medRxiv *, the vaccine-induced cellular and immune response of MS patients receiving a range of therapies are assessed with special regard to spike-specific IgG CD4+ and CD8+ T-cell responses.
A preprint version of the study is available on the medRxiv* server while the article undergoes peer review.
67 MS patients receiving either no treatment, or one of glatiramer acetate (GA), dimethyl fumarate (DMF), natalizumab (NTZ), S1P receptor modulators, or anti-CD20 mAb (rituximab (RTX) or ocrelizumab (OCR)) therapies were recruited for the study, in addition to 13 individuals as healthy controls.
All participants had received both doses of any approved vaccine, and blood samples were collected from participants before and 2-4 weeks after vaccination, depending on the type of vaccine received.
Total SARS-CoV-2 spike IgG was found to be significantly elevated by similar magnitudes in almost all groups following vaccination, with patients receiving S1P, RTX, or OCR demonstrating reduced antibody responses, undetectable in some cases. While exhibiting similar levels of spike-specific antibodies to patients receiving other drugs, patients receiving DMF or NTZ exhibited higher levels of receptor-binding domain (RBD) specific antibodies.
In contrast, patients receiving S1P, RTX, or OCR also had significantly reduced RBD-specific antibody titers. Regarding IgG seropositivity, only RTX caused a significant drop in total spike IgG, while S1P, RTX, and OCR patients had significant reductions in total RBD IgG seropositivity.
S1P receptor modulators are known to influence CD4+ levels, and as expected, this group showed reduced CD4+ T-cell percentages both before and after vaccination compared to the no-treatment group. All other MS patients showed comparable CD4+ levels to those observed in the untreated. Patients receiving S1P receptor modulators, RTX, or OCR therapies exhibited reduced CD19+ B cell percentages before and after vaccination.
CD4+ cells from all groups produced similar percentages of cytokines such as interferon- (IFN), tumor necrosis factor- (TNF), and interleukin-2 (IL-2). However, frequencies of IL-4 and IL-10 secreting cells were unchanged post-vaccination in any MS treatment group. Spike-specific CD8+ T-cells were increased post-vaccination in all patients but those receiving GA, and again, IL-2, IFN, and TNF levels were produced by CD8+ cells to high levels with minimal IL-4 and IL-10.
Having observed vaccine inefficacy in those receiving the anti-CD20 mAb therapies RTX and OCR, the group employed a univariate analysis of antibody responses against several metrics, finding no association with gender, mRNA vaccine type, or last measured IgG levels compared to post-vaccination levels.
Pre- and post-vaccination percentages of CD4+ and CD8+ T-cells were also found to have no association with human leukocyte antigen levels, which is the major risk factor for multiple sclerosis. However, these patients did see an increase in CD19+ B-cells, spike/RBD IgG, and spike/RBD seropositive patients post-vaccination.
Some prior reports have indicated that the variability in the timing of anti-CD20 mAb doses and vaccines could influence their efficacy. However, the group reported no correlation between infusion-vaccination interval and total spike/RBD IgG levels.
However, the time from the start of anti-CD20 mAb therapy to the time of vaccination (cumulative treatment duration) was found to influence seropositivity. The two patients treated for over 40 months were seronegative, and the two treated for less than 35 being seropositive.
The patients treated for a shorter duration had also specifically received the anti-CD20 mAb drug OCR. In comparison, those treated for a longer duration had received RTX, likely explaining the more detrimental effect observed from the latter regarding seropositivity.
In conclusion, S1P receptor modulators and anti-CD20 mAb therapies were found to significantly reduce total spike and RBD IgG generated by vaccination compared to untreated MS patients or healthy controls.
CD19+ cell percentage following vaccination was found to correlate strongly with spike seropositivity, suggesting that B-cell reconstitution in lymphoid tissue and subsequent circulation is responsible for antibody generation. This may explain seropositivity among anti-CD20 mAb patients with shorter treatment times, where B-cell reserves in lymphoid tissue are eventually depleted, ultimately resulting in a seronegative response.
MS treatment did not alter CD4+ or CD8+ cytokine output, though treatment with RTX resulted in increased CD8+ T-cell production and subsequent IFN secretion.
Despite the partial protection conferred by vaccination via cell-mediated immunity, most MS patients receiving these therapies remain highly vulnerable immunocompromised patients. Thus, they are at higher risk of infection, hospitalization, and death from COVID-19.
In particular, prolonged anti-CD20 mAb therapies have been demonstrated to eliminate the benefit of vaccination in many cases, meaning that individuals receiving these drugs will need to act and be treated with extreme caution regarding disease control for the foreseeable future.
medRxiv publishes preliminary scientific reports that are not peer-reviewed and, therefore, should not be regarded as conclusive, guide clinical practice/health-related behavior, or treated as established information.
Journal reference:
MS is a chronic autoimmune disease that affects the central nervous systems ability to communicate efficiently. According to the National Multiple Sclerosis Society (NMSS), about one million people in the United States are living with the disease.
Health experts consider MS to be an inflammatory disease. It affects the myelin sheath, a fatty insulating layer surrounding the nerve cells that helps them transmit electrical impulses rapidly.
It is unclear why, but in people with MS, the B cells of their immune system attack the myelin sheath. This gradually erodes nerve impulse transmission. Individuals with this progressive disease experience debilitating symptoms such as numbness, tremor, fatigue, or blurred vision.
Stay informed with live updates on the current COVID-19 outbreak and visit our coronavirus hub for more advice on prevention and treatment.
Many people with MS have experienced significant relief from the progression of their disease by using modern drugs called anti-CD20 monoclonal antibodies. Specifically, these drugs target B cells, limiting their ability to attack the myelin sheath to slow or even halt the progression of MS.
Because they work by limiting the activity of the immune system, health experts consider people taking anti-CD20 drugs as immunocompromised.
The immune system is complex, featuring multiple cell types. A recent study in Nature Medicine investigated whether the immune systems of MS patients on anti-CD20 therapy would respond to vaccination with a COVID-19 mRNA vaccine such as Pfizer or Moderna.
Vaccines work by provoking immune system responses among B cells and T cells. Since many people are dependent on anti-B cell therapy to control the progression of their condition, it was unclear if the COVID-19 vaccine would provoke an appropriate immune response among MS patients.
Amit Bar-Or, M.D., a Penn Medicine physician, served as lead investigator. In this study, we looked at antibody and cellular responses, said Dr. Bar-Or. Even among people with decreased [B cell-mediated] antibody levels, we saw robust T cell responses, in some cases even stronger [than among people not on anti-CD20 therapy].
In other words, while not an optimal response, involving both B cells and T cells, the response is adequate.
While the study was small, with just 20 MS patients, an ongoing investigation involving 600 participants will assess the effectiveness of administering additional vaccine doses to MS patients.
Dr. Bar-Or noted that his teams study was inspired, in part, by emerging research among patients receiving immunotherapy to treat cancer. Despite being immunocompromised, theyre getting robust T cell responses [] [The COVID-19 vaccine] is indeed protective among these patients, he said.
Although MS patients made fewer antibodies to the virus compared to people not on immune-suppressing drugs, their T cell responses were markedly robust. This shows that vaccination is likely to provide ample protection against SARS-CoV-2 infection.
According to the NMSS, people on anti-CD20 drug therapy should get vaccinated, as they may expect at least some immunity.
While this is good news for cancer patients and clinicians, it is also of academic interest to researchers who study the immune system. This teaches us about human immune responses, Dr. Bar-Or noted.
The present study is already having an impact on guidance for immunocompromised patients, said Dr. Bar-Or, citing recent changes adopted by the NMSS.
The study sheds light on the fundamental mechanisms underlying the development of multiple sclerosis, said Dr. Bruce Bebo, Executive Vice President, Research, for the NMSS. This kind of research is helping NMSS focus research investments, he added.
Were getting closer to cures and treatments for MS. We have good treatments for the relapsing or remitting form of MS, but we dont have them for the hard-to-treat progressive form.
Part of the reason for that has been a lack of understanding of the fundamental mechanisms driving the more aggressive, progressive form of MS. The fundamental biology [behind these two forms of MS] is related, Dr. Bebo said, but distinct.
Thanks to the present study and related research, theres a tremendous amount of excitement in the research community [] Were getting closer to cures and treatments for MS.
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IOWA CITY, Iowa (KWWL) - The University of Iowa Hospitals and Clinics have been studying COVID-19 vaccines since the very beginning. Iowans have stepped up and joined clinical trials for just as long, assisting in the research leading up to vaccine approval.
Iowans participated in the Pfizer vaccine trials before it received emergency use authorization, and now full FDA approval. Another vaccine option could be on the horizon, as a UIHC doctor says the world needs to keep studying the shots as the pandemic evolves.
I dont think we have a full understanding of the capability of the vaccines we have now," Executive Dean of the Carver College of Medicine Dr. Patricia Winokur said.
More than 400 Iowans have stepped up to be a part of the multiple vaccine trials since the start of the pandemic. If you take into consideration all of the other types of trials held for other COVID-19 research, the number of Iowans would go up to around 800.
I feel comfortable with my participation in the trial," Marion resident and vaccine trial participant Dawn Goodlove said.
Goodlove was one of 150 to take part in the Novavax COVID-19 vaccine trial that began in January 2020. It would be another vaccine option that expects to receive emergency use authorization in the upcoming months.
I thought this might be a way for me to contribute to a solution. A vaccine to try to end this pandemic," Goodlove said.
An additional vaccine can help open up the opportunity for those who might be allergic to ingredients in the current ones available. The Novavax shot is made differently than the Pfizer, Moderna, and Johnson and Johnson vaccines.
And then remember, we still have the rest of the world that needs to be vaccinated," Dr. Winokur said.
The UIHC doctor sharing the Novavax vaccine can be a vaccine that is easily accessible to other countries that might not have the greatest technology. The shots don't need to be stored in as cold of freezers as the ones currently authorized do. This vaccine would also be easier for more providers to offer to patients because of the easier storage option.
Dr. Winokur says many pharmaceutical companies have stalled or completely stopped their production and trial processes due to the lack of qualified participants. Many who wanted the vaccine have already received it, and a participant would need to be unvaccinated in order to qualify. Dr. Winokur believes everyone who is currently unvaccinated would most likely pass on the opportunity.
"I think the Novavax trial everyone has been fully vaccinated and we continue to follow them for the efficacy of the vaccine," Dr. Winokur said.
The Novavax company is expected to release its trial data to the FDA within the next couple of months in order to be approved for emergency use authorization.
As a participant in the UIHC study, Dawn Goodlove says she is confident in the Novavax vaccine. She says she has come into contact with multiple people who were positive with COVID-19 and has not contracted the virus herself after beginning the trial.
Its a pretty easy way to show how much you care about your community whether its just your family and friends or a broader worldwide community," Goodlove said.
UIHC is also currently making its way through a clinical trial to study the efficacy of the Pfizer booster shots. Those involved with the two vaccine trials agreed to log their symptoms and be monitored for two years.
If you would like to take a look at any of the clinical trials available to take part in, you can find them on the UIHC website.
Biden meets with business leaders on COVID-19 vaccine mandates
President Joe Biden invited CEOs and business leaders to the White House on Sept. 15, 2021, to discuss COVID-19 mandates.
LOS ANGELES - iPhone owners will soon be able to add a digital copy of their COVID-19 vaccination card to their Apple Wallet, thanks to an upcoming software update.
A spokesperson for Apple confirmed that while the feature to add a COVID-19 vaccination card specifically to Apple Wallet is not available just yet, it will be in an upcoming update.
For now, the most recent iOS 15 update released on Sept. 20 allows users to add their vaccination status to their health app where other health information including medications and health status can already be documented.
According to an Apple developer blog post published Tuesday, iPhone users can download and store verifiable health records, including COVID-19 vaccinations and test results in the phones health app.
"Users can choose to share verifiable health records stored in the Health app with approved third-party apps requesting this information, like airlines, event venues, and other businesses that facilitate in-person interactions," the developer blog reads.
Apple to soon allow iPhone users to add their COVID-19 vaccine cards to their Apple Wallet's.
The new update comes as a rapidly growing number of cities across the U.S. are requiring people to show proof they have been inoculated against COVID-19 to teach school, work at a hospital, see a concert or eat inside a restaurant.
New York City, New Orleans, San Francisco and Los Angeles were among some of the first cities to impose such rules at many businesses last month.
The measures are an attempt to stem the rising tide of COVID-19 cases that has pushed hospitals to the breaking point.
When New Orleans imposed its vaccination mandate in August, Mayor LaToya Cantrell called proof of vaccination the best way to protect businesses. She said she is not imposing capacity limits or contemplating a shutdown similar to the one that devastated businesses in 2020.
"Unlike this time last year, we have a tool that we did not have," she said, referring to vaccines.
Last month, Louisiana set daily records for the number of people hospitalized with COVID-19, reaching 2,907 patients on Aug. 13. Ninety-one percent of those hospitalized were unvaccinated, according to state data.
Meanwhile across the nation, more Americans have now died from COVID-19 than did in the 1918-19 Spanish flu pandemic approximately 675,000.
This grim statistic is prompting health and state officials to sound the alarm on the need for more Americans to get vaccinated.
The U.S. population a century ago was just one-third of what it is today, meaning the flu cut a much bigger, more lethal swath through the country. But the COVID-19 crisis is by any measure a colossal tragedy in its own right, especially given the incredible advances in scientific knowledge since then and the failure to take maximum advantage of the vaccines available this time.
Just under 64% of the U.S. population has received as least one dose of the vaccine, with state rates ranging from a high of approximately 77% in Vermont and Massachusetts to lows around 46% to 49% in Idaho, Wyoming, West Virginia and Mississippi.
RELATED: COVID-19 has killed about as many Americans as the 1918-19 flu
Globally, about 43% of the population has received at least one dose, according to Our World in Data, with some African countries just beginning to give their first shots.
"We know that all pandemics come to an end," said Dr. Jeremy Brown, director of emergency care research at the National Institutes of Health, who wrote a book on influenza. "They can do terrible things while theyre raging."
COVID-19 could have been far less lethal in the U.S. if more people had gotten vaccinated faster, "and we still have an opportunity to turn it around," Brown said. "We often lose sight of how lucky we are to take these things for granted."
The current vaccines work extremely well in preventing severe disease and death from the variants of the virus that have emerged so far.
The Associated Press contributed to this story.
DOVER, Del. (CBS) Firefly Music Festival kicks off Thursday in Delaware, and organizers are trying to prevent the spread of COVID-19. Firefly ticketholders must show proof that theyve been fully vaccinated or show a negative COVID-19 test taken no earlier than 72 hours prior to entry.
The website says you must bring a government-issued photo ID that matches their proof of vaccine.
The festival kicks off Thursday at the Woodlands of Dover International Speedway with headliner Billie Eilish.
Michael Flynnthe man Donald Trump once selected as the standout candidate to become his National Security Adviserhas shared his apparently genuine concern that there might be COVID-19 vaccine in his salad dressing. Since he was pardoned by Trump for lying to the FBI last November, Flynn has gone full QAnon and went as far as to call for a military coup earlier this year. But his descent into quackery went further this week when he fell for an absolutely ridiculous conspiracy theory about vinaigrette. Somebody sent me a thing this morning where theyre talking about putting the vaccine into salad dressing, or salads, said the ex-Trump official. Im thinking to myself, this is the Bizarro World, right?Snopes appears to have found the source of Flynns concerns, reporting that there is research being done to see if mRNA vaccines could be grown in edible plants like lettuce in the future, but no one has yet proposed putting the COVID-19 vaccine into Flynns or anyone elses salad.
By Emily Cousins | Staff Writer
Additional shots for the Moderna and Pfizer vaccines have been approved for emergency use by the U.S. Food & Drug Administration, but they have only been recommended for immunocompromised people.
In a news release, the FDA said people who are not immunocompromised do not need to worry about additional doses yet, but anyone who is in close contact with an immunocompromised person should get vaccinated according to their health status.
Todays action allows doctors to boost immunity in certain immunocompromised individuals who need extra protection from COVID-19, FDA commissioner Dr. Janet Woodcock said. As weve previously stated, other individuals who are fully vaccinated are adequately protected and do not need an additional dose of COVID-19 vaccine at this time. The FDA is actively engaged in a science-based, rigorous process with our federal partners to consider whether an additional dose may be needed in the future.
The ever-changing state of COVID-19 makes it difficult to predict if booster shots will be needed for the general public, Vahedi Shah lead epidemiologist for the Waco-McLennan County Public Health District said via email.
The CDC and FDA are looking at the data available from other countries as well as studies by Pfizer to make the determination, Shah said. We will follow the recommendations made by these organizations.
Baylor medical director Sharon Stern said via email that doctors are learning more daily about the immune response and how long it lasts.
If you look at current immunizations, you will find tetanus booster every 10 years, influenza every year and some shots like MMR and varicella that do not require boosters after the initial series, Stern said. We had years and years of data to figure out which schedule to put those on.
Stern said the Centers for Disease Control and Prevention has not recommended a booster shot for the Johnson & Johnson vaccine, and she would suggest following what the CDC has advised.
Shah said doctors are still researching the combination of the Johnson & Johnson vaccine and mRNA vaccines.
At present, any student who would like to get an mRNA vaccine after a J&J should consult with their healthcare provider, Shah said.
Shah said the FDA and CDC have decades of experience working to curb the spread of diseases, and people should follow the guidance of these experts.
The more the virus circulates in the population, the higher the chances for mutations, Shah said. If a higher proportion of the population is not vaccinated, there is a strong possibility that the vaccines may be less effective against new mutations.
Stern said at this time, all the vaccines are effective against known variants.
Chances are, the brilliant vaccine scientists will be able to tweak the current vaccines if we have a variant that the vaccine does not protect against, Stern said.
Reports of vaccinated Americans catching COVID-19 have invigorated vaccine skeptics, but such breakthrough infections are expected, and no vaccine is 100% effective. And thats not unique to COVID-19 vaccines.
Still, some Facebook posts have suggested otherwise.
"First in history, a vax that does not prevent catching or spreading a virus, and only lasts for months," one post says. "Mind boggling!"
This post was flagged as part of Facebooks efforts to combat false news and misinformation on its News Feed. (Read more about our partnership with Facebook.)
"Vaccines are the best defense we have against infectious disease," the Centers for Disease Control and Prevention says on its website, "but no vaccine is actually 100% safe or effective for everyone because each persons body reacts to vaccines differently."
This is as true for the flu vaccine as it is for COVID-19 vaccines.
"Some fully vaccinated people will get sick, and some will even be hospitalized or die from COVID-19," the CDC says. Vaccinated people with breakthrough infections can also spread the disease.
But most people who get COVID-19 are unvaccinated, and fully vaccinated people who are infected are less likely to suffer a serious illness. Studies show that vaccinated people are eight times less likely to be infected and 25 times less likely to be hospitalized or die from COVID-19 than unvaccinated people, according to the CDC.
"Vaccines remain effective in protecting most people from COVID-19 infection and its complications," the agency says.
All COVID-19 vaccines approved by the World Health Organization for emergency use are required to have an efficacy rate of 50% or greater.
As for how long the COVID-19 vaccines provide protection against the disease, if and when everyone will need a booster shot is still being debated. In August, the Food and Drug Administration authorized Pfizer and Moderna to give a third dose of their vaccines to certain immunocompromised people because it could increase protection for people such as organ transplant recipients, Yale Medicine recently noted. In September, an FDA advisory committee recommended booster shots of the Pfizer vaccine for people who receive their second shot at least six months prior and who are 65 and older or have a high risk of a severe case of COVID-19.
But, again, plenty of other vaccines have boosters. The flu vaccine, of course, is annual, and vaccines against Hepatitis B, whooping cough, chicken pox and measles, among other diseases, require multiple shots.
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