June 03, 2021
CARBONDALE, Ill. A virtual conference next week will examine medical, legal and policy efforts during the COVID-19 pandemic and their impact on health policy.
The COVID-19 Pandemic and Its Impact on Health Policy: A Renewed Focus on Healthy and Equitable Communities is the theme of the 21st SIH/SIU Health Policy Institute. The virtual event is from 8 a.m. to 2 p.m. Tuesday, June 8.
Eric D. Hargan, former deputy secretary of the U.S. Department of Health and Human Services will deliver the keynote address COVID-19s Impact on Health Policy Federal Considerations.
A panel presentation, COVIDs Impact on Illinois, will feature four state agency officials: Theresa Eagleson, director, Illinois Department of Healthcare and Family Services; Paula Basta, director, Illinois Department on Aging; Colleen Callahan, director, Illinois Department of Natural Resources, and Grace Hou, secretary, Illinois Department of Human Services.
The conference includes breakout sessions on various topics such as childrens growth and development, mental health, and caring for an aging population and a moderated panel presentation on COVID-19 Health Disparities: A Path to Revitalizing Communities.
A symposium brochure provides additional details regarding speakers and topics.
The conference is intended for a variety of professionals, including physicians, nurses, psychologists, counselors, social workers, health care administrators, attorneys, law enforcement personnel, patient advocates, educators and students interested in health and health policy.
Continuing education credits are available where applicable. Registration information, including fees, is available at http://bit.ly/SIHSIUHPI. The registration deadline is 8 a.m. Monday, June 7.
Event sponsors include the SIU School of Law; Southern Illinois Healthcare; SIU School of Medicine Department of Population Science and Policy; the Illinois State Bar Association; Illinois Association of Healthcare Attorneys and the Illinois State Medical Society.
State health officials are encouraging employees in health care, hospitality and retail industries to get tested regularly for COVID-19, even if they dont have symptoms, in an effort to minimize virus transmission during the upcoming tourist season.
Maines Department of Health and Human Services announced Wednesday that its expanding free rapid testing at 61 sites across the state, most of them Walgreens pharmacies.
While COVID-19 rates are declining in Maine, testing remains critical to keeping our businesses open and our communities healthy as we get out and about this summer, DHHS Commissioner Jeanne Lambrew said. If youre concerned about your exposure to the virus through your job, we encourage you to visit any Walgreens location in Maine to monitor your health with a series of free, rapid tests.
Previously, only people with symptoms were recommended for testing, but because many younger people are asymptomatic, the hope is to limit spread among those who might not be aware they are carrying the virus. Although Maines vaccination rate is relatively high, there are still nearly 400,000 adults who remain at risk, and another 160,000 children under the age of 12 in Maine who are not yet eligible for a vaccine.
A list of testing sites is available online at: maine.gov/covid19/keepmainehealthy/testing.
Curtis Picard, president of the Retail Association of Maine, said the increased testing option is another tool for retailers to use to keep customers and staff safe.
It doesnt really change anything, but its good to know its available, he said.
Asked if he thought it might be seen as cumbersome for workers to get regularly tested, Picard said he didnt think so because there is no requirement.
Meanwhile, the Maine Center for Disease Control and Prevention reported 61 new cases of COVID-19 on Wednesday, the fourth consecutive day of fewer than 100 cases.
The seven-day daily case average now sits at 86, the lowest its been since Nov. 1, according to data from the Maine CDC. Thats down from 225 two weeks ago and a springtime high of 479 cases on average on April 17.
Two additional deaths were reported Wednesday as well the first COVID-19 related deaths reported since a week ago.
Hospitalizations also continue to decrease. As of Wednesday, there were 87 people in the hospital with COVID-19, including 29 in critical care and 18 on ventilators. The fifth straight day of declining numbers dropped the total to the lowest it has been since April 11.
Things are for the first time in months heading in a positive and favorable direction, CDC Director Dr. Nirav Shah said Wednesday, referring to the virus as on the run, but not yet out of sight.
Cases, hospitalizations and deaths have been falling dramatically across the country as well. The daily cases average, about 16,000, is the lowest since the early days of the pandemic, although some of the decrease is a function of lower testing volume, especially in some southern states. Maines testing volume remains high and currently ranks eighth among all states over the most recent seven-day period, according to the U.S. CDC.
Since the first cases were detected in Maine nearly 15 months ago, there have been 67,880 confirmed or probable cases of COVID-19 and 827 deaths. Both are among the lowest per capita of any state. Since vaccines have been in circulation, there have been 333 breakthrough cases, which means 99.96 percent of vaccinated people have not gotten the virus.
Shah said there is no question that vaccinations have been key to Maines declining trends, but he also said more work is needed.
The less virus thats circulating, the more epidemiological dead ends there are, he said.
Maines pace of vaccinations has been decreasing steadily for seven consecutive weeks and has fallen even more dramatically over the last week. Doses have not reached 10,000 on any day since May 21 after routinely eclipsing that mark daily from early March through early May.
Other states have seen similar declines. At peak in mid-April, the United States was administering more than 3 million shots every day. Now, the average is closer to 1.2 million per day.
Overall, Maine has administered 717,993 first doses, accounting for 60.6 percent of all residents over 12 who are eligible, and 703,619 final doses, representing 59.4 percent of all eligible residents.
Despite a steady decline, Maine trails only Vermont among states with the highest vaccination rate, according to a Bloomberg tracker. The top six states are all in New England. The bottom five states are all in the South. The U.S. rate is about 48 percent among those over 12.
Geographic disparities in vaccination rates also are seen in Maine. Southern counties and those along the Midcoast are leading the way with vaccination rates of 60 percent or higher among those eligible, and Cumberland County has even gone over 70 percent. On the other end, some rural counties are struggling to reach 50 percent. Looking at doses that were administered Tuesday, the figures range from 1,168 shots in Cumberland County to just eight shots in all of Piscataquis County.
Shah acknowledged that some counties are outperforming others but said even Maines lowest performing counties would be on par with California in percentage of population that is fully vaccinated.
Meanwhile, state officials and health care providers are increasingly working with businesses to offer smaller clinics. Some are dangling incentives as well.
Lambrew said the state had received at least 30 inquiries from Maine businesses about hosting small clinics on site. She also said the state is examining other ways to incentivize getting the vaccine, although no details have been confirmed.
Were always looking for good ideas, she said.
MaineHealth this week is partnering with Beckys Diner in Portland on a pop-up vaccination clinic that began Wednesday and continues Thursday. Anyone who gets vaccinated from 6 a.m. to 2 p.m. also will get a $15 gift certificate to the landmark diner.
A Federal Emergency Management Agency mobile vaccination unit has been traveling the state will come to Portland next week, setting up at Rising Tide Brewery on Fox Street from 11 a.m. to 7 p.m. from Thursday June 10 through Sunday June 13. The unit will then go to Old Orchard Beach from June 15-18.
As the state looks to fill gaps in vaccinations, more and more public places and businesses are starting to look like they did before the pandemic. Masks are not required for vaccinated individuals in most instances. Gathering limits are no longer in place.
Northern Light Eastern Maine Medical Center in Bangor announced Wednesday that the positive trends on cases and vaccinations will allow the hospital to adjust its visiting hours to 10 a.m. to 4 p.m. Patients are still limited to one visitor per day and visitors must still be screened for symptoms and wear masks while inside.
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Massachusetts Governor Charlie Baker signed legislation on May 28 creating another statewide mandate for employers to provide emergency paid leave related to COVID-19. The COVID-19 Paid Leave obligations outlined in this article will begin 10 days from the governors signature, which means you will need to quickly adjust your policies and practices before the June 7 effective date. What do Bay State employers need to know about this latest legal compliance challenge?
How Much More Leave?
The law requires all public and private with employees in Massachusetts (other than the U.S. government) to provide up to 40 additional hours of paid leave to employees who are unable to work due to COVID-19. The amount of paid leave an employee is entitled to depends on the number of hours they work in a given week:
What Can Employees Use the Leave For?
Employees may use COVID-19 Paid Leave for the following qualifying reasons:
Further, employers must provide COVID-19 Paid Leave for employees to care for family members under the following circumstances:
Employers must retain the same employment benefits for those eligible for COVID-19 Paid Leave while they are on leave. These benefits include group life insurance, health insurance, disability insurance, sick leave, annual or vacation leave, educational benefits, and pensions.
Protections for Employees
Employers cannot compel employees to use other paid leave provided by the employer before using COVID-19 Paid Sick Leave. Retaliating against employees for using leave is also prohibited. Employers also cannot require, as a condition of taking leave, that an employee search for or find a replacement worker to cover their shifts while the employee is out on COVID-19 Paid Leave.
The Executive Office of Labor and Workforce Development will create and distribute a notice of rights under the COVID-19 Paid Leave law to employers. Employers must post this notice in a conspicuous location accessible to employees and additionally provide a copy to each employee.
What Will This Cost Employers?
Employees are entitled to full wage replacement, up to a cap of $850 per week per employee. In other words, any employee who earns less than $850 per week will receive full pay during their COVID-19 Paid Leave. Fortunately, the law creates a $75 million COVID-19 Emergency Paid Sick Leave Fund to reimburse eligible employers for the costs of this new mandate. Eligible employers will be reimbursed from the Fund for providing COVID-19 Paid Leave until the amount of the Fund is depleted. Information on which employers are eligible for reimbursement from this Fund is set forth below.
Differences Between COVID-19 Paid Leave and Leave under the Families First Coronavirus Relief Act (FFCRA)
The American Rescue Plan Act of 2021 (ARPA) signed into law by President Biden on March 11 extends paid leave under the FFCRA on a voluntary basis through September 30, 2021. As with the initial paid leave provided for under FFCRA, this voluntary paid leave is applicable to employers with fewer than 500 employees. APRA further extends tax credits available to employers with fewer than 500 employees who choose to grant employees paid leave. Though paid leave provided under the FFCRA and COVID-19 Sick Leave overlap in many areas, there are key differences in the two schemes employers should be aware of.
Term
Where the FFCRA has been extended until September 30, 2021, the COVID-19 Paid Leave will only be available until either (i) 15 days after the Fund issues notice that the $75 million amount is approaching depletion or (ii) September 30, 2021, , whichever occurs first.
Employer Eligibility
The extended FFCRA applies only to employers with fewer than 500 employees and is voluntary. Massachusetts COVID-19 Paid Leave applies to all employers with employees in Massachusetts, irrespective of size, and is mandatory.
Intermittent Leave
Employees will have the option of using COVID-19 Paid Leave intermittently and in increments as small as one hour. By contrast, in most situations, employees cannot take intermittent paid leave under the FFCRA. Intermittent leave is only available under the FFCRA when a non-teleworking employee must care for a child whose school or place of care is closed, or whose childcare provider is unavailable, because of COVID-19 related reasons. Otherwise, paid sick leave for qualifying reasons related to COVID-19 must be taken in full-day increments.
Reimbursement Eligibility
Reimbursement for COVID-19 Paid Leave is not available if the employer is eligible for tax credits under the ARPA. Therefore, reimbursement from the Massachusetts Fund is only available to employers with 500 or more employees. Employers with fewer than 500 employees are not eligible to be reimbursed by state the Fund for providing COVID-19 Paid Leave unless the leave does not qualify for reimbursement under the ARPA, such as if an employee took incremental leave that is unavailable under the extended FFCRA.
Employers will need to follow certain steps to seek reimbursement, such as submitting an application to the Executive Office for Administration and Finance. Reimbursements will be sent directly to employers within 30 business days. Given that the Fund is limited to only $75 million, employers are strongly encouraged to submit reimbursement requests as soon as possible.
Employers with fewer than 500 employees should apply to the federal government for reimbursement through payroll tax credits for all COVID-19 Paid Leave provided. The federal payroll tax credit is limited to $511 per day and $5,110 in the aggregate.
West Virginia is expanding its incentives to encourage residents get vaccinated against COVID-19, with the state later this month starting weekly lottery drawings offering cash, trucks, guns and scholarships to those who've received at least one immunization shot.
Starting June 20, West Virginia will give out $1 million and other prizes each week up until Aug. 4, when two grand prizes of nearly $1.6 million and $580,000 will be announced, according to state officials.
Other prizes include two new custom-outfitted trucks, 25 weekend getaways to local state parks, five lifetime hunting and fishing licenses, five custom hunting rifles and five custom hunting shotguns. Two full four-year scholarships to any institution in West Virginia will also be awarded to vaccinated 12- to 25-year-olds.
"The prizes to me are secondary to the fact that we're trying to save your life," West Virginia Governor Jim Justice told a Tuesday news conference at which he detailed the blitz of coming incentives and made an impassioned case for getting vaccinated.
"All of our hospitalizations, all of all our our ICU units, all of our deaths, for the most part, are all people that have not been vaccinated. I don't know how it gets any simpler than that," the Republican governor said.
"These vaccinations are amazingly safe and they'll protect you I don't know how in the world people are sitting on the sidelines still saying, no, I'm not going to do one, I'm not going to do it," Justice continue. "Then they go off and they travel, and then there is absolutely what I would say is a lot of 'sad singing and slow walking,' and that's what goes on at a funeral."
Acknowledging that some might question the practice of essentially bribing people to get immunized against a deadly virus, the governor indicated that logic dictates he do whatever works.
"If you step back and think, now why in the world would you have to give away something to get somebody vaccinated. Unfortunately it's the way of the world in a lot of situations," Justice reflected. "The faster we get them across the finish line, the more lives we save."
The state also has a financial incentive to get more resident vaccinated. "If the tab just keeps running, the cost is enormous, the testing costs are enormous, the hospital costs are enormous," he said.
All West Virginians who have received one immunization shot are eligible, but must register to enter the lottery.
West Virginia continues to offer thechoice of a $100 gift card or $100 savings bond to those between ages 16 and 35 as part of an effort unveiled in late April to convince younger residents to roll up their sleeves.
The lottery has West Virginia joining other states and businesses trying to give hesitant Americans a reason to get vaccinated against a virus that has killed nearly600,000Americans. Kroger, the nation's biggest supermarket chain, last weeksaid it would give $1 million to five customers and free groceries for a year to another 50 to encourage more Americans to get vaccinated.
Ohio recently reported a spike in the count of those getting vaccinated after its governor said the state wouldaward $1 million to five vaccinatedresidents, prompting West Virginia's Justice to quip about one of the states bordering his: "I can't stand for Ohio to be ahead of us in anything."
In fact, West Virginia lags not only Ohio but also most of the country when it comes to vaccination rates, ranking 45th among the 50 states, according to the U.S. Centers for Disease Control and Prevention. Ahead of only Mississippi, Alabama, Louisiana and Wyoming, the percentage of West Virginians 18 and older who've received a first shot on Tuesday stood at 49.2%, while that tally came to 56.9% in Ohio, the CDC found. Highest among the states is Vermont, at 82%.
Nearly 2,800 West Virginians have died of COVID, with five people dying of the infection since last Thursday, and 571 new positive cases reported in the state in the last 24 hours, the governor relayed. West Virginia's daily positivity rate is 4%, with 4,550 active cases, the state's lowest count since Oct. 27, 2020. "The good numbers are driven from the standpoint of we continue to get people vaccinated," Justice said.
Of the 207 West Virginians currently hospitalized with the virus, 81 are in intensive care, and in all probability none were vaccinated, Justice said. The same could be said for those who've died, he added. Knowing all that, "Why would I take a chance with my family or myself?"
As of Tuesday, 75% of West Virginians 50 and older had received at least one shot, and 51.2% of eligible residents 12 years and older had received their first shot, according to the state. Recent outbreaks had 14 nursing home residents becoming ill with COVID, all of them unvaccinated, according to the state's chief coronavirus health official, Dr. Clay Marsh.
Illinois Governor J.B. Pritzker on Wednesday hinted the state could soon follow the lead of states dangling vaccination rewards, with little more than half of Illinois residents fully immunized.
"There are a lot of different incentives out there, and I hope people take advantage of them," Pritzker told an unrelated news conference in Peoria, according to the Chicago Sun-Times. "We're looking forward to potentially doing a vaccine lottery, as you've heard about in other states."
Lawmakers in Illinois recentlyapproved a budgetthat includes up to $7 million in prizes for vaccinated adults and as much as $3 million in scholarships for those younger than 18.
Mount Everest, the world highest peak, and other peaks of the Himalayan range are seen through an aircraft window during a mountain flight from Kathmandu, Nepal January 15, 2020. REUTERS/Monika Deupala
Climbers returning from Mount Everest and other Himalayan peaks are struggling to find a return flight back home after Nepal banned most air travel to contain a surge in COVID-19 cases, mountaineering operators and hikers said on Wednesday.
Most regular international flights are closed through June as a deadly second wave of the coronavirus hit the Himalayan nation tucked between China and India.
Nepal issued 742 permits 408 of those to climbers aspiring to make it to the top of the world's highest peak, Mount Everest in the April-May climbing season. And hundreds of climbers are now returning from the mountains before the onset of annual monsoon rains.
Tashi Lakpa Sherpa, a senior official at Kathmandu-based private firm Seven Summit Treks, said climbers were finding it difficult to get home as only five weekly flights - to India, Qatar and Turkey - were operational.
"The situation could worsen as more climbers wind up their expeditions and return to Kathmandu in the next few days," Sherpa told Reuters.
Andrew Hughes, from the United States, said he had to pay for an expensive seat on a chartered flight to Qatar on Wednesday night due to the shortage of regular flights.
"We find ourselves in a situation where there is no transparency or rationale for the prohibition of outbound flights for foreign nationals," said Hughes, who returned from Everest last month.
Mexican climber Viridiana Alvarez, who had been stranded in Nepal for nearly three weeks after climbing Mount Annapurna, the world's tenth highest peak at 8,091 metres (26,545 feet), said she was lucky to find a seat on a chartered flight.
"There is no reason to be here because there is no climbing it is a little boring," said Alvarez, 38, who is also flying to Qatar on Wednesday night.
The Nepalese government has defended its decision to cut international flights in a bid to contain the pandemic.
"Instead of having no flight at all, I think this is enough for now," Raj Kumar Chettri, a spokesman for the Civil Aviation Authority of Nepal (CAAN) said. "If required we'll allow more charter flights."
Our Standards: The Thomson Reuters Trust Principles.
Everyone over 16 is now eligible for free, safe, and reliable COVID-19 vaccines in California.But it can be difficult to find out where and how to get a shot. Enter your zip code or countyto find confirmed vaccination locations near you, and learn how to make an appointment.
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Moderna Inc (MRNA.O) said on Tuesday it had entered into an agreement with Thermo Fisher Scientific (TMO.N) for manufacturing and packaging its COVID-19 vaccine, as the U.S. vaccine maker looks to scale up production.
Under the terms, Moderna said Thermo Fisher's commercial manufacturing site in Greenville, North Carolina will be used to provide fill/finish manufacturing services and supply packaging for hundreds of millions of doses of the vaccine.
"The addition of Thermo Fisher to our network will support our efforts to scale up our manufacturing ability," Moderna's chief technical operations and quality officer, Juan Andres, said in a statement.
Earlier on Tuesday, Moderna filed for full U.S. approval of its COVID-19 vaccine for adults
Thermo Fisher said in March that it would work with Pfizer Inc (PFE.N) and BioNtech SE (22UAy.DE) to produce their COVID-19 vaccine in Italy.
In April, it announced a deal to buy contract researcher PPD Inc for $17.4 billion to add muscle to its pharmaceutical services business.
Our Standards: The Thomson Reuters Trust Principles.
DENVER (KDVR) Frustrations are boiling over across Colorado as many people seek answers as to why their COVID-19 vaccine isnt showing up in the Colorado immunization database even though they were vaccinated.
The biggest concern right now is that the deadline to qualify for the first $1 million Colorado Comeback Cash prize is quickly approaching.
The first winner will be announced on Friday, June 4.
If you received an email record from your COVID-19 vaccine or if you still have your vaccine card, make sure youre filling out the information in the form above exactly as it shows up on those records.
Some have said they are entering their information into the immunization database exactly as it showed up on their vaccination card and their record is not being retrieved.
Others say they are waiting hours for a code to get into the immunization system and then it does not work.
According toColorado.gov, heres what you do:
If you have been unable to verifyyour immunization information through the online Colorado Immunization Information System (CIIS) portal,it is most likely because the information the provider reported does not exactly match what you are entering in the portal.
When searching through the portal, the following fields must match exactly what the provider entered: first name, last name, date of birth, gender, and mobile phone number and/or email address. If you entered your information in the portal and believe you entered it exactly as the provider did, you should contact your provider to ensure your information was entered accurately and to confirm how it was reported to CIIS.
If thats not possible, you can contact the CIIS Help Desk to verify you are in the system and/or to update your contact information on your CIIS record.
Here are the numbers for theCIIS help desk:
The Problem Solvers are investigating multiple reported issues with Coloradans, who should be eligible, not showing up on the states CIIS database.
Specifically, a veteran reached out to the Problem Solvers saying the outpatient Veterans Affairs facility he received his vaccines in was in Cheyenne Wyoming. That veteran is concerned he and other veterans may not be eligible.
A spokesperson for CDPHE says, We are pleased to announce that individuals vaccinated through the VA will be eligible. Discussions with the Department of Defense are ongoing, and we are confident we will have more positive news to report soon.
The spokesperson said, There are more than 5.6 million COVID-19 vaccine entries in CIIS, and we are confident the database is working as it should. We have 10 staff members dedicated to ensuring the data is accurate.
CDPHE also said Coloradans who were vaccinated out of state may not be on file:
Coloradans who were vaccinated out-of-state likely do not have their COVID-19 vaccine(s) on their record in CIIS. CIIS does not automatically receive vaccination data for Colorado residents from non-Colorado providers. They can contact theCIIS Help Desk, and if they provide proof of vaccination, CIIS staff can add them.
The Problem Solvers are reaching out to Governor Jared Polis office to address concerns with the missing immunization records and the eligibility for the vaccine lottery. We
Many people have experienced sore arms and feeling wiped out for a couple of days after getting a COVID-19 vaccine. Some get fevers, chills and headaches. Those familiar side effects have become widely accepted as the price of protection against the too-often-deadly coronavirus.
But its the rare, more serious side effects that have grabbed the headlines and given some people pause about whether to get vaccinated or get the shots for their children.
Such side effects include rare allergic reactions to an ingredient in the mRNA vaccines (SN: 1/6/21) and rare blood clots in young women associated with Johnson & Johnsons vaccine (SN: 4/23/21).
Now, a group that monitors vaccine safety for the U.S. Centers for Disease Control and Prevention is investigating whether there is a link between Pfizers mRNA vaccine and a few mild cases of heart inflammation, called myocarditis, in adolescents and young adults. So far, cases of myocarditis have not risen above the number normally expected in young people, and no one actually knows whether the vaccine triggers the heart inflammation or not.
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We are seeing these potential side effects because we are looking for them, and thats a perfect example of how our safety system is supposed to work, says Alexandra Yonts, a pediatric infectious disease doctor at Childrens National Hospital in Washington, D.C. Were being very aggressive and proactive, and thats good.
Heres what is known, the experts say: The risk of serious side effects from vaccination remains far smaller than its benefits. The vaccines are highly effective at preventing severe illness, hospitalization and death, even against variants (SN: 5/11/21). The vaccines may also help block infection and transmission of the coronavirus (SN: 3/30/21).
As of May 28, worldwide, more than 1.8 billion doses of COVID-19 vaccines have been given, according to Johns Hopkins University. No vaccines are completely risk-free, says Yvonne Maldonado, an infectious diseases epidemiologist at Stanford University School of Medicine. But the side effects known to be caused by the vaccines are usually short-lived and clear up on their own or are treatable or reversible, she says.
Out of every million doses given of the mRNA vaccines, overall about 2.5 to 11.1 severe allergic reactions to an ingredient called polyethylene glycol will happen. Thats why people are typically monitored for at least 15 minutes after the shot. The risk is obviously highest for people who have known allergies to polyethylene glycol and they should probably avoid taking the mRNA vaccines. If the jabs are broken down into smaller doses, people with the rare allergies might still be able to get the shots safely, researchers reported in April in the Annals of Internal Medicine.
A small number of people who have facial fillers made of hyaluronic acid may get swelling around their fillers a few days after a shot of an mRNA vaccine. The European Medicines Agency recommended that the vaccine makers warn people of the possible reaction. In Modernas clinical trial, three people developed the swelling. Nine other cases were associated with either the Pfizer or Moderna shots, researchers reported April 7 in the Journal of the American Academy of Dermatology.
Its not a high number, says Herluf Lund, a plastic surgeon in St. Louis, Mo., and the immediate past president of the Aesthetic Society. But its also not unheard of, because its not just the COVID vaccines that are tied to this; almost any vaccine can be tied to this swelling around fillers. Illnesses can also trigger the swelling. The reaction isnt an allergic reaction, its a side effect of revving up the immune system. The immune system when it first starts up is a bit like a shotgun; it fires and hopes it hits something, he says. Once the immune system recognizes the vaccine or virus as its target, the swelling goes away.
The swelling isnt dangerous and usually clears up quickly, either on its own or after taking antihistamines or steroids. It, of course, scares the heck out of the patient, Lund says. But dont run to the emergency room, he says. Just pick up the phone and call your doctor.
About 13 cases of rare blood clots are predicted to develop in women 49 and younger for every one million doses of Johnson & Johnsons vaccine. Only two such clots for every million doses are calculated to happen in women 50 and older or in men 18- to 49-years old. A test can identify an uncommon immune response that is leading to those clots, ensuring patients can get the right care (SN: 4/16/21).
Those handfuls of side effect cases per every million doses of vaccine are lower than your chance of getting bit by a shark if you go to the beach, of getting hit by a car if you cross the street, or being killed in an airplane crash, Maldonado says. And yet we seem to go to the beach, cross the street and get on airplanes every single day.
On the other hand, more than 169 million people have contracted COVID-19 and more than 3.5 million have died worldwide. That includes more than 33 million cases and 593,000 deaths in the United States. Overall, COVID-19 was the third leading cause of death behind heart disease and cancer in the United States in 2020, and ranks in the countrys top 10 leading causes of death for children.
People may think a vaccine is responsible for a health problem if it happens soon after getting a shot, Maldonado says. But that problem may have happened anyway even if the person didnt get a vaccine, she says. There may be a temporal association, but not a causal one.
But, she notes, people just get nervous because its new. While the speed at which the vaccines have made it into peoples arms is unprecedented, the technology behind them has been in development for years, she says. These are probably the most highly studied vaccines ever.
That ongoing surveillance is what alerted public health officials to instances of myocarditis happening post-vaccination. The CDC hasnt reported how many children have been affected by myocarditis after getting a COVID-19 vaccine, but said that the number of cases is still within whats called background levels. In any given year, doctors expect to see about two cases of myocarditis for every 100,000 children, Yonts says, but that may be an underestimate. Some children may have indicators of inflammation in their blood, but dont develop symptoms. Those subclinical cases arent included in the counts.
Typically, infants and teenagers are more likely to develop the condition than pre-adolescent children. The cases being investigated for a link to the vaccine have happened in older teens and young adults, more commonly in males than females, and have tended to happen about four days after the second shot.
Viruses are the most commonly implicated cause of myocarditis, Yonts says. The inflammation is a product of the immune system trying to fight off the infection. Since vaccines prime the immune system, too, it is possible that a COVID-19 vaccine might trigger the heart problem in some kids. Other vaccines, particularly the smallpox vaccine, have been associated with rare cases of myocarditis in the past, she says.
But there has not yet been any cause and effect established between myocarditis and COVID-19 vaccines, stresses Yonts, who previously worked in the U.S. Food and Drug Administrations vaccine evaluation branch.
Doctors are being urged to be on the lookout for the symptoms of myocarditis in their young patients and to report any problems. Yonts says two kids, and possibly a third, who were seen at Childrens National Hospital have fit the overall pattern of mild myocarditis symptoms that might be a side effect of the vaccine.
Such symptoms include chest pain, which may get worse when kids are lying down; faster or irregular heartbeats; shortness of breath; and dizziness upon standing up or being more active. Those symptoms come after the more common vaccine side effects, such as fatigue, body aches and chills. The myocarditis cases seen after vaccination have all been mild and went away on their own within a day of developing symptoms, Yonts says.
COVID-19 itself sometimes causes myocarditis. For instance, of 1,597 college athletes who had a SARS-CoV-2 infection, 37 were found to have signs of myocarditis, researchers report May 27 in JAMA Cardiology.
The disease can have other consequences, too, Yonts says, including long-COVID and an over-the-top inflammatory syndrome called MIS-C, which may lead to organ failure and death (SN: 5/12/20). That condition can develop four to six weeks after even very mild cases of COVID-19. And while COVID-19 is generally milder in children than adults, plenty of children get severe cases of COVID-19, she says. In my practice, Ive seen many kids admitted to the ICU, who require blood pressure support, or are severely ill with COVID-19. I have seen far more of those at this point than I have seen of the very mild symptoms of myocarditis.
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