She met Freddy in her third year of high school. Her parents were not for it, because Freddy was older, and they thought she was too young to attach herself. So when she graduated from high school, they made her travel for several months. Freddy was quite despondent; I felt like I was babysitting him. But it made for an even deeper friendship with Baby, because I became good friends with her eventual husband.
Beck: When did your friendship shift to being long distance?
Mary-Ann: I left the Philippines in 1984, when I was 25.
Beck: How did you keep in touch?
Mary-Ann: Email, letters, cards. When the cell phone came about, calling became easier. We used to buy phone cards. When she had a baby, shed bring her baby to see my mom. Then, of course, my mother will call me: I just saw Babys newborn. When are you going to have a kid?
Also, by the time [my husband and I] moved to California, we were going to Manila at least once a year, maybe more. Over about the last 15 years, they would also come through the U.S. at least once a year, because Freddy developed lymphoma. He went into remission, but most years he would go for his big checkup at Sloan Kettering [in New York]. [On the way,] they would fly to San Francisco and spend a few days with us.
Beck: I know that Baby got sick pretty early on in the pandemic, but did you ever have a conversation with her about the pandemic and how it was changing our lives in those early days?
Mary-Ann: There was a conversation before Baby got sick, because one of our other high-school classmates husband got sick and died early in March. Then our classmate died a week later. I was thinking, Holy cow, this thing thats coming upon us.
Beck: You mentioned some texts, but were you able to talk with Baby at all while she was sick?
Mary-Ann: No. I tried calling her, but she wasnt answering. But she was still sending text messages. The last conversation we had was about [our classmate] who had COVID-19 and was dying.
She likes to dress me; I dont know why. Back in February [before I canceled my trip to Manila] she started sending photos over text: These are the dresses that I asked some friend who owns a boutique [to put on hold] that I think you should try on because I think theyd look good on you. I feel bad because I said, Baby, Im trying not to buy clothes. I dont want to have more than I need. But I think she takes such pleasure from dressing me. Maybe because she cant dress her daughters anymore. Sometimes I still cant believe shes gone.
Read: Notes from a videochat memorial
Beck: Were you able to have a funeral? A digital one at least?
Mary-Ann: Yeah; it was a Zoom attended by hundreds of people. They had a picture of the urn with her photo beside it and flowers. The other people who paid tribute to her talked more about [her professional life]. My eulogy was about my memories of her. Once, she told me, I can be my old self, like when we were kids, when we were together.
Countries around the world are taking all steps possible to prevent, contain and respond to COVID-19. This is necessary to flatten the curve and stem this global pandemic which has implications for all of us: for our health and our human rights. UNDP is committed to rights-based solutions to COVID-19.
The COVID-19 pandemic is a public health emergency but it is far more. It is an economic crisis. A social crisis. And a human crisis that is fast becoming a human rights crisis. United Nations Secretary-General, Antnio Guterres
In many societies, exclusion and marginalization mean people live in the shadows either because they do not have the means, or the power to participate fully in public life and claim their rights, or because rights-holders cannot effectively discharge their obligations.As governments try to respond effectively to COVID-19 and its implications, we must ensure that human rights standards and approaches remain at the forefront. In times of crisis, assistance is provided in a way that supports everybody and reinforces efforts to leave no one behind or it can perpetuate the divisions in our communities and reinforce barriers and inequality. The difference between these outcomes is in our approach and whether it is rights-based.
What are the lessons from the socio-economic response so far?
To support socio-economic response and recovery to COVID-19 the UN issued a framework for immediate socio-economic response to COVID-19 (SERF) in April 2020 which sets out the strategy and blueprint for the UNs urgent socio-economic response to countries and societies in the face of COVID-19.
A recent review of over 100 socio-economic response plans (SERPs) has managed to give us some key lessons and indicators of how human rights-based approaches and perspectives can support recovery, responses and resilience and what more can be done. Here are some of the key lessons learned:
Where the UN is already investing and working together on human rights before COVID-19 pandemic we are better off: equipped to build on existing knowledge, work, analysis, partnerships and capacities. Making human rights a central priority of COVID-19 responses means guiding the response. A large number (over 70 percent of SERPs reviewed) aim to do this but only a smaller number offer evidence of this consistently.
Recognizing people left behind is not enough, we need to translate that analysis into action. Over 50 percent of SERP analyses of populations left behind were used for targeted action but more needs to be done. A human rights-based approach to data and how to identify groups who face intersecting forms of disadvantage or discrimination is needed.
We can more effectively use recommendations and outputs from the human rights mechanisms:
Only a small margin of SERPs reviewed use recommendations from the UN human rights mechanisms as guideposts for their human rights analysis or consider the guidance they have issued for COVID-19. Thematic advice on the human rights dimensions of the COVID-19 crisis has been swiftly put forward by many special procedure mandate holders and mechanisms of the Human Rights Council bringing practical advice and recommendations on how to support disadvantaged or marginalized groups as well as inclusive policies on many areas including: social protection, inequality and macro-economic policy. Lets make better use of these important resources.
Civil society and National Human Rights Institutions are active partners and we need to support them and leverage their expertise at country and regional level: in many countries civil society and NHRIs have played critical roles on the frontlines of the COVID-19 response and providing essential advice to influence emergency and long-term policy making. Importantly they also can represent or play a bridging role to those who are disproportionately impacted.
Rights-based analysis and approaches to the macro-economic response and to protecting fundamental freedoms can help rethink inclusive economies and build a new social contract.Protecting fundamental freedoms such as protecting civic space and public participation, promoting police accountability and advising on emergency measures supports human rights and social cohesion.
Ls we recover forward better, we need to include strong measures to address structural drivers of exclusion, inequality and discrimination in laws, institutions, policy, programmes, attitudes and practices. The root causes of marginalization and inequalities have to be tackled. Most plans intend to eliminate structural drivers of exclusion with more consideration needed on the root causes.
How can human rights help COVID-19 recovery and response?
To help ensure that human rights are at the centre of our efforts, UNDP worked with our partners in the UN Human Rights Office and the UN Development Cooperation Office and issued a programmatic Checklist for a Human Rights-Based Approach to Socio-Economic Country Responses to COVID-19. This tool provides a list of potential actions, tools and resources to ensure a people-centred and human rights-based approach to leave no one behind in COVID-19 response.
We need to act quickly and together to support all in our societies grapple with this pandemic. A human rights-based approach is the best tool we have.
For more information on UNDPs human rights work, please contact: Sarah Rattray (sarah.rattray@undp.org)
Written by Sarah Rattray, Policy Specialist for Human Rights, Crisis Bureau, UNDP
On April 6, the first death linked to COVID-19 in DeKalb County was reported. At that time, 248 days ago and only 17 days into the pandemic locally, there were just 22 reported cases of COVID-19 in the county.
Now, 5,831 people living in DeKalb County have contracted the disease, and as of Thursday, 55 people have lost their lives.
The first case of COVID-19, a DeKalb County resident in their 40s, was reported on March 21, 264 days ago. The first case of the disease in Illinois was detected Jan. 24 in a woman who'd just traveled from Wuhan, China, to Chicago.
As 2020 comes to a close, the Daily Chronicle put together a timeline of COVID-19 deaths to date amid the county marking its deadliest week of the pandemic on record Thursday, with seven residents dead in six days, all but two of them elderly people who lived in long-term care facilities.
What story do the numbers tell?
More than half (or 60%) of all reported deaths in the county are linked to long-term care facilities, according to the DeKalb County Health Department, which reports all cases linked to long-term care facilities per state requirements, and age brackets, such as a person "in their 70s," rather than a specific age. The Illinois Department of Public Health reports genders of deaths daily, but does not link them to a long-term care facility or zip code.
The correlation between deaths and long-term care facilities then, is determined based on the local health department's daily COVID-19 tracker, which shows changes in case counts and death totals every week day.
Daily Chronicle reporters throughout the pandemic have been able to track down family members of residents at some facilities, including Pine Acres Rehab and Living Center in DeKalb, which was the epicenter for the county's first lethal outbreak. At the end of its months-long ordeal from May 28 to Aug. 17, the facility reported 12 deaths in residents and 82 total cases in both employees and residents. One death at Pine Acres was in a resident who was later determined to live outside the county, so was taken off the local death toll, according to the health department.
The second, more deadly outbreak came in the summer at Willow Crest Nursing Pavilion in Sandwich June 24 through mid-October. By the time the first outbreak was complete, 15 residents were dead and 68 cases were reported.
Both Pine Acres and Willow Crest have reentered outbreak mode in the months since, but with no new reported deaths to date.
Since Monday, however, five more long-term care facility deaths were reported: three at Lincolnshire Place in Sycamore, one at Prairie Crossing Living and Rehab Center in Shabbona and one at Bethany Rehabilitation and Health Care Center in DeKalb. It's the first fatal cases for all three facilities to date.
Out of the 55 total deaths in DeKalb County to date, 33 of them occurred in residents at long-term care facilities. To date, there have been no reported deaths of employees who work at these facilities, according to the county health department.
Deaths in DeKalb County match up with trends seen statewide and across the world: many in elderly populations at nursing homes or long-term care facilities. The state health department requires local health departments to track all cases and deaths linked to such facilities, although some in DeKalb County seem not to fall under that umbrella: such as Barb City Manor in DeKalb or Opportunity House in Sycamore, the latter of which is listed on the IDPH long-term care outbreak list however.
Local deaths have been reported in younger populations, too: 14.5% occurred in those in their 50s or younger. On Sept. 18, a baby less than one year old died from the disease.
Of the total deaths, 56% of them are in residents in their 80s, 90s or older. There have been 31 deaths in that age bracket, followed by eight in their 70s, seven in their 60s, four in their 50s, three in their 40s, one in their 30s and an infant.
Only one age bracket in the county people in their 20s has yet to report a COVID-19 related death.
Timeline of COVID-19 related deaths in DeKalb County
April 6: 1 man in his 50s
April 19: 1 resident in their 70s, gender unknown
May 9: 1 man in his 60s
May 19: 1 man in his 50s*, 1 woman in her 50s (*the man in his 50s was subsequently determined to live outside the county so was taken off the local death list, according to the DeKalb County Health Department)
May 28: 1 woman in her 70s who lived at Pine Acres Rehab and Living Center in DeKalb
June 1: 96-year-old Virginia Hennecke, who also lived at Pine Acres (the DeKalb County Health Department reported this death June 2, but the Daily Chronicle received confirmation that Hennecke died from the virus June 1)
June 3: 1 woman in her 90s who lived at Pine Acres
June 4: 1 woman in her 60s, 1 woman in her 90s, both residents of Pine Acres
June 8: 1 resident in their 80s, gender unknown
June 9: 1 woman in her 90s, 1 woman over 100, both residents of Pine Acres (1 additional death was reported in a Pine Acres resident this day but the resident was determined to live outside the county, according to the health department. The death was still reported attached to the long-term care facility per IDPH requirements.)
June 10: 1 woman in her 40s
June 12: 1 man in his 80s; 1 man in his 90s who lived at Pine Acres
June 17: 1 man in his 90s who lived at Pine Acres
June 19: 1 man in his 50s; 1 woman in her 70s who lived in Pine Acres
July 2: 1 woman in her 80s
July 6: 1 woman in her 90s who lived at Willow Crest Nursing Pavilion in Sandwich
July 14: 1 woman in her 90s, 1 woman in her 80s, both were residents of Willow Crest
July 17: 1 woman in her 80s who lived at Willow Crest
July 22: 1 woman in her 90s who lived at Willow Crest
July 28: 1 man in his 80s who lived at Willow Crest
July 29: 1 woman in her 70s who lived at Willow Crest
July 30: 1 woman in her 80s, 1 woman in her 90s, both lived at Willow Crest
July 31: 1 woman in her 80s who lived at Willow Crest
Aug. 6: 1 woman in her 60s
Aug. 12: 1 woman in her 70s who lived at Willow Crest
Aug. 14: 1 woman in her 60s
Aug. 19: 1 woman in her 80s who lived at Willow Crest
Aug. 28: 1 man in his 70s, 1 man in his 80s
Sept. 1: 1 woman in her 90s who lived at Willow Crest
Sept. 17: 1 man in his 30s becomes the youngest person to die locally
Sept. 18: A baby dies from COVID-19, becomes the new youngest person to die
Sept. 30: 1 man in his 90s who lived at Oak Crest-DeKalb Area Retirement Center
Oct. 5: 1 Willow Crest resident in their 70s, gender unknown
Oct. 6: 1 man in his 80s
Oct. 14: 1 woman in her 60s who lived at Willow Crest
Oct. 29: 1 resident in their 80s, gender unknown
Nov. 12: 1 man in his 50s
Nov. 20: 1 woman in her 40s
Nov. 25: 1 woman in her 60s
Nov. 30: 1 man in his 60s
Dec. 3: 1 woman in her 70s
Dec. 7: 1 woman in her 80s who lived at Lincolnshire Place in Sycamore; 1 man in his 40s
Dec. 8: 1 woman in her 90s
Dec. 9: 1 man in his 80s, 1 woman who lived at Prairie Crossing Living and Rehab Center in Shabbona
Dec. 10: 1 man in his 70s, 1 man in his 90s; both were residents of either Lincolnshire or Bethany Rehabilitation and Health Care Center. Local and state health departments did not specify.
Editor's Note: This article is the most up-to-date timeline of COVID-19 related deaths in DeKalb County, and has been updated beyond what appeared in the print version of the Daily Chronicle Dec. 11.
After battling COVID-19 in the hospital for more than 80 days, 60-year-old Kaukauna woman reunites with her family Post-Crescent
Boise, Idaho Governor Brad Little authorized an increase in Idaho National Guard support from 100 to up to 250 personnel serving on active duty in an effort to enhance medical capacity and COVID-19 response throughout Idaho.
The authorization comes nearly a month after his executive order mobilizing 100 personnel for 30 days, coinciding with the public health order rolling Idaho back to a modified Stage 2 of the Idaho Rebounds plan.
The new authorization also allows Guard personnel to continue performing their mission through March of 2021.
For nearly a month, Guard personnel have been assisting at facilities across the state, from multiple hospital and medical clinic locations to food banks and public health district facilities.
Guard personnel are performing tasks that include COVID-19 testing and screening, patient data entry, traffic control, and facility decontamination and sanitization.
As medical providers across the state continue to call on the Guard for assistance, this additional authorization enables our guardsmen to continue helping in the fight, Governor Little said. With members of the Guard performing these missions, it frees up healthcare workers to focus on providing critical patient care. We are deeply grateful for their service.
# # #
Days before her 91st birthday, Margaret Keenan became the first person in the world to receive the Pfizer-BioNTech COVID-19 vaccine outside of clinical trials.
Keenan, who was sporting a polka-dot cardigan over a festive shirt, was given the first dose of a two-dose vaccine at the University Hospital Coventry in England, setting off the first mass vaccination effort against a virus that has now infected at least 70 million people worldwide and killed 1.5 million. An 81-year-old named William Shakespeare was next in line for the vaccine.
Keenan and Shakespeare are also the first humans, outside of a trial setting, to be given a vaccine that harnesses "mRNA" technology. This relatively new tech, which relies on a synthetic strand of genetic code called messenger RNA (mRNA) to prime the immune system, had not yet been approved for any previous vaccine in the world.
Related: Coronavirus live updates
But the COVID-19 pandemic served as an unexpected proof of concept for mRNA vaccines, which, experts told Live Science, have the potential to dramatically reshape vaccine production in the future. In fact, two COVID-19 vaccines developed by Pfizer and Moderna, are 95% and 94.1% effective, respectively, at preventing an infection with the novel coronavirus causing COVID-19.
On Thursday (Dec. 10), a panel of experts voted and recommended that the Food and Drug Administration (FDA) grant emergency approval to Pfizer's vaccine, or permission for it to be distributed prior to full approval under emergency situations like a pandemic. The panel is set to assess Moderna's vaccine on Dec. 17. Healthcare workers and vulnerable individuals in the U.S. could receive the Pfizer vaccine as early as next week.
COVID-19 has really "laid the foundation" for rapid production of new vaccines, such as mrNA vaccines, to fight future pathogens, said Maitreyi Shivkumar, a virologist and senior lecturer in molecular biology at De Montfort University in Leicester, England. "With the technology that we've developed for SARS-CoV-2, we can very easily transfer that to other emerging pathogens."
Here's how mRNA vaccines work, and why they could make such a difference for vaccine development.
mRNA vaccines are inspired by basic biology.
Cells store DNA that holds coded instructions for making proteins. When a cell needs to make a protein, it copies the appropriate instructions onto a messenger RNA molecule a single strand of genetic material. A cellular machine called a ribosome then runs along this code, reads it, and shoots out the correct building blocks to make the protein. Proteins are the essential workers of the body, forming the structure of cells, making tissue, fueling chemical reactions and sending messages: Without them, everything would shut down.
Around three decades ago, scientists realized that they could synthesize mRNA in the lab, deliver it into human cells and use the body to make any protein they wanted, such as proteins that could help fight a range of diseases in the body from cancers to respiratory illnesses. In 1990, researchers at the University of Wisconsin and biotech company Vical Incorporated figured out how to make mRNA that could direct mice cells to create proteins, according to Business Insider.
In the 1990s, Hungarian-born scientist Katalin Karik started building on this work, but ran into major roadblocks, the biggest being that the mice's immune system would deem synthetic mRNA foreign and destroy it, sometimes even creating a dangerous inflammatory response. A decade later, while working at the University of Pennsylvania, Karik and her collaborator Dr. Drew Weissman, figured out that they could create an invisibility cloak for synthetic mRNA by swapping out a piece of the mRNA code for a slightly altered one, according to STAT News. That tiny edit allowed synthetic mRNA to slip right into cells without rousing the immune system, a finding that the researchers published in multiple papers starting in 2005, according to STAT News. These results caught the attention of two key scientists: one who later helped found Moderna and another who helped found BioNTech.
Neither company initially set out to develop mRNA vaccines against infectious diseases, but eventually started to expand into that field with mRNA flu, cytomegalovirus and Zika virus vaccines in development or clinical trials. But then a deadly virus presented a unique opportunity to test, in large groups of people, just how powerful the technology could be.
On Jan. 10, Chinese researchers first published the genetic sequence of the novel coronavirus on a preprint online; within a week, Weissman and his team at the University of Pennsylvania were already developing synthetic mRNA against the virus and both Moderna and Pfizer licensed this team's formulation from The University of Pennsylvania, according to a perspective posted on Sep. 3 in the journal JAMA.
Within 66 days of the sequence being published, Moderna, in collaboration with the National Institute of Allergy and Infectious Diseases, developed a vaccine and kickstarted the first U.S. clinical trial to test it against COVID-19.
Five of the vaccines currently in clinical trials are mRNA vaccines; though they are made from different recipes, they use the same underlying concept.
Both Moderna's and Pfizer's vaccines are made up of synthetic mRNA that carries the code for the spike protein. The mRNA is enveloped inside a fatty nanoparticle that acts as a Trojan horse, infiltrating human cells and delivering the spike-building instructions without awakening the immune system. Once cells have gotten hold of the mRNA, they create the spike protein, which in turn triggers the immune system to produce an arsenal of cells to fight the spike protein and thus protect the body against SARS-CoV-2.
The vaccines developed by Moderna and Pfizer are likely so successful because they're "mimicking a viral infection," by activating two major immune responses in the body, said Dr. Otto Yang, a professor of medicine in the division of infectious diseases and of microbiology, immunology, and molecular genetics at the University of California, Los Angeles.
The better-known response involves antibodies: The cells expel the spike proteins they make; these trigger the immune system to create antibodies against them, Yang told Live Science. Antibodies are found in blood, tissues and fluids but they can't access a virus that's already inside the cell, "so the immune system evolved a way to deal with that," Yang said.
Related: 14 coronavirus myths busted by science
That response involves killer T cells, also known as CD8 T cells. These killers scan cell surfaces cells display small pieces of all the proteins they make on their surface and destroy the ones that are infected by a virus. SARS-CoV-2 vaccines can also wave a warning flag for killer T cells: after the mRNA prompts cells to make the spike protein, cells display processed fragments of it on its surface.
This gives mRNA vaccines an advantage over more traditional vaccines such as those for flu or rabies, that are made from killed versions of the actual pathogen or their target proteins. Killed virus vaccines can't get into cells, so they trigger antibodies but not the killer T-cell response, Yang said.
But mRNA vaccines aren't the only ones that trigger both these immune responses; the University of Oxford vaccine, made from a weakened cold virus called an adenovirus that infects chimpanzees, also does, Yang said. This adenovirus is genetically modified to not be able to replicate in the body and to include the genetic code for the spike protein. These vaccines also prompt the cells to create the proteins themselves, rather than providing already-made ones; and because the cells make the proteins, they display fragments of them on their surfaces.
Vaccines like the Oxford vaccine also show great promise in the future of vaccine development, experts told Live Science. And such vector vaccines have been studied extensively when compared to mRNA vaccines, according to the JAMA perspective. But the Oxford vaccine, developed with AstraZeneca, showed less efficacy than the mRNA vaccines did; in late-stage clinical trials, the Oxford vaccine was 62% effective at protecting against COVID-19 in participants who were given two full doses and 90% effective at protecting those who were first given a half dose and then a full dose, according to findings published on Dec. 8 in the journal The Lancet.
It's not yet clear why, but one major possibility is that the Oxford vaccine could be overwhelming the immune system when people are given an initial full dose. In addition to the spike protein, the adenovirus also has its own proteins. Because all of these proteins are foreign to the body, the immune system creates defenses against all of them. "There's no way that the immune system has any sort of guidance that 'OK, I'm only supposed to make a response against spike,'" Yang said. On the other hand, the mRNA vaccines are more targeted, telling the immune system to respond only to the spike protein.
But before we can say that mRNA vaccines are fundamentally better than other options, Yang said, scientists need to see detailed data from the trials, rather than gleaning information from "snippets from press releases." It's also not yet known how long mRNA vaccine-induced immune responses will last. That being said, mRNA vaccines are the "first technology that allows us to [make killer T cell responses] without giving a whole live virus," Yang said. Though rare, live but weakened virus vaccines have a slight risk of causing a more serious disease, whereas mRNA vaccines, as far as we know, do not, he added.
mRNA vaccines do not integrate into our DNA (the DNA is stored in a cell's inner core called the nucleus, a place that the synthetic mRNA doesn't go) and the mRNA generally degrades after a few days, Shivkumar said.
In the first day that Pfizer's vaccine was administered to several thousand people, two people who had a history of severe allergic reactions had anaphylaxis-like symptoms, prompting the U.K.'s regulatory agency to warn people with severe allergies to avoid getting that particular vaccine. But experts say the general population shouldn't be anxious about getting this vaccine and it isn't totally unexpected as allergic reactions can occur with a number of vaccines, Live Science reported.
"I do not believe that mRNA vaccines pose any significant greater chance of a severe allergic reaction than other vaccines," said Justin Richner, an assistant professor in the department of microbiology and immunology at the University of Illinois (who previously, as a postdoctoral fellow, collaborated with Moderna on their as-of-yet unapproved mRNA vaccine to fight the Zika virus), noting that the safety data from the mRNA vaccine trials looked very similar to other vaccines. "If anything, I would predict that there is less likely to be an allergic reaction in the mRNA vaccines as the production does not require eggs like other vaccines," he said. (Most flu-vaccines are made using eggs so they can contain bits of egg protein, according to the CDC).
Another huge advantage of mRNA vaccines is how quickly and easily they can be developed.
"The beauty of the mRNA platform is that you can easily swap out the genetic code," Richner said. In theory, if scientists know what proteins to target on a virus to stop it from infecting human cells, such as the spike protein for SARS-CoV-2, they can use the same platform that was developed for other vaccines such as the COVID-19 vaccine and just swap out the code for the spike protein with the code for the new protein.
The real problem lies in finding the correct target, Richner said.
Because scientists had previously conducted research on similar coronaviruses those that caused severe acute respiratory syndrome (SARS) and Middle East respiratory syndrome (MERS) they knew early on that the spike protein was probably the optimal target, Richner said. But they may not get so lucky with other viruses, as previous failures, such as with HIV, have revealed.
mRNA vaccines are cheaper, easier and faster to develop, and in theory, scale up more easily when compared to traditional vaccines. That's because older vaccine technologies rely on growing the virus or the proteins in the lab, Shivkumar said. Traditional vaccines are often grown in eggs or cells and then weakened or killed.
"After obtaining knowledge of the pathogen," researchers can synthesize and have an mRNA vaccine ready for delivery in about a week, Richner said. "For traditional vaccine development, this process would take at a minimum one month and usually several months."
mRNA is a chemical that can be made in a factory setting (such as in a test tube or tank) "relatively easily" once a pipeline is established, Richner said. "Manufacturing is going to be a big advantage going forward." Pfizer recently experienced production delays, but those delays are only "because it's the first time making an mRNA vaccine to this scale," he added.
Still, this easy genetic swap isn't a sole capability of mRNA vaccines, as the adenovirus vector vaccines also have this advantage. "The Oxford vaccine is more traditional, but it is, again, slightly sort of a jump from the traditional ones because it has the same backbone," Shivkumar said. Prior to the pandemic, the group that was developing the Oxford vaccine was working on a vaccine against the coronavirus that causes MERS so "they actually just swapped in the SARS-CoV-2 sequence into that same backbone," she said. But with the adenovirus vector vaccines, scientists still have to rely on the slower biological processes, namely, growing an adenovirus in the lab.
Theoretically, mRNA vaccines can tackle any virus and one day, might even be able to tackle multiple pathogens at once, according to the JAMA perspective. But practically, we won't know how universal these vaccines can become when confronted with a variety of new viruses. SARS-CoV-2 is "not a particularly difficult virus," said Dennis Burton, a professor of immunology and microbiology at the Scripps Research Institute in California. There will likely be "more severe tests and then you'll be better able to judge how universal RNA vaccines could be. Still, there's "every chance" mRNA can be truly revolutionary, but we need more information before we can be sure, he told Live Science.
Either way, no matter how quickly genetic information can be swapped in and out of mRNA vaccines, "you can't skip all the safety data," Richner said. The "slowdown is always going to be the clinical trial," Richner said.
Despite their promise, mRNA vaccines still have some limitations. For instance, right now, Pfizer's mrNA vaccine must be stored at polar temperatures of minus 94 degrees Fahrenheit (minus 70 degrees Celsius). "Especially in developing countries and countries where it's impossible to have minus-80 freezers everywhere, I think it's still not ideal, so you would still need to rely on the more traditional vaccines," Shivkumar said.
Moderna's vaccine can be stored at freezer temperatures of minus 4 F (minus 20 C). The difference in storage requirements between the two vaccines likely comes down to the recipe that the company used to make them; the ultra-cold temperature may keep either the nanoparticle shell or the mRNA more stable, Yang said.
But if those mRNA vaccines could be stored and delivered at higher temperatures, with the impressive efficacy that they showed, "I can imagine that they will sort of be a game-changer globally," Shivkumar added. In the future, Pfizer may be able to improve their vaccine to be more stable at higher temperatures, Richner said.
Related: The most promising coronavirus vaccine candidates
In the past, mRNA vaccines didn't produce a strong enough response compared to more traditional vaccines, Shivkumar said. "Because with the mRNA you use such low levels and it degrades so quickly, the amount of protein produced will be relatively lower than if you were to be given either a protein or an attenuated virus," she said. But clearly scientists have figured out how to make mRNA stable enough to trigger a strong protective response. While this would need to be checked with every pathogen, it's clear the technology has "definitely improved," Shivkumar added.
"It's very exciting to have these mRNA vaccines," said Dr. Octavio Ramilo, the chief of infectious diseases at Nationwide Children's Hospital, Columbus, Ohio. But "it will be good to have more than just one strategy," because you never know which one will stick, he said. Not all platforms will necessarily work as well for every pathogen, especially since each virus might have a unique strategy to hide from the immune system, he added.
It's also important to understand how these vaccines will work in children and the elderly, Ramilo said. Though many of the trials have included elderly participants, children have been absent. Children can respond to vaccines differently than adults, Ramilo told Live Science.
Especially babies' immune systems change "dramatically in the first year," Ramilo said. The flu virus tends to impact children and the elderly more severely than other age groups, Ramilo said. But vaccines don't work as well in those groups, he said. So having multiple platforms and understanding how they work "is going to be fundamental to leverage and to make them work in different situations," he added.
And if another new virus comes along years from now, we'll hopefully have learned lessons from 2020. The pandemic served as a "proof of concept" that mRNA experts had been waiting for, Yang said. The fastest vaccine developed to date prior to the COVID-19 pandemic was the Mumps vaccine, which took four years to develop and license it in 1967. Not counting the years it took to develop the vaccine, the Ebola vaccine was the fastest ever tested in clinical trials which took less than a year during the Ebola outbreak across West Africa. That is, until the world was faced with a deadly pandemic.
Just nine months into the pandemic, the fact that new vaccines are already finished clinical trials "is pretty impressive," Yang said. "When you're talking about a vaccine possibly being FDA-approved only a few months after it was first tried in a human that is amazingly fast."
"I'm not sure that it could actually be much quicker than this."
Originally published on Live Science.
Tribal leaders on the Rosebud Reservation in South Dakota say they plan to hold the Indian Health Service accountable as the first vaccines are set to be delivered to Indian Country. Kirk Siegler/NPR hide caption
Tribal leaders on the Rosebud Reservation in South Dakota say they plan to hold the Indian Health Service accountable as the first vaccines are set to be delivered to Indian Country.
These last few days have been chaotic at the Nimiipuu Health Clinic on the Nez Perce Reservation in Idaho.
The director, Dr. R. Kim Hartwig, is trying to manage testing and treating patients for COVID- 19 and other diseases, while also racing to get a plan in place to distribute a vaccine.
"It's not something that we have a timeline [for], it's like, I got a call and was told, 'You're gonna get a vaccine in two weeks, get a plan together,' " she says.
Only a handful of Hartwig's frontline workers are expected to get the initial Pfizer vaccine because the tribe doesn't have the special refrigeration and storage it requires. But she's OK with waiting a few more weeks for the expected second Moderna vaccine that won't need that. It's a feat in and of itself to be getting a vaccine this fast to rural Lapwai, Idaho, population 1,000.
"I'm thankful for that," Hartwig says. "If I have to scramble some to make sure my community is safe, that's what I've committed my life to."
On the Nez Perce Reservation, Dr. R. Kim Hartwig is scrambling to manage testing and treating patients for COVID-19 and other health issues, while also racing to get a vaccine distribution plan in place. R. Kim Hartwig hide caption
On the Nez Perce Reservation, Dr. R. Kim Hartwig is scrambling to manage testing and treating patients for COVID-19 and other health issues, while also racing to get a vaccine distribution plan in place.
The federal government has designated an allocation of the first coronavirus vaccines to hard-hit Indian Country. Native Americans have long endured health care inequities, and they're four times as likely to be hospitalized by COVID-19.
Still, reaching everyone who needs it will be a monumental challenge, and there is plenty of skepticism about the federal government's ability to deliver, after a century's worth of broken treaties and failures to meet government to government obligations with sovereign tribes.
"We're treating this as any other challenges we're faced with," says Commander Andrea Klimo of the Indian Health Service.
Tribes had the option of getting the vaccine shipments from their state or the IHS. More than half of the 574 federally recognized tribes are doing what the Nez Perce are, and opting for the IHS, says Klimo.
Klimo, an enrolled member of the Chickasaw Nation in Oklahoma, is leading the government's task force in charge of distributing the vaccines to tribes.
"We're tackling it head-on and working through things such as hesitancy or any sort of perceived trust issue, as they come along," Klimo says.
There will be a lot of scrutiny on the IHS as the first vaccines are expected to begin being distributed in the next couple of days. Congress has long underfunded tribal health care, and consequently, Native people aren't always confident in the IHS's ability to deliver.
"We're going to hold their feet to the fire because it's their trust responsibility, their treaty obligation," says Rodney Bordeaux, president of the Rosebud Sioux Tribe.
At the IHS hospital in Rosebud, S.D., only 10 of the 30 beds are even being used right now because of staff shortages. The tribe has had some of the highest COVID-19 rates of infection in the region. Curfews, mask mandates and other lockdowns have been enforced, Bordeaux says, unlike in the surrounding state.
If the IHS fails to distribute the vaccine as planned, Bordeaux says that hopefully, Congress will provide another round of stimulus as a backup.
"It's very bad, we've tried working with Congress to get more funding, but we have not [yet] been able to do that," he says.
Already CARES Act funds helped pay for mobile units that his tribe will use to deliver the vaccine to communities across its 2,000-square-mile reservation.
Economists hold that a good is most efficiently allocated when it goes to the people who value it the most and hence are willing to pay the most for it.
Its for that very reason that bioethicists and infectious-disease doctors worry that initial doses of a coronavirus vaccine, once granted an emergency-use authorization, will make its way into the arms of wealthier Americans first.
An independent group of medical experts voted Thursday to recommend that the Food and Drug Administration issue an EUA for BioNTech BNTX and Pfizer Inc.s PFE vaccine candidate. (The advisory panel is set to meet on Modernas MRNA vaccine candidate on Dec. 17.)
Health-care workers and nursing-home residents should be the first to get vaccinated, the Centers for Disease Control and Preventions Advisory Committee on Immunization Practices, or ACIP, recommended on Dec. 1.
States arent required to follow the committees recommendations, but health experts are urging governors to stick to ACIPs recommendations going forward because it gives them a science-based framework to follow that can ultimately help end the pandemic more swiftly.
That said, wealthy Americans who are accustomed to flying in private jets and can afford to pay steep annual fees for personalized care through concierge medical practices arent too keen on waiting in line for a vaccine.
Speaking to Stat News, bioethicist Arthur Caplanof New York University did not hold back his feelings on well-connected individuals with the money and/or connections to get a vaccine if and/or when one or more become available.
There absolutely will be a black market. Anything thats seen as lifesaving, life-preserving and thats in short supply creates black markets, he said.
Dr. Ehsan Ali of Beverly Hills Concierge Doctor Inc. said he has been receiving phone calls and texts from patients all day long inquiring about when they can get the vaccine. His practice, unlike many other concierge practices, accepts some insurance plans.
Andrew Olanow, co-founder of the concierge service Sollis Health, which serves patients in Beverly Hills, Manhattan and the Hamptons, said he started fielding questions from patients as to when they can get a coronavirus vaccine as soon as the pandemic took off in early March.
His practice charges $3,000 a year for adults under the age of 45, plus $2,000 a year for each additional adult. For people above 45 years of age, the membership fees start at $5,000 a year plus $3,000 for each additional adult above 45.
Once you started seeing trial data become available, particularly from Pfizer PFE, -1.46%, thats when we started getting much more pointed questions from patients, Olanow said. They want to know exactly when there will be a vaccine, he said.
People ask, When specifically is that vaccine going to be available?
He tends to respond to these types of questions by assuring patients that he and his staff are taking all the appropriate steps now, such as procuring ultralow-temperature freezers to store the Pfizer vaccine, so that if/when its approved, Sollis Health be ready to get its patients vaccinated.
Dont miss: The perils of transporting millions of COVID-19 vaccines with dry ice across the U.S.
Well be working hard to get access to the vaccine for the members of our practice when it becomes available to a certain risk profile, Olanow told MarketWatch. My guess is that we, as members of the private sector, will be able to move quicker than the public sector.
As Gillian Tett wrote in the Financial Times: Definitions of pre-existing conditions may vary. As could the concept of essential worker. In states such as New York and Illinois, for example, financiers and bankers were defined as essential workers during COVID-19 (which gave them the right to go into the office). So were journalists.
The net result, then, will be numerous loopholes which could be exploited or, to use the language of Wall Street, be prone to arbitrage.
Ideally, the distribution of a coronavirus vaccine would follow the same principles and framework that informs organ-donation registries, saidGovind Persad, a professor of health law and bioethics at the University of Denver.
At the United Network for Organ Sharing (UNOS), that framework is based on medical utility and justice, said Joel Newman, who has served as a staff liaison on the ethics committee at UNOS, a private nonprofit organization that manages the nations organ-transplant system under contract with the federal government.
Justice, he said, refers to fairness, while medical utility refers to all the evidence-based criteria that we know would point to good treatment outcome.
The key in our experience is to strike a balance between these factors, he said.
If medical utility were the only factor determining who receives an organ transplant , that could mean that we treat more people who may be relatively healthy and who havent been waiting as long, he said.
In contrast, overemphasizing justice would mean that we treat many very sick patients, but many may die soon afterward or need a repeat transplant, thus removing the chance for better-matching people to get a successful transplant.
To overcome these challenges, UNOS relies on a computerized matching system that scores an individual and takes into account other factors including the location of the donor and blood type.
However, an individuals financial or social status is never taken into account, Newman, a senior spokesman for UNOS, told MarketWatch. Not only would that be illegal; it would also go against UNOSs ethical code of conduct.
That said, wealthier people who may require an organ transplant are more likely to expedite the waiting process compared to lower-income people, Persad said.
Affluent patients can sometimes do this by getting on multiple organ waitlists in multiple facilities or multiple states, traveling to a foreign country, or convincing a doctor to misstate exactly how at risk somebody is to move them up in line.
Well-resourced Americans could potentially use those same strategies to receive some of the earliest doses of a coronavirus vaccine, said Persad, who co-wrote a paper titled Fairly Prioritizing Groups for Access to COVID-19 Vaccines with Dr. Ezekiel Emanuel, a member of President-elect Joe Bidens coronavirus task force, and Dr. Monica Peek, a professor at the University of Chicagos medical school.
For instance, because different states likely will follow different allocation models after health-care workers and long-term-care residents are inoculated, it could create an opportunity for arbitrage where theyll go where they think they have the best chance.
Having some kind of residency requirement could make shopping around more difficult, he added, but ultimately there need to be vaccine-allocation criteria that health-care providers internalize as an ethical obligation.
Ideally youd also want to have one that makes sense to people, he said.
When it comes to college admissions another area where the wealthy often have the upper hand, for various reasons one could make the case that an upper-income family donating money to boost their childs chances of getting accepted indirectly benefits other students by potentially adding funds to scholarship programs, Persad said.
That likely is not true for COVID-19 vaccines because there are hard short- and medium-term manufacturing constraints rich people paying Pfizer or some other supply-chain actor more wont make more vaccines available.
Ashley Nerbovig, For the Detroit Free Press Published 8:00 a.m. ET Dec. 11, 2020
The United Kingdom began nationwide distribution of Pfizer/BioNTech's highly anticipated COVID-19 vaccine with this woman. Associated Press
As health providers prepare to distribute the coronavirus vaccine, we should be ready for an onslaught of disinformation.
Social media users are already attempting to circulate false claims about people who got the vaccine. Rumors are also swirling about the ingredients used to create the vaccine.
Some disinformation questions the need for the vaccine or attempts to paint vaccination efforts as nefarious, according to research by First Draft, a non-profit that investigates online information. People who spread misinformation are also taking advantage of the many unknowns about the vaccines, according to the report.
And as we know, people dont like ambiguity, the authors, Rory Smith and Seb Cubbon, wrote in thereport. This is when the rumor mill kicks into gear and misinformation runs rampant.
Misinformation is an umbrella term for misleading or false information. Disinformation refers to false facts that bad actors spread on purpose to confuse people and sow distrust in information sources.
[ Read the 2020 report: Americans decided their own truth this election season ]
In May, the Department of Homeland Securitys cybersecurity agency, CISA, laid out some simple steps you can take to reduce the likelihood of unknowingly spreading false or misleading information related to COVID:
The more shocking the information is, the more likely it is to be false.
Ashley Nerbovig covers mis- and disinformation. Follow or DM her at@AshleyNerbovig.
Read or Share this story: https://www.freep.com/story/news/health/2020/12/11/covid-vaccine-disinformation-misinformation/3879269001/
Michigans health department leaders announced their prioritization plans for distributing the coronavirus vaccines Friday afternoon, Dec. 11.
Health care workers will be first in line, along with residents and staff of long-term care facilities. Other essential workers will come next, followed by people at high risk for severe COVID-19 illness due to underlying medical conditions and people 65 years and older.
While distribution has been divided among four phases, Dr. Joneigh Khaldun, chief medical executive for the Department of Health and Human Services, said some phases will have overlap, depending on dose availability.
The COVID-19 vaccine will help all our communities eliminate the virus, Khaldun said. Because initial allocations of vaccine will be limited, we must prioritize how the vaccine will be distributed across the state and will use the guidance and principles outlined by the CDC and national experts. We want every adult to be planning now for how they will get their vaccine once it becomes available to them.
MDHHS estimates the first phase of distribution will begin later this month and span about five weeks. The timeline estimates the fourth grouping -- all remaining individuals 18 and older -- to begin receiving the vaccine in weeks 15-20, or in late March/early April.
Khaldun said the health departments goal is to vaccinate 70% of Michigan adults, or about 5.4 million people, by the end of 2021.
Prioritization is based on recommendations from the U.S. Centers for Disease Control and Prevention, and the national Advisory Committee on Immunization Practices, which is made up of medical and public health experts who develop recommendations on the use of vaccines in the U.S.
The phases are as follows:
The first COVID-19 vaccine, from Pfizer and BioNTech, is expected to be approved for emergency use authorization by the Food and Drug Administration in the coming days following a Thursday vote by the FDAs advisory panel in favor of the authorization.
Related: FDA panel recommends approval of Pfizers coronavirus vaccine for emergency use
Meanwhile, Modernas vaccine is a step behind and is expected to receive FDA approval before the end of the year. Both vaccines showed better than 90% effectiveness during Phase 3 trials.
Distribution of vaccines will be handled by hospitals, local health departments, pharmacies, EMS, the Michigan National Guard, and outpatient clinics. The initial allocation of the Pfizer vaccine will send doses to 56 Michigan hospitals and 16 local health departments.
The minimum age for receiving Pfizers vaccine is 18, though the FDAs advisory panel recommended emergency use authorization for individuals 16 and older. Khaldun said she was aware of the recommendation, and shed base Michigans recommendations on official guidance from the FDA.
The states top doctor said it is important to note that while scientists worldwide are working to develop a COVID-19 vaccine faster than any vaccine before, they are still following the proven process. Scientists had already begun research for coronavirus vaccines during previous outbreaks caused by related coronaviruses such as SARS (Severe Acute Respiratory Syndrome) and MERS (Middle East Respiratory Syndrome). That earlier research provided a head start for rapid development of vaccines to protect against infection with COVID-19.
The process for approval of a COVID-19 vaccine is scientifically sound, and no steps have been skipped, Khaldun said. People should know what to expect when they get a vaccine- such as mild side effects like a sore arm or low-grade fever. They should also plan on making sure they get their second dose to make sure they get the full benefit of the vaccine.
The Pfizer vaccine doesnt contain the actual coronavirus. Instead, theyre made with a piece of genetic code for the spike protein that studs the virus. That messenger RNA, or mRNA, instructs the body to make some harmless spike protein, training immune cells to recognize it if the real virus eventually comes along.
Khaldun noted that many people will get mild symptoms like a sore arm, low-grade fever or general malaise, which indicates that your immune system is responding to the vaccine. Other symptoms reported during trials include chills, fatigue, headache, and muscle or joint pain.
Four individuals in Pfizers Phase 3 trial reported Bells palsy, which causes temporary weakness or paralysis of the muscles in the face, and two individuals with histories of allergic reactions in the UK reported having allergic reactions to the vaccine.
Read more on MLive:
As Pfizer prepares to ship COVID-19 vaccine, Michigan manufacturing plant takes center stage
Michigan expects to get 257,000 vaccine doses in first shipments
Michigan reports 5,157 new coronavirus cases, 61 new deaths
How Michigan bars, restaurants, others can get slice of $10 million coronavirus relief grant
